Possibly ASD ir Normal Toddler Behaviour

[AA20192022]

Hi All,
I have just had a meeting with the SENCO at my son’s nursing and she has suggested that we refer him to autism assessment. He is behind on his speech, and will be referred for SALT which I am aware. Alothough he is behind with speech, there has been quite a big improvement in the last few weeks and hus understanding is good. The Senco raised concerns over his attachment to his muslin cloth and how he puts it in his mouth and bites to comfort. She also said that he can struggle with certain transitions and can get distracted by toys when its story time or snack time. She also mentioned that he has formed a strong attachment to his key worker and this can be a sign if ASD as he has become too attached. She went on to mention things like EHCP and addition support of he goes to a main stream school or the possibility of a special school. I am quite confused as these also sound like normal toddler behaviour.. any suggestions or similar experiences?..

How old is your DS? It sounds like a big leap suggesting autism and applying for an EHCP based on what you have said in your post.
As he hasn’t been observed yet by a specialist teacher or assessed by SALT her comments could be premature.
Did the HV have any concerns? Did he meet other developmental milestones?
Did you already have any concerns in other areas such as toileting, eating, sensory needs ( apart from his comforter)
Obviously if he does have some additional needs, early identification and assessment and applying for help and support will really help.
Have the setting applied for any funding already e.g.Preschool Inclusion Supplement?

@24Dogcuddler he is 2 years 8 months. Health visitor did bot express much concenrs at his 27 month check and said he is very interactive and social so its hard to say. He has met his ither develpmental milestones, but he is not jumping although he is trying.

How long is the wait for SALT? I’d ask if a specialist teacher or someone from the Early Years Team or Area Senco will be coming to observe?
Doesn’t sound too concerning from the information given so far. He’s still young maybe the setting are expecting him to sit and listen for too long in a group.
Some tips on here to encourage jumping

https://therapiesforkids.com.au/blog/jumping-milestones-for-children-18-months-to-5-years/

It is good that nursery are on the ball in terms of noticing possible delays and taking action.

Some of what nursery has noticed could be typical toddler behaviour; your DS is very young.

With his speech delay, does he use gestures to communicate and did these develop along a typical timeline? Eg was he index finger pointing at 18 months?

Has he had his hearing tested since the newborn test? Even if you think he can hear?

Since the nursery has raised concerns, I think referral for further assessment is a good idea whether DS ends up with an ASD diagnosis or not.

What support is the nursery providing? What have they tried but it hasn’t worked?

As well as a referral to SALT, if your ICB commission sensory OT, look at a referral to OT. Unfortunately, not all areas commission sensory OT on the NHS anymore.

As pp suggested, the nursery asking the Area SENCO/early years specialist teaching service for advice is a good idea.

Early years inclusion funding isn’t available to 2 year olds in all LAs. In some LAs it isn’t available until 3, but if it is in your LA, definitely push the nursery to apply.

How delayed is DS’s speech? If significantly delayed, that could be behind the nursery suggesting an EHCP. If the nursery is suggesting an EHCP because they believe DS needs more support than they can provide and/or he needs an EHCNA so his needs are better understood, then I would let them apply or make the request yourself. EHCPs are based on needs rather than diagnosis. An EHCP is one way of securing therapies DS might not receive or might not receive enough of.

Hi @AA20192022

I can imagine that this all might be a little confusing for you because, you're right, some behaviours can be very similar to typical developmental behaviours in toddlers. It is great that your nursery is being proactive though and you already have a referral for a Speech and Language Therapy assessment (I hope where you are the NHS waiting list is not too long!). An autism initial assessment can also be very long in some areas. An assessment report with specific recommendations from a Speech Therapist can go a long way in helping you receive any support and SLT funding you may need when applying for an EHCP.

Early intervention for communication development in young children is important and the good news is there are lots of communication strategies that you and the nursery can be putting into place to help develop early communication skills immediately, and these would be the same initial steps (maybe with some slight tweaks depending on individual needs) with or without a diagnosis of autism.

I hope you are able to receive support from a Speech Therapist soon so you and the nursery can start implementing some of these strategies.

Lucy Colcombe
Private Speech Therapist in a nursery