Could my two year old be autistic?

[lucilastic]

I'm growing increasingly concerned about her lack of speech. My DD is 27 months and does not really say any words at all. Occassionally if I persist she will repeat a word but it's all random.
She has been referred by the HV for a repeat hearing test (although I'm convinced her hearing is fine) and has been referred to SALT. Am waiting for an appointment.
She has good eye contact, is cheerful but is a loner. She'd rather spend time in her bedroom singing and looking at her dolls than be downstairs with the family a lot of the time.
In the park she runs round and round in circles and apart from the swings is not interested in anything else.
She does play (ie) chasing her sister around and other kids at toddler group) and her use of toys seems appropriate and not obsessive or complusive.
I am just so worried about her.
The HV doesn't think she's displaying autistic behaviour but she does sometimes flap her hands, doesn't point and grabs my hand to get her a drink rather than point.
Is it too early to predict? My eldest spoke at around 16 months.
DD is one of four children, we live with family and to be fair, she never has to attempt to actually speak.
Any reasurance would be gratefully recieved.
BTW, she doesn't have tanturms, eats ands sleeps well.
She has been humming her favourite nursery ryhmes for months now but no speech.

HVs are not trained to properly recognise autistic behaviours so she should not be making such assumptions.

If you are worried you will continue to be so until you receive answers. You already have concerns and on reading your message there are things here that needs further evaluation. You will need to be persistant though in order to get answers.

I would go along to your GP asap and ask for your DD to be referred to a developmental (note that type) paediatrician for further evaluation.

Continue to make and record your own observations and if you have a camcorder or something like that you could film her playing and interacting with her siblings at home (this is helpful to show the paediatrician as it shows her in her home environment). You may want to look at the National Autistic Society's website.

Never forget that you are her best - and only - advocate. She will also remain your beautiful daughter regardless of any diagnosis she may eventually receive.

As Atilla said really.

Chasing in circles is what my ds3 (ASD) calls play but tbh tehre's nothing on your list that makes me worry at this stage apart from the lack of pointing; absence of a triadic point and no speech at two warrants a check up with a Paed IMVHO (triadic point- looks at you, at the object being indicated, then back at you again)

Better to check now than wish you had alter on.

Eyre contact is an irrelevance; plenty of very autistic kids who have it.

Hi, i am a mum of 2 autistic dd's. We picked up on dd2's autism when she was 2 years old, she was non-verbal, would flap her hands, would not follow instructions and would line up her toys. Dd2 is now 4.7, she has never really been naughty (other than climbing furniture) and has only recently started having tantrums.

As Attila said, HV's are not trained to recognise autistic traits. You know your dd best and after having 3 other children i'm sure you know if something is not quite write (even though all children arw different).

If you are worried then talk to your GP and get a refferal.

Good luck xx

I had niggling doubts about my DS when he was between 18 months-2years. He also didn't speak and was sent for hearing tests which i knew would be fine. I was very lucky that my HV took my concerns seriously and we had a diagnosis of Autism when he was 28 months so although it isn't often diagnosed that early, it is possible. All I would say to you is trust your instincts. Where autism is concerned the earlier a diagnosis is made, the greater the chances are for help with speech etc. Also don't be afraid of a diagnosis, my DS is 6 in 2 weeks his diagnosis has been changed to aspergers and he is a very bright, chatty and loving boy. Good luck.

I agree that HVs are not trained to recognise autism but I'm surprised that she is not seeing some concerns in the leading by the hand at 27 months and the lack of pointing. I think you need to push to get a full assessment to get a better answer one way or the other.

I am not surprised at all; my HV saw no concerns in a non verbal, non pointing incvontinent four year old. Some simply ahve had no training on ASD.

It could be alot of things but the advice is always get It checked better to give speech therapy to a child who does not need it than not give it to a child who did need it. I think whenever a parent has children whose speech patterns are so different it's right to look into it as obviously it's not a parenting issue. But my nephew was a late talker also a 4th child and with speech and play therapy for 6 months caught up. Sometimes speech delays can make children seem autistic as it impacts on social and play skills but sometimes it is Autism. Nothing you do for autism or speech delay is harmful it's just more structured play and communication techniques. You will never regret getting help even if it turns out to be just delay. Search Hanen and threads will come up about a book you can get 'It takes 2 to talk' which is much recommended on here. Don't expect much from speech therapy are underresourced and can be very occasional - if you can afford to go private. Also self refer to portage or any early years team. My autistic son sings better than he speaks so that is not necessarily reassuring. Does she do social greetings eg wave byebye etc. For autism you look for a lack of to and fro so it could be babble but she responds to others - you can have a conversation without speech. Afaisic is a good site with speech problems explained and there's a US site called teachmetotalk or something similar with podcasts and info.

Thank you for your responses. Am surprised that the fact DD leads me by the hand is a red flag.
Would this not be the actions of a child you can't speak? Taking the parent to whatever it is they want? I told the HV about the hand leading and she seemed to think that was a good sign.
I have voiced concerns already with my GP but she said there was nothing to do yet until she has her 2.5 yr check.

Yes it is a red flag for autism but yes is also a sign of
communication developing but possibly not at age appropriate rate- but this what needs to be assessed.

Dd2 did the 'leading my hand thing' when she wanted something.

It's classic with communication disorders, one of which is ASD.

I can sense your anxiety and it puts me right back to where we were 18 months ago - is he isn't he. Most of us on here have been through that so we know how you are feeling. I know its worrying but the delays in the system are long enough, wait and see is a really bad idea. You are an experienced Mum, you are worried, thats enough reason to seek referral. Try another GP at the Practice to get on this list to see a paediatrician - thats the gateway to a multiteam assessment if there are concerns about autism or see if your local surestart centre does a speech therapy or HV drop in where you can see someone else if you are stuck on a waiting list. Some children can wait 12 months or more for diagnosis. Children are being diagnosed with ASD from 18 months now - lots of GPs don't know this as it used to be much older.

Have you found MCHAT? Its a checklist for ASD - you can find it online - you need to download the instructions of how to score it as well as the checklist - it will also help you understand what the red flags are so you can look for them / test some things out. There are lots of speech difficulties which have nothing to do with ASD. ICAN is another site you might want to look at. Sometimes its only when a child starts talking that you can tell if its ASD or just a speech problem.

Here is some info from teachmetotalk.com. Sorry I know its going to worry you further but early intervention is the key. My nephew loved his speech and play therapy and even though he turned out not to have ASD it stopped him falling behind any further. Intervention has also made a massive difference to my son:

From teachmetotalk.com
"The following guidelines can serve as ?red flags? for parents who are wondering, ?Should I be worried??

· Difficulty making and maintaining eye contact with an adult by 6 months

· No big smiles or other warm, joyful expressions during interaction with another person by 6 months

· No back-and-forth sharing of sounds, smiles, or other facial expressions by 9 months

· No babbling by 12 months

· No back-and-forth gestures, such as pointing, showing, reaching, or waving by 12 months

· No consistent responding to their names by 12 months

· No words by 16 months

· No following simple and familiar directions by 18 months

· No two-word meaningful phrases without imitating or repeating & says at least 50 words by 24 months

· No back-and-forth conversational turn-taking by 30 months

· Any loss of speech or babbling or social skills (like eye contact) at any age

The presence of any of these concerns warrants an immediate discussion with your pediatrician and insistence for a referral to an early intervention program and/or speech-language pathologist for a complete evaluation of your child?s communication skills.

Let me also add that babies who are doing well with social and language development exceed these milestones by leaps and bounds. These are very, very low thresholds for communicative skills. If your child is not meeting these basic guidelines, please don?t dismiss your feelings. Seek professional help from your pediatrician, your local school system, or an early intervention agency"

lucilastic, you sound very much like I did 18 months ago :( Obviously no-one here can say your dd has autism, or indeed doesn't have autism (that's certainly what I wanted the hear all those months ago).

You are worried, please push further than the HV. HVs know NOTHING about autism. My mum is a HV, she now has a personal investment in ASD & is the only HV in our very large area who has even heard of M-CHAT let alone has any idea of how autism can present in very young children. We were told there was no way that ds could have autism - he was so happy & loved cuddles, he didn't spin or rock or scream when he was touched, he didn't headbutt or bite or have huge tantrums

With hindsight the red flags for me were - failure to respond consistently to his name (we went through the whole does he have hearing problems rigmarole - v. common in ASD), he pointed sometimes but not triadic & he would do some hand dragging. Ironically we didn't have any concerns about his eye contact until he became verbal. ASD is about impairments not the complete absence of ability - ds could/can do most of the things they look at on M-CHAT for example but not as well as his NT sisters (quality or quantity).

"Let me also add that babies who are doing well with social and language development exceed these milestones by leaps and bounds."

Absolutely - my 17mo baby far exceeds my 4yo ds with HFA in most aspects of social communication despite his year of very intensive therapy. His skills are taught, not innate in the same way hers are.

Thank you for the detailed replies. I really appreciate them.
Am going to go back to the GP.
I just want my DD to get the appropriate help she needs, if she needs it.
I can cope with a potential diagnosis as long as I know we did all we could for her and that she is happy.

Thanks again - will update.

Just to add that for me, the moment I knew DS1 was autistic was when I read that it wasn't so much the dragging you by the hand that was a worry but the throwing your hand towards the desired item (as if you were a tool). That was the moment that put it beyond any dooubt in my mind. I don't know if your daughter does this, but despite the pain of the diagnosis, I still think the greatest thing I've ever done for him is to get him diagnosed very early.

As an alternative if GP not cooperative, tehre is a charity called BIBIC you could google. They charge £50 (in the field, a pittance) and do a very comprehensive assessment of the child- not focussed on any one diagnosis, but just, say, to get to the root of communication issues.

I found their apperwork very helpful in making me understand what was going on.