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.

Hi OP

I how you don't mind me commenting on just gross motor skills?

DS was very very delayed, didn't walk until 18 months and not confidently until nearly 3. No problems after this.

But yes, I would get your HV involved, because it's not going to hurt.

All the best.

My DD is autistic. She didn't do this exactly but the way you talk about being "unreachable" does, honestly, ring a bell with me. My DD used to more go into a sort of trance and once the docs ruled out petit mal they said it was just one of those things. I think you are right to keep an eye on her because you tend to know when something is not quite typical I think even if you don't have other kids.

That said, it sounds like you know how to handle the tantrums for now and she is managing well at other times, so while I would ask for the HV's opinion - or nursery staff if it is a nursery school rather than only childcare - I wouldn't push for any diagnosis just yet.

I’m v small too - carrying on the back loads your pelvis and back and is a good lower body work out. I had a lot of back and pelvis problems after my first; regularly carrying for as long as he was keen really helped so much. It’s basically a piggy back. Don’t do loads at first, just build it up slowly.

It’s just a soothing / co regulating suggestion. She may eventually ask to be carried when she’s having a wobble or it might be a way to bond after one. Or just something close to do together.

Both mine liked to hang out on my back while I did things around the house and kitchen.

But it may not work - who knows. The deep pressure can be soothing for some. My eldest wouldn’t go in a carrier till he was able to sit up and go on my back as he was so damned nosey. Needed to see everything! I felt like a total failure till we cracked that. And I then understood all the screaming was intense frustration.

Once he mastered running around and climbing he was much less frustrated.

stopped charging up and down the length of the house on hands a feet once he started playing football around aged 8!

I remember watching my then 1.5 year old being able to paint quietly on the paper while the wild 7 yr old was STILL insisting on painting his whole body ffs 🤣

He’s the most normal though ultra chilled teen ever now.

I teach children in send school and a lot of the things we do physically under the OT’s guidance really help tackle emotional regulation stuff.

Thanks, that’s really helpful to hear. The stressful naps and difficult wake-ups sound very familiar! It’s reassuring to hear how much things have improved with age, even if he’s still quite emotional now. It’s interesting hearing from people whose children were similar but never ended up with a diagnosis too.

Hi, thanks so much for commenting on the gross motor side of things! That’s reassuring to hear that your DS was also later with walking but caught up well afterwards.

My DD is quite petite like me, so I do sometimes wonder whether the stairs are partly just more physically difficult for her because of her size 😅 With things like jumping, I’m also wondering whether I just need to give her more opportunities to practise those kinds of movements through play.
Thanks again — and I think you’re right that there’s probably no harm in mentioning it to the HV.

My inner chimp book (for kids) was really helpful for my youngest who had a lot of mood swings from 3/4 on to now.

It was useless for my eldest but I now feel he had an outer chimp which he exercised regularly!

Probably for aged 5/6 on

I can't comment on the other stuff by my DD didn't roll until 10 months, crawl until 13 months and didn't walk until around 20 months. We were worried but she seems to be okay now at just turned 4. She still isn't as physically confident as others but she is improving all the time.

Hi mine was like this, turned out she was profoundly deaf in one ear. Sorted with grommets and now she hears perfectly

Thank you, that’s really interesting. The “unreachable” and trance-like part particularly caught my attention.

DD doesn’t go into a trance instead of crying, but often towards the end of a big meltdown, if I’ve eventually managed to get a TV programme or something on my phone in front of her without making things worse, she can go very still and stare at it incredibly intensely with a completely straight face. Even though the screaming has stopped, she still won’t really respond to me talking to her and can stay like that for 10 minutes or sometimes longer before she seems properly “back”. I’ve always thought of it as her still being overwhelmed rather than fully calm. Does that sound at all similar to your DD?

She also seems to find transitions quite difficult in general, although I’m aware that may just be very normal toddler behaviour. She’ll often casually keep saying “no”, or even say “yes”, when I tell her we need to get changed or move on to something else, but then just carries on with whatever she’s doing. If we then actually try to make the transition happen, she can get upset and it may turn into a tantrum or meltdown.

I definitely don’t want to jump to any conclusions from that, but it’s interesting hearing that the “unreachable” feeling rings a bell for you. I think I’ll mention it to the HV and also ask nursery whether they’ve noticed anything similar around transitions there.

@WarriorN

Neurodivergent isn’t “a thing”

Are you talking about the Neurodiversity Movement? Even before they existed, and despite whoever it was who first smashed the words together, the term “neurological diversity” had been used many years previous.

The word neurodivergent is used by many who don’t feel it necessary to share their medical history, just as the word “disabled” is used in a similar way by people with a range of different disabilities. It may be a “catch all”, but it isn’t a dirty word and can be useful in a number of ways. That it has been picked up by identity politics is largely irrelevant. There are a number of disability related words which have been co-opted, often in a negative way, some of which are being reclaimed and some which aren’t. We shouldn’t change our language because others choose to weaponise it. You are more than welcome to not use the word yourself for your own reasons, but policing others, using your own opinions and stating them as fact, isn’t useful either.

@WarriorN Thanks, I'll definitely have a look!

Thanks for sharing this, that’s really reassuring. I hadn’t been too concerned about her physical development on its own, but combined with the meltdowns and sleep/regulation issues I started wondering whether it might be worth mentioning everything together to someone.
Hopefully she may just be on the slower side physically and completely fine overall.

@coffeemornings Thanks, that’s something I’d never considered — glad the grommets sorted it for her

I think the main thing is that a diagnosis on its own doesn't fix anything really (it did for my DD, actually, but that was because she was 11 when she was finally diagnosed and it helped her feel ok about herself and her identity as a neurodivergent person).

The main thing is supporting her development and making sure she can cope with what life demands of her, which you would do whether or not she is neurodivergent. At 2.5 that's fairly straightforward because all sorts of variety is completely typical. You just want to make sure that you think/watch carefully about transitions to nursery school and school because that's when things can begin to get tricky, and it is better to know what support people are likely to need than only know about it when the child suffers a burn out or similar because the effort of being neurodivergent in a world built for others gets too much.

What I mean is keep an eye on her and an open mind, really. Seeking a diagnosis for a ND wouldn't change who she is and might help her, but it's too early to do that just yet. So even though of course she may be neurotypical and need no extra support - and I hope that's the case because it's easier for you both - trust the little flag that has popped up in your mind and make sure you keep checking in with nursery and school staff as she gets older.

My newly turned three year old was very similar to this at 2-2.5 years old but has improved massively in terms of the screaming/ tantrums and screaming at bedtime in the past few months.
Mine is quite the opposite in terms of motor skills though. She is definitely on the advanced side of normal in a lot of things motor skills wise but she has lots of opportunities to practice.
My three year old is also a delight at nursery- hers is also in her second language and she communicates really well.
We are definitely having more meltdowns at the moment than normal as she is starting preschool next week, she hasn’t communicated anything but I think she’s anxious of the change.
My daughter almost seems ashamed when I ask her about her meltdowns after they happened, she will look at the floor or change the subject but be reassured they have massively improved with age.

Thank you, that makes a lot of sense. I think that’s probably where my head is at too — I’m not looking for a diagnosis at 2.5, and I know it wouldn’t change who she is anyway. I’m more trying to understand how best to support her when she gets overwhelmed, and whether the overall pattern is something worth keeping an eye on as she gets older.

I really liked what you said about trusting the little flag without jumping to conclusions. I think that’s exactly it for me. She may well just be a very reactive toddler who grows out of a lot of this, but I don’t want to dismiss the things that have made me wonder either.

I’ll probably mention it to the HV, keep checking in with nursery, and just see how things develop over time. Thank you for taking the time to explain your perspective — it’s genuinely helpful.

My first DS was like this. After every single nap he would have a full meltdown where nothing at all could calm him down.. just had to wait it out.

He was also a very screamy colicky baby, and did often cry a lot while going to sleep.

He’s 5 now… still “highly strung” sometimes and will still occasionally have a lying on the floor tantrum… but he has mostly grown out of it and I don’t think he is neurodivergent.

I was about to answer OP, when I saw @ByDreamyMintNewt 's reply, which is pretty much exactly what I was going to say!

Thanks, that’s really reassuring to hear, especially that things improved so much over a few months.

If you don’t mind me asking, did the really intense meltdowns start quite early for your DD too, around 12–18 months, or were they more something that developed closer to age two?

Also, when you say screaming, was she still somewhat responsive during it, or more completely overwhelmed? With my DD she sort of stays in one place almost as if she’s stuck there, screaming and sobbing continuously, sometimes with gagging or really catching her breath. If I talk to her, touch her or even move around too much she can suddenly thrash, push me away or arch backwards, so there’s very little I can actually do until she starts coming out of it herself😭

I’m just curious how similar the actual episodes were, as otherwise a lot of what you’ve described sounds familiar.

@NorthFacingGardener That sounds quite similar, although DD’s after-nap meltdowns were more of a phase rather than happening after every nap.
Did your DS also have the same kind of meltdowns at other times of the day, outside nap times?

OP, I'm a useless HV 😉 as well as a mother.

My own DD had very similar tantrums, sometimes you could see her building up to one and all you could do was stand back and let her go through it because we quickly learned no amount of interference, once she started, would be able to stop it in its tracks. She did outgrow them in time, although at 16 she still remains very easy to upset at times, especially if she is overtired. It does sound like she can get overstimulated very easily, but this can often be a developmental stage and something they grow out of.

With my hv hat on, if you contacted our team I would be arranging to do a development review for her age and having a chat with nursery to see how she is there. Does she join in with things like carpet time, play alongside others, role play and follow instructions easily?

Depending on where you are, you could also be offered parenting classes, not to teach you how to be a parent, but to help you understand child development and behaviours more and give you some strategies to deal with them. Or a referral to the chold and parents service if you needed more targeted support.

I think you are being very sensible, and a watch and wait approach is probably best for you and DD, but it never hurts to flag any concerns you may have as there may be support out their that you might want to access now or in the future.

Hiya,

I have a 2.5 YO who has a lot of these traits. Didn’t start walking until he was 2, only just saying a few things, plus lots of issues with tantrums, sleep and regulation. I know they all develop at different rates but I have 3 others so it’s hard not to compare. I spoke to HV ( I had mentioned several times prior ) and he is now on the under 5s pathway. We have had support from speech and language and physio also, so worth a mention!

Yes when she loses it she is completely out of control of herself, the only way is to let her ride it out. She sometimes will fall asleep after one, they are definitely related to tiredness or being unregulated in some way.
She is however a delight in so many ways, she is great at sharing and plays beautifully with other children. So many parents in the playground approach me to compliment her behaviour and confidence. When she’s good she’s very good, when she’s bad- beware!

Also tantrums to some degree started way before she was one. Like I say she way way ahead in motor milestones- walked at 9 months and the tantrums came with that haha