Is there any point to an assessment for my 2.5yr old?

[Moneybum]

I don’t really know how any of this (ASD/ND assessment) works.

i suspect my DD has ND traits. Her kindergarten teacher agrees it is possible she is autistic or somewhere in the spectrum, but has also said labelling children isn’t helpful and there is no point in an assessment before a child is 7 as there is no support to be had. I have also seen some toddler diagnoses “age out” and there are ASD toddlers who aren’t considered ASD when older - a confusion of toddler and ND behaviours I guess?

I do respect this kindergarten worker and understand where she is coming from, but in another sense, I can’t help but think it DOES matter to know. For one, I would educate myself on how best to support my DD.

Anyway, things that have meant I have considered this for my daughter:

• taught herself to read. Hyperlexic. She can read a fairly lengthy kids book front to back. Not really sure when this skill was learned as it only became properly apparent when she could talk - and
• delayed speech - was considering a speech assessment for her as she didn’t really talk at all until after 2, but then all her language seemed to come at once. Her vocab now is good
• Petrified of loud noises - terrified of hand dryers etc
• not good in social settings - very clingy at playgroups etc. Her Kindie teacher told me they had been considering if kindergarten was the right setting for her. She has settled a bit more now but plays alone / does observer play. I think a lot of this again is finding the loud noise and unpredictability of the setting hard to manage
• can struggle with transitions - cries at Kindie when they move from snack time to play time or vice versa. We do a lot of prep and pre warning at home before changing what we are doing.
• bounces and jumps a lot.

generally she is a very happy lovely little girl.

As I said her Kindie teachers opinion is that she is either v bright or possibly ND. I am aware a lot of the above could be considered developmentally appropriate for a toddler. I think this is what is driving me mad - how do you know the difference?! 🙂

In summary, I don’t care whether she is ND or not, the only reason I would want to know is so I could help make things easier for her (if and when I could, recognising I might not always be able to) and I think I would need to take a stronger hand in being her advocate in different settings perhaps than if she were NT. Should I be pursuing private assessment? If so, now or when she’s a little older so some of the toddler stuff fades away and it’s clearer what we are dealing with without that confusing things? I am willing to pay if it is appropriate

sorry about the length! Really appreciate any wisdom x

I think there is enough in your post to warrant further assessment, and personally, I would be seeking an assessment. A diagnosis isn’t a label.

It is a poor HCP who diagnoses a toddler as autistic if they aren’t actually autistic purely because they are displaying developmentally appropriate behaviour (although just because DC show many developmentally appropriate behaviours doesn’t mean they aren’t also autistic).

Your use of kindergarten suggests you aren’t in the UK, so I can’t comment on the support available or process.

Thank you for your reply.

we actually are UK - it’s a nursery really, but they call themselves Kindie. (And I unwittingly have just replicated that here!)

Have you spoken to your HV?

Since you are in the UK I would definitely be looking at a referral now. If you go via the NHS the waiting lists are long.

You could look at the MCHAT and Ages and Stages questionnaires.

Luckily most support is based on needs rather than diagnosis.

My DS was just diagnosed with ASD just after his 4th birthday. We were aware from around 2 that we were likely looking at neurodiversity. We sought a referral for an ASD assessment shortly after he turned 3 because his struggles were starting to manifest more visibly at nursery. We went private for the diagnosis in the end: the outcome wasn't a surprise but the assessment did reveal more about his specific needs and it's given us a stronger position from which to advocate from at nursery (they were supporting his needs before, but it's more that I feel empowered to say "x or y will/won't work because he's autistic.") I'm glad we didn't wait until 7. There is support, though we've had to be proactive seeking it.

I agree with the PP that you should ask for a referral. Even when some of the behaviours you describe are typical, they are more extreme than usual e.g. struggling with some transitions is typical, crying daily at everyday transitions is not. With my DS, it became far more obvious between 3 and 4 that he was different to other children. Of course, your DD may go the other way, in which case, you just take her off the waiting list.

Thank you @Headfirstintothewild

her ages and stages assessment didn’t come back with any areas of concern and she scored well in most things. The Mchat tool indicated low risk. I did mention at the 27m appointment with the HV her speech and reading ability but they didn’t seem concerned and again I got the “she’s v bright” message.

I think you are both right though - thanks for sharing your experience@BusMumsHoliday - that being more explicit about my concerns with the HV can’t hurt and I can always take us off a waiting list in future if we get put on one.

would you both be happy waiting with the NHS route given her young age? Or should I go private? We could afford it relatively comfortably but I am concerned it takes assessment spaces away from people who need it more and our situation isn’t at present urgent enough to merit trying to jump a queue…

Have you done the ASQ-SE? You could also ask nursery if they can refer to SLT about her play skills and OT for her sensory differences, without seeking a specific autism assessment; some health authorities allow this referral route.

Personally, I wouldn't rush a private diagnosis now. You sound relatively clear about where she needs support - do you feel like she's getting that support at nursery? Have they requested any support from the Local Authority early years team on developing her social skills and supporting her sensory needs?

I wouldn’t rush into a private assessment now. Instead I would speak to the HV and get the ball rolling for an NHS referral.

Don't wait until 7. There is support to be had if needed before then. Especially when she starts school at 4/5.

I have a referral via my GP. My child is nearly 4. Spoke with GP and they have referred us to the Child Development centre where they will do an initial assessment and see if they want to put her on the list for a diagnosis assessment.
We have: delayed speech with no words until 2, transition difficulties, sensory issues with clothes, loud noises such as hand dryers upset her, very rigid with game play and if we do it one way once then that's the way we're doing it forever! Also unable to communicate why she feels sad or even if she does feel sad. Slight toilet issues. Hyperactive behaviour a lot. Runs off, climbs is, jumps on us. She's so quick you don't have chance to stop her sometimes.
She does not show any of this at nursery. So they are not aware really. I have tried telling them.

Nursery also noticed some slight issues with her speech so we have a SALT appointment soon. She struggles to pronounce the beginnings of words.