Casual remark at nursery has me worried about DS

[Oceanwarmedbythesun]

DS turned two in December and he does struggle with social situations. He will sometimes push and bite. Nursery tell me when this happens as they should, and they commented that he isn’t very verbal. I thought he was about average and now I’m worried.

He has a lot of words - well over a hundred, but he isn’t asking questions or using sentences much, I do know some of his friends are saying quite complex things like over there mummy and so on.

I am just wondering if it’s anything to be concerned about?

If you contact your old hv, her number might be in the red book, they'll put you in touch with the local ones or at least pass your details on.
You could even mention the comments from the nursery staff and they'll be able to reassure you or get the ball moving if they're concerned

OP, you seem pretty determined that there’s no way for you to access help.

Not at all, but I want to know if the help is actually needed. Otherwise you just come across as slightly neurotic.

Nursery have raised a concern. That seems enough grounds for a professional to see DS to determine if it’s worth investigating further. FWIW, and I’m just a mum of a kid with speech delay, it sounds to me like it warrants a look.

I must not have explained very well @Rainallnight . Nursery haven’t raised any concerns, they just said he isn’t very verbal. It wasn’t said in the context of them being concerned or implying that he was behind in some way. I’m not being dismissive about it - that’s why I’m asking here - but it definitely wasn’t ‘raising a concern.’

You're concerned enough to post here.

You will have a health visiting team, you just need to be proactive and contact them to ask for his 2 year review. Google "health visitors in wherever". My son had his 18 month and 2 year reviews in covid when no one was having them because I was concerned and requested them. The result was that he was referred and diagnosed with autism before 3 years old. He's 4 now and is the happiest and most delightful little boy. At 3 I thought he would never talk. Now he doesn't shut up!

If there are concerns around his speech/development, early intervention (nefore 4/5 years) makes a huge difference. Don't forget there will be a waiting list for things like speech and language.

And if he has his review and everything is fine, then you have reassurance.

As others have suggested, I think - rather than worrying about it - it'd be best to organise a meeting with the nursery staff just to either allay your fears or give them the space to talk about anything they might be concerned about. In my experience, creche workers are not experienced in spotting neuro-diverse children (as opposed to primary school teachers) and at least you'll feel better that you are being proactive.

Some children simply don't have the speech explosion until they are 2.5. That could be your child. But I get the feeling (and correct me if I'm wrong) that you have some other niggling worries about your child and that is why this offhand remark has resonated with you?

In the meantime, there are two things I would look out for:

1. Is the language your child is using conversational, or is it used simply to get needs met? I.e. does he talk about anything or anybody at creche - unprompted - on the way home? Does he point out things like a motorbike passing or a plane overhead?
2. Is your child using the words he has learned to build sentences? Or is he saying sentences exactly as he has learned them? Most autistic children with speech delays learn language in a different way - called gestalt language processing. This is where they learn words and phrases (sometimes quite long phrases) but don't learn to break them down until they are older. An early indicator of that is getting mixed up between "he" and "she".

These are just things that you could start trying to spot over the next couple of months. If you are still concerned at 2.5 years, I would start thinking about getting him assessed.

We last had a parents evening with nursery in December, just before he turned two. No concerns were expressed, but he’s moved up a room since. I would have said the biting peaked at around 18 months but eased off at 20 months and is a rare occurrence now but it does happen, usually when tired / not quite himself, but the nursery have always said it’s when children aren’t verbal.

There was one point where I kept lists of his words - he got a LOT just after 2 and I lost track - but he had around seventy at two, although that’s probably counting some duplicates like Hiya/hello mama/mummy. But then just after he turned two he was picking up a lot. So I thought my worries were about nothing, but then nursery saying he isn’t very verbal made me worry all over again.

His most recent report said he needed helping on how to manage sharing / conflict which is true, he really isn’t very good at that. Not sure if that’s a sign of neurodiversity or not though .

And - sorry, I missed some of that! Yes, he’s constantly pointing stuff out to me - horses, planes, tractors, sheep! He doesn’t talk about nursery though: I think this is where I worry. So for instance if we went past a pond he might say ‘duck! Quack quack!’ but he wouldn’t say ‘mummy duck!’ Does that make sense? He also doesn’t use his own name or say me or I, but he does know the names of some of his friends.

Am I missing something? Aren’t nurseries as an EYFS provider supposed to have a sen-co lead? Ours certainly did.

why can’t you ask for them to start the ball rolling if you have concerns or the nursery have expressed concerns (which is does sound to me like they have)

you also need to get your act together re: GP and other health provisions for your child. Are immunisations up to date?

I agree with the poster who said that nursery are likely saying it as an explanation for the behaviour rather than a concern about language development.

I understand what you mean about the Mummy Duck. That would be an example of where he might use words as building blocks. That said, he's still very young and that ability might come over the next few months. And just to add complexity to the mix, some children are Gestalt Language Processors and are not autistic!

I wouldn't worry too much about the biting. That's just a phase that a lot of kids go through - neuro-diverse and neuro-typical.

I understand that you already had your parent/childminder meeting before Christmas, and no particular issues were raised. That's a good sign. I think it would be difficult to spot signs of autism in a 24-36 month old anyway - half the class would fall into the category of struggling to share, struggling to resolve issues verbally and having particular fixations on things.

In that case I would just have a quick chat with his caregiver that made the offhand remark, just to see if there was something else underlying it. You could offer a meeting (pick up time can be hectic) but if she doesn't have any particular concerns she'll let you know there and then. I would ask how he is engaging in group activities, whether he has any food issues at creche and whether loud noises or bright lights seem to bother him. They might not even know, but raising those questions will inevitably lead to them observing him a bit closer and then they can come back to you with what they have seen.

@Wellillsayitifnoonelsewill - we don’t have a SEN coordinator as far as I know.
I’m not sure what I need to get my act together about given I’ve said a few times that no child my DS’ age has had a two year check yet.

Thanks @Merrow and thanks @lastapache - he has no issues with loud noises (good as he’s usually the source!) and he eats very well. I know it will help massively when he can say no mine, my (toy) and he can but seems to fall into bad habits sometimes.

It’s really hard to know what is normal as they are all so different and also present differently when out and about and have different challenges. So checking on here and getting a sort of majority view is helpful. I do ask friends too but they aren’t as honest as here!

My son is a few months older than yours and I would say at that point he was at a similar stage language wise as yours. He didn’t bite etc though so I am not sure if that’s a red flag. We had a HV appt at 26 months and he was only saying single words and they weren’t at all concerned, they said they are seeing children born around that time showing a little delay in comparison to the children born in the years before, due to the pandemic. He is now putting three/four words together and like other people it literally happened overnight. If you are concerned though I would start pushing now, SALT waiting lists are really long.

Only reason I know about it is that nursery did raise a concern with me about my DS! He went through a biting stage and they were surprised because he was very verbal, and they said it was something they usually saw when the language wasn't there yet. But with DS I think even though he had quite complex sentences that didn't mean he could verbalise his quite confusing feelings, and once that clicked for him (plus a lot of work on "kind hands" etc.) he was fine.

I’d probably go private if there was a concern to be honest- I think the problem is he does seem to be following a normal trajectory but ‘not very verbal’ made me wonder. But then there’s a huge range of ‘normal ’ I know!

I think DS was possibly a bit young to be effected by the lockdown but who knows … hard times

@Merrow i work with older children and I think even then, it’s so hard to get some things across. I know with DS sometimes it is probably that he’s tired and confused and feeling insecure and stressed and then someone takes something away from him and the world ends! I suppose it’s a reminder about how strange the world is to them. He does understand gentle hands as I sometimes have to remind him of this when he is being a little too enthusiastic with our very tolerant cat, harder with biting really! Gentle mouths doesn’t work!

We got this book I hated called "teeth are not for biting" (it was at a point of desperation), which annoyed me as that is obviously what they are for, but there was a repetition of "ouch, biting hurts" that we tended to use with him. But the day he realised that he could just move to another part of the room if someone was annoying him was a relief for all involved.

I think the pandemic did affect them sadly. I am not sure about your set up but DS only had me really for most of his first year (DH was a key worker and went to work everyday), we couldn’t go to any playgroups/baby groups and anytime we went out everyone was wearing a mask and keeping their distance. So over the first year they didn’t get to develop the building blocks of language in the same way, they didn’t get to see different people forming words or interact with other children etc.

Oh definitely for yours - I’m guessing he was born in spring / summer 2020?

DS was born mid December 2020. Things had started to open up in April when he was about four months, and we were thankfully able to go to baby classes and socialise. It was nice. He started nursery at ten months, no initial problems at all but he did struggle when he moved up to the toddler room a bit.

He is early Autumn 2020 but I think things were just really slow to reopen here! Glad you were able to get out and about though. I wouldn’t worry just yet though. Our council is now running free sessions for children born in 2020/2021 however to help with speech, maybe see if there is anything like that in your area? I believe they got a government grant specifically for it.

The focus here is on his lack of speech but you also need to look at how to stop the biting. Yes it could be being frustrated but it’s awful for the other children. You’ve said. ‘It’s just when he’s tired’ but that is still one time too often for the poor child who is being bitten!

@Oceanwarmedbythesun I don’t think you’ve mentioned where you’re based OP but I’m in Scotland and our “2 year” check with the HV is done between 27-30 months. I believe it’s the Ages & Stages Questionnaire 3 that they do. You can get copies online which allows you to see roughly what would be looked for at that age.

Nobody is going to think you’re neurotic for raising a potential concern about your child 🤔 There should be a HV number in your red book, on your GP website, or call the GP surgery and ask for a contact number. “Nursery have mentioned him but being very verbal and it’s made me a bit concerned so I was hoping he could be seen”.

The biting could definitely be frustration if he feels he can’t verbalise his feelings properly but really still needs to be addressed.

@Oceanwarmedbythesun Here is the communication section of the form.

@Username24680 - they use the same forms in England too

I would get his hearing checked properly by the GP and an audiologist. He might have had a series of ear infections (very common at this age) and that can impact their hearing while they have the infection and sometimes it continues for months afterwards as the ear drum recovers it’s elasticity. Hearing is vital for language acquisition. If his hearing is normal, is he making big strides in gross or fine motor development at the moment? Children often have big leaps in one area of development at a time and then switch to the next area. Is he sleeping well. Good quantities of unbroken sleep are also essential for good brain development. Lastly if you are still concerned just book him in to be assessed with a private Speech and Language Therapist (you said thats the route you would take). There is no harm and if there is an issue, the earlier you pick it up and implement therapies, the better