Would you speak to the Health Visitor about this, or am I overthinking it?

[NotAnotherBanana]

I’m going back and forth over whether this is actually worth speaking to our Health Visitor about, or whether it’s all still within the broad range of normal toddler behaviour.

DD is nearly 2.5 and there are a few things that have made me wonder whether she finds regulation a bit harder than average:

• She has fairly intense meltdown-like episodes where the full-on screaming/hysterical crying itself usually lasts around 20 minutes, sometimes closer to 30. I’m not including the recovery period in that. During that time she becomes completely unreachable — she can’t tolerate being touched or talked to, eye contact can make things worse, and also even me moving even slightly escalates her. She often has to come out of it entirely in her own time, and if we revisit the trigger too soon she can go straight back into it.

• Her gross motor development has always been on the slower side. She rolled at around 7–8 months, rolled back at around 10 months, crawled forwards just after 12 months and walked just after 18 months. At nearly 2.5 she still can’t jump. On stairs she needs me to hold one hand while she holds the handrail with the other, and she can’t alternate feet yet — she goes up and down one step at a time, bringing both feet onto each step. Her fine motor skills seem good.

• Sleep/regulation has also always been a bit unusual. As a baby she was extremely difficult to settle and woke very easily and frequently. She also had reflux and spent a lot of time crying and arching her back, so I’m aware some of her early unsettled behaviour may well have been due to discomfort.

• Until she stopped regularly napping at home at around age two, she very often had to cry intensely for around 20 minutes before falling asleep for a daytime nap. This was full-on crying rather than mild protesting, and attempts to comfort or intervene usually made her more distressed rather than helping her settle.

• She has also had periods of severe dysregulation on waking from naps. At around 1–1.5 years old, there was a phase lasting several weeks (possibly up to a couple of months) where she would sometimes wake from a nap in what felt like a full meltdown and be completely unreachable. During those episodes I often couldn’t touch her for around 30 minutes without making things worse and just had to sit next to her and wait.

• More recently, she has still occasionally had similar episodes after daytime sleep. She also tends to become hyper rather than sleepy when overtired — running around, climbing on me, getting more and more wound up — and can then either crash into a meltdown or suddenly fall asleep. Massage sometimes helps if I catch the overtiredness early enough, but it’s very hit and miss.

Her speech and fine motor skills are good, she settled incredibly quickly at nursery and they haven’t raised any concerns. She follows instructions well there, including in her less familiar language. She still naps for around 1–1.5 hours at nursery, even though she generally refuses naps at home.

She’s our first and only child, so I don’t really have anything to compare it with, and I keep wondering whether I’m just overthinking a collection of normal toddler traits.

Has anyone spoken to their Health Visitor about a similar mix of things at this age? Were they helpful, did they just reassure you, or did they suggest any further review/referral?

I’m not really looking for a diagnosis at 2.5 — I’d just like to know whether this is the sort of thing you’d mention to a HV or whether you’d simply keep an eye on it for now.

That is what the HV is there for, to give advice and support with development, she may suggest a watch and wait approach, but best to start to talk about it now, as if she does feel that any of these are signs of neurodiversity you can get your DD on the under 5s assessment pathway and get her some support in time for pre- school and school.

@Calypsocuckoo Thank you, that’s really reassuring. I think I’ve been hesitating because none of it feels hugely alarming on its own, but taken together I keep wondering if it’s worth mentioning.
You’re right that it probably makes sense to start the conversation now even if it just ends up being watch and wait.

She sounds entirely normal. My 3.5 year old was worse a year ago with full hour long meltdowns, banging her head on the floor in rage and would scream and cry falling asleep and waking up. She’s grown out of a lot of this now though and the tantrums are far less frequent or extreme. She doesn’t cry at bedtime anymore (just tries to negotiate staying up later) and generally is happy when she wakes up. Hang in there. Everything is a phase at that age.

That’s really reassuring to hear, thank you. It’s especially helpful hearing that she had similar sleep-related meltdowns and that things improved so much with age. Hopefully DD will follow a similar path!

Not really anything too worrying tbh op. Dd2 had awful melt downs she’d scream and scream and now at 5 is totally fine. They’re very young to self regulate still, give it time and see how they get on I’d say

There was a thread in parenting the other day about long meltdown-type tantrums. If that wasn’t you who started it, might be worth a read.

Apart from the gross motor stuff, she sounds very like my now 7 year old was at that age. I could never understand people with babies who just woke up without screaming! She’s now a “typical” 7 year old as far as I can tell.

But there’s never any harm in mentioning a concern to someone. You could also speak to the nursery about it.

Sounds completely normal to me.

Thanks everyone, that’s really reassuring to hear. It’s helpful hearing from people whose children were similar at this age and then grew out of a lot of it as they got older. I think I’ll still mention it to the HV just to get her view, but it’s definitely reassuring to know this can also just be a phase.

Just bumping this in case anyone else sees it this morning. I’d also be really interested to hear from anyone whose child was similar at this age and was later found to be neurodivergent — particularly if they had the same sort of long, unreachable meltdowns or difficulty with regulation/sleep.

It’s only crossed my mind because there are some neurodivergent traits on both sides of the family, so I’m curious whether anyone had a similar experience. Equally, it’s really helpful hearing from people whose children were like this at 2–3 and simply grew out of it as they got older too.

I don’t think you’re going to get any answers from the HV, @NotAnotherBanana , to be honest. I don’t want to denigrate the good work that they do but you’ll get some leaflets about child sleep and dealing with tantrums and that’s it!

@magicalsummereve Do you mean because what I’ve described sounds pretty normal for a 2-year-old, or more because that’s generally the level of support you’d expect from a HV?
I think part of the reason I was considering contacting them is that I genuinely wasn’t sure who else I should be speaking to about this sort of thing. I’m not really expecting a diagnosis or anything at this age — I just wondered whether someone should look at the overall pattern and tell me whether it’s worth monitoring or whether I can just relax about it a bit.

That’s generally the level of support from HVs. They can reassure and give you a bit of a handhold but they can’t diagnose or really help much in a practical sense, although they can’t diagnose signpost you to other people who can (not suggesting that you need this!)

The sounds quite reactive. One of my sister’s kids was like this and is actually far easier than the others now. I would just keep an eye. My HVs were all a special kind of useless

That makes sense, thank you — that’s really helpful to know. I wasn’t expecting them to diagnose anything, more just hoping they could give me a sense of whether the overall pattern is worth keeping an eye on and, if needed, point me in the right direction. I think I’ll probably still contact them and see what they say.

I don’t think there is anything wrong with speaking to the HV, but nothing you’ve said sounds particularly unusual, maybe other than rolling so late. Perhaps she just didn’t have enough tummy time though if she was a fussy baby? Everything else, within reason like unless it’s all happening like 6 times a day, sounds quite normal for a high needs baby who had reflux.

Neurodivergent isn’t “a thing” - it’s a term that was originally developed as a political social justice theory for people with Aspergers. It’s been co opted now as a catch all for cognitive disabilities and also picked up by identity politics.

As she’s settled so well at nursery I wouldn’t be concerned though I understand it’s tricky for you at times.

In my experience HV aren’t at all trained in this sort of thing and babies and toddlers have a very wide range of differences. 2.5 is still such a young age - all we can do is offer and encourage and meet immediate needs.

Lots of opportunities in soft plays, trampolines, trampettes to develop the stair skills and jumping.

My eldest always woke from a nap crying inconsolably; it’s why I ended up breastfeeding for so long as it was the only thing that would console him. He smashing middle school now. My youngest didn’t really tantrum but has has more emotional regulation issues from age 3-8 which I’ve spent a lot of time working on. But it’s totally in the realms of normal. And between relatives who are much older, it’s actually the two girls who were extremely passive as toddlers who’ve been diagnosed with difficulties, though both are at university. (One quite considerable physical sensory processing difficulties who needed a lot of OT and is likely autistic but she’s in the US where the system is V different.) The siblings who haven’t had a diagnosis (both also girls) threw the biggest tantrums ever. Both sets of parents were quite blindsided as their firstborns hadn’t said boo to a goose!

There’s an EXREMELY wide variation of normal. Our culture is pathologising normal. For the most part it’s when these things are still a huge issues across school and home at around age 5-8 that support may need to be sought but moving forward this is going to be less focussed on diagnosis (which does very little) and more on “what does this child need to thrive.”

I do get the concern however; I found the reality of a baby that didn’t seem to be like the others very challenging. Rolled very late, never ate, never slept alone, didn’t have an off button, found clothes and labels and shoes etc really itchy. Actually he’s turned into the most emotionally advanced teen we know. Still can’t sit properly on a chair mind you. But neither can I!

That’s interesting, thank you. “Reactive” is actually a word I’ve found myself thinking about her quite a lot too — she seems to react very strongly to things when she’s tired, frustrated or startled, and once she tips over into being overwhelmed it can take her quite a while to come back down.
It’s reassuring to hear your sister’s child was similar and is much easier now though. I think I’ll probably still mention it to the HV, just to get their view, but otherwise keep an eye on how things develop.

Do you ever carry her on your back in a soft carrier? Like a boba or similar?

Long walks with her on you back might be soothing. Boba’s are good as they have the feet straps which offer a bit of foot proprioception. Only way I got mine to nap sometimes. And mastered the art of lowering them onto the bed.

(If you’ve not had her in a carrier before, only introduce it when she’s in a good mood on a sunny day, going somewhere interesting, with a snack!)

My dd was similar and now at 6 is on the waiting list for ASD and ADHD assessments (referred by school). But there was also a lot more then meltdowns and sleep issues at all ages. I don’t think I’d worry too much at the moment with what you’ve said about your dd.

@mindutopia Thanks, that’s helpful. She definitely was a very fussy refluxy baby, so I’ve wondered how much of the early stuff was just that.
I think the bit that makes me question it more is less the frequency and more what the episodes actually look like. The full-on, unreachable stage itself is usually around 20 minutes, where I can’t really touch or talk to her without making it worse.
That said, I know there seems to be a huge range with toddlers, so it’s reassuring to hear that none of this sounds especially unusual to you.

Thanks for taking the time to write all of that — it’s really helpful hearing your experience, especially about children who seemed quite different as toddlers and then developed absolutely fine.
I do take your point that there’s a very wide range of normal at this age, and nursery going so well is definitely something I find reassuring too. I think I’ll probably still mention the overall pattern to the HV just to get another view, but I’m not looking to label her at 2.5. Mostly I’m trying to work out what she needs when she gets overwhelmed and whether there’s anything worth keeping an eye on as she grows.

@WarriorN We did use a carrier when she was younger. She didn't like being carried facing towards me though, as she was very refluxy. I’m not sure I could manage her in one now — I’m quite small and she feels very heavy these days 😅
It’s a good thought though, thank you!

Thanks, that’s really helpful to hear. I think that’s the sort of perspective I was curious about — whether similar meltdowns/sleep issues ever turned out to be part of a bigger picture later on.

It’s reassuring that you wouldn’t be too worried based on what I’ve described though. I’ll probably still mention it to the HV and just keep an eye on how things develop.

If you don’t mind me asking, what else was noticeable with your DD at around 2–3? Just curious what the wider picture looked like for her.

This reminds me of my son at this age. I was relieved when he stopped napping as his naps were so stressful! I used to have to have a bowl of snacks ready and TV on when he woke up as he was sooo grumpy and difficult. He was also generally an extremely difficult baby (I have 3 children and the others were a revelation after him!)

He's 8 now and isn't diagnosed with anything. I wouldn't be surprised if he is neuro divergent though. He's still extremely emotional and moods can change very rapidly. Gets upset and says horrible things. But he's also generally doing well - clever, funny, creative. We've come a long way from those toddler days.