Autism or normal toddler behaviour?

[Doododoo]

My 17 month old DD has refused all food that isn't purée since 6 months old, she'll occasionally eat crispy things such as melty puffs, cheerios, biscotti etc but everything else she puts in her mouth she immediately spits out. She won't even touch fruit.

Paediatrician says it's a sensory thing and he thinks she could be autistic and will review again when she can talk (she makes mama and dada sounds only so far). He’s basing this on her food refusal and observing her during the hour long appointment.

She has sensory issues surrounding her feet, if she steps on something such as a wipe that's been left on the floor, some crumbs she will lift her foot up and cry and cry for ages. She used to have problems with long sleeves but that seems to have passed now. She's recently started lining up items such as purée pouches, bottles, similar types of toys and will repeatedly line them up, she repeats a lot of actions again and again like stepping in and out of the kitchen, walking up and down the hallway, slapping her ears or pulling her hair. She laughs and smiles when happy but she does not ever smile back at me or family or strangers when they smile first. She wakes hourly and always has done. But this is my first child and I'm not sure what's a cause for concern and what's just normal bonkers toddler behaviour.

I'm wondering what other signs of autism I should be looking out for at this age (17/18 months) as she doesn't seem to have any of the symptoms I've read about. She responds to her name, she makes eye contact just fine etc

Not sure what I’m asking for really just want someone to tell me what they think

The symptoms you've described could be related to autism or they could be completely neurotypical.

Does she point at things just to share interest with you? Does she bring things to show you?

My son is 5 and eating has always been an absolute nightmare. From as soon as we started weaning her would only eat certain things and at the age of 5 he’s no different. He’s very sensitive to the texture of food.

He’s also got a really heightened sense of smell.

He used to hate getting his hands dirty and he’d really cry about it and he still gets a bit strange if he accidentally drops any food on himself. He also used to hate warmth on his skin, I.e if I took a pair of socks off the radiator and went to put them on his feet he’d have some kind of meltdown.

His behaviour has certainly had strange aspects to it…..I can’t even put my finger on it…there just seemed to be something different about him compared to other children. He also seemed very emotionally immature and came across much younger than he was, even when he was playing. Me and my husband have had numerous chats over the years about whether he may be on the spectrum.

Prior to starting school he was with a childminder for just under 4 years and I had so many talks with her about my worries and she said that although this attitude to foods/textures may be a concern, she was happy he was completely within the realms of normal for everything else.

He’s just started school and is doing really well and according to the teachers he’s perfectly behaved and loves to learn.

Despite his earlier issues he now doesn’t mind so much about getting his hands dirty., I.e he’s happy doing arts and crafts and getting glue, glitter and paint all over him. He’s also quite happy playing on the beach and having sand stuck to him whereas a few years he would never have been okay with that.

He was also very slow to talk which always worries me but now he doesn’t stop and has a quite an extensive vocabulary.

He also now loves wearing clothes that come fresh and warm from the radiator!

My worries are definitely easing as I see his quirks start to fade and his behaviour starting to normalise….which I think is probably being with his peers at school whereas at the childminders the other children were much younger than him.

Prior to him starting school I spoke to the teacher about concerns I had about him possibly being on the spectrum so I’m looking forward to speaking to her about it at parents evening next week.

I have come to accept that if he is on the spectrum then it’s certainly not causing him any huge issues and if his only problem for now is going to be a issues with eating then I’m happy with that.

Other than that I shall just see how things pan out as time progresses….

That’s what I thought.

No she doesn’t, she’d bring something to me if she needed me to do something like to open something for her but she’s never pointed at something for me to see or brought interesting things over, not interested in playing together

Thanks for replying I really appreciate it. Sounds similar to DD in regards to things on hands, if she gets any dirt/water/food on her hands she holds her hand out crying until I wipe it

That’s really reassuring that things seem to have got “better” for him and don’t bother him so much now, I don’t think I’d have ever worried about it if the doctor hadn’t brought it up and now I’m wondering if everything she does is normal or not.

I think I need to take your approach to it and just see what happens

Look up m"chat for toddlers

mchatscreen.com/

I'm wondering what other signs of autism I should be looking out for at this age (17/18 months)

None, at that age. If your DD is autistic, you will know about it.

Have an 18 month review with the health visitor team and complete the ages and stages questionnaire as part of that. That was sufficient to document the things we'd noticed by that age. When he returned for his 2 year review and completed the questionnaire for that age, that they triggered them to send off necessary referrals (paediatrics, OT, SLT) and he was diagnosed at 2 and a half.

A child will develop a liking and preference for the first foods offered, and if you have weaned her on pouches and ultra-processed snacks (melty puffs, cheerios, biscotti...) it is to be expected that she will refuse other types of food.
Fruit in pouches tastes completely different than the real fruit. Try it. Food in pouches is also combined to have sweetness as the dominant taste, so sweetcorn, apple , carrots are added to savoury pouches to increase palatability and a child's wired preference for sweet food. Add puffs, a child's version of Cheetos since they have the same ingredients, corn flour and oil pressed into an extruder machine, and other snacky stuff, and you have real food refusal.

All this is meant to reassure you. Don't make an assumption of autism based on a preference of ultra processed baby food engineered to requite zero effort - either smooth puree or no chewing required food .

Tons of kids don't like to have sand, dirt, grass on them and it doesn't mean autism.

My ds had no speech at 18m just babbling which didn't start til well over 12m. He would shake his head, spin, flap etc. No interest in others unless he wanted them todo something. Pointing to get things but not for interest. Limited show of emotions mostly anger or blank expression. We saw hv at 20m and she agreed there were signs. We self referred to salt and salt and hv referred jointly to paediatrician for a review. We saw paediatrician when dd was 25m (pre covid so wait times were not as bad. ) She suspected asd too so put on pathway. 15m had assessment and dd was diagnosed. This helped as when he started nursery at 2 it was clear he would need support, as professionals were already involved and he had been assessed for pathway support was put in place from day one. He's now 7, has full speech (although how he uses speech is not typical) he's in mainstream school with24 hours of support a week and mostly achieving to age related or above. He's had numerous support including salt, ot and pastoral to help him achieve in school.
I think early diagnosis and support is key, is your child in nursery? Has anyone else expressed opinion?

There are lots of possible ASD traits there.
My eldest is Autistic one of her earliest traits was hair pulling. But hard to know until you've done the pathway.

if they have offered a further appointment take it,
girls are fabulous at masking to fit in.

Ear covering Hitting themselves punching their head banging their head flapping their hands covering mouth with hand are all signs of autism

They’re not foods she’s always had, I always made puree from scratch by blending whatever finger foods I’d steamed for her and we did BLW with bitter vegetables etc and always offered whatever we were having which is healthy meals from made scratch, she’s offered proper meals with vegetables mixed in and on the side and fruit for afters biscotti is something she only tried for the first time at 14 months, cheerios again only at about 14 or 15 months

she tries to eat anything I offer her but as soon as it touches her tongue she pulls it off her tongue and cries and has been that way since the day we started weaning :(

thank you for the reassurance

Thanks so much for sharing, I really appreciate it. She won’t be starting nursery for another 6 months although I’m considering her starting soon just one day a week.

The HV cancels all appointments last minute, she’s cancelled the last 6 appointments snd she’s not seen DD for about 8 months (she was seeing her very regularly before this) so I’ve not been able to discuss with her

I hasn’t considered it just the paediatrician

Can I ask was the hair pulling just when upset or at any point? DD sometimes does it when she’s upset but mainly she’ll do that or the ear slapping totally of nowhere then carry on as normal

Thank you we are going back in 2 months, the doctor was hoping things would be a bit clearer around then and that she’d hopefully be talking

she tries to eat anything I offer her but as soon as it touches her tongue she pulls it off her tongue and cries and has been that way since the day we started weaning

This is exactly how my experience has been. My son also now retches and is sick on occasions too when certain foods are in his mouth.

I can honestly say that weaning was one of the most stressful experiences I’ve ever gone through. Meal times would repeatedly and up with me in tears because his refusal to eat was so frustrating and worrying.

He’s 5 now and the refusal, tears, gagging and vomiting are still quite a common occurrence.

It’s so emotionally draining seeing something that is considered by most to be enjoyable (eating) as something that is such a battle and an ordeal for him.

Thank you, she does hit her ears and pull her hair or hit her head but this is quite a recent thing

Did you ever see speech and language therapy or anyone about it?

I’m sorry you’ve been through the same but it is nice to be able to talk to someone who’s been through the same experience. I hate it, it’s been the worst part of parenting so far, every meal time is so stressful and same as you I often end up in tears. I hate it at play groups when they all sit down for snack time and she won’t touch anything or she’ll spit it out and cry whilst all the other children, some much younger) are all eating it.

She ate a spaghetti bolognese once and really enjoyed it (just that one time) and I was crying happy tears because it was so lovely to see her eating like a normal child and enjoying food.

Sensory feeding disorders are often separate to autism but often co-occur. Sensory feeding disorder at this age usually is associated with prem babies / NGT feeding or reflux as an infant (I used to work in the field - autism feeding issues were often easy to tell apart from SFD when you were looking at the child). Sensory feeding programme might help (although rarely in the NHS any more)

On the other hand, many of the other behaviours you describe are autism traits. My child has some differences / traits but everyone dismissed it and felt he was fine. And he was....until he suddenly wasn't at year 2 and fell out of education spectacularly. He now has an autism diagnosis and goes to a SEN secondary. So you're right to keep an eye and needs change a lot over the years as the environment changes around them.

I remember the first time I saw my son eat spaghetti bolognese and I cried too.

I celebrate him eating something new in the same way someone might celebrate passing their driving test….it feels like such an exciting achievement.

O know what you mean about how hard it is seeing how they react around food compared to how other children do because it’s soul destroying.

If we ever get invited out for a family meal I purposefully find ways to get out of it because I can’t bear how stressful it will be and the thought of everyone else watching and judging is just too much to bare. I hate Christmas because that can’t be avoided and whereas everyone else is tucking into a yummy dinner, my son is sitting there eating a sandwich. It’s just awful and I know people are blaming me or thinking I bought it all on myself or I’m pandering to him etc, but they have absolutely no clue how difficult it is having a food refuser. Honestly, the last 4.5 years of my life have been so stressful and upsetting regarding my son’s eating and I hate it.

Im very luck in that one of my colleagues is a Paediatric Speech and Language Therapist so I offload to her all the time and we have spoken about sensory issues (and my concerns about ASD) and she has been really reassuring and said that it’s important I don’t make a big deal out of it, that I don’t get upset in front of him, that I praise him for trying new food (even if he has just one lick/bite, and that I never tell him off if he is sick. She said that as he outgrew all his other sensory issues then it may be that he outgrows this one too.

I’m also hoping that now he’s started school and will be watching other children eat food he may join in and be more open to different textures and tastes. At the minute though we just send him in with sandwiches. The school do snack time every day where they offer pieces of fruit to the children and my son has never had one piece of fruit whilst there.

I used to belong to a really good Facebook Group, I will look back through my history, which was a support group for parents going through food refusal and it was so helpful. I will go and see if I can track it down.

Here you go OP:

Sensory feeding disorders are often separate to autism but often co-occur. Sensory feeding disorder at this age usually is associated with prem babies / NGT feeding or reflux as an infant (I used to work in the field - autism feeding issues were often easy to tell apart from SFD when you were looking at the child). Sensory feeding programme might help (although rarely in the NHS any more)

My son had food allergies which he didn’t grow out of until he was over 2 years old and I often wondered if this contributed. I was always so wary of what I fed him and worrying over whether it would harm him and I do worry that all my fretting and anxiety around his diet during the first year of life in particular, has led to these issues and aversions.

@Doododoo sorry lots of typos in my post . It perhaps would be helpful for someone to see her regularly. It may well be sensory or pickiness and nothing more but I think better to know.

Hi
hows your little one doing ? Going through the same with my DD❤️