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Suspect development issues with a child I know - wwyd?

38 replies

BobMarley · 11/04/2012 16:33

I hope you guys can give me some advice. I'm not quite sure if I can explain this properly. But I'm genuinely a bit concerned and would like to know what you would advice me to do in this situation.

A boy that I know very well has a few 'quirks' that tell me there might be some development issues. I started looking on the internet and he could have some asperger's traits but obviously I'm no expert and want to know what you think.

The things I've noticed (he will be 2 next month):

  • As a baby he always stared up to the sky and craned his neck.
  • He rolled really early (3-4 months), never crawled but walked quite late at about 18 months
  • He doesn't really point at things with his index finger but uses his whole hand
  • His eye contact is sometimes very good, sometimes he ignores you or looks away
  • His speech is quite good but does not say the word 'yes' or 'thank you' at all.
  • His walking is a bit clumsy and he quite often holds is hands on shoulder height when he walks
  • Has never cried when detached from his parents
  • Has so far been a remarkebly easy and self sufficient baby/child
  • Has a bit of an obsession with collecting certain objects in 3's
  • His interaction towards me is intermittent, sometimes it is there, sometimes he seems clueless what I want from him (I have 3 children myself and one the same age so do know roughly how they are expected to respond)

Is this enough reason to be concerned? And if yes, what would you do? Try and talk to the mom? Or would you wait and see what happens when he goes to pre-school (which probably won't be another year) as I understand his behaviour would be become more noticeable (or not!).

OP posts:
saintlyjimjams · 11/04/2012 16:40

Yes I would be concerned. Whether or not to say something is a tricky inexcusable If you are in a childcare role I think you have to say something really (although god knows what - the parents may already have concerns so you may not have to say much). If you are a friend, rather than chikdcarer to this child I woukdn't say anything unless asked.

If you need a way in I would mention the lack of pointing. As it's nob-subjective. Or ask whether he ever points at things when with his parents (so don't tell iykwim). Say that you understand that not pointing can signal that some help is needed, waiting lists are long so it might be worth getting a referral which can be cancelled if pointing starts (that way you're not diagnosing iykwim). The problem of course is that she might get fobbed off by gp and or HV and not get a referral but at least you will have said something.

saintlyjimjams · 11/04/2012 16:40

Oh FFS - bloody iPad god know what inexcusable should be! But not that!!

saintlyjimjams · 11/04/2012 16:41

Ha ha at nob-subjective. I really need to just mnet on the computer!

StarlightMcEggsie · 11/04/2012 16:51

I'm in the camp that says to always say something if you are concerned.

I hate this idea that a small vulnerable child has their possible needs ignored due to it being no-ones business but the parents or because a fully grown adult is worried about being on the receiving end of bad feeling.

But my view stems from being bloody angry from someone who knew of ds' autism but was too scared to mentioned it whilst I was searching everywhere for someone to treat me as something other than an overanxious parent.

BobMarley · 11/04/2012 17:16

Thank you for your replies. I am really unsure what to do. I am not a childcarer but a friend so really not qualified to make any judgments.

saintlyjimjams if he starts the finger-pointing, does that mean he is probably ok and the other things aren't necessarily worrying? Or did you just mean to mention that one so he gets assessed?

starlight I would mention it if I was sure enough that there is something to worry about. Yes, it would probably upset her, but she would listen. But I really don't want to upset her needlessly. She is absolutely in love with her boy (he is adorable) and I don't want her to think there is anything 'wrong' (for lack of a better word!) as she is a bit pfb and anxious about doing everything right as it is.

OP posts:
StarlightMcEggsie · 11/04/2012 17:25

If you have child the same age, perhaps you can get the CHAT or MCHAT and say that you picked it up from somewhere to do your iwn child and thought she might like a copy to do her own child or just accidentally have two in your bag when you are searching for something and hand it to her because 'you may as well).?

BobMarley · 11/04/2012 18:01

starlight - good idea but she will see straight through that. She knows me very well! To be honest, I think deep down she might know because she is always telling me what her son is doing now and it is almost desperately overcompensated for what he isn't doing if that makes sense.

OP posts:
ArthurPewty · 11/04/2012 18:30

This reply has been deleted

Message withdrawn at poster's request.

cansu · 11/04/2012 18:30

Personally unless it becomes much more obvious, someone else raises it or she seeks your opinion I wouldn't. I knew there was something wrong with dd about six to 8 months before I did anything about it because I wasn't ready to deal with it. I know my friend spotted it early too because her ds has SN issues. She used to say 'isn't she very self sufficient' because she knew dd was far too contented on her own! However I am very grateful to her for letting me come to it in my own time. She has needless to say been a shoulder to cry on since!

BobMarley · 11/04/2012 18:35

Thank you cansu that is very insightful. I think she might know deep down but isn't quite ready to go here. Nor are the symptoms severe enough to know for sure. So I think I might leave it for a bit longer and make some subtle remarks in that direction as your friend but let her get there by herself. If she doesn't I will intervene at some point.

But I detect here then that the symptoms I mentioned do warrant to be a bit concerned?

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TheLightPassenger · 11/04/2012 18:38

this is v tricky. I can see why you are concerned, the child you describe sounds a lot like my DS (who turned out to have severe language delay by 3 (now mostly resolved but remaining ASD traits)). Given the child has some speech, a GP or HV is highly likely to fob your friend off, even if she does agree with your concerns. I'ld be inclined to wait until she says anything tbh.

Another possible way in is if you have concern about him understanding instructions etc is to suggest she get a hearing test for him.

cansu · 11/04/2012 18:43

Yes I think there are some things in your list that might be on an ASD list. I think that even if she went to GP with these things at that age he would be on a kind of wait and see list though. It's a hard one definitely and I can see why other people are saying they would rather be told.

saintlyjimjams · 11/04/2012 18:44

I meant mention the finger pointing because I have vague hopes a gp or HV might realise that means he fails the CHAT (although that's probably unrealstic and she'd still get fobbed off). I (have said) the stuff about 'you can always cancel' (even if I think they shouldn't) because I think it's a gentler way to make the suggestion iyswim.

BobMarley · 11/04/2012 18:48

Which ones on my list do particularly concern you guys? Because next time I see him I will pay particular attention to those!

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saintlyjimjams · 11/04/2012 19:15

LAck of pointing a big red flag for me, along with what sounds like difficulty with adult directed attention.

Good that he's talking though. Did he point before he could talk iyswim?

BobMarley · 11/04/2012 19:25

The pointing came up a while back when my son was doing that and my friend mentioned that her son didn't. She hasn't mentioned it since and I've only seen him stretch his hand towards things rather than point, but will pay a bit more attention next time I see him. And I'll also pay a bit more attention towards his interaction with me. The things I mentioned have been things I have noticed on occasion but have not been paying that close attention to it, to be honest.

However, now that people here think that there is a cause for concern I'll pay some specific attention to it. I should see him tomorrow.

OP posts:
BobMarley · 11/04/2012 19:27

Sorry saintlyjimjams forgot to answer your question. Unfortunately I can't remember whether he pointed or talked first.

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saintlyjimjams · 11/04/2012 19:27

Does he ever drag you or place your hand on things rather than point?

AgnesDiPesto · 11/04/2012 19:35

My DS (ASD) had some of signs.
He walked late (18 months), stopped pointing when had previously, too easy / self sufficient. Collected objects (from 2.5)
But tbh he is young and as speech ok, some interaction / eye contact its not as you say very obvious. What you describe would not be considered a speech delay yet.
Looking at MCHAT yourself would be best
What happens if you interrupt his collection of items? Does he get cross?
Is there a to and fro e.g. if you sat him on your knee and did an action song would there be a back and forth of interaction between you? Does not have to be verbal could be a happy gurgle - but a you do something fun, he responds, you continue, he wants more - its the 2 way nature of interaction and the quality of interaction.
Does he look at your mouth when you talk rather than your eyes?
Does he do pretend play? Imitate e.g. head, shoulders, knees and toes type songs?

You can look at some websites like first signs or teachmetotalk which has a milestone list below:

"Gross Motor

If a child is?

Not rolling by 7 months of age
Not pushing up on straight arms, lifting his head and shoulders, by 8 months of age
Not sitting independently by 10 months of age
Not crawling (?commando? crawling?moving across the floor on his belly) by 10 months of age
Not creeping (on all fours, what is typically called ?crawling?) by 12 months of age
Not sitting upright in a child-sized chair by 12 months of age
Not pulling to stand by 12 months of age
Not standing alone by 14 months of age
Not walking by 18 months of age
Not jumping by 30 months of age
Not independent on stairs (up and down) by 30 months of age?an early intervention/developmental therapy referral may be appropriate.Here are some other gross motor ?red flags?:
?walking? their hands up their bodies to achieve a standing position
only walking on their toes, not the soles of their feet
frequently falling/tripping, for no apparent reason
still ?toeing in? at two years of age
unusual creeping patterns
any known medical diagnosis can be considered a ?red flag?: Down?s syndrome, cerebral palsy, congenital heart condition etc.

Fine Motor

If a child is?

Frequently in a fisted position with both hands after 6 months of age
Not bringing both hands to midline (center of body) by 10 months of age
Not banging objects together by 10 months of age
Not clapping their hands by 12 months of age
Not deliberately and immediately releasing objects by 12 months of age
Not able to tip and hold their bottle by themselves and keep it up, without lying down, by 12 months of age
Still using a fisted grasp to hold a crayon at 18 months of age
Not using a mature pincer grasp (thumb and index finger, pad to pad) by 18 months of age
Not imitating a drawing of a vertical line by 24 months of age
Not able to snip with scissors by 30 months?an early childhood intervention/development therapy referral may be appropriateHere are some other fine motor ?red flags?:
Using only one hand to complete tasks
Not being able to move/open one hand/arm
Drooling during small tasks that require intense concentration
Displaying uncoordinated or jerky movements when doing activities
Crayon strokes are either too heavy or too light to see
Any know medical diagnosis can be considered a ?red flag?: Down?s Syndrome, cerebral palsy etc.

Cognition/Problem Solving

If a child is?

Not imitating body action on a doll by 15 months of age (ie, kiss the baby, feed the baby)
Not able to match two sets of objects by item by 27 months of age (ie, blocks in one container and people in another)
Not able to imitate a model from memory by 27 months (ie, show me how you brush your teeth)
Not able to match two sets of objects by color by 31 months of age
Having difficulty problem solving during activities in comparison to his/her peers
Unaware of changes in his/her environment and routine?an early intervention/developmental therapy referral may be appropriate

Sensory

If a child is?

Very busy, always on the go, and has a very short attention to task
Often lethargic or low arousal (appears to be tired/slow to respond, all the time, even after a nap)
A picky eater
Not aware of when they get hurt (no crying, startle, or reaction to injury)
Afraid of swinging/movement activities; does not like to be picked up or be upside down
Showing difficulty learning new activities (motor planning)
Having a hard time calming themselves down appropriately
Appearing to be constantly moving around, even while sitting
Showing poor or no eye contact
Frequently jumping and/or purposely falling to the floor/crashing into things
Seeking opportunities to fall without regard to his/her safety or that of others
Constantly touching everything they see, including other children
Hypotonic (floppy body, like a wet noodle)
Having a difficult time with transitions between activity or location
Overly upset with change in routine
Hates bath time or grooming activities such as; tooth brushing, hair brushing, hair cuts, having nails cut, etc.
Afraid of/aversive to/avoids being messy, or touching different textures such as grass, sand, carpet, paint, playdoh, etc.?an early childhood intervention/developmental therapy referral may be appropriate.NOTE: sensory integration/sensory processing issues should only be diagnosed by a qualified professional (primarily, occupational therapists and physical therapists). Some behaviors that appear to be related to sensory issues are actually behavioral issues independent of sensory needs.
Possible visual problems may exist if the child?

Does not make eye contact with others or holds objects closer than 3-4 inches from one or both eyes

Does not reach for an object close byPossible hearing problems may exist if the child?
Does not respond to sounds or to the voices of familiar people
Does not attend to bells or other sound-producing objects
Does not respond appropriately to different levels of sound
Does not babble

Self-Care

If a child is?

Having difficulty biting or chewing food during mealtime
Needing a prolonged period of time to chew and/or swallow
Coughing/choking during or after eating on a regular basis
Demonstrating a change in vocal quality during/after eating (i.e. they sound gurgled or hoarse when speaking/making sounds)
Having significant difficulty transitioning between different food stages
Not feeding him/herself finger foods by 14 months of age
Not attempting to use a spoon by 15 months of age
Not picking up and drinking from a regular open cup by 15 months of age
Not able to pull off hat, socks or mittens on request by 15 months of age
Not attempting to wash own hands or face by 19 months
Not assisting with dressing tasks (excluding clothes fasteners) by 22 months
Not able to deliberately undo large buttons, snaps and shoelaces by 34 months?an early intervention/developmental therapy and referral may be appropriate.
Social/Emotional/Play Skills

If a child is?

Not smiling by 4 months
Not making eye contact during activities and interacting with peers and/or adults
Not performing for social attention by 12 months
Not imitating actions and movements by the age of 24 months
Not engaging in pretend play by the age of 24 months
Not demonstrating appropriate play with an object (i.e. instead of trying to put objects into a container, the child leaves the objects in the container and keeps flicking them with his fingers)
Fixating on objects that spin or turn (i.e. See ?n Say, toy cars, etc.); also children who are trying to spin things that are not normally spun
Having significant difficulty attending to tasks
Getting overly upset with change or transitions from activity to activity?an early intervention program referral may be appropriate

THESE ARE THE FOLLOWING LANGUAGE MILESTONES THAT A CHILD SHOULD HAVE MASTERED BY THESE AGES FROM THE ARTICLE ON THIS SITE TITLED ?WHEN TO WORRY?

· 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 development exceed these milestones by leaps and bounds. These are very, very low thresholds for all the skills listed. If your child is not meeting these basic guidelines, please don?t dismiss your feelings. There is in all likelihood a true developmental delay or disorder present. "

BobMarley · 11/04/2012 19:36

Oh gosh, it so difficult to remember specific behaviours when I have not been paying particular attention to it. I've definitely never seen him place my hand on things and he has never dragged me anywhere. But think he might have dragged his mum places, but certainly not regularly as I see them quite often and can't form a picture of that in my mind iyswim.

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notactuallyme · 11/04/2012 19:36

I really wouldn't. Unless you are a professional, I just wouldn't. What if you are wrong? It's not like a life threatening sign of illness, it's a possible developmental issue. Providing your friend sends him to nursery etc it will get picked up if it needs to.

ArthurPewty · 11/04/2012 19:45

This reply has been deleted

Message withdrawn at poster's request.

BobMarley · 11/04/2012 19:52

Thank you for the list AgnesDiPest that is quite useful although it is difficult to remember exactly what he did and didn't do at what age. I don't think it is a really obvious case.

I'm really torn between worrying her unnecessarily and at least making her aware of potential issues and things can then be picked up early. As I understand that early intervention is important.

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StarlightMcEggsie · 11/04/2012 19:52

Most nurseries know feck all about developmental issues. Why woukd they when even the majority of schools no next to nothing.

StarlightMcEggsie · 11/04/2012 20:00

BobMarley. The reason I'd want it flagged sooner rather than later is because the older the child gets, the more life experience they gain that have to be explored as reasons I.e school bullying, parenting. This makes being taken seriously a very long and drawn out process.

Once medical professional have agreed there are problems it can take years to get a dx if at all. Many agencies now refuse intervention unless you have a diagnosis. Then, when you have one intervention only comes if you fight tooth and nail for it at which point you discover that it is too generic in nature and your child needs specific and individualised provision if they are to have any chance of making progress. That's the beginning of the REAL fight.

Meanwhile the child is falling further and further behind.