Childminders flagging up possible ND

[Senorfrijoles]

My 17 months DS has, for months, been highly distressed at so many things. Some sensory experiences seem to overwhelm him, lots of screaming daily. My sense was this was more than normal toddler upset. This seems to be confirmed as his child care arrangements are now breaking down.

We've needed to use 2 separate child minders (shortage of child care in out area), one has said they cannot meet his needs and cancelled contract waving any notice payment because they just couldn't manage, they've suggested a nanny. The other child minder asked to meet with us as they feel his sensory needs are beyond what they can manage without more support. They've (CM) been in touch with the local CM senco about him (anonymously but now will give details with our permission). The CM still engaged with is great and want to work with us, but not sure how we can get them more support. They've expressed he may be ND (ASD was mentioned)

We've spoken to our HV who has arranged to come out to see us, we will feed all the CM's comments back to her. What support is even out there for kids this young? My guess not much can/will be done by HCPs due to age? At a loss of what to do, other than to try and figure out how afford a nanny. Any advice would be welcome.

I believe you can do the M-CHAT screener with a child of this age, you can find it online. He is right at the lower end of it though so higher chance of false positive.

Sorry I am not sure about the support - hopfully someone has info for you.

Child care breaking down is so hard. I'm really sorry.

I agree with doing the MCHAT. Are there other signs he's potentially autistic (e.g not pointing, not following a point, lack of interest in other people/children)? And you've checked with the GP that there's no physical cause for the distress?

I would look on your local authorities "local offer" page for children with special needs. Also try googling special needs nursery and your area and see if one comes up. He may be too young for it - and might not need that care - but they might be able to offer advice on how to apply for a place if other child care arrangements don't meet his needs.

In terms of other signs, he doesn't reliability answer to his name, he has intense focus on some tasks (taking lids one/off cannisters/bottles), never really crawled the "normal" way (hitch crawled), terrible sleeper. He does point though, and thus far has met milestones.We'll look at the mchat. It's so hard to know as he's very young, all of this still could just be normal development, I think? My sister's eldest was diagnosed with ASD at 3, but he had a very "typical" presentation (delayed milestones, when he did learn to speak was very eccolalic, lined up toys/blocks etc). DSis lives in a different country which is why I can't just ask her about services available.

@BusMumsHoliday thanks for the advice. We did contact the GP and they said they wouldn't offer an appointment because there didn't seem to be any illness. HV did intervene and the GP then sent us to the pharmacist to rule out ear infection. Turns out he did have an ear infection but even though that's now better (had antibiotics)the sensory issues are still there. Luckily HVs are very helpful, they may be able to advocate for us to have a GP appointment for a general check, especially now that 2 child minders have expressed concern. Will ask them when they come for our home visit.

I'll have a Google of special needs nurseries to see if any are available locally.

You're right that he's still very young and it sounds like he's doing really well in a lot of areas. I wouldn't presume that its autism or, indeed, that the distress is definitely sensory - though that is obviously one explanation. You want to look at all possible causes and I'm glad the HV are helpful. They may be able to refer direct to community paeds.

Has he has a hearing test beyond the newborn screen? If he's had untreated ear infections, it could have affected his hearing - and that might in turn cause sensory distress. Also, a friend's DS had asymmetric crawling and terrible sleep, and it emerged that he had mild CP (the muscle spasms were causing pain that woke him). Absolutely not saying that your DS has CP, but just pointing out that you want to keep an open mind. I hope you get some answers soon.

I second a physical check and a hearing check.

As well as the MCHAT have a look at the 18 months Ages and Stages Questionnaire and the 18 months social & emotional Ages and Stages Questionnaire.

Push for a referral for an autism assessment and also to SALT (in some areas you can self refer). Many ICBs don’t provide OT support for sensory reasons, but if your area does ask for a referral to them (or self refer if you can). If you have Portage in your area, you could look at a referral to them, too.

Some areas have early years autism services via the LA. Some only support older DC but it is worth looking what is offered locally. Some areas also have SN nurseries.

It is also worth you starting to read up on EHCPs. IPSEA and SOSSEN are charities and have lots of useful information on their website and the SEN code of practice has an early years section.

Good point about the hearing check, I had glue ear as a child and ended up getting grommets for it, it caused me a lot of issues with noise sensitivity.

Actually, now I think about it, maybe I was just sensitive to noise! But my mum definitely thought it was linked to the glue ear as sounds were suddenly much louder for me. Recurrent ear infections is a symptom I think.

I want to say thank you all. I will certainly look into everything suggested. I spoke with my Dsis as well and she was surprised at the CM's suggestion of ASD as DS points, waves, brings people toys, engages in imaginative play (likes to "feed" his teddies), walked at a typical age, says roughly about 10 ish words, eats really well, all the things you'd expect of a 17 month old.

The daily screaming/meltdowns suggest something is wrong but there's a lot to work through and focusing on only 1 possibility might lead us to miss other possibilities.

You are right that all possibilities should be explored. Any good autism assessment would consider alternatives before diagnosing. However, nothing in your first paragraph necessarily rules out ASD.