2 year old - can’t work out what the issues are

[Lil43]

Hi,

I would really love to hear from anyone who has had similar experiences and how things turned out. My DD is 2.1 and she is doing ok with her single words, she says loads of them but she isn’t motivated to communicate at all. She often says the words to nobody in particular and her speech
level is just not progressing. She doesn’t point and rarely waves either. She does give me shared interest with her toys sometimes.
My main concern is that I find it so difficult to get her attention and focus on me, I can be dancing in front of her and sometimes she won’t notice. She doesn’t answer to her name sometimes, she can’t respond to questions and making requests is fleeting. Her receptive language is quite poor but I don’t know if it’s because she doesn’t understand or because she can’t focus enough to learn. She is able to follow a couple of commands like put nappy in the bin and close the door (if she feels like listening).
I just can’t seem to work out what the issue is - I’ve spoken to professionals but no one can give an answer, nursery have raised concerns about her lack of concentration too. I do feel like it’s asd but maybe adhd/both or maybe even something else. Has anyone experienced anything similar?
Thanks

DD was a little bit similar. She hit all milestones for number of words, so I wasn't worried - but then other people pointed out she never asked for anything. She was a late waver, and would point at things in books if asked (e.g. "where is the cat?") but not to get our attention or point something out to us until much later.

She did come to share things with us though - I can't really remember what and at what age.

This waiting bit is hard, but generally I think it's hard to get an ASC diagnosis much before 3, and ADHD generally later (more like 7). The do often go together (and there are some overlaps - e.g. executive function issues and hyperfocus are common to both).

Generally the advice is to try to get involved in whatever they are interested in (even if it seems a bit odd, and even if they don't show any appreciation for that to start with). Try to find ways to make yourself useful to what they are already interested in/doing.

Here are a couple of videos that may be a useful starting point by a YouTube channel I really like. She also has a FaceBook group (same name) and there are lots of parents there who are worried but don't have any diagnosis yet, so it's a good place to share worries and ideas.

Interaction/play ideas:

Eye contact: Other ideas (not therapy):

But the whole channel is great I think: www.youtube.com/c/NurturingNeurodiversity/videos

Chirp Speech Therapy also has a bunch of videos with ideas on sensory stuff, eating, clothes, and interactions as well as specifically speech. Worth an explore: I found some useful ideas here when DD was small:
www.youtube.com/user/ChirpSpecialNeeds

Hi @LightTripper thanks so much for sending these links over and your advice, that is really helpful. And for the Facebook group suggestion as well, this period does feel like a very lonely place right now.
My dd does sound quite similar to how yours was, if you don’t mind me asking, how is she doing now?

She's doing great! She's 6 now. She's at a MS school (though it's private, so small class sizes, which I think probably helps). She doesn't have a 1:1 though I know the class TA does give her a bit of extra attention particularly at the start and end of the day to help her get all her things together, and with changing tasks. She has friends (although I think she is less interested/sophisticated in her friendships than some of the other girls: but she also gets on with some of the more "gentle" boys who are interested in bugs and nature and Lego like she is) and although she's quite a sensitive and anxious person, she's generally very happy and doing well with the academic side of school.

She had a bit of support in nursery helping her connect with the other kids (just a nanny with some SN experience who would come in a couple of hours a week and try to encourage her to notice what the other children were doing, comment when they were doing something interesting/similar, etc. - I think they called it "scaffolding" her interactions). She also had some SLT in nursery and the beginning of Reception (playing turn taking games, sequencing stories and doing a bit of conversation about her week).

It's so hard when they are little as you just have no idea what is going to happen, but if it's at all reassuring all the autistic girls I know are doing pretty well (if it does turn out she's autistic). I think sensory issues can be the most difficult to overcome, so it's really worth reading anything you can on sensory regulation, and helping teach our kids methods to regulate and practice some self-care when they start to get overwhelmed, as those are skills they can draw on for their whole life. I think sensory regulation is generally very helpful for ADHD folk too, though I know much less about that. I do keep seeing positive references to this "How to ADHD" channel (the woman who runs it has ADHD) so that might be worth a look - but I don't know if it has anything about children or is purely adult focused: www.youtube.com/channel/UC-nPM1_kSZf91ZGkcgy_95Q

Sorry - one final thing - have you had her hearing tested? If not it's worth doing that early on, just to check that isn't the source of any problems... It's also worth getting a referal for a developmental assessment (or whatever they do for kids who may be on the spectrum in your area: probably your nursery could advise?) as waiting lists can be long - so it's worth getting into the system. Some areas will have "drop in" SLT or OT sessions. If you Google for "Local Offer" and your local authority name, that should have some information on how to access services in your area. Otherwise your nursery and/or GP should know. The 2.5 year check is usually a good opportunity to flag concerns, so you are nearly there!

@LightTripper thanks for your reply and so glad to hear your daughter is doing so well, that’s wonderful!
That’s really interesting to hear what help your daughter got when she was younger too.
We have had a hearing test which came out ok. She just wasn’t cooperative in the test at all - wouldn’t turn her head to look at the pictures but made it clear she heard the sounds.
I’m struggling to get a referral to the paediatrician. We had the 2 year check already and it came back with a high score on the autism questionnaire plus very delayed on the communication. We can’t get a referral until they repeat the review in January. It’s all very frustrating as there’s a years waiting list at least.
I just hope I can help dd in the meantime before we get to see a paediatrician.

Honestly I think most of the things you would want to do you can do anyway. I don't know if private SALT might be an option? NHS SALT is a bit hit-and-miss. I know people who have been very happy with theirs but our one seemed a bit at a loss what to do with DD given she could talk/had a big vocabulary. It was entirely focused on getting her to ask for things. The private one she had through nursery was much more focused on communication, turn taking, sequencing, more general communication "principles" rather than just talking.

Remember that a lot of what you read about "early intervention" is designed to make $$$$$ from scared parents and their insurance companies for unscrupulous practitioners in the US, and some of it is actively harmful. You can do an awful lot just by trying to get involved in what your DD is already showing she is interested in (even if that is picking bits of fluff off the carpet or balancing on your bottom, which I remember being favourite games of DD aged 2!)

Definitely worth checking out your "Local Offer" page though. Our area has for example an ASD coffee morning once a month, and you don't have to have a diagnosis to go, but there is an SLT and OT there and you can book a 10 minute slot to get some quick advice - plus just talking to the other parents/carers is good. Some areas also have something called "Portage" which we didn't really get on with but many people say is great (I think it's a kind of play therapy: depends a lot on the person you get I think). Every area is different and I know not all have such good services: but maybe when you are in in January you can ask them if there is any support (even informal) available while you wait?

Hi @Mohit1234
Dd is 4 now and started mainstream school, although I suspect she will eventually need to go to a special school sometime in the future. She has a diagnosis of ASD and speech delay. She is still not fully verbal but has progressed with her language and can ask for things to get her basic needs met.
Her receptive language has progressed greatly as has her concentration and play skills. Hope this update helps.