15 month old autism concerns

[BeRubySquid]

Hi all,
I’m hoping for some advice or reassurance from other parents as I’m feeling a bit unsettled after a nursery experience yesterday with my 15-month-old.
She started nursery a few weeks ago (she was 14.5 months at the time) and goes one day a week so I can work and also to support her social development. Yesterday was her 3rd full session, and when I arrived she was crawling in a corner crying. A staff member said she had only just started crying, but also mentioned she’d been quite upset and unsettled for much of the day.
They said she only had a 40-minute nap (she normally has around 2 hours at home) and that she hadn’t wanted comfort from any staff. I wasn’t too surprised about that as she is quite wary of unfamiliar adults, and each time I’ve dropped her off it has been different staff members rather than consistency with the same key person, which I do find a bit odd.
The staff then mentioned they had observed her “flapping” and tapping the back of her head on the wall and asked if I had noticed this at home. I explained she does sometimes flap when she is excited or upset, but it isn’t constant, and the head tapping isn’t something I’ve seen at home. I asked if they were concerned and they suggested I speak to the manager.
The manager then came over and said she was “stimming”. I asked directly if they were concerned and whether I should speak to my health visitor, and she said no, she wasn’t concerned yet and to just monitor it for now and not speak to my HV at this stage.
I came away feeling a bit confused and upset, especially as I had previously mentioned some behaviours to my health visitor who said they were completely normal for her age.
When we got home she didn’t show any of the same behaviours at all. She played normally, had dinner, a bath, and went to bed early as she was very tired.
I’m wondering if what nursery saw was just her being overwhelmed, overtired, and struggling with a new environment?
For context, she is generally a very affectionate and happy child at home. She will come for cuddles while playing, enjoys books, and I’m her main source of comfort. She does sometimes look blank if asked for a kiss, but is otherwise very engaged with us.
Some other behaviours I’ve noticed:

• Sometimes ignores her name
• Acknowledges me, smiles, laughs and crawls over, but will sometimes completely ignore her brother
• Not walking yet, but very strong on her legs and will stand if supported
• Can follow simple instructions (e.g. “come to mummy”) but not more complex ones yet
• Enjoys repetitive play like opening/closing cupboard doors but will move on easily
• Says “Dadda” consistently and appropriately, has said “mama” once
• Often stands on all fours and looks through her legs
• Loves spinning/turning objects but doesn’t fixate for long
• Very interested in sensory things (lights, textures, sand, rice, etc.)

On the positive side, she has good eye contact, loves songs and anticipates actions (especially tickling parts), enjoys peekaboo, and gets excited waiting for it. She will interact with us, watch other children, smile at strangers, feed herself well, and sleeps reasonably well aside from a current regression. She also gave me a toy yesterday when I asked, after a pause, which felt like a big moment. I suppose my question is: has anyone else had concerns like this around this age? Were you advised to wait and see? Is there anything I can be doing to support her development? I am planning to call my health visitor on Monday, but would really appreciate hearing from other parents who may have been through something similar. Thank you so much for reading

My son was diagnosed at 5, which is considered pretty young. At 15 months it is difficult to tell and a wait and see approach is likely to be best. It sounds like she is verbal, speech delay is the biggest flag for autism at the most complex end of the spectrum.
It is good to get advice and to be aware of developmental signs, however in my experience, even if it is autism, with support and the kind of parenting you are providing children can make great progress.

Thank you for your reply. I’ll be honest, I was shocked when the manager said what she said because at this age, I didn’t think they would observe that kind of behaviour and raise it as a potential red flag. I’m a qualified childcare practitioner myself (although I haven’t practiced for over 10 years) and we were always advised to wait until the children were nearly at school age to raise any type of concern, because they develop so differently and at different paces. Thanks again for your reply and I hope your little one is thriving!

Yes, you’re right about the age for diagnosis. It could be nothing with your little one, our nursery raised issues when DS was 4 and suggested a referral where someone came in to observe him. Is there autism in the family? Starting school made things a lot clearer for us, he is doing pretty well now at 16. You sound clued up, which will be a huge advantage for her.

You will worry about it now. Speak to ypur HV.

Thank you. I just didn’t know if things had drastically changed since I stopped practicing. I just don’t want her labelled when like you say, it might be nothing and she might just catch up. Once she’s settled I think she will thrive at nursery, we just need to get over this first hurdle. I’m upping her hours to 2 more 3 hour sessions a week so it’s not such a huge time frame between sessions, hopefully this will help. I’m not sure if there’s autism in the family. I was diagnosed with ADHD as an adult and I’m 95% sure my mum is on the spectrum. A lot of red flags were missed with me as a child and I refuse to let that happen to her. I will support her and advocate for her as long as I need to.

your little one isn’t such a little one anymore! Glad he’s doing well. Thank you again for your kind words.

If this was only her 3rd session then it might well be stress adjusting. Maybe it wasn’t too stressful the first two times as it was new but maybe going back she has just realised she is there for the duration and this is overwhelming. Having more frequent sessions will likely help.

Are you sure this is a good nursery?

I'm not sure I'd leave a baby somewhere if they've been crying all day and not able to be comforted anyway, whatever the reason

Thank you. I think this too. I know her very well and I know she only shows these kinds of behaviours when stressed. The manager just looked so concerned it’s thrown me off. I’ve upped her sessions now to 2 extra 3 hour sessions, so hopefully it will help. I stand by the fact of having different staff every time we go is a problem for children of this age from a consistency point of view. She also missed last week because she was ill so this was her first time back after 2 weeks, which I also reminded the manager of.

I see your point, but last time I went to fetch her she was happily playing with a staff member. I think yesterday was just an off day for her. She had a cold and cough last week so missed last weeks session, so it was 2 weeks since she’d been.

She’s only been a couple of times so it’s probably too early to say how good the nursery is and whether she’ll settle.

I disagree slightly with the consistent person though. Whilst it makes perfect sense to have a key worker, initially I’d be wanting her to get to know a few members of staff so she doesn’t become dependent on one - and then is upset when that person is off.

You will know yourself, it’s highly unlikely to get a diagnosis at such a young age, even if she is nd. It really is a case of watch and wait.

She is very lucky to have you though, you have the expertise to make sure she’ll get whatever support she needs in future.

Hi Op, my daughter is five and has autism she was diagnosed at 3 , a lot of what you describe my daughter did but so do a lot of babies who aren’t autistic , hearing the word stimming can be scary but everyone stims , tapping our fingernails , twiddling our hair , they are just regulatory behaviours. We are a nuro diverse family so I was more aware and I knew my little one was autistic and referred her at 14 months . She was non verbal until 4 but she’s doing amazing , she’s in mainstream education , has friends , athletic , sociable , wacky sense of humour . I know the worry and fear you are experiencing but your girl is so young and is likely not autistic but if she is , you have mentioned so many positives with the right help in place she will thrive . We had a multi disciplinary team who diagnosed my daughter and the psychologist shared with me that she was autistic . Sending you a big hug ❤️

Thank you, when I said about consistency, I kind of meant the staff in the room entirely. I wouldn’t want her to bond with one person because as you say, when they’re off it would upset her. I just haven’t seen the same staff member twice when I’ve dropped her off or picked her up and I find myself having to tell them about her when I drop her off, I just feel like they don’t really know her. Thank you for your kind words ❤️

This was lovely to read, thank you! I’m so glad your daughter is thriving ❤️ it just goes to show with the right input and a mum that loves them they can achieve anything 😊

DS was diagnosed at 2.5 but after a regression so it was obvious to professionals but not to the nursery staff who needed the changes pointed out to them. Only highly experienced autism specialists would be able to diagnose a 15 month old - or experienced parents.
DS was a late walker and late with all motor skills and that is common with autism due to motor planning issues not any physical reason.
You can read up on what therapy would be given if autism was suspected at that age and try implementing it yourself - it’s basically more targeted play so it’s not going to cause any harm - at worst you will have given extra help to a child who turns out not to need it. MCHAT is a screening tool for autism in young children. But my experience of nursery and mainstream school staff was they were clueless and often jumped to conclusions eg if they had been on a one day sensory course they concluded all DS behaviour was sensory related when it had various causes. Their level of knowledge is very basic.

I think it is wise just to observe and be aware of it. Lots of behaviour comes and goes at that age.

One thing I want to point out is that autistic children (especially girls) can behave differently at home and when out and about or in a setting where they don’t yet feel secure. My daughter was diagnosed age 6 and she would do things outside that she didn’t do at home such as pushing her body against me repeatedly or licking/biting. She still does this and that’s how I know she is anxious. Her speech was a bit delayed ( has caught up) and she ignored her name but her main challenge was sleep.

btw she’s at school now and has no issues (high masking at school) but it was a relief for us to have a diagnosis as it means I know why she’s behaving certain ways and I can help her. I carry ear defenders and fidgets etc and I give her deep pressure along her arms which helps too.

Thanks for this. Was he a late crawler? She crawled at 12 months, but I didn’t walk until I was 23 months. She has amazing fine motor skills and has used her first finger and thumb to pick things up for quite a while. I will look all of that up, thank you so much for your advice. I do feel the nursery manager shouldn’t have said anything in this situation and maybe waited until she’d been attending a while longer and was a little older. Thanks again.

Thanks for this, it’s definitely something I’m going to keep an eye on and see how we go. Was / is your daughter affectionate? I’ll give it another 3 months and if she isn’t walking I will reach out to the health visitor again and ask for some support. I mask my ADHD when out in public because I’m so afraid people will think I’m weird. Now I have her I force myself into social situations like baby groups because I don’t want her to have the same problems that I did. With the deep pressure on her arms, is that like squeezing her upper arms? If so, that’s really strange because that’s something I get my partner to do to me when I’m feeling a bit over stimulated and it makes me feel better! Having a baby has made my ADHD so much worse. I’ve got it under control again a bit now but the first year after having her was a rollercoaster.

With the deep pressure- yes it is pressing gently into the muscle up and down. Look up deep pressure techniques for kids. There are other ways to do it too. It’s interesting that you get something out of it yourself- so she may do too . Worth a try !

my dd is really cuddly and sociable yes. Lots of eye contact too. She didn’t have any problems leaving to go into nursery but struggled when she started school - that’s when we started getting the stomach aches and anxiety and ruminating for hours and hours in the evening about her day. It was v stressful but she’s much happier in her second year now because she has some adjustments in place.

If you google autism and girls pdf you will find a useful document about how symptoms present differently in girls.

Also I just want to say - autism or no, it is ok for your child to develop in her own time and don’t compare her to others, although difficult. I regret spending those years worrying about it all and wish I could go back and just appreciate every second of what she was.

Ds was diagnosed at 6, and with hindsight there were signs and things raised by nursery but more as behavioural issues. Ds was/is so sociable, smiley - was cuddly as a baby/toddler (only on his terms now, but incredibly loving). He didn’t stim as a toddler/preschooler.

I suppose my point is that there are no set of traits that autistic people share. I also don’t think we would have done much differently if he’d been assessed any earlier - you sound incredibly tuned in to your child, and fully accepting them as they are and meeting them where they are is the most important thing.

I think it’s too soon for anyone to say if your dd has autism. I was a childminder for 16 years and would not have taken on a young child for 1 session a week as it’s so difficult for them to settle, I did a minimum 2 sessions for early years. I would look at childcare choices website and see if you are entitled to more hours and maybe book in another half day. I feel your dd and staff need time to build a relationship so dd feels secure. It may be that down the line she does get a diagnosis but it’s difficult to establish secure attachments 1 day a week.

My DS was diagnosed at 3. I had approached pediatrician with concerns at age 2. Noone else ever picked up on it and some will argue that he doesn't "look like an autistic kid" whatever that means. At that age the signs were that he never settled at creche - over 18 months he cried every day at drop off (only went for 2 hours per day). He became extremely fussy with food from months. Developed obsessions with road signs, bugs, tractors. We had to read the same books 10 times per day and he could have taken his driving theory test at age 2. From 2 onwards he would give long monologues about bugs, reciting his favourite bug books word for word. He used to copy other kids alot, repeating what they say and mirroring their movements. Had explosive meltdowns with disproportionate reactions. Clothing sensitivity - labels have to be cut out, will not wear shorts or shorts sleeves.

Don't even worry about. My daughter this twisting hand thing we called magic hands. Looked exactly like a type of stimming behaviour I saw online and it panicked me. She grew out of it. She always didn't answer to her name and then she did. No-one should be offering any diagnosis except a professional and it is too young. A lot of the behaviours at this age can be developmental and similar to other things. Don't worry until you see clearer signs when she's older.

I think as everyone is hyper sensitised to ASD they sometimes they see normal stress reactions as something abnormal . The nursery maybe shouldn't have worried you after just a few sessions. The behaviours you mention seem normal for a LO who is very upset at be I ng left in a strange place with strange people . My son used to do all kinds of stuff ie roll himself up in a rug or hide under furniture if he was upset ! He's absolutely not autistic . Try not to worry or speak to HV a b out what nursery said but Imo parents are the best at spotting if something is wrong .

15 month olds dont need to socialise, they need to form and maintain strong attachment to their main caregiver, aka you. If you dont need her to be in nursery for work, then take her out. It sounds to me like shes very stressed while shes there and thats why shes displaying those behaviours. Also, nurserys and schools are far to quick to label children as SEN when they find them difficult to manage, I would know as I am a teacher! Good luck, keep your baby wiht you as long as you can. xx

I have two children. Tween and a teen now. One is autistic and one is not. Both struggled to settle in nursery and wouldn't ever nap there. Both did MUCH better in a local authority preschool than a private nursery setting. Autistic child especially, was a game changer for him. The nursery was a good nursery, I think the "school nursery" type setting was a better fit for their personalities.

The only difference between their development that was really obvious at toddler age was speech delay (the autistic child) - no mama, dada, etc. Some other signs around eye contact, not responding to name. I flagged this to HV at 18m and they referred for hearing check. But apart from that it's the 2 yo check where they started looking to referrals to SALT, etc.

I think it's very early Both in age and time in setting to bring this up personally. But sounds like you are very clued up. Talk to your HV if you want to, otherwise just wait until 2yo check