A bit worried about my nephew (3)

[Orangemochafrappacino]

I am by no means an expert but I have a child the same age and he seems so different to her and her peers.

He seems in his own little world a lot of the time. Calling his name won't get his attention if he is engrossed in something. He is Toilet trained for wees but most days will just wee and poo himself without saying anything like he just doesn't even notice. He talks but not conversationally if that makes sense - he mostly just repeats what you say or the end bit of a question to reply e.g. 'Do you want to go to the park' he'll respond 'Go to the park'. He doesn't initiate any conversations or try to share anything with anyone even non verbally, it's kind of like he doesn't even realise other people are there sometimes. He has the same little catch phrases and utterances for things but it's like an echo of a previous conversation rather than applicable to the current one iyswim. If we go anywhere he just legs it without looking back - just literally runs into crowds or through resturants/shops. Nothing you tell him seems to really 'go in'. He will have full blown meltdowns anywhere busy like play centres, parties that kind of thing and just try to run out. He's not really that interested in other children and his interactions are mostly just snatching things from them without registering their distress.

He is a really sweet, smiley little boy - loves a cuddle, really affectionate etc but my brother made a comment to me on the weekend about how he thought things would have gotten a little easier by age 3 but they are finding it trickier than ever. I can see he feels a little out of step with other parents and even with me and his neice. My dd had some mobility issues when they were younger so it seemed like they were just concentrating on different things developmentally but now the difference between them is quite stark. Even my DH who is mega chill about this kind of thing mentioned to me yesterday that something seems a bit off with him. I don't want to interfere but we are all close and DB was really supportive to us when DD was having her problems.

I've suggested a GP appointment as that's what I would do but he's a bit reluctant at the moment. Could anyone reassure me that this could just be his normal development or does it sound like cause for concern? Sorry ended up being a long post.

Sounds like he might be autistic to me. Id start with a Speech Therapy and or Occupational Therapy referral after getting GP/Paediatrician to rule out any medical reason for his different developmental trajectory. If it matters, one of my kids is Autistic and Im a Speech Thrrapist.

No it doesn’t sounds at all normal developmentally. I’m not sure about the purpose of a GP appointment - contacting the HV would be a better option. Were there no concerns identified at his last developmental assessment?

I also think it sounds like autism - my DS is autistic. We saw a (very experienced) health visitor for a developmental check as we had concerns about his speech & some behaviours when he was about 3yo. She referred him to the paediatrician after witnessing him have an epic meltdown. It takes a while - and various assessments - to get a diagnosis, but worth investigating if just to know how best to support him.

I have an autistic child, obviously they are all different, but I researched autism and went through the assessment process with my child, and I would guess that your nephew is probably autistic. Does he attend any kind of childcare setting? If so they would usually be flagging any concerns to the parents. But the parents can also ask the local health visiting team for an appointment to discuss his development and next steps if a referral is needed.

I think there can be a lot of denial, parents hoping that their child will just grow out of their behaviours (and at 3 he is still young, of course). However, what your brother won't be aware of at this point is that the process of getting assessments, diagnosis and support is REALLY long, so they need to start sooner rather than later. Of course if he is assessed and not diagnosed then fine but better that way around than going undiagnosed and unsupported for longer than necessary.

Sounds pretty classic ASD, you (or they, really) could try the GP although it's limited what they can do in an appointment and it's a lucky dip whether they take it seriously.
However they can refer either to your local services or to a Right to Choose provider who is likely to be able to assess much quicker.
Another option is to get him into a school nursery and raise your concerns, they have a senco and links through to the relevant support networks and can refer for assessment with much clearer information than you could muster. However it's likely to be slow.
The main thing is to get him into the system as soon as possible and keep advocating until you/his parents get somewhere. Waiting would just delay things.

Thank you for the comments. Autism is where my head was going to as well. Neither of us have seen or spoken to a HV since our kids 1st birthday, not sure if that's just our area or not? He does go to pre school for a couple of mornings but they've not said anything (not that DB has told me anyway). Should be seeing him in the next couple of days so will bring it up & tell him there will be a wait.

While your brother waits for assessment/intervention for his son I can recommend Ausome trainers. Theyre based in Cork in Ireland but have really good online education/training courses re parenting an autistic child. The founder and trainers are autistic so have real knowledge. It might hekp the family with current challenges.