4 Year Old Development / Possible Autism

[newname2668]

My DS has just turned 4 and I am fairly certain that he is autistic. Amongst other things, he is very prone to meltdowns, struggles with any change of routine and isn’t good with strangers (which becomes problematic with medical staff, restaurant staff etc). I have briefly spoken to his GP about this who agreed that he could be Neurodivergent but said he was too young to diagnose and that they wouldn’t usually do this until age 5.

I am particularly concerned about starting school in September and I want to try and prepare him as much as possible and would be grateful for some advice.

He still has a bottle of milk at bedtime and is extremely attached to it as part of his bedtime routine. He will not drink milk anywhere other than in bed (no cup of milk on the sofa etc). He cries for his bottle before bed and I just don’t know how to get rid of it. The problem isn’t so much the milk but the fact he still wears a nappy to bed at night because he has a big drink in bed. He has been potty trained for daytime wees for about a year but is scared to poo on the toilet. He has only pooed on the loo twice in a year but otherwise saves it for bedtime when he has his nappy on.

On a similar note, he will only go to the toilet when completely naked from the waist down (shoes and all). This involves me stripping him. I am trying to courage him to push his own pants / trousers down etc, but it’s very slow progress and he just wants me to do it.

He started attending nursery in September 3 mornings at week and settling in was horrendous. It took three months of unbelievable meltdowns at drop-off. He is now pretty happy to go into nursery but I think it is only because it is part of his current routine. Once the routine changes in September, I’m almost certain we will be back to extreme meltdowns again.

Once his school place is confirmed in a few weeks, I’m planning to phone the school and try to speak to the SEN Lead to explain and see whether they can offer any support. But I’m absolutely dreading September and going back to the meltdowns.

On the whole, he plays on his own at nursery although they have that he is fairly happy to play alongside others (but independently). However, I know that he can lash out at other children sometimes I’m worried about interacting with others at school.

I don’t know whether to push for a diagnosis with the GP and whether there is any benefit in that.

It anyone can offer any words of wisdom, it would be greatly received.

Does his current nursery have any concerns about him and his development? You may have a meeting with his new teachers before he starts and before any settling in sessions so that would be a good opportunity to raise any concerns you have or anything the nursery has picked up on. They will probably say they will see how he gets on when he starts.
If the nursery or school raise concerns then absolutely go to the GP and request a referral for an assessment, however it is a very long wait.
My son was diagnosed at 3.5yrs but there was never any doubt about his autism so they do diagnose some children younger.

My boy is in a similar situation
we just paid privately to have an autism assessment on Saturday at Spire

His nursery are incredibly supportive and will help apply for an EHCP

can your nursery help?

Sounds very sensible to contact the SENDCO. I think you’re doing all the right things.

Incidentally, wearing a nappy at night at age 4 is totally normal. My DCs were not dry at night until a long time after they started primary school. (One is autistic, the other isn’t). There is a hormone that makes children dry at night and it varies a lot from
person to person at what age this kicks in.

Unfortunately his wonderful key worker has just left the nursery for a new role and it happened very quickly whilst we were on holiday so I didn’t get a chance to discuss it with them as I had planned. His other key worker is great but only sees him one morning a week. I had briefly discussed this with her previously (during the meltdown at drop off phase) and she agreed that he could be neuro divergent but we didn’t discuss in detail which we probably need to do now he’s more settled.

That’s reassuring to hear about the night nappies - thank you!

Hi there. Have you noticed any differences with his social communication? Does he struggle to express himself and/or find it hard to interact with others? This would be a key indicator of ND. The nursery will have a senco and it could be worth arranging a meeting with them so that you can discuss your concerns and see what they could put in place in the meantime. This will help with transition to school as they will already have tried some strategies to see what works for him, so they’ll have something that they can implement straight away when he starts school.

Thanks for this. Yes, he definitely communicates differently - a lot of his speech is repetitions of things he has watched (which I know can be an ND trait) - I think it gives people (especially nursery staff who only spend a few hours with him) the false illusion that he’s more communicative than he really is. His key worker who has just left had a really good understanding of DS so I’m absolutely gutted that they have left. But I’ll find out who the SENCO is and arrange a meeting.