Advice on 20month old - ASD?

[angpat]

Hi, I would really appreciate any advice or insight. I started to have concerns regarding my son a few months ago , as he was delayed in speech and language he has had glue ear and hearing loss so thought it could all be due to that. He had grommets inserted a few weeks ago. Since then his understanding has really improved. So currently he is scoring low on MCHAT. He points to request and to share interest for the past month or so - he actually points all the time as well as grabby hands and a lot of times will look at us at the same time (not always )
he understands simple commands. He is interactive with adults and children, sits with children , smiles at them. He plays with toys appropriately although he does have a preference for cars and slides. He has a great relationship with nursery staff , our families and us. He uses gestures eg waves , kisses, claps at himself etc he has good imaginative play feeds doll , feeds us , toy phone etc and has really developed since watching Ms Rachel who I think he has learnt a lot from. He is constantly doing actions for wheels on the bus even when the song isn’t playing ! He points to body parts too. I am currrntly pregnant and he has acknowledged I have a massive belly and smiles at it and rubs my belly and his belly when I say where is baby
my concerns are - he stims quite a lot - spinning in circles with his eyes to the corner sometimes , hand flapping when frustrated or upset or when he doesn’t wsnt something , shakes his head , looks at his hands a lot but I don’t think he overly examines them or wriggles his fingers etc and no eye stimming
I think he vocal stims as he babbles as lot Dada , nana eeee sounds sometimes to himself and sometimes when looking at us as if in conversation. I notice it is worse when he has had sugar or is tired.
so my main concerns are the speech delay which may or may not be related to the hearing loss of at least 6 months and the stimming. Could this be autism despite scoring low on MCHAT? As anyone’s child had a diagnosis despite scoring low ? Anything else it could be? Thanks so much for reading

Evening OP

The thing about autism is that it varies so so so much. The best analogy I ever heard was not to think of it as a straight line with no symptoms one end and lots on the other, but a colour wheel that everyone has an individual plot across.
my DD is 3.5 with speech delay. She only started stimming in the last few months. The only other issue she has is a noise sensitivity and issues with her social communication. You would never pick her out in a room as being different because she doesn’t do any of the more “common” traits that people associate with autism.

so really, the only thing that now matters is just being really conscious of anything that may affect him either socially with forging relationships or if he needs support with learning. New things may appear, some may go. The behaviours listed are common autistic traits or could just be regular toddler behaviour. The good thing is now you are aware of it and can get him any additional support he may or may not need as he grows x

Thanks for your reply! Was your daughter pointing and interactive despite the speech delay? What were your concerns re social communication ? I guess I wanted to know whether stimming could also be associated with other conditions other than ASD or if can be outgrown as normal toddler behaviour with delayed sensory processing. Is your daughter doing okay at nursery ?

The MCHAT isn’t diagnostic. Some of what you describe can be within the normal range and some could be explained by the speech delay, but if you are concerned speak to the HV &/or GP.

Unfortunately DD sensory issues with sound cause issues at nursery but they’ve been great at accommodating it - use of ear defenders, recognising when she needs a break from the room etc.

lots of SALT recognise ASD traits - ours did - so perhaps start with the speech therapy and go from there?

Yes I have a speech assessment with the London children’s practice with Jackie coming up who is apparently experienced with ASD so maybe can give me some clarity during the assessment. He is also having speech sessions at Maximum potential and also had an OT assessment- neither had concerns re traits and nursery do not have concerns either as they think it’s all age appropriate and also hearing related . I guess time will tell too. What are the issues with your daughter’s social communication ?

I am a GP myself so I am aware how little some know about developmental conditions ! Especially those who don’t have the obvious textbook signs. Annoyingly my HV is on short term sick leave too but hopefully can get to see her soon! Again I’m not sure how good they are at diagnosing when no obvious signs too!

Ah we are in London too. Can I ask what OT you are using?

DDs biggest speech issue atm is she can’t answer an open question. If I asked her what she did at nursery today, she wouldn’t answer.

Oh ok - so she had a diagnosis based on her speech delay and noise sensitivity?
we used kids in sync in Barnet if yoi are in north London. Otherwise we are using maximum potential for speech therapy who also do OT! They have a few locations.

Thanks - I might have a chat with maximum potential as I feel like her sensory issues also contribute to her communication and speech delays!

I think it’s one of those things that only time will tell. DD is like a completely different child from even a year ago. Sounds like you are doing everything already to support DS!

Would you say her symptoms or needs have got worse or better compared to a year ago? Sorry just wanted to know other experiences !
which part of London are you from as may be able to suggest other OT too

Her speech has improved ten fold. Yesterday she said “spit that out mummy, that’s not yours!” When I nicked some chicken from her plate! That was a completely new sentence for her.
She didn’t even have functional speech a year ago and didn’t speak at all outside the house. Her sleep was atrocious and we spent a long miserable winter at home because every single activity we tried to do she couldn’t cope with. At nursery she needed lots of 1:1 and support at meal times to keep her at the table and she did lots of hand leading.
she seemed to go through a massive leap over the summer and started playing with other kids at nursery, much more confident, sound sensitivity all but disappeared apart from babies crying and whinging. Shes having a spurt of really bad noise sensitivity again which I’ve been told is really common in the winter as their tolerance level is just almost always maxed out. But she’s nowhere near as bad as she was last year!

we are SE London x

For OTs in London try Aniesa Blore, Melinda Eriksen, Diana Pierags or Moyna Talcer. All are excellent especially if you are thinking about an EHCP.

That’s amazing glad she has improved ! I have also heard Kikis is really good in Clapham!

Will give them a call! I rang Maximum Potential yesterday and almost choked at their fee - would you say they are worth it?

Yes their initial assessment is very expensive ! I think they are all quite similar though , although kids in sync are cheaper! but that is quite far from you
If you could get an assessment done at a cheaper place they can sometimes use that assessment to do sessions which can work out cheaper !

@angpat any update on your DC? My DS still does some stimming( staring at hands or finger flicking) he started at 3 and continues at 4. No other sensory issues. ASD was ruled out due to him having good non verbal communication despite speech and language delay.