Handflapping in 20 month old

[Waitingonastar]

DC handflaps whenever they are excited, accompanied by nonverbal mouthing. It strayed when they were a few months old, then disappeared, then re-emerged about three months ago. Happens frequently throughout the day, a few times an hour. It’s marked enough that someone meeting us for the first time would definitely notice it.

They also sometimes happily walk in circles gesturing as if playing out a game or scenario in their head. Speech is not brilliant but has around 6 consistently used words - mama, dada, no, my, Etc. Vocabulary is not expanding really though, has had these same words for months

No other obvious ASD flags - points at objects, makes eye contact (not brilliant at responding to their name but will do it sometimes) Loves imaginary play, babbles loads, likes people and interacts well with other children. but I think I should contact GP (no HV) no idea how soon we’ll be given an appointment. Is there anything else I should be doing?

Anyone else had a child who hand flapped when excited and it wasn’t ASD? Up til now I’ve been adamant there is nothing wrong , it was just a habit or a quirk, but the flapping and ‘playing out own scenario in head’ is getting more pronounced.Thank you

Does he point to share interests with you? like a plane in the sky? that's the type of pointing that is crucial at this age, much more than pointing to request or to objects in books or those that he can touch.

@AladdinMum Thank you for your response

I can’t think of occasions when they’ve pointed to planes but they will, for example, point to our car and get excited, saying “my!” When they see it

I’m not sure hand flapping is actually the right description- more wrist twirling when excited. It’s a very distinct action.

DH and I have been watching closely all weekend. They’ll clap a bit if we clap, will join in ‘winding the bobbin’ when we sing the song, babble with intonation.

Calling the GP on Monday, I can’t sleep for googling and obsessing

Them pointing to your car and saying "my" sounds like potentially a request? like requesting to go on it? specially if it's something they like doing. Pointing to share interests is when they see something new and exciting and they just want to point it out to you so you don't miss it (like if saying "mummy look!"), sometimes this gesture is paired with a look back where they look at you to make sure you are looking at the object they are pointing to. This could be a plane in the sky, a balloon, a big bird flying in the sky, a train in the distance, a police car with flashing lights, etc. Pointing to share interests tends to emerge from 12-18M of age.

Autism presents differently in the different sexes so it would be useful to know what sex your child is.

I can’t think of many examples of them doing any equivalent of “ mummy look!” type gestures or sounds. They never seem to notice planes and have never shown any interest in vehicles etc. They have recently noticed bees in flowers and will shout “ bee” and run over. Whether they then look back to include me , I honestly can’t say . I haven’t paid attention to it, just been relieved they could say “ bee”

They don’t spontaneously clap or wave but will copy if Someone else does it.

If I’m being totally honest, thinking of my elder child at a similar age they’d see a dog, point and shout “ mama, woof” over and over. They won’t do that but will smile at the dog, and if encouraged by me saying “ look , a dog, dogs say woof” over and over, they might eventually say “ woof “ they won’t do that ‘practically falling out the buggy from pointing so much’ thing, they are much more passive about it.

Now you’ve said it, I can picture it with my elder child . With them id crouch down beside the buggy, point at something and say what it was, they’d also point, turn to me for confirmation/adulation, maybe repeat what I’d said . My 20 month old will just look at what I’ve pointed at.

I feel a cold knot in my stomach typing this , but now I think about it they very, very rarely say “ mama” when addressing me - they will only say it if they see me when I enter the room or if they want me to lift them for a cuddle or I point to myself and say “ what’s my name”. They have never attempted to utter their own name, or that of their sibling. It’s almost like a point of principle where their sibling is concerned . We’ll go round the table pointing to each member of the family, they’ll correctly say “mama” “ dada” then pause at their sibling, grin and say “ dada” then laugh. They know it’s not dada, it’s definitely not a comprehension issue.

With their language, they have used more than 5-6 words, but not regularly if you see what I mean? For example a few days ago we were playing with bucket and spade and I was repeating those words and they eventually said “ pade” but have not used it again, even though we’ve played with those toys again

My child is a girl

In sum I’d say the behaviours which concern me are:

Wrist twirling When excited

Wandering up and down in imaginary scenarios. This is a new thing, it’s emerged in last few weeks. They’ll engage happily with you if you interrupt them while they are doing it

Not much spontaneous pointing or waving bye bye, though will do it when copying others ( though that’s common in females with ASD isn’t it? Being able to pass or mask or copy.)
I watching them playing closely with their sibling yesterday - they were pointing but in a bossy way if you see what I mean, pointing And babbling to show what they wanted, or what they weren’t happy about.

Language development, though we are starting to decipher two word sentences in the babble eg said “no, me bisc” (biscuit) when offered an apple yesterday. If it wasn’t for the other flags the language wouldn’t worry me too much on its own.

It’s the first three flags that are causing the rising waves of panic I feel as I type this . Sorry it’s so long

Ds2 didnt just "flap" when he was younger, he FLAPPED. He did the mouthing thing too. He is 12 now and is not autistic, he has complex motor stereotype and some other cunning thing where he can make his fantasies so real he can almost see them (that has an acronym too but I forget what it is).

Complex motor stereotypy can be seen in autistic people too, so having one doesnt exclude having the other.

With ds2 his movements got less overt as he got older as he became more self conscious and modified them. He will still make hand movements and facial movements when unobserved and playing mind movies to himself.

I did worry about autism until I heard of CMS (he was 7 by then), then I worried about CMS until I spoke to some adults with the condition on an American forum. Then I stopped worrying altogether. Ds2 found it helpful to have an explanation to give people in the days when he still made modified movements in public.

Our SN foster son, who had lived with us since he was 5 has always flapped his hands and arms. He walks up and down, twiddles a blade of grass or a straw in his fingers for half an hour. He lined up all of his toy animals in a row. He talks to himself. When he first came he lived in a world of his own. He did not know what a cat or a dog was and when given toys he just looked at them.

When he first came to us he was barely speaking and had mobility issues. He has made amazing progress and did go for an autism assessment when he was 6. We were told he does have many autistic traits but not enough for an autism label.

He is now 13 he has learning disabilities and attends a special school and when he is excited he still flaps a bit but he has learned to modify his behaviour. His speech is normal and he is outstanding at sports. He always does his very best at whatever he is asked to do.

Whether a child is assessed as autistic or not there is no magic treatment to cure them.

The wrist twirling came in handy as he is an amazing spin bowler and plays for his county at cricket now.

Health visitor perhaps more appropriate than GP? Assessment process is years and often unless seriously delayed in meeting milestones, they hold off approval for assessment until 7 years old?. I say that as mine was evidently autistic at 2, probably before even. Just got the official diagnosis after being on the waiting list nearly 3 years and she's 9 now.
Its much easier to be accepted for assessment once they are school age too

My dd did the hand twirling which when she got to about 4 progressed to hand flapping. I never really thought anything of it. She’s 14 now and not autistic. Try not to worry.

I understand why you are feeling so anxious, based on what you are describing and the fact that you are so worried, I would advise you to speak to your Health Visitor.

Any one red flag/asd characteristic alone, does not necessarily mean a child is on the spectrum. Children with delayed speech and language can display asd traits but it doesn't mean they are on the spectrum. However, when you look at traits (red flags) of autism like hand flapping/spinning the difference to a neuro typical toddler would be things like the frequency and purpose and length of time they would flap for. @AladdinMum explains it with pointing, an autistic child can point and give eye contact but it will be different.

When you have multiple traits and issues like delayed language, lack of response, poor engagement with joint attention, social and developmental delays, these would warrant further assessment.

I was fobbed off by 3 Health Visitors for my eldest who was very clearly not only autistic but had severe learning difficulties. The earlier you seek advice and help if there is a problem, the earlier you can access interventions and support. This can make a big difference later when they start nursery/school.

I have posted this before, but have a look at m-chat.org/
I always suggest making notes of concerns that you can use for appointments and assessments. Notes like age, what they are doing, words, social interactions, any other behaviours noticed etc. The M-Chat will be helpful to use as guide.

If you are that worried speak to someone. If there is nothing to worry about you will be reassured and if there is something you can know you have started seeking help early and that can only be a positive thing.

Take Care

Hand-flapping is not a "red flag for autism" at 20 months though, it's an age appropriate behaviour when a child is excited. It only becomes a "red flag" if they dont grow out of it.

Hand flapping is normal when a child is excited, but there is a difference with "autistic" and "typical" hand flapping. The difference can be the frequency, type and obviousness of the stimming behaviour. The purpose is often different, so whilst it can also be for excitement, it will also be for sensory purposes. The OP has noticed the frequency and also that it is accompanied by mouthing, which is another self sensory regulation.

Hand flapping is frequently listed as a red flag for these reasons, and I can see why it then causes alarm for parents who think "but my baby does that"! There are usually other indicators/signs that are present, which may or may not be obvious to parents when autism is the reason.

Yes except the "autistic" hand flapping you describe can and is also seen in some non autistic children. Small children do various things to self-regulate and at a young age I really dont think frequently and obviousness help much in distinguishing between the two.

Does your child attend nursery?

It is very obvious to good practitioners when behaviour of a child is outside normal ranges and if they attend a nursery it’s worth speaking to them. A nursery can also get early help if they feel that a child needs it.

@Waitingonastar can I ask how your LO is doing now?

Hi
I’m wondering if there is any update on your son?
I am currently going through the same thing with my little one. She is 14months old

Hi how’s your daughter ? ❤️ any update ?