‘Normal’ twin development delay or ASD?

[TwinItForTheLongHaul]

I should start by saying I’ve talked to my HV about this and she has referred on, but she’s warned me it’ll be a long wait...

I have identical twin boys, who’ll be three in Feb. They’re developmentally quite delayed, physically as much as with communication (can’t jump, can’t climb stairs, can’t draw a straight line, can’t put on their own shoes or coat, didn’t walk til they were nearly 2).

Communication is also an issue. Speech wise they’re not bad. They have a decent vocab - over 100 words at a guess - and can speak in short sentences though I find some of their speech patterns a bit odd (for example, they’ll say ‘what cereal do you want?’, ie pronoun reversal - but they are still very young, so perhaps not that unusual.)

What seems more pronounced to me is the delay in receptive language, or it might be a more general cognition thing. They don’t seem to ‘get’ a lot of things - I took them to a dance class and the idea that they should stand in a circle and join in was just utterly beyond them. They wouldn’t understand ‘go and get your coat from the bathroom’ or ‘have you turned the tap off?’ Trying to explain the concept of weeing in a potty or getting themselves dressed would be utterly impossible. Having said that, I do think they play dumb to avoid having to do things they don’t want to do. They understand simple instructions well enough when they want to - ‘shall we watch the Gruffalo?’ always gets a response!

Socially, they aren’t particularly interested in other children but they’ll sometimes play with them; they are very, very wrapped up in each other, and play together and chat away hilariously. They are very affectionate with people they know well.

There aren’t any ‘classic’ asd symptoms in other ways, ie no repetitive behaviours, no avoiding eye contact, no obsessive interests, no meltdowns etc.

I don’t know what I’m looking for really, other than some thoughts. I spoke to an EdPysch colleague (I work with young people, tho not in this capacity) who was very reassuring and said it sounds entirely ‘twinnish’, rather than asd. The HV agrees there are clear delays, but isn’t being drawn on what’s behind it (fair enough). I’m concerned about the wait time for referral and we’re toying with going down the private route, but it’s sooo expensive, and it might all be nothing other than a ‘twin thing’. And even if it is asd they might still be too young to diagnose anything anyway, and I don’t want to pay £500 just to be told ‘wait and see’.

Does anyone have any words of wisdom?

My friends little boy sounds pretty similar however his speech is much more limited! He had just been diagnosed with this at 3 years old and will be reviewed again in a year before he starts school for possible ASD.
This is the link for Social Communication Disorder:
www.understood.org/en/learning-attention-issues/child-learning-disabilities/communication-disorders/understanding-social-communication-disorder#item0

Took a year from first querying his delays and he’s had 2 x group speech and language session and 2 x hearing tests and only recently a paediatrician appointment... however if your twins are due school start 2019 it may be quicker!

Have you tried speaking to TAMBA, OP? They have lots of resources (and experience) which might be really useful. My twin boys are non-identical and squabble continually so I can't compare, but it does sound a bit like they are bouncing off each other in terms of communication; they obviously understand each other, and you 'get' them for the most part, in their world that's all they need!

Do they attend a nursery/ preschool and if not, would you consider it? That might be a way of getting them to mix more with other DC even if it takes a while - mine aren't particularly close but it did take them a few months to play apart rather than together. Or presumably they can start nursery at a local school in September if you want them to?

Please have a look at your local Childrens Centres too, they often have extra helpers at their groups (twins can be really overwhelming at classes where they have to follow instructions!), and also run some groups/ courses on things like speech therapy and play therapy - might help!

Delayed development doesn't always mean ASD . It can be other conditions which cause learning difficulties. Walking at 2 is very late for NT children . Were they born early ? Is that their corrected age ? I would always trust your instincts , my ds has SN ( not asd ) and I knew very early on but was dismissed many times as anxious or neurotic 🙄 ( I'm neither ) .. I would ask to get referral to a speech therapist or developmental paediatrician as it will probably be a good 6 month wait anyway so you can always turn it down if you feel happier about them at the time .
Will they go to nursery soon as they will be a better judge on any potential issues having seen many many toddlers .