Concerned about my 3 year olds development

[Concernedmama2]

Hi everyone,
I’m really concerned about my 3 1/2 year old (born May 2022), and I’m getting more and more concerned as he’s approaching reception age.

He is still in nappies, refuses to sit on the toilet and doesn’t show any signs of readiness.

He doesn’t talk. He only has 3 words - hiya, mama, and he tries to say banana (comes out as nana or nanana).

He understands simple instructions like put your shoes on, go wash your hands, but any open ended question he can’t answer. He doesn’t know how old he is and if you ask him how old he is he doesn’t know what it mean and won’t show you with his fingers.
instead he will hum to the same tone you asked the question to answer if that makes sense. “how old are you?” “Hum hum HUM hum”

He doesn’t understand abstract concepts like holidays, doesn’t know what Christmas, vacation, Halloween are, doesn’t understand “the weather is cold/hot”, “this is pretty” “this is silly, this is smart”, “these are your parents/grandparents” etc…

He struggles a lot with his emotions and can have a very hard time with boundaries, being told no, having something taken off, etc…

He doesn’t seem to understand punishment, or at least, he knows it’s something that’s negative and that he’s in trouble but it won’t change his behaviour.

He doesn’t really play with toys besides his toy train but he will spend hours listening to music and audio books and learn his audiobooks by heart (he will hum along perfectly to the narrator’s tone), but I’m not sure he understands what the stories are about as he replays part of a sentence again and again and again and then skips ahead.

on the other hand, he’s got a really good memory (knows his audiobooks for one), he taught himself the alphabet and all letter sounds at 2, he also this year learned numbers 0 to 100. He can type “82” if you ask him. He recently started reading simple 3 letter words (will point to them and not by memory). He can count a group of items up to 20 items and he knows 6 dots = number 6.

But he can’t draw or write or trace anything with his hand besides straight lines and sometimes circles.

I am so worried about what reception will look like for him, he hates noise and singing and will not be able to follow group instructions.
He will not sit down and listen to what the teacher wants him to do.
I tried enrolling him in a sport once but he would just look away and wander off mid 1 on 1 instruction.

He used to hate being around a lot of people and he would scream the whole place down but thankfully that has calmed down.

He loves people and playing with children but he doesn’t know how to play with them or what they’re wanting to play.

He doesn’t go to nursery but he goes to play groups often and he has a blast there for the most part but keeps to himself in the music room and on the ride on cars (he doesn’t do well during dancing and singing), he doesn’t have separation anxiety and never has.

I’m so concerned for him and don’t know how to help him and prepare him for reception.

You're right to be concerned.

Contact your doctor.

From what you've said, he needs nursery/more social interaction

Hi @Concernedmama2, I would go to the GP firstly. Also, it would be very beneficial to enrol him in a setting if possible. I am a teacher and find that children who haven’t attended any setting at all (including childminders, they also count as a setting!) struggle with school much more. Settings can also be very helpful in assessing development, and putting strategies in place to help. My DD, now 4, would not play with her peers at all or give any eye contact, but her nursery were AMAZING and helped her so so much. I am not saying settings can work miracles, but they can be very helpful and supportive.

You need to write a list of your concerns or just copy and paste this post on your phone. Go to the GP and ask for a referal for a hearing test, SaLT and developmental peadetrician.

When you know which school he is in you need to collect the SENCO immediately to share your concerns and apply for an ECHNA.

Obviously impossible to diagnose from a single post but a lot of the things you say point to ASD. Certainly with only 3 words at three years old there is likely a significant language delay. What did your health visitor say about his speech and development at his 2 year check? Have you been to your GP? Early intervention is key and so if he is neurodivergent or has a developmental delay the earlier it is identified and support put in place the better. It will also be crucial in finding the right school for him that any learning needs are identified. If you haven’t sought help already definitely book a GP appointment next week and get things started.

Obviously impossible to diagnose from a single post but a lot of the things you say point to ASD. Certainly with only 3 words at three years old there is likely a significant language delay. What did your health visitor say about his speech and development at his 2 year check? Have you been to your GP? Early intervention is key and so if he is neurodivergent or has a developmental delay the earlier it is identified and support put in place the better. It will also be crucial in finding the right school for him that any learning needs are identified. If you haven’t sought help already definitely book a GP appointment next week and get things started.

Contact your GP or Health Visitor. He may need a speech and language evaluation from what you have said. He should be speaking sentences of 4 or 5 words and his vocabulary should fairly good in terms of words he is able to say - I think it's over 1,000 for 3 year olds. It could be because he hasn't spent time in a nursery independently which can impact speech development.

As there are other concerns you have too, you should speak to a professional and see what they say rather than worry about him. There could be lots of things you can be doing now to help before he starts school. Don't wait any longer.

Thank you for your reply.

He did a few sessions with a speech therapist but they said they couldn’t help him further as he already uses baby sign language and can point to things to communicate.

I asked my GP to refer him to occupational therapy, another speech therapist and for a hearing test but all three referrals have been declined.

I will be moving to a new city in the next few months and will start the process anew

That's quite odd I think as he is missing some significant milestones. Keep pushing.

Would you consider a nursery place for him, even two mornings a week or something when you move - would you qualify for childcare vouchers? The nursery would help you to seek advice and support through their agencies and get things moving before he starts school.

Yes I’ll look into getting him enrolled as soon as I move
I am unsure whether to stick to nursery when he’s 4 for an extra year or to start reception straight away

The problem with sticking with nursery for an extra year, is that he will then be expected to go straight into year 1 which is an even bigger leap for him than nursery-reception will be.

When is his birthday?

No he won't.

Definitely apply for a delayed school start when the time comes. Give him the extra time you can to develop before beginning reception.

Agree with pp to go back to the GP and ask for a pediatric referral.

He was born 14th of may 2022

Some things wouldn't concern me such as the wandering off mid instruction, struggling with emotions, not knowing abstract concepts and not liking many toys. My son is 3 and is similar with all of this - he much prefers adult items to play with or just being outside. However the language element is indicative of a delay as the milestone is that they should be speaking in sentences now and have a large vocabulary of words. I'm surprised that the speech referrals have not been pursued and would push for this along with looking up some strategies for encouraging more communication. Open ended questions are hard to understand at 3

Thank you for your reply. That is quite reassuring to hear!

I will try and post an extract of him speaking to explain my concerns better

I’ve included a sample of him speaking along to one of his tonies, imitating the narrator:

vimeo.com/1139655145?share=copy&fl=sv&fe=ci

I have a DC who has asd and from what you’re saying it does sound like it could be that. Do you have a health visitor? You need to push to get a referral to get on the waiting list for an assessment or at least a consultation with a developmental paediatrician. The waiting list is usually years. You could do with getting him enrolled at nursery so they can start the EHCP process, ideally he would need one before starting school and then you’ll have a better chance of getting him into a school that can support his needs rather than just the one in your catchment area. Nursery could also help with his development so will be useful and it could even be that he catches up with his peers.
Sadly speech therapy and occupational therapy on the nhs has become almost non existent so unfortunately don’t rely on getting that.

I would definitely want a hearing check, he may be saying what he's hearing.

Thank you! I’ll look into private hearing checks for children

Definitely agree with this.
Being unable to communicate has a knock on effect on social development and emotional regulation so it's hard to say whether those issues are separate or it all stems from communication. Hearing check a great first port of call.

He sounds a bit like my DS who is now 6. Especially not being able to answer the open ended questions around what Christmas or birthdays are. He does have an ASD diagnosis which I didn’t have to fight for at all. He started nursery at 3 (couldn’t go before this because of Covid) and they immediately helped with referrals etc.

We delayed his school start as he was also a summer baby, again, no push back, school were very helpful.

What I will say now is that things look so different at age 6 to what they did age 3. He can now chatter away - in his own way and tone. He plays alongside other children. He can now read and write! and the other day he told me he was looking forward to Christmas unprompted! He also notices the weather and comments on it.

I would look to get him in nursery asap and do a school start delay. If you get the approval, they just start a year later in reception, they don’t go straight into year 1.

Even though you are planning to move in a few months I would start him at nursery as soon as possible get their opinion and get the ball rolling. Your move could be delayed and might not be for another 6 months.

He needs full developmental check. Hwaring vision skills eg bayley scale and filull slt screeningThe voice recording could be oral apraxia of speech he is trying to say things

This isn’t necessarily true.

If his birthday is between 1st April and 31st August, you can request to defer the Reception place and start in Reception the following year.