ASD signs in 2 year old? What was your high functioning ASD child like as a toddler?

[MamaAffrika]

My friend has a two year old daughter that I suspect may be on the spectrum. Nursery have no concerns, they just say she is very independent and likes to play alone. Parents have no concerns, they think their child is very relaxed.
Motor development was slow but within normal range. Poor co-ordination and lacks confidence climbing, going up steps ect. Facial expressions are usually neutral, hardly ever smiles - doesn't ever laugh unless thrown in the air by parent. Doesn't make eye contact easily. Often won't respond to name. Very undemanding, will play alone for hours. Can be left watching Cbeebies for 2 hours while adults are in another room. Loves bikes / wheels. Doesn't engage in pretend play e.g. baby dolls.

Does this sound like a high functioning ASD girl? I know early intervention is best but is it my place to raise concerns with my friend? Would you say anything or wait till / if the professionals notice anything?

So the thing about being diagnosed as autistic is that you need to have the characteristics and they need to impair your day to day life. Sounds like they very much aren't with this little girl. So she's obviously able to manage the transition from parents to nursery, the many transitions in a nursery day, dealing with a range of different adults, engaging to some degree with activities at nursery? Do you think she's OK with all this? She's presumably verbal?

What sort of nursery does she go to? In my personal experience, some nurseries are fantastic at spotting developmental differences.

I have autistic and NT kids and they all have done some of this. The autistic child could be very self contained but i think my nt 3 year old would watch tv for 2 hours happily if allowed. And not all kids like dolls. Does she ever do any role play, like garage, car fixing, phone calls etc? Or do the bikes talk to each other?

But she sounds like a contented soul who likes her own company. That's OK too! Not all toddlers have to be nutters. 😊

Like Lego says she sounds quite happy and content. It is good that neither her parents or nursery are concerned. If there are issues they will start to become apparent as time goes on. Not every child is diagnosed at a young age either. My Ds is 14 and on the diagnosis pathway at the moment although I can now see looking back that he had asd characteristics even when he was very small.

Thanks Lego. She is verbal but single words only. I find the lack of expression and eye contact very odd but as you say, it doesn't impact her life so perhaps you're right. She is fine with any adult, doesn't matter if the adult is brand new to her, she's happy to be left alone with them. Thanks for your help x

Thanks Punx, you're right, if there is something there then time will tell. What signs did you notice in your child as a toddler?

Looking back now, it feels like a long time ago! He was late to speak. Pretty much non verbal at two. He did have some speech therapy and his speech did develop in the end. He was very quiet, would not really talk or interact much with others. Definitely some sensory issues too. I think we realised he probably had asd around the age of eight as we noticed that he was very rigid in his behaviour too. He did cope through most of primary, some teachers did comment, unfortunately nobody offered us any support. It started to fall apart in year six and has been difficult since then, we now have the joy of a huge nhs waiting list and a very unhappy fourteen year old.

So yes I think early diagnosis is good but like lego says they won't diagnose unless it is having a significant impact on that child's life. I do think pre schools and primarys seemed to be better informed now of neurodevelopmental conditions. Even though Ds is only fourteen I think there was definitely less support back then.

Punx... What a journey, thanks for your detailed reply.

My ds has autism and was very different to the dc you describe. He could not play by himself, was very unsettled and very demanding. He did show lots of emotion especially joy/excitement. He showed big emotion, if that makes sense. But no emotion on his face when he was anxious, in pain, sad. I didn't think he had autism when I went to my GP. I just knew we could not continue the way things were. Life was so very hard for both me and ds. It was an absolute nightmare trying to go from a to b because I didn't understand him.

DD was very much like that. She only had single words (I guess your friend's DD's speech is good as you didn't mention it) but she is on the low functioning end (I.e. severe LD on top of her ASD). Nursery didn't find anything amiss either. In the end we pulled DD out as no support was forthcoming (because in their eyes, DD was fine). So I would not read too much into an unconcerned nursery.

If parents are worried, I would run it via HV or GP. often a hearing test is a first step.

I would not say anything to your friend. she probably 'knows'. You mention early intervention - if you are UK based - do not worry. There isn't really such a thing. You may get a handful of session SALT but other than that nothing. Intervention, it ain't!

I have a 2.5 year old DS who is on the diagnostic pathway at the moment. As others have said above, don't read too much into unconcerned nursery, they haven't a clue what they're looking at most of the time, and if they're anything like ours they "don't go looking for problems" and "don't want to label a child for life"... meanwhile labelling our DS as a spoilt little brat with a neurotic mother who hasn't got any clue how to parent.

What would really concern me here is the lack of communication from this little girl. I disagree with those above who say this isn't impairing her - it is clearly impairing her ability to do the main thing that children are meant to do at this age, which is learn to communicate.

Most 2 year olds are all about communication in one way or another. They want to show things to others, they want to have praise and look up at adults for it, they want to look at others' faces to gauge what their reaction should be when something new happens.

My DS does that kind of communication when he's feeling relaxed and happy at home, but basically doesn't do any of that social referencing away from home. He doesn't join in with other kids at playgroup except on rare occasions (where a more socially competent child will specifically include him).

We are about to start sessions with SALT and OT dealing specifically with giving him the skills to navigate social situations, and to get better at self-help skills. He is highly verbal and very far ahead in some ways (abstract concepts, language, music); but his lack of communication, reciprocity and social referencing, and his inclination to cling to baby habits because he realises he can't navigate things the way other children can, are really impairing his ability to join in and learn at nursery.

DH and I are both probably on the ASD spectrum, very mildly. I have a diagnosis (made when I was an adult), DH doesn't - we are pretty similar in terms of wiring and very mild social impairment - he had a more supportive upbringing and was labelled "quirky and intelligent", I was a girl so was labelled "weird and antisocial despite being good at school". These days, increased social pressure means that even "quirky and intelligent" is going to make life hard - so we are pursuing as much help as we can possibly get, as early as possible.

I guess though Derby Racer that she is unlikely to get a diagnosis if both the parents and nursery don't think there are any problems. When my Ds saw the consultant she spent 45 mins with me taking a detailed history and then saw Ds for less than 5 mins. She made it clear then that diagnosis was only given if there was a significant impact on his life (there is). She will base her decision on diagnosis on the history, the 5 mins with him and a speech and language assessment. She will not meet with him again at all before making her decision. So I guess if I and the school had said there were no problems, it would have probably not got pass referral stage.

Letsgooutside... Yes! It's the social side of communication and interaction that's missing. But also other tiny things that I think is odd like if I pick her up she doesn't hold on or balance her weight at all. If I move then I have to hold her on with two hands else she'd fall. I have a DC who is a very similar age so I find it strange. I also think it's odd that she doesn't seek out interaction / company and is happy to be left with a strange adult - no separation anxiety at all. Her face hardly ever changes (her parents say she is serious) but her dad also calls her a 'little weirdo' cause she does unusual things like just lying down on a path in a park - not a temper tantrum - just calmly lies down like she's having a rest. Her parents share lots of photos and she is never smiling in a photo. 😪

Thanks Rainbowbash - I think ASD in girls is really misunderstood. We are UK based, I thought early intervention was good here. I really didn't realise it was pointless. I suppose there's nothing to do other than wait. I don't have anything concrete to base my concerns on so I don't think I could bring it up with my friend. I think she'd only realise that her child wasn't typical if she had another child.

well, we got some help in terms of extra support at nursery. a few hours 1:1 though nothing like early intervention.

UK doesn't do early intervention. it's all wait and see and if referral is put in place then more wait to get s diagnosis. My daughter is low functioning so whilst she flew under the radar between 2 and 3 as she had single words (loads in fact) between 3 and 4 a gulf opened up.

DD also received early intervention but that was privately funded by us - I was pretty early on aware the DD was different even though nobody saw it/listened to me.

If parents are in denial, I'd stay shtum for now.