Possible autism in toddler

[Thomasthetank]

Our son has just turned two and we're concerned about the possibility of autism.

He has never really pointed at anything, either to get our attention or to show us something. If he wants a drink he will get his beaker out of the kitchen cupboard and give it me but if the beaker is on the draining board, he'll stare at it grizzling but won't point to it or try to use speech to explain what he wants. His speech is poor and doesn't seem to be improving despite us attending a speech group run by our Health visitor. At the group he tends to just wander around the room and isn't interested in what is going on for most of the time; if he's asked to get a toy out of the bag for example he just stares blankly and doesn't copy what the other children are doing.

He has a few words such as mama, dada, no but words that he used previously a few months ago such as dog, ball, yes, up, down, wow, don't get used any more, instead he just babbles away. He doesn't really seem to respond to his name consistently, usually he just ignores it and carries on with what he is doing unless he is looking at me at the time (his hearing has been checked a couple of weeks ago and is fine). He can't comprehend what we say to him, for example, if I said "get your shoes" when his shoes were in sight of him, he wouldn't know what to do. If I said to "stand up" he wouldn't get what I was asking him to do. When we speak to him face to face, he stares intently at us but obviously hasn't got a clue about what we are saying, he doesn't nod his head to mean yes. He can't pick things out in books if I ask him to show me the teddy/ball and tries to turn the pages to the end of the book quickly then gets up.

He goes to toddler groups but these are hard work with him. He tends to pick up a piece of fluff or paper off the floor the minute we get there and won't let go of it for the whole session to the point that other parents notice this. If he loses the fluff, it's an instant tantrum. He doesn't sit for a few minutes to join in with songs, instead he just roams around and doesn't seem to remember actions that go with simple songs. At snack time he just plays with his snack, squashing and dropping food on the floor rather than eating. Toys like ride in cars seem to baffle him and he doesn't seem to know how to play with them, instead he fiddles with the wheels. He does get very frustrated and head bangs when he gets cross, arching his back and going rigid. If groups are very busy, tantrums happen several times over a session and he often covers his ears and closes his eyes or sits cuddled into my lap as if it's too much for him.

He is very affectionate, loves kisses and cuddles and approaches us for these. He makes good eye contact with us and his sisters but not with other people. He always runs up to us if one of us has been out of the house and wants to be picked up and enjoys playing with his sisters. He has good fine motor skills and is able to build towers with lego and hold crayons with a good grip.

We'll take him to the doctors this week to ask for a referral to look into his speech and understanding of speech problems. I've looked at the checklist for autism in toddlers and he seems to meet most of the criteria apart from the eye contact and affection side of things. Has anyone else had experience of this with a toddler?

[sickofsocalledexperts]

It does sound like there are quite a few autism flags here such that you should ask GP for referral to the community paediatrician. The earlier any diagnosis comes the better as early intervention is key and can really shape outcomes for the better. They will probably say "too early" "wait and see" but don't be fobbed off (like a I was at 2, still makes me angry ). Good luck

[Obstacles]

I can see why you are concerned as there are a number of likely indicators. Agree with previous poster that it would be good to start the process to see if it is autism (or not). Just make up your mind that you won't leave the gp without a referral. If you print out your post you will be able to remember all your concerns even if your ds causes havoc.

If he goes to a speech and language group does the hvy have concerns. By the way some of the sweetest most affectionate boys I know have autism.

[chocnomore]

have you done the M-Chat? it is an Autism sceening tool.
you can do it onine here: www.m-chat.org/mchat.php

if it flags up anything, print it out and take it to the GP with you. I agree with sickoof - I would ask for a referral to a developmental paed. you should also be able to self refer for SALT. but I would really get the ball rolling to get seen by the developmental paed.

might be also worth asking for a hearing test just to rule out any underlying hearing issues.

make a list with all your concerns and take it with you when you see the GP. it is all too easy to forget to mention things during the appointment.

can you take your DP come along? you will beless likely to be diagnosed with paranoid mum syndrome if you both go (this was probably my diagnosis for a year - GP only referred me once I dragged DP along).

good luck

[AgnesDiPesto]

Yes my son was just over 2 when we noticed signs - firstly of language issues then when we read up realised could be autism (which it was). He also lost words, its important to flag this up loss of language at any age merits referral. The GP should refer to paediatrician but you can also usually refer yourself to SALT (its worth doing this yourself just to get on the list a bit sooner). Sometime you get treated as an over anxious mother but when the nursery also said he had lost speech and distanced himself we were taken a lot more seriously.

You might find the Hanen books It takes two to talk (speech problems) or More than Words (autism) useful. You don't need both - More than Words is more suitable if you are thinking it might be autism. A diagnosis process can take a long time and these books will help with ideas in the meantime e.g. using pictures, choice boards etc to communicate.

Don't push yourself to do groups etc if its not working, it can feel like something you should be doing but often a miserable experience.

www.teachmetotalk.com also has some useful ideas e.g. toys to encourage speech.

[chocnomore]

btw, DD has autism and has good eye contact and is very affectionate.

(eye contact and affection (or lack of) are not part of the diagnostic criteria for ASD.

[Thomasthetank]

Thank you so much for the replies from everyone. I did the M-CHAT and CHAT online and it flagged him up as high risk for autism, he fitted most of the autism criteria apart from the eye contact/affection side of things which is what made me doubt myself. I read the second part of the tests that the professionals would do and he wouldn't have been able to do any of it. We'll take it with us to the GP and insist on him being referred, I'm fairly good at being bolshy with drs when necessary! His hearing test done last month was fine, he could hear all sounds/pitches in both ears (I was hoping really that it would be a hearing issue that we could then easily sort and these issues would then resolve).

His speech/understanding has never really got off the ground, I was concerned at 18 months but was told he was too young and needed time. It is much more obvious now he is six months older and not keeping up with his peers. He appears to have lost the few words that he had around Christmas time and instead babbles non stop in response to us chatting. He seems to have lost the few bits of pretend play that he did such as cooking with his play kitchen, mixing up play food with a spoon and saucepan, pretending to give me a drink etc over the last few weeks. I really noticed his understanding issues at soft play this week - a just walking toddler of 14 months waved to us half way up with her mum. Dad had gone on ahead and she told her "hurry up catch daddy up or he'll go down the slide without you" and she then clambered up the steps shouting "wait dada, me go". It made me realise how little of my speech he seems to understand at a time when he should be able to understand me even if he can't always reply properly, even simple things, like "go to park" "go in car" etc. He can't copy words/noises if I say them to him as part of a game. He has learnt to point to our nose if we make a beep noise but any other body parts are not understood. If I point to my eyes, he doesn't point to his if I ask him. We'll look into those books, they might help him understand us a bit more.


The health visitor whose speech group he goes to just says to let him roam around instead and that he'll be taking it in even if he's not joining in! When they try to get him to pick a drink, he just stares blankly and appears to not have a clue what they're waffling on about. The only time he joins in at the speech group is after the other children have started playing with bubbles/balls and he notices then comes across, laughing. When they say to tidy up etc, he hasn't got a clue when he's told to pick up the toys and doesn't copy the other children doing this. I'm not really all that impressed with the health visitors, I think if it was just a general speech delay their help would be fine but anything more than that and they just seem to fob me off. He's been to a surestart crèche a couple of times while I did a first aid course and the feedback was that he spent the whole time playing with bits of fluff and the bin. When he got upset and wanted me, he wouldn't go over to the nursery nurses and just sobbed by himself.

I think we'll call it a day with the groups for now as he isn't getting anything from it at the moment. I've found a group about half an hour away for autistic/suspected autistic toddlers and have emailed to find out if we can join that instead.

Thank you again. Will see how it goes at the doctors tomorrow. Would a self-referral to SALT be suitable for these issues whilst waiting for an appointment with a paediatrician?

[sickofsocalledexperts]

If you do end up in the autism world, google ABA as the best-evidenced early intervention; SALT did nothing for my boy as they didn't know how to motivate him to vocalise. I was told by a HV when my boy at 2 - "just wait and see, we wouldn't offer anything till 3 anyway". Advice which I now realise was quite quite wrong!

[chocgalore]

the paed would most probably get a SALT involved anyways so just get the referral for Salt in place now yourself (if GP won't refer to SALT). Stress the lack of understanding and communication (also non-verbal) if you end up self referring.

[Thomasthetank]

We saw our GP today and have been referred to the Children's mental health team for assessment hopefully we'll be seen within a month.

[chocgalore]

glad the GP took you seriously and referred.

[Thomasthetank]

Thank you choc. I rang the CAMS team this afternoon and they don't see children of this age until they've been seen by paediatrics so our GP has done the referral to paeds instead. I'm not sure how long the waiting list is, will chase things up in a fortnight and see if there are any cancellations. We got lots of info from the Autistic Society today which I need to read through and DS is going to try out a toddler group for Autistic/suspected autistic pre-schoolers tomorrow morning which should be fab!

[Divinity]

Give your local surestart a ring too as there may be a disability support group for you. My son went the camhs route (he was 4 when the process started) and it took 18 months from initial assessment to diagnosis which is actually fast. Paeds may be different, but if you think of this sort of scale it might help. Glad your gp is on the ball.

[SwayingBranches]

Your 2 year old sounds exactly like mine, down to the speech and eye contact and cuddles.

Did you find out about a playgroup from the autistic society? When I read about ones round here it says diagnosed which makes me sad cos it's way too stressful taking him to a regular toddler group so I don't.

[Thankgoodnessforcheerios]

My DS is 28 months and is having his assessment next week, he has already had a neuro assessment which had an outcome of more than likely somewhere on the spectrum. He has also been referred for speech and language therapy and occupational therapy - he has no words at all, could say mama, dada, book, ball and a few others but lost these at about 18 months. He seems to have some sensory issues, loves textures and to squeeze things really tightly, it was my neck for a while but thankfully that has stopped now! He has good days and bad days with eating, won't eat or drink anything cold. Juice has to be warm. He won't try anything new, I think this is partly due to his allergies though and how reactions made him feel in the past.He also suffers from acid reflux and wakes a lot at night, not sure if this is because of the reflux.
He is extremely affectionate towards me and DP, we get lots of hugs and kisses. He has no interest in my DD who is 11 months or other children.
We have luckily found an excellent children's centre especially for children with SN 0-5 which has been a life saver. Good luck with the toddler group tomorrow, I hope you get all the support you need.

[Thomasthetank]

Swaying, i found the toddler group by looking up north east autism groups and it came up, run by a charity. Could you ask if your ds could attend the groups without a definite diagnosis, sorry if you already have! Perhaps if you explain to the leader , they might be able to swing the rules. I know what you mean about regular toddler groups, i come away so stressed and feel self conscious the whole time because DS is so obviously 'different' to the other children there. Now he's bigger and stronger, it's hard to handle melt downs when he screams, head bangs, head buts, goes rigid etc while everyone looks on!Has your son been referred for assessment? I'd love to know more about him.

Thank goodness, what did the neuro assessment consist of? It'd be great to find out more about the assessment process if you don't mind updating. Ds too hates anything hot or cold, everything has to be lukewarm. He also loves to squash things particularly food. Have he moved forwards any with speech/understanding since regressing at 18months?

[Thomasthetank]

Has he, sorry!

[Thomasthetank]

Just remembered he will eat chocolate ice cream if thawed out a bit but then he does love his chocolate!

[Thankgoodnessforcheerios]

Thomasthetank no progress with verbal communication however staff at the children's centre have said he is very bright and feel once he sees the SALT and with the possible use of PECS he will progress quickly, I am hopeful but who knows...He has good understanding, he now points to things if I say where is the ... and he will also point to things and wait for me to say what it is, the wall, the fireplace, the coffee table, the tv, the tv unit, the bookshelf, the cushions, the sofa. If I do not give him the answer he is looking for he will point at the object again, once I got confused between the names of his tweenies and he continued to point until I got it right! This is progress, he couldn't do this 2 months ago.
The neuro assessment took about an hour and a half. She asked me about my concerns and the areas she looked at were

Social interaction
Understanding
Speech
Non verbal communication
Play
Feeding
Self help skills
Gross motor skills
Sleep
Routines
Other behaviours
Education
Birth history
Medical history
Family history
Griffiths Development Assessment- assessed physical development- she watched the way he moved around the room, whether he could roll or throw a ball.
Personal and social awareness- observed eye contact and attention.
Receptive and expressive language- listened to him vocalise and assessed his understanding.
Eye hand co-ordination- she gave him a pencil to draw on paper
Assessed visio perceptual ability, speed and precision- she had some games/puzzles for him to play with.
She then examined him, looked for dysmorphic features, asked about any cafe au lait marks. She also examined his joints.

From this assessment she referred him to our LA team for an autism assessment and also to OT. My health visitor had previously made the referral to the SALT.

[Thankgoodnessforcheerios]

He has his assessment for autism on the 11th March so I will let you know how it goes I am presuming it will be very similar to the neuro assessment. I brought along his baby book which was quite detailed what with him being my first, DD's who is 11 months is only half full! It is useful for remembering when they reached all those milestones.

[SwayingBranches]

No I didn't think to ask! Which seems ridiculous. I should! He has been referred to the community paediatrician, I didn't think to ask how long it would take, though the doctor said I can go back to her to chat if I like. She's the child development doctor at our GP's. Ds scored 16 on the m-chat, including most of the critical ones.

My ds is nearly 29 months so a bit older. He's picked up some makaton from Something Special so we've been trying to as well. It's sweet because if we sign something to label it he makes the sign for "sign", and often says "ta" as he's picked that up. He says "ta" after being cuddled too! But using any form of visual clue helps, like putting him in his cot and we can say lie down and he'll just stare, but tapping on the mattress he does understand. He's on the list for a hearing test, but he can hear lots of things and words that mean something to him said softly from another room like juice or banana!

He did point for the first time the other day, he pointed at dh and said daddy! He said mummy for the first time last week, but like with daddy it was more labeling than wanting our attention! And he did motion for us to follow him this weekend because we always motion for him to follow us. So that felt like a massive break through! He does look stereotypically autistic at times with tip toe walking, running in circles and handflapping. And while out other people don't even exist to him, they're more like furniture! He adores playing with his 9 year old brother though.

Bit of an essay!

[Thankgoodnessforcheerios]

Yes definitely ask swaying branches. I thought the same but when I spoke to our local children's centre they were fantastic and very interested in what's going on and how far we have got with a diagnosis, they have offered lots of support and made sure we are in contact with all the right people.
That's great that he has picked up some signs, I am working on this with my ds but he just laughs at me. He also does a lot of pointing but as you described above it is more of a label that pointing because he wants something.
Hugs for your other post, I haven't commented as I have no experience of 11 year old boys and this is all very new to me too.

[Thankgoodnessforcheerios]

Sorry swaying branches no experience of almost 10 year olds.

[SwayingBranches]

Thanks for that

We just keep being encouraged that ds2 is moving forwards, it's slow, I think he slides back on some and if he's poorly so much vanishes until he's better, but progress is good. He said juice today, copying not asking, but a word is a word!

[Lealea200]

Hi my son is 3 he don’t talk and enjoy normal things in life his never communicated with anyone the only time he wants my attention is when he wants something and uses my hand to communicate. I took him to groups and never wanted to play just ran around the room never taking notice of the children or toys and activities that were on. He doesn’t talk since December he has become very visually with things like he knows the alphabet from a-z and can count to 10 it’s all he enjoys doing. But he doesn’t talk and say anything else except the Alphabet and 1-10 am finding it very difficult because it can’t be easy for him. He gets very upset when things are his way like when he lines things up and ones not in the right place it irritates him. He doesn’t enjoy most things and his eating is terrible he doesn’t like a lot of textures I keep trying things with him but am getting no where, his had speech therapy and is under going a autism test and other tests sorry for the long paragraph just wanted to see if anyone else is having the same problem or kind of the same and have any ideas how I can help him.