Concerns about 2yo DD

[Mamawith2]

Before I share my concerns, I want to start by saying I will be addressing these issues with my daughters Dr at her 2y appointment next month....I'm just worried her symptoms aren't stereotypical asd enough to warrant a referral to a behavioral pediatrician. Here are my concerns....

-always a very serious baby....have to work hard for social smiles (apparently husband was like this though)

-doesn't like much affection....doesn't give hugs or lean in for hugs (occasionally will with husband)

-doesn't really wave hi or bye without prompting

-super smart in some ways (knows letters and letter sounds, numbers, matching, sorting, counting, etc...)

-has to be reminded to greet us often (she will run to the door and hug me when I come home) but instead of saying "hi" she makes statements about us like...."mama work" after I come home from work or "mama night night too" after I get her out of the crib in the morning. She does say hi to me sometimes...just not that often unless we prompt her to.

-has been into counting on her fingers a lot

-when runs she sometimes look out of the side of her eye with her head turned

-some echolalia

-doesn't like to interact with adults....but likes kids

-fleeting eye contact....terrible eye contact up close and often when she asks for something shell look at the object vs us. During songs, or conversations from far away she can hold our gaze for a while

-adhd can't sit still for a while

-sometimes shuts down in social settings and won't interact with even mom and dad much

Positives....
-always wants to copy husband and i
-asks for us to come play with her
-does some pretend play (feeds toy animals, makes animals "kiss")
-has joint interest (points us things shes excited about and looks to make sure we're paying attention)
-talks about her cousins and likes playing with them
-can be really goofy and involves us in her games
-understands some sarcasm
-no really speech delay-no pronouns but uses some sentences and asks some questions
-receptive language seems good

She passes autism tests here in the US (mchat) as low risk. I'm worried the Dr won't take my concerns seriously enough. I know she would be at the high end of the spectrum if she is on the spectrum....but I would regret not getting her help now if she really needs it. Does this sound like any of your high spectrum toddlers? Did any of you have these concerns and your toddler grew out of them? She has such good joint attention which makes me doubt autism.

My HF daughter is now 5 and sounds like she was a lot "worse" than yours at that age. We had a very difficult time getting an assessment, albeit in the UK. She was referred at 2 but they didn't agree to assess until 5.

I would obviously look into it and note your concerns but in all honesty I don't think you will get very far at such a young age because her social communication sounds quite good.

Keep pushing away though, us mums are usually right :)

Thank you for your response. Can I ask what your red flags were at my daughter's age? I go back and forth between wether she would get a diagnosis....I know this next year will really show

Your DD sounds completely normal to me! Things like echolalia and not being able to sit still are typical behaviour for a 2yo.

Hi there!

For my DD (now 5, very verbal, not needing 1 to 1 at school but diagnosed autistic just before her 4th birthday) the key things they worried about were (lack of) pointing for attention (she would point at things in books if you asked her "where's the cat" - but was late to do the "plane Mummy!" thing); and lack of asking for things (she had a big vocabulary but quite noun heavy, and if she couldn't do something she'd tend to get frustrated and give up/move on, rather than asking for help - similarly she would never ask for a drink, a wee, TV, etc. at an age where you would be expecting that). She was also late to say Hi/bye. She was still playing by herself when peers were playing alongside, then playing alongside when her peers were moving on to playing together: just a bit late with that stuff. All quite subtle (or so it seemed to me!) but much more on the social side where your daughter seems to do pretty well? Autistic kids often also prefer adults to other children (more predictable). DD was also a very late walker, which I think looking back was probably a sensory thing.

Keep an eye - if she has different needs then being aware and accommodating them will help her - but nothing leaps out as obviously autistic as PP said! But we're all a complex mix of different sensory, social and other needs, so no harm in reading up, learning more on neurodiversity (autism, ADHD), etc. In terms of "help" don't panic too much about missing out. A lot of autism interventions are pretty dodgy anyway and a huge amount depends on how you understand her, support her and encourage her rather than "therapies" - none of which requires a Dx.

I'd raise the fact you see differences, but go in with an open mind on what those differences might be.

I still think there are some things to keep an eye on and raise your concerns over. I just think they will probably adopt a wait and see approach.

Mine had similar type things going on but she did have a speech delay and was and is incredibly literal so didn't get sarcasm at all. She didn't pretend play back then although she does now. The prompting thing could be something though - it's something that was picked up with DD in her assessment. I'd not even mentioned it because it was so normal to us but they seemed to think that was a big deal. As is the fact that you are worried. I think sometimes we just "know" when something is off.

Light tripper-

I so appreciate your response...I'm struggling to find many symptoms of girls this young with HFA.

My DD didn't really have a delayed reaction to pointing to show that I can think of. She does some pretend play....makes her stuffed animals do things such as turn off the lights, feeds them, changes her baby dolls diapers....doesn't pretend play as much as some others her age, but from what I've seen it's definitely developmentally normal. She's definitely less expressive than some others her age but I don't think she's behind....she does occasionally ask for her water or a snack (usually when she sees it though). She does ask for help....sometimes she'll struggle and give up but she definitely asks for help to. She just seems so quirky to me...she still babbles and repeats things a lot....does weird mannerisms and her social skills are just awkward....like she'll ask for help without really coming up to us to ask....I feel like a lot of labeling or making statements versus interactions....she's definitely noun heavy too. She'll randomly laugh and make weird noises. Lots of repeating what I say.... although she talks too. All of these behaviors are still developmentally "typical" so I feel like it's a waiting game to see if she grows out of these behaviors by 6m-1yr or not....if she doesn't I'm sure she'll get a dx.

You're second to last paragraph really hit home for me. I've been driving myself crazy trying to decide if she is on the spectrum or not. I'm so worried that I'll miss it and she'll lose out on early intervention. You're right that I know her needs the best....instead of stressing about whether or not she is on the spectrum, I should be using that energy to work with her on the skills she is delayed in.

It’s really hard to tell, isn’t it? I have 4dds, 2 with ASD. Completely different presentations. Not milder/more severe, just different in different areas. I did have to fight for their diagnosis, fast forward a couple of years and it’s very clear they are autistic. For my 7yo, who was much less obviously autistic, the main signs were lack of friends and wanting to play the same game (tea parties) all the time. We were worried her speech wasn’t to clear and she was s little late at drawing etc, but now is exceeding all expectations at school. But she can’t stand being in busy places, now frequently meltsdown, can be quite challenging in her own way.

I guess I’m saying it’s hard to tell, but keep observing and making notes and do mention your concerns to a professional.

Abdoluteunit-I appreciate your responses....thank you! I haven't found anyone to talk to who has a daughter with HFA. My DD does some pretend play....some with prompting but some without... It is still somewhat memorized but everyone I've talked to with toddlers this age say that's common. My DD can be somewhat literal at times but her humor can be sarcastic as well....for example she thinks it's funny to call a pineapple a "pinebowl"...no idea where that came from... she'll point to it and call it that....ill say "no" and she'll insist that's what it's called ...or the other night, she kept bringing random objects to my husband saying they were going to go "night night" in her crib and laughing (objects that don't belong in her crib such as a bow, a hairbrush, a diaper, etc..." She's not very empathetic but that could be a personality thing.... How did your daughter interact with you? (Eye contact, speech, etc..." As a toddler? My DD is just odd...I love her so much, but she is seriously so quirky (randomly laughing occasionally, making weird faces, saying things over and over, odd movements) and not a fan of most people other than my husband and I.

I agree that if she gets. Dx, it probably won't happen for a year or two since all of her quirks now can be taken as normal toddler behavior.

Imip-thank your for your response. Did you not have any red flags when your DD was a toddler (2ish)?

honestly, she sounds fine to me (I have a DD with severe ASD and one with suspected HFA).

I think a lot of the things you are seeing are just typical toddler behaviours.

How old is she - did she just turn 2 or is she rather short of 3?

Red flags at 2 would be signs now, but not red flags then. One dc liked to be rocked back and forward, rocked pretty violently in her high chair. Had a little language like the pinebowl you mention. Use of language can give real clues, but it’s not an answer and could be normal development. All my concerns about older dc were recorded in her red book and I read it back now and think WTF, and look st this along with my concerns should but her straight on the ASD pathway, but no, it ended up being a very long battle for us.

I really wouldn’t worry too much now, just enjoy her as she doesn’t have any challenging/worry behaviour, when she’s a little older, read the diagnostic criteria for ASD and it may help you know the signs professionals are looking for (triad of impairments).

OP, what history (if any) is there in your family of ASC/ADHD/dyslexia/dyspraxia etc?

If there is family history, it's worth mentioning that at the 2 yr review in relation to your concerns.

I think you may need to find a way to manage the uncertainty for a couple of years, because as others have said a wait and see response may be likely. So you have to find a way to stay true to your instinct and put support in place yourself that you think may be needed, whilst also playing the waiting game. Ultimately, if you have the resources, you could take her to the Lorna Wing centre for assessment (but not sure how young they assess? But definitely specialise in assessing girls)

@Moccaicecream she is a week away from being 2. What was your suspected HFA DD like around this age? Any concerns you noticed? I agree a lot of my concerns could be chalked up to normal toddler behavior....in the past I've just said oh she's quirky or has anxiety....now I'm noticing some possible stimming and wondering if there's more to it. There's also just a social disconnect I notice....her interactions with us are just different than other kids her age, and her speech is just different....not necessarily behind yet but just kind of odd.

so she isn't even two yet? I really would try not to worry.

As for my suspected HFA DD (9 years old) - no no suspicion at that age. But I compared her to her older severely autistic sister and as DD2 didn't have delays (in fact advanced across the board), I just assumed all is well.

@MapLand

Nothing diagnosed...a lot of social anxiety, but I think it is partially to the environment my siblings and I grew up in....no repetitive/stimming behavior. I don't see ASD. My nephew has some behaviors that could be very very mild ASD....his teacher wanted him evaluated at 3 but they said he was NT....Also my SILs brother has ADHD, so my nephew's behavior could be from his side. My husband is an engineer and his siblings are all in the medical field or engineering field....but I don't really see ASD at all.

Thanks, I'm realizing that even though my concerns are valid, I do not to treat my anxiety and that will be a priority. I'm in the US....I contacted Early Intervention (government funded intervention for specific delays in children under 3) but she doesn't qualify. I'll probably still take her to a developmental pediatrician, but I think they'll dismiss my concerns at this point.

I appreciate your responses

@moccaicecream

Yeah, honestly I wasn't very concerned until she started running looking out of her peripheral vision. She's been doing this the last few months...I haven't seen examples of this in NT kids. Because of that, I think I'm analyzing everything else. Before the stimming, I just chalked it up to quirks/anxiety/personality, etc....

Hi do you have any updates on your DD ? X