Autistic assessment: Are early labels ever good?

[lazygirl]

How early do you think it is useful to have an assessment. I'd have thought that below age of 4 or so toddlers are prone to all sorts of behaviour that could be interpretted as indicative of something but I'm not sure that's useful really. Won't they just be labelled, possibly for a long time?

It could benefit to know now, only in that he/she might need help at school later on, and so the necessary support could be put in place before school starts, if a diagnosis was made.

Yeah I get that. But I would have thought that's a good reason to get an assessment at some point but maybe wait until they are at school and past the 'settling in' period? What sort of support before, additional home help.
My thought is that the kind of approach or resources you might want to use with an austistic toddler are probably good practice to use with all toddlers right?

I think it depends on what scale of autism you are thinking about. Dd1 has ASD, and sometimes, to outside observers, I am sure she looks like any other toddler (she is 3.3) - a bit nutty, a bit wayard, cheeky and bright.

What isn't obvious to these outside obsevers is that 98% of the conversations dd and I are having as we walk around the shops/park/etc are totally learnt, set phrases and have a set pattern. so when I am stood there asking what she would like for lunch, getting a reply, asking when we should have lunch/what we should do next etc, the whole thing is a set piece (tis good conversational practise regardless, but not spontaneous)

It is also not possible for people other than family to realise how large her dread of water is (to the extent that she will not drink. a single drop.Ever). so when I ask her if she want s drink and she says "have one a bit later", it actually means "not on your life you mad woman". THis is something that everyone involved with her is trying very hard to crack, before yet another summer of having to force feed her liquids.

The types of therapy she is having might well be best practice for most toddlers, but the implications if she doesn't "get" something are larger. Eg speech therapy - as outlined above dd1 has very delayed speech. she can name/label things but cannot use speech spontaneously beyond a 2-word level (red car, bed now, more biscuit). She can , however, understand embedded sentences such as "is that a large berry on the floor behind her?" and react accordingly. THe disparity there is enormous. We of course sing lots of songs and ebcourage speech at home, but this has resulted in a lot of learned phrases ("let's go home and have some lunch" when I know she has little concept of "home") - this needs unpicking, and advice from professionals. If this were left until after she started school, that's just a good few wasted years, really.

Thank you, of course what you say makes great sense, I was being a little general I suppose. The op started from a friend being offered an assessment for her toddler and whether it would be a useful thing or not... The assessment seems inappropriate in her case, her ds is 3, talks well, engages with others including unfamiliar adults and children, has a very strong bond with his family, intiates conversations about variety of topics and so on. The assessment offer has come from very recently attending nursery it seems on basis of a only couple of incidents

All evidence shows that Early Intervention has the best results, therefore that means early diagnosis (see NAS website). I am talking about around the age of 2. I think it is clear by that age, if not before as in our case, that there are genuine issues. I have never heard of a child getting an incorrect dx at an early age that is then considered a complete mistake. Sometimes it may be revised, e.g. AS and not classic Autism, or other things added such as dyspraxia and, of course, many children who seem to have poor prospects at a young age can emerge as HF and vice versa.

An early dx can be a very good thing. One of my biggest regrets is that ds1 didn't get an assessment at an earlier age than he did (3.5yrs old). Ds2 was given a full assessment at 2yrs old and those two years of help before starting school made a huge difference to us.

I have no idea whether your friend's child has ASD but I would say that there's nothing in your description of him that necessarily rules it out either. Ds1 had more classic autism at that age and wouldn't have been able to do those things but ds2 certainly could.

It may be true that many children do things which could be seen as traits of ASD, but the point of an assessment is to look at the whole picture. A child who lines things up and speaks late will not be given a dx of ASD if they don't have the triad of impairments.

Making a dx before a child reaches school age will help not only the child and their family but also the school. Without a dx I suspect that my ds2 would have been labeled as being cheeky and/or naughty. The work that was put into his transition to primary school has been a great help. The school was able to call in the outreach team before ds2 even started so that they could get some idea of how to help him. The teacher understands that she may need to re-phrase some of her instructions so that ds2 understands and doesn't take everything literally. She knows that if he refuses to do something that it's not ds2 just being naughty.

I know of a few people IRL who have seen the same Paed as my two boys for similar reasons. Some have been given a dx of ASD. Others have been told that their child is not autistic. The Paed is very happy to be able to tell someone that their child is fine. He doesn't hand out 'labels' just because a child has turned up for an assessment.

Earlier the better. DS1 was diagnosed just as he turned 3- he could have been easily diagnosed a year earlier. We would have done things differently had he been. Aged 8 he's non-verbal & severely autistic. Starting interventions earlier would have been helpful to us.

The earlier the better IMHO. In this country appropriate state help doesn't exactly grown on trees even with a diagnosis - without a diagnosis it makes it much harder to get help.

my son is 3 and half now, we have been to see the consultant paed and he wants to see us again next June, he thinks my son has asd traits, not a diagnosis.... I have mixed feelings about this atm.

my ds has early years support at nursery twice a week, he is getting one to one help, it is not in place yet, but I have been told they will have someone for him very soon.

I live in Scotland, my ds goes to a pre-school attached to the school he will eventually go to, when he is 5(so glad he is not starting school next year), so he will have lots of support, without a diagnosis.

he also has speech therapist, who is organising some kind of umbrella type group of professionals to meet and talk about my ds... all this without a diagnosis of anything... I am not really sure what I am trying to say, you can get support without a dx, is it the right support, I am not sure, I still feel very clueless about it all, not having a dx means I cannot focus on one thing being a problem, is that good or bad?

I do remember when my dd was at another pre-school nursery, they had some concerns about her, just about the time they had some chats about autism at the school, I spoke to my hv and she told me not to worry( I think my dd is eccentric, may have some traits but they are not effecting her school life atm)

it might be worth getting your friend to talk to hv or doctor, just to discuss this?

Get any assesment on offer, if there is a problem the sooner strategies are in place the better, and if it turns out to be misdiagnosed the interventions won't do any harm. Most strategies used for children with ASD or other learning diffs are generally good practice strategies with more understanding and consideration behind them. It's also better to have a diagnosis rather than being more and more misunderstood as they get older, especially as mainstream teachers have so much on thier plates they often don't notice smaller details in a childs behaviour. It takes so long to get the support you need both in mainstream and SEN schools that the sooner the process starts the better. Good Luck. (I teach ASD/SLD when not hanging out on maternity as I am now ;-])