3 year old autism referral

[Fizzysticks]

My daughter has been flagged by her pre-school as potentially being autistic and they have put a referral in, she has just turned 3 years old. It did take me by surprise as that thought hadn’t entered my mind, and now feeling guilty about being so oblivious as I’ve always thought she was smart, with some quirks. She has spoken in complete sentences for at least a year and her vocabulary is great and picks up new words daily- using words such as “antagonising” in correct context, the flow of conversation is back and forth and doesn’t seem scripted. She loves being with adults, plays very well with us and is starting to enjoy imaginative role play. However, she refuses to engage with her peers despite lots of coaching from her nursery school and instead will just glue herself to one of the teachers. She is also a very anxious child, hates loud noises although this is improving as she’s now ok with the Hoover/hand driers. The biggest concern is the way she reacts to the unexpected and doesn’t seem to handle change very well. She has a fear of anyone looking a bit “different” from the norm- men with long beards or hair, the very elderly etc and will completely meltdown or hide in fear and is very hard to calm down. She is sensory seeking, often mushes food up in her hands and puts her fingers in my mouth for comfort, which I’ve tried so hard to get her to stop doing. Character wise, she’s an amazing little girl who is loving and funny but has been described as “wild” as she has tendencies to run off whilst at her extra-curricular activity and does occasionally last out at me or her older sister (biting or hitting). I think what I’m asking is whether this sounds familiar to anyone with experience of autism? I’ve always just assumed that, with encouragement she would grow out of her anxieties. Thanks in advance.

It is brilliant the nursery is on the ball, and I think a referral for assessment is a good idea.

What support is the nursery providing? Have they asked for advice from any outside agencies?

Thank you for replying and yes it is good that they are in the ball. I was only told about the referral on Friday and there was no real conversation about it, other than that they had concerns. I wish I’d asked more but was just very taken aback. Unfortunately my daughter has newly developed a fear of the manager, whom whilst isn’t very maternal, isn’t horrible either! It seems she’s trying to force interactions with my daughter which, in my opinion is making it worse and she would probably benefit more by keeping a wide berth until her anxiety settles. It’s probably a very silly and obvious question but what kids of things should I ask?

I would request a meeting with the nursery. Follow it up with an email.

I would ask them questions such as:
What concerns they have noticed?
What support have they already tried that hasn’t worked?
What support are they going to provide going forward?
Have they kept a diary or understated ABC charts or STAR analysis to spot triggers?
Are they going to make a SEN support plan? These are called different things e.g. IEP, ISP, My Plan/My Plan+, one page profile, pen portrait… but they are a document that sets out DD’s needs and the support the will provide.
Is it a referral for an autism assessment that they have done and who have they referred to?
Have they referred to any other outside agencies &/or do they plan to seek advice from any other agencies/services?
Are they going to request an EHCNA? (If not, you can do this yourself. On their website, IPSEA has a model letter you can use.)

You might find the book the Out of Sync Child helpful. Also this booklet and some of the Occuplaytional Therapist’s resources useful.

Does DD use ear defenders?

Some areas have SALT &/or OT drop in sessions for early years DC. It is worth checking if your area does.

Thank you so much for giving me such a detailed template of questions, I really do appreciate it. I haven’t heard of a few things you mentioned as this is all so new to me but I will be doing my research on it tonight. I’ve already had a brief read on the sensory booklet you linked and it’s very informative, thank you. Would thinking about an EHCNA be too premature before an assessment (although the waiting list for that is probably long…?) And good to know that a parent can apply for that too. My daughter doesn’t wear ear defenders, she is getting better in noisy environments similar to bowling alleys, but would not be ok if I took her to a kids show like the ones in Centre Parcs.
I will check and see if our area has SALT or OT drop-ins as that could be very helpful.

You don’t need a diagnostic assessment or diagnosis before requesting an EHCNA. EHCPs are based on needs, not diagnosis.

If she will tolerate them, I would try DD with ear defenders.

That’s really useful to know about EHCPs, as I’ve always blindly assumed they were given following an actual diagnosis.
I’m willing to give anything a try so will definitely purchase some ear defenders 😊