Are we doing the right thing sending our potentially ASD 2 year old to nursery?

[Snacks4days]

It's a long one so I am just going to jump right into it.

DS is due to start nursery in two weeks. He is developmentally delayed and on the waitlist for an appointment at a child development centre for a multidisciplinary assessment for ASD. He has seen SALT and community pediatrician who have said in their professional opinions he is severely on the spectrum but official diagnosis can only be obtained through CDC. He only says very limited words (5) which are only said when he sees objects (no further use to communicate with them for example he says "nana" when he sees a banana but does not ask for banana or say banana when hungry). He does not respond to his name, nor does he understand simple directions given to him (pass that to me, sit down for example). He does not point nor understand if you point at something. He will not take your hand and lead you to something to communicate. The closest we get is a 360 cup thrown at our head if it is empty and he is thirsty.

Nursery staff are lovely, SENDCO and team are already aware of him and making a EHCP to put in place on his first day attending using what reports we have already gathered from medical professionals. However, the issue was his settling in session he had recently where parents take their LO's to the nursery so they can spend an hour and a half getting used to the room, talking to staff ect. Since then we are not sure if this is the right move for DS. We spent the first 30 minutes with him in the room with all the other children and staff letting him get out of his shell and allowing us to just put him down. We left him for an hour with them without us there and what we came back to broke out hearts. He was clinging to one of the nursery staff looking absolutely traumatised. Just thousand yard staring off into the distance, didn't even recognise us when we came in the room. Just all around acting like an animal frozen in place due to terror. Apparently not long after we left, he realised we had gone and he melted down and when one of the nursery staff went over to comfort him (the one he was clung to) he just latched onto her and refused to let go. That was only 1 hour of being there! We took him home and he finally started to come out of his shocked state after about an hour of being back home in his safe environment. It's got us wondering, are we doing the right thing? Is this just going to traumatise him?

To be honest we have some reservations upon seeing the room he is going to be in because he has so little understanding and is pretty much a 10 month old in a 2 year old body going into a room that is clearly for normal 2-3 year olds (little tables and chairs that he will 100% climb on; a water dispenser and little cups for the children to access water themselves that I can see him pulling over). We are also a bit concerned they are underestimating how delayed he is because the nursery worker was telling us all about what they get up to in the room and alot of it DS would not be able to join in with (potty training, the water dispensing, group activities). He will need constant supervision to be in that room without hurting himself and we are worried that they will not be able to do that without taking attention away from the other children.

Every single medical professional is like "YES get him in nursery!" but they haven't spent as much time with him as we have so don't know his as well as we do but maybe we are being too protective? Maybe it will be terrible initially but eventually he will adapt and start to benefit from it? But what kind of trauma would it inflict upon him until we get to that point? Are we doing the right thing? What's your experience sending your child to nursery? How did they react in their settling in sessions?

Who said to you ‘severely on the spectrum’, that doesn’t even make sense.

My son was saying way less at two, wasn’t walking or anything and no one said that. It’s way to early to be diagnosing ASD.

Send him to nursery - it might help.

Also - an EHCP is made by the local authority, not nursery, and they’re not going to do it at two years old.

Yes, ASD is clear in some 2 year olds. It is also true that many 2 year olds display ASD traits and grow out of them. If you have medical professionals on your side, trust them.

I would send him, but I would transition him very slowly - literally 5 minutes with you in the room, 5 minutes without you. It could take a long time but doing it gently is much better for him.

@ItOnlyTakesTwoMinutes Sometimes it really is that clear and needs are that severe. If a setting has applied for an EHCP while the child is 2, it's very likely not to come through until they are 3 anyway, such are the delays in the system.

I’d manage his transition in small increments. Week one 45 minutes building up to a half day. Week 2 all half days. Week 3 increase times. Take him early as possible so environment fills up around him, less shocking. He will be in a language rich environment and you say the staff are SEN aware, that’s good. They will immediately see his needs and respond. Make sure you have a quiet calming retreat space at home for him to decompress/meltdown with non overstimulating sensory resources. Don’t hang around in the nursery or at the door, it increases anxiety by 100!! Be calm in your body when you hand him over, ‘time to play’ and leave. Your anxiety projects into him and he then wonders what it is about this place that’s making you so anxious. Try to project calm.

Do you have experience of this? I have quite a lot and I’ve never seen this to be the case at age 2 for a child who’s presenting as OP has described. In fact, even non verbal non walking or responding toddlers do not get EHCPs at 2.

GDD is obvious in two year olds. ASD isn’t, it could be any number of things. Before diagnosing ASD genetic testing would take place @Snacks4days has this been ordered yet?

I don't know if this will help or hinder but thought I'd share

My autistic dd started showing signs before she started nursery. She went to one nursery in the september and it was clear they didn't want her there. They mentioned that they thought she was autistic. I pulled her out and she started another one in the January.

At the second nursery, they said she's autistic and they're going to put support in place. They got her into a nursery for children with autism. The nursery had 16 places and because of them she got one.

They said though that dd was just playing alone in the sandbox and didn't play or communicate with anyone. This broke my heart, op.

They also made me really uncomfortable with the way they treated us. It was clear she wasn't welcome there for another year.

Pros
They got her into a nursery (aged 3-4) for autistic kids (if she hadn't been there, I wouldn't have known about it). (The senco was well connected and it helped). Her being at the autistic nursery helped her get a place in a school for autistic kids.

Cons
Shitty experience and felt unwelcome. Constantly worried about whether she was happy. She was left to play alone in the sand box.

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Sorry for the long post. I don't regret sending her because overall, they helped us by getting her into the right nursery. And as a single mum, I did need a break.

But she only went for 3 hours for three days a week. And I think, it may have been better to utilise local provisions instead, like stay and play sessions and groups for parents of autistic kids. If you have family support, maybe utilise that instead.

BTW, I chuckled as your dc throwing a cup at you when thirsty! Mine did the same. Things get better, op.

❤️

The local council should host support sessions and 'stay and play' groups for 0-5 year olds with special needs - they're great and run weekly. It'll mean socialisation for your baby but you'll be there to provide support ❤️

@ItOnlyTakesTwoMinutes I am just using terminology used by the community pediatrician and the SENDCO at the nursery. I cannot speak for your own experience, only my own and that is what they have told me.

Maybe the SENDCO is referring to an internal EHCP that only the nursery sees which feeds into the one created by the LA but that was the phrase she used when we met her. She specifically asked us to send her all the medical reports we have accumulated from his speech and language therapy sessions and his appointment with the community pediatrician (who was the one who said to us that he is presenting severely on the ASD spectrum after assessing him herself).

Obviously I cannot comment on your experience in the system but this is my own and I am looking for advice on how best to help my DS adjust to nursery when I cannot communicate with him. Do you have any advice for me with regards to that?

Sorry - I realise I didn’t actually answer your question was just so taken back by what was written.

I sent my DS who was presenting in a very similar way to your DC last year to pre school. He’s still delayed by 12-18 months. My DS settled in really well, he enjoys it. He did go through a phase of getting upset when we left but it was short lived. I think it’s the right thing for you to do and targeted, intentional play with professionals would be really beneficial for your DC.

I wish you both the best of luck! My DS is honestly just perfect and I’ve learnt to enjoy him entirely for who he is not who I thought he would be (it can be hard seeing others develop so much around you).

Let’s not bully the mum of a two year old because she doesn’t know chapter and verse on an assessment journey she is just beginning 🤨

OP - your DS might settle but it does sound to me like he might find this setting traumatic. I think often a bit too much faith is put in nursery and its ability to make children develop social skills. Could you hold back to age 3? And then consider play groups or similar, maybe for other kids with SEN?

Can I just check whether you need the childcare for work, for a break? Are there other options you're considering if you have to work and need childcare OP?

I think you were wrong to try and sneak out of the settling session. That's parenting number 1! It will erode trust.

Sorry, I think intentions behind what one is saying may easily be misconstrued on the internet. I didn’t mean to be unkind, I was perhaps a bit tactless. I do mean well.

@MumOfOneAllAlone thank you for your reply! It's good to hear something good came out of the terrible experience. That's one of our fears actually that he will just be left in the corner by himself because there's 3 staff to 15 two/three year olds and he doesn't actively seek out human interaction when he needs something like normal 2 year olds!

We attended one of those stay and play sessions actually but there was only 2 other children there (one a baby, one toddler of similar age) and the other toddler and parents left half way through so he didn't get the social interaction we are sort of looking for from these things. He's much happier staying at home with all his toys (his favourite thing to do is open and close the cupboard doors on his toy kitchen) so with it being just a little baby only just crawling it wasn't really worth disrupting his routine for? But maybe other sessions will be better?

Another reason for sending him to nursery was so I could get some time to get on with things without him underfoot! Familial help is nonexistent...DS's paternal grandmother was taking him out once a week with his cousins but she stopped doing that (probably because of how much hard work he is compared to his cousins but she will die before she admits that). TBH she isn't the best for childcare since her advice for DS's delays are "just don't give him water when he hits you with the cup, then he will be forced to talk to you". When asked to clarify, yes she genuinely meant give him no water until he verbally asks for it. She is also convinced DS is not responding to his name on purpose to be defiant...I am NC with my family so no help there.

We did attend one Portage Stay and Play which a bit of a bust because no one turned up but things might be different in the new year so will try again! We just want DS to get some experience around other children. Yes I was also looking forward to some time to myself but I'd rather have him underfoot and adapt than traumatise the poor boy!

We might push it to 3 and give him more time to develop his communication skills? It's just we have all these medical professionals going "you should really get him in nursery" we were questioning

For child interaction purposes mainly to see if maybe it would help him develop but I'm not going to say I wasn't looking forward to a couple of hours without a child swinging off me haha

No, I wouldn’t. But I also wish I hadn’t put my NT 2 year old in; and I’m not sure I’d put him in now at 3 if he wasn’t already there. He does the minimum days and I’m strongly debating taking him out… I will when fees go up (again 🙄) in February.

It doesn’t sound like your DS will cope. He’ll get on with it, I suppose, but it’s not a choice that sounds like it’s in his best interests. It might be in yours, if you’re desperate for a break - I do understand no familial help; we’ve got nothing either; nobody but me or DH have ever had DS. It is relentless. I use nursery days for work so I can’t say how much of a benefit being able to use them for other things would be; I’d guess it’d be a pretty big draw.

I put my DD in at 2 because I needed to work. I was under the impression she just had a bit of a speech delay but we have ASD diagnosis at 3.

Nursery have been incredibly helpful. They're a very warm caring setting. My daughter learns a lot there and is happy with the staff but it wasn't always the case. I'd definitely make sure it's not a place with high turnover of staff, and ask about applying for extra funding 🙂

I'd be absolutely scuppered for school if I hadn't put her in childcare.

She's come on loads since she started as well.

I think them pushing the nursery thing might be because it will help to start the ball rolling for assessments in an educational setting which are needed for an echp. If he is fine with busy environments then I would give it a go but just for a few hours but if you think he will be distressed then maybe wait till he is slightly older.
You need time to yourself, looking after a child with additional needs is blimin hard work and you need to put yourself first. You can't pour from an empty pot.

My DS was on the pathway at 2, and diagnosed at 3 with EHCP put quickly in place, thanks in part to the Nursery he attended. However, if I could do it over I wouldn't have put him in Nursery. He didn't enjoy it and in my experience, you can't make our kids socialise until they are ready. My DS would drag the car garage into the cloakroom to play alone, where he was happiest.
We found it was better to take him to soft play, swimming, etc and encourage his social skills that way. Often our kids are a couple of years behind socially so won't be ready for it at the same time as other kids anyway. You can't fit a square peg in a round hole.
DS started mainstream, moved to a special school and recently moved again to another better suited ASD specialist school. He has little friends, but has done it all in his own time.
I guess what I'm saying is listen to the 'specialists' but trust your judgement. You know your child best and they will do things in their own time.

The nursery staff advised us to do that and to be fair to them he normally doesn't really look to us. For example if we take him anywhere we have to follow him because he just takes off without looking back so we wrongfully assumed he would fixate on the toys and we'd come back and find him still slamming the toy kitchen cupboard doors.

I think what happened was he fell over or bumped himself which took him out of that fixation and upset him and that's when he noticed our absence and things spiraled

I think you go with your gut on this. You know your DS better than anyone on MN, better than any medical professional, better than any nursery worker. He doesn’t sound ready at all and I would delay nursery until he is a bit older.

Hi OP, I have an almost 3.5 year old who has just had the referral accepted for an autism assessment. I am very surprised they would suggest ‘severe’ autism at this stage. There are some clear signs of intentional communication there by the sounds of it, such as 5 verbal words and giving / throwing you a cup when he wants another drink. I would agree that at 2 years old it is sometimes clear, but it’s rarer to see that. It’s not clear for many until 3 or 4 years old and they can and do make so much progress between those ages.

If your DC has a lot of sensory needs and stims a lot, and generally appears to be in their own world, then I could see a need to describe it as ‘severe’, but again, my son probably only had a few words at just turned 2 and now has probably over 250 at 3.5, but it’s generally non-functional still, and his first words were letters and numbers, so it’s not so much the fact that he is verbal, but the fact that how he is communicating is atypical for his age… but anyway, no one has even mentioned that our son could be autistic let alone give a ‘severity’ rating as it’s not their place to do.

I had no idea about how my son would be in a setting, but I took him fully prepared to air lift him out the place should he have a meltdown, however he went in like a bull in china shop, periodically looking back at me, but otherwise quite happy and interested in the toys on offer. Sometimes he didn’t like saying goodbye once he went regularly, but has since settled. The main issue has been the lack of ‘early intervention’ and the lack of funding for him to have extra support when at school, but the staff are supportive nevertheless. One other thing I would say is that the first setting he went to didn’t feel like the right fit, and we are all round happier with the one he is currently at. You’ll know if it’s not right for your son.

You don’t know how he’ll be until you allow a settling in period at the end of the day, and even lots of NT kids struggle, and at that age it’s considered to be within the range of ‘normal’, but it might be that an ND child might take longer or may never really cope with an environment set up for neurotypical children. Only time will tell. The setting will probably call you if he becomes really distressed and ask you to take him home, as with any child. Good luck with it all, it’s definitely the harder parenting path! We are pretty much super parents, because we have to be!