'Emerging needs' in 2 year old

[UsefulZombie]

Hoping for some advice/similar experiences/general reassurance. Apologies if it's long!

DS is 2 years and 4 months. Since the latest lockdown lifted, I've been working really hard to get him to playgroups and playdates to make up for missed socialisation. Whenever I've taken him to more class-based groups, he's been very distressed (I assumed due to a combination of noise, new places, and lots of people) so after trying a few different ones with the same result we've put that on the back burner a little. He will now attended large playgroups happily (provided there isn't any singing!).

I recently took him to a playgroup at the local children's centre. He'd passed his 2 year checks, although a few things were flagged up under fine motor skills and problem solving. The group is held by an Early Years Practitioner and there's maybe 7-10 other children there. The first time we attended the group, DS was very distressed so I took him to a quiet corner until he felt a bit more comfortable - fortunately he did calm down so we were able to stay and explore, and he stayed pretty happy until the singing started at the end. We attended again the following week and he didn't get distressed on our arrival and got stuck in straight away which was a huge relief. The EYP came over to speak to us briefly but DS was sort of doing his own thing at this point so they didn't interact much together. We haven't been back to that group since because I've since become pregnant and developed HG.

I've since had a call from our health visitor who feels that DS is displaying signs of 'emerging needs'. These include:
Not noticing other children, including not looking at a child that ran into him
Not responding to his name when EYP addressed him
Not copying the play I was modelling for him, primarily just picking up and discarding toys rather than any meaningful play
Lining objects up

This is pretty reflective of how he plays at home - he will line objects up, build towers and lego, play with books, and do mark making/play with stickers. He does show some signs of imaginative play occasionally - he will make toy dinosaurs 'stomp', feed me pretend icecream, and put his cuddly toys to bed and sing them Twinkle Twinkle. I think his language his pretty good - he loves numbers, shapes, and the alphabet and talks about them (and associated songs) a lot. He loves books and will recite passages from them (sometimes in context, sometimes not). He is a truly wonderful little boy - very affectionate, tells me and his dad that he loves us, makes eye contact, and responds to his name maybe 50% of the time. He doesn't go to childcare/Nursery so I'm his primary carer, but he will allow my dad to look after him for an hour or two quite happily. He used to be very interested in other children but this has diminished over the past few months. He will very occasionally say the names of his little friends though.

He does seem to lack some sophistication in his play, and is not hugely interested in playing with others. He will run around at soft play/play groups but not really fix on any toys in particular. He does imitate me sometimes, and will point/respond to me pointing maybe 10% of the time. He does repeat certain phrases - often from books or songs - over and over again with little context, but these frequently change depending on his interests. He loves dinosaurs and can name maybe 15 different types. He will follow instructions occasionally, and will say 'bye' when appropriate occasionally too. He does wave backwards (as in towards himself rather than towards others). He cannot stand confined spaces and will become very distressed if I need to go into changing facilities to change his nappy when out and about - but he's absolutely fine if you do this at home or in an open space. He doesn't seem too tied to routine or distressed when things don't happen as anticipated.

The health visitor is going to put us back on her caseload and presumably do some further investigation. I'm really hoping for some similar experiences - if your DC displayed these traits, were they signs of additional support needs? What did that support entail? How are they managing now?

Also looking for experiences of those with similar DC adapting to the addition of another baby - DS will be nearly 3 when DC arrives.

Thank you so much if you've read this far!

To add, I've just put the 'Toddler Club' on to see if he shows any interest, and he's definitely watching with occasional smiles. That doesn't demonstrate disinterest in others, surely?

Whatever happens, he's still the same child you know. Either he's absolutely fine and he gets some extra attention now which is not a bad thing, or he does need some extra support in some areas and you are very lucky to have had it flagged early. My DD used to get very distressed by playgroups and noise and for her is was ASD, but because noone flagged it or listened for a long time, she was on waiting lists and didn't get proper support until she was well into primary school and really struggling to cope.

It may well be that your son is absolutely fine, and that's great. But even if not, you'll be ok.

He's so young I wouldn't worry too much. My dd had similar issues at her age including:
Not being able to tolerate large groups, especially singing, had to stand in the corridor for this part or just leave.
Putting her hands on her ears when she was upset, even though there was no noise
Not reacting to her name
Having a bit of a script when it came to speaking, thinking that we had to do a certain thing in a certain space.

Anyway to cut a long story short she's 6 now and doing fine at school. Professionals still can't decide if she has autism or it's just severe anxiety causing her sensory issues and slightly ritualistic behaviour at times.
I remember the feeling of being completely floored when someone mentioned it. Your child is perfect to you and it made me feel so overwhelmed when someone mentioned that my DD might be different or have some additional struggles. I always think of the saying 'I wouldn't change my kids for the world, but I would change the world for my kids'.
Stay strong and keep on at the health Visitors and don't think too much into things. There's probably a lot of kids his age who will not have socialised as much.

Thank you for some really relatable and empathetic responses. I'm certainly feeling grateful that it's been potentially flagged so early, but I hate that I'm now second guessing everything he does.

I think the health visitor has noticed a few things which could be indicators of autism. He's obviously very young still and as you say lockdown has been a very different start to life that normal (my DS is a similar age!). So I think it sounds really positive they have decided to put him on their caseload for some extra input and take it from there.

In terms of his speech and communication he should be following simple instructions (e.g. get your coat and your shoes) the majority of the time by now - obviously there is the usual times of toddler defiance!

The repeatative speech can be a sign of autism and called echolalia. It really depends how meaningful the rest of his speech is in terms of communicating with you?

Sorry I don't have a child with autism but I am a speech therapist and have a DS very similar age to yours so I thought I'd give a perspective.

@Hopefulbride18

I think the health visitor has noticed a few things which could be indicators of autism. He's obviously very young still and as you say lockdown has been a very different start to life that normal (my DS is a similar age!). So I think it sounds really positive they have decided to put him on their caseload for some extra input and take it from there.

In terms of his speech and communication he should be following simple instructions (e.g. get your coat and your shoes) the majority of the time by now - obviously there is the usual times of toddler defiance!

The repeatative speech can be a sign of autism and called echolalia. It really depends how meaningful the rest of his speech is in terms of communicating with you?

Sorry I don't have a child with autism but I am a speech therapist and have a DS very similar age to yours so I thought I'd give a perspective.

Thanks for your response and your perspective. I'd say he definitely doesn't follow the majority of instructions. Large chunks of his speech is in context to me I think - he'll ask me to draw things and we'll talk about them, or we'll talk about what we're watching or reading together, or he'll tell me about what he's eating. The potential echolalia is sometimes triggered by something (for example, he'll see the number 10 and say 'ten in the bed' over and over) but sometimes not - or at least I've not twigged what has jogged that association for him.

Another Speech Therapist here. I agree that there’s a pattern of things you’ve mentioned there that could be signs of autism. You’ve also talked about lots of strengths though and, if it is autism, it sounds like he’s a little one that would be on the higher functioning end of the scale.

Remember that any investigations or even a diagnosis aren’t going to change who his is. He’ll still be that wonderful little boy. What a diagnosis could help however is help other people understand the things he finds more difficult and therefore put the right support in place for him to thrive when he starts school or nursery. Early intervention and awareness is important and it’s a real positive that your health visitor is trying to support with that. There’s lots of bright, affectionate, amazing people out there who also have a diagnosis of autism, it’s not going to change any of those brilliant things you’re already seeing in him.

@Busygoingblah

Another Speech Therapist here. I agree that there’s a pattern of things you’ve mentioned there that could be signs of autism. You’ve also talked about lots of strengths though and, if it is autism, it sounds like he’s a little one that would be on the higher functioning end of the scale.

Remember that any investigations or even a diagnosis aren’t going to change who his is. He’ll still be that wonderful little boy. What a diagnosis could help however is help other people understand the things he finds more difficult and therefore put the right support in place for him to thrive when he starts school or nursery. Early intervention and awareness is important and it’s a real positive that your health visitor is trying to support with that. There’s lots of bright, affectionate, amazing people out there who also have a diagnosis of autism, it’s not going to change any of those brilliant things you’re already seeing in him.

Thank you. I really needed to hear that last sentence in particular.

Obviously we don't know you child, so have no idea what the outcome will be. I can only echo the above poster that I would definitely go along with any involvement from paediatricians/health visitors. If your son does have autism or similar, his life will be SO much easier at nursery and school if he has a diagnosis. My son was a bright, loving boy like yours, and didn't get his diagnosis until 8. Life at school since has been so much happier, as the adults at school are able to adapt to his needs/weaknesses, while celebrating his strengths(he has lots).
The other thing I would mention is that it is v common for family members /friends to reassure you that he is fine.

OP please please stop stressing. You sound a little defensive so let me first say....these issues being picked up are in no way judgemental to either you, your parenting or your gorgeous boy.
I'm an early years teacher and I'm actually really impressed with this EYP and health visitor. They have picked something up and are acting on it to support you and your child. When things like this are investigated early it puts children at a great advantage for school as things are already in place and you may even have a diagnosis (or not if not needed) by then. If your child was to have been missed and not had these things picked up until Reception it's a long, difficult process and some children I have raised concerns about haven't been diagnosed or had EHCPs until year 4!
Take all the support, investigation and help you are being offered, it's all to set up your child well for what he may need.
And let me say again, nobody is judging in any way and it doesn't change your lovely boy.

At 2, it could be something or nothing.
Some of what you describe reminds me of DS at the same age. We just got his autism diagnosis yesterday at age 8.
If it helps: DS is fantastic (I'm only a little bit biased!). He's affectionate, bright, funny and can be sociable (albeit occasionally and on his own terms).
If you met him you might think he was a little quirky.
He has "special interests" and will spend hours researching something completely random like the fall of the Ottoman Empire or Krushchevs secret speech.
He has some odd anxieties and a tenancy to overthink things. Sometimes he needs to spend some time wrapped in a blanket watching "soothing documentaries".
But overall autism is not a negative in his life. In many ways its a positive.

@Russell19

OP please please stop stressing. You sound a little defensive so let me first say....these issues being picked up are in no way judgemental to either you, your parenting or your gorgeous boy. I'm an early years teacher and I'm actually really impressed with this EYP and health visitor. They have picked something up and are acting on it to support you and your child. When things like this are investigated early it puts children at a great advantage for school as things are already in place and you may even have a diagnosis (or not if not needed) by then. If your child was to have been missed and not had these things picked up until Reception it's a long, difficult process and some children I have raised concerns about haven't been diagnosed or had EHCPs until year 4! Take all the support, investigation and help you are being offered, it's all to set up your child well for what he may need. And let me say again, nobody is judging in any way and it doesn't change your lovely boy.

Thank you for your response, I'm definitely going to go some reflecting on that. I'm a very anxious parent and I'm just so desperate to protect him/for him to be happy and healthy and well, this has stirred up some real feelings of powerlessness that I'm struggling with. But reading these responses has been invaluable in grounding me and making me very grateful that his support network are so vigilant and keen to help.

@unlimiteddilutingjuice

At 2, it could be something or nothing. Some of what you describe reminds me of DS at the same age. We just got his autism diagnosis yesterday at age 8. If it helps: DS is fantastic (I'm only a little bit biased!). He's affectionate, bright, funny and can be sociable (albeit occasionally and on his own terms). If you met him you might think he was a little quirky. He has "special interests" and will spend hours researching something completely random like the fall of the Ottoman Empire or Krushchevs secret speech. He has some odd anxieties and a tenancy to overthink things. Sometimes he needs to spend some time wrapped in a blanket watching "soothing documentaries". But overall autism is not a negative in his life. In many ways its a positive.

This is truly heartening to read thank you. This is very much what I imagined having a happy 8 year old would look like, so I would be very happy should DS follow in your son's footsteps

Hi @UsefulZombie I would echo what others have said about the benefits of early intervention.

If your little one does have additional needs then the best thing you can do for him is to access as much support as possible. This will improve his overall outcomes, including his happiness and confidence.

My DS has a variety of developmental needs and we were able to source private speech and language therapy for him and also find a special inclusive pre-school. I credit these two interventions for helping him be the confident, sociable, chatty and generally awesome boy he is today! Without those interventions, my fear is that he would struggle even more and would not have the same confidence and willingness to keep trying when so many things are so hard for him.

Your boy sounds great, and a diagnosis or any support won't change that. Good luck to you

DS has autism and a lot of what you are picking up on were things I picked up on at a very similar age so I think the advice on here to work with the people checking this possibility is good advice.

At this stage I think you probably still need to have hope that your DS is NT but actually what I found was that by the time a diagnosis came around for us I was seriously relieved to be getting it so that we could constructively support DS.

I am going to go a little against the grain on early intervention here because I got the best advice I ever got from an SLT on the whole early intervention. She pointed out that DS was a child and his condition meant he was developmentally delayed and we would be continuing to support him with needs for many many years into the future (like any other child) so while getting on top of the diagnosis and picking up and working on deficits was incredibly important it was far more important to recognise that autism is a marathon not a sprint. Oh and absolutely yes to the previous poster our son is still the most incredible little boy we could have ever wished for and personally I wouldn’t change a thing about him he is absolutely perfect as he is.

Thank you very much for the replies - lots to think about. I'm really grateful for all of the experiences shared and feel quite reassured that whatever DS's journey looks like, he'll still be his lovely self and he can still be happy and thriving

Hey @UsefulZombie - we're about 6 months behind you, I think, with our 21m old son. His childminder has raised some concerns with us, largely around him not speaking yet, but also other things (not always making much eye contact, very solitary play, etc) which may be starting us on a path to assessment for autism. It scares the heck out of me, but only because I want him to be happy.

I don't have much to add, but I'm bookmarking this thread cos you've had some great advice here. I'd be interested to know how things go for you in the next few months xxx

Early years teacher here and I would be asking if he’d had his hearing tested?
Not responding to you, not listening to you and others, being a little introverted in his play around others and not liking the noise of singing would have me asking about his hearing overall.
That would be a good starting point.

@crazymuseummum

Hey *@UsefulZombie* - we're about 6 months behind you, I think, with our 21m old son. His childminder has raised some concerns with us, largely around him not speaking yet, but also other things (not always making much eye contact, very solitary play, etc) which may be starting us on a path to assessment for autism. It scares the heck out of me, but only because I want him to be happy.

I don't have much to add, but I'm bookmarking this thread cos you've had some great advice here. I'd be interested to know how things go for you in the next few months xxx

Thank you for your response. I'll try to keep this thread updated, but feel free to PM me. I'm also feeling the fear, purely of the unknown, and what the future might hold, and what it means for his happiness. But regardless he has two parents who adore him and nurture him and that will never change, so that's a pretty OK start right?

@Secretescape

Early years teacher here and I would be asking if he’d had his hearing tested? Not responding to you, not listening to you and others, being a little introverted in his play around others and not liking the noise of singing would have me asking about his hearing overall. That would be a good starting point.

Thank you, this is certainly something we'll investigate.

@UsefulZombie You're absolutely right. We spend so much time second guessing ourselves, even whilst knowing deep down we're doing all we can right by our little ones. Xx

We were given the same advice about hearing tests by our childminder. Saw GP about ten days ago, and have referral for tests at the children's ward at the end of this month.

Have a lovely day with your little guy xx

[quote crazymuseummum]@UsefulZombie You're absolutely right. We spend so much time second guessing ourselves, even whilst knowing deep down we're doing all we can right by our little ones. Xx

We were given the same advice about hearing tests by our childminder. Saw GP about ten days ago, and have referral for tests at the children's ward at the end of this month.

Have a lovely day with your little guy xx[/quote]
And you with your son @crazymuseummum. We went to the aquarium this morning and we're chilling at home this afternoon, sharing a bath and watching Zog. Trying to focus on enjoying him in the now and put the anxiety/unknowns aside x