I think my 2.4 month old has autism

[GrapePearPea]

Hi all, hope you are all doing well.

My little girl is 2 years 4 months. I am really concerned about her lack of language development. She can say words like mumma, daddy, whats that, boo, shoes, socks.. but no sentences yet. She also doesn’t always say the words when appropriate so I think it’s mimicking, as opposed to understanding. Her eye contact is poor. When trying to tell her off she seems completely oblivious to me and doesn’t look at me. Sometimes laughs. She ignores me a lot when I say her name. I have been saying for months that she ignores me; at times it’s like she has no awareness I am there. She has a older brother who she gets on with, she will smile and play with him. However she doesn’t play appropriately with other children her age at the park. She just snatches, gets into there face when they don’t like it. No concept or understanding of sharing. I look around at other toddlers playing and my little girl just behaves so differently to them. She has terrible tantrums when she doesn’t get her own way. Throws herself on the floor, hits and kicks me. As time goes on the more tantrums she has. She is obsessed with pouring liquids into her blocks and tipping her drink onto anything she can. Now positives - she’s a great eater, no problems there at all. She is open to trying new food and will use a fork and spoon to eat. Physically she is brilliant, good at climbing and getting up the stairs. She is good at bedtime, sleeps through the night no problem. She is taking to potty training well, she will wee in the potty if no nappy on (but won’t if wearing pants, just wets herself). She won’t poo on the potty yet.
I’d love to hear your thoughts. She has her 2 year review in a few weeks which has been delayed due to covid. I raised my concerns with the HV who was very dismissive and told me it’s much more common in boys and we are all on the spectrum... so not sure my concerns will be taken on board by this particular HV.

Thanks for reading.

Whereas I would never give any opinion on a child described on the internet, I think you know yourself that there is enough there to have raised your concerns, and therefore it makes sense to get further assessment.
If your HV dismisses those concerns then go to your GP.
Or does she go to Nursery at all ?

Hi,

Thanks for the response. It really is a deep gut feeling something isn’t quite right. No doesn’t go to nursery, and has lacked social interaction due to lockdown. That is one consideration I have, whether it’s just delay due to no interaction, no baby groups etc since March last year. But still, I am concerned there is more to it. Dad also sees signs but he is in denial I think.

Can anyone who has been through this tell me what the next steps are. I know she’s going to score low on social / language at her 2 year review. She can’t do any of the things on the questionnaire (social / language). So the HV must refer her on to something? Speech therapy maybe? Do they then refer on for autism assessment? Or would the HV do that (though as I say; very dismissive)

The route for assessment is different indifferent authorities.

Where I am, the HV can refer to the CDC (Child Development Centre) to see a Community Paediatrician, and, if they agree with the concerns, they refer to a MDT (multi-disciplinary Team) for a fuller assessment. The wait for this is ridiculously long (like about 2 years).

I have read on here that in some authorities, the dc get referred to CAMHS for the Assessment, whereas CAMHS aren't involved here.

SaLTs (Speech and Language Therapists) do make up part of the MDT, so , sometimes, HVs refer to SaLT if the parents aren't on board / ready to hear about other concerns, as somehow it seems less threatening. But the SaLT still then has to make the referral to the Paediatrician, which just makes the process longer. That is where some parents are on their journey though.

Some HVs do suggest taking a child along to Nursery for a while, to get them used to interacting with other children and to help develop language. Particularly after this last year, when little ones haven't been able to socialise at playgroups etc as they usually would, I actually don't think that's a bad idea, but I would do it alongside a referral, not instead of.

I wish we could send her to nursery. We are in London so nursery’s are about £70 per day. I had to leave my job as childcare for both kids would have far exceeding my salary, even taking into account government support. It would have been crippling for us so now we are on one wage. Funding doesn’t kick in until next January due to her birthday being in October. Sadly we just can’t afford to send her to nursery until we get funding. As soon as play groups open up again I’ll be taking her to as many as possible. I didn’t realise the process was so long, it’s a shame really as early intervention probably has a huge impact. Will see what happens with the HV. She did mention they don’t refer to speech therapy until 2.6 so maybe will be waiting until then before she’s seen by speech therapy. I’m spending a lot of time with her one on one trying my best to help her with her speech.. but feel I am getting nowhere. She doesn’t hasn’t grasped understanding, so she’s not at all interested and doesn’t really interact back to me. It’s really hard work and stressful.

Re nursery could you ask HV about 2 year old funding? As you have concerns re speech and language development? If you are on low income this should be possible.

Sorry just re read your last post and saw she won't get funding yet.

My son (now 3.5) was very similar. He has a development delay but we are unsure why. It's being investigated (possible ASD) but initially it was picked up via the HV questionnaire, who then referred to SALT at 18m. SALT are key really to the referral journey in my opinion (although all cases are different). To put your mind at ease nursery is good to see how they are in groups and that environment but kids (especially girls) can mask, which makes things tricky from what I hear. My little boy learns through copying / mimicking and tries to blend in with the crowd using these tactics, however, when he's at home, that's when I see how he is normally.

I understand that feeling of communicating with your child and it being 'one-sided'. Lack of joint attention is difficult to deal with, especially when you're a stay at home parent (I am also). But you're doing the right thing simply by playing / talking loads as communication foundations come from play.

Everyone says it but your instincts are key in all of this as you know your child best. Any sort of diagnosis (if relevant) can take time, due to waiting lists, but also it is important to see how the child develops through time x

Thank you! It’s so weird how each area has different processes. HV haven’t seen my little girl since she was tiny. Only now at 28 months will they see her. I definitely anticipate a referral to SALT if that’s the process. How long is the wait? Does anyone have any experience with SALT? What do they do when they first see your DC?

I agree it's very different per region. In Scotland, there is a 14m assessment, that's where we first picked up my wee boy's comms issues.

The waiting lists also differ - I was seen fairly quickly, in a few weeks. There are private SALTs too. I saw one for around £100 for an initial consultation. You can do that in conjunction with NHS if that's something you would consider.

Salt will do an initial assessment and gauge where they are on a communications front for their age and where they are having challenges. From that, there's a plan put in place for sessions with them but also a bit of straightforward homework suited to the child's needs. That's what happened with us anyway. Hope that helps.

Hi @GrapePearPea, Just wanted to share my experience with you in case it is helpful, my dd is 29 months. She was diagnosed asd last month. I probably live in one of the worst areas for support and ended up going private with everything.
If this isn’t an option then I would suggest you don’t take no for an answer from the health visitor if they are hesitant to do a referral. Mine was absolutely rubbish and refused for several months. You can also get the referral from the GP if not.
I also managed to do a self-referral to SALT, it’s probably different in all areas but if you can get hold of their phone number you may also be able to do this.
Also you can self-refer to a service called Portage, which I believe can be very helpful. Not available in my area but I think it is in most.
There’s lots of free speech resources online - try contacting iCan or follow some speech therapist accounts on Instagram, I follow one called @mrsspeechiep who’s extremely knowledgeable about autism but there’s lots of others out there.

It might be worth you joining the nurturing neurodiversity group on Facebook too. There are lots of parents pre-diagnosis there, and some post-diagnosis who are knowledgeable about different systems but also things you could do with DD. On the YouTube channel there are also some good videos including some on things you can do to encourage interaction.

you can definitely go via health visitor, isn't she due a 2 year checkup? If you describe what you have described here, she would be referred for a speech & language etc assessment by one of the child development teams. Waiting lists are long at the moment, but it will be important to get the ball rolling. Speak to your GP as well. Lockdown has had an effect, but the way you describe it, I am sure GP's / HV will agree this required further investigation. Listen to your gut feeling.

Thank you everyone. Yes she has her 2 year check up at the end of the month. It’s with the same HV that told me we’re all on the spectrum so I’m not convinced she will take my concerns seriously. Will see how it goes. Is it SALT that then refer for an autism assessment if they suspect it? Or will they refer to paediatrician first then they will refer on? Just trying to get my head around the process. She starts nursery next January so if there is an issue; I want her to have the support she needs there.

I think it will depend on area. In my area the 2 year check resulted in physio (she was more behind physically rather than in speech). We separately went to a SALT drop-in a bit later I think (this was pre-Covid), and because she was seeing two services they offered us a more general paediatric assessment.

In my area the 2 year check was always done at a children's centre and not by my normal HV so that probably helped (our normal HV was pretty much like yours!). If there is no way to see a different HV and yours remains unhelpful, try your Local Offer website (Google your local authority name and "Local Offer"). That should tell you the different routes to see different services (you might have to hunt around a bit: ours has a search bar so you could search for SLT/SaLT). It should have numbers you can ring to find out how the process works in your area. Otherwise I'd try GP.

If worst comes to worst I'm sure her nursery should be able to observe and support and put you on the right route to Dx if necessary: but limbo is horrible so I'm sure you'd like to get things moving before then if you can!