Suspected ASD: send son to nursery or stay at home, and therapy options?

[FunFearlessAlex]

I suspect our 13 month old DS is autistic. It was obvious from very little and I'm more certain every day as he has no gestures, very little interest in social interaction and has been obsessed (main form of play) with opening and closing doors etc since he started crawling at 7 months old.

I'm meant to go back to work in September and the plan was for DS to go to nursery full time. I'm now not sure if it's the best option. In the few settling in sessions in all the photos he's just sitting on his own staring at toys. I worry he will not get the 1-on-1 interaction there he needs to develop social skills. At home I try to use ABA and speech therapy techniques with him but there's nothing like that in the nursery.

What do I do? We should be financially ok if I quit my job. I can also try to go part time but will probably need to change jobs for that.

Also, did anyone start an ABA programme, like Early Start Denver Model at such a young age? I'm looking for therapy options but I'm not sure where to start :( I don't think we'll get any support from NHS any time soon as Health Visitors have so far been less than helpful.

He’s very young to be thinking about therapy in my opinion.

i had concerns about my DS at the same age, he went to nursery 3 days.
it helped massively.
children aren’t going to socialise at 13 months.

I wouldn’t give up on nursery based just on the settling in sessions. Have you spoken to nursery about DS’s additional needs? Nursery can provide support (although without additional funding, 1:1 and direct SALT is unlikely) and help with securing further support, including a more specialist placement if necessary. If the nursery needs advice on how to support DS, there are people they can approach/refer to. If they need more funding to support DS, they can apply for early years inclusion funding. An EHCNA could also be requested.

If the HV isn’t being supportive, have you spoken to the GP? Have you looked at the Ages and Stages Questionnaires?

If your area has Portage, you could look at them. In some areas, you can self refer.

In some areas, you can self refer to SALT and OT and in some areas they have drop in sessions. It is worth checking if your area does. I disagree that 13 months is too young for therapy. It absolutely isn’t.

Before deciding to go down the ABA route, you might want 5o read around ABA. It is quite a divisive and controversial subject.

I have mentioned the delays to his key worker but haven't spoken to the SENCO yet. I think at this point I could only ask them to observe his behaviour as, as you say, I don't think they'd be able to provide any support given how young he is? From what I've read there's no chance we'd get extra funding at this stage so any therapy would have to be privately funded I imagine.

SALT and OT teams here don't accept referrals from parents (and OT team does not help with sensory regulation needs either). He's been in black for communication in every ASQ starting from six months, he's just had his hearing checked and there's no problems there. He also barely eats anything other than breast milk, not even fruit purees but I'm being fobbed off by HVs and his GP.

I know ABA is controversial and I wouldn't want to put him through any rigorous programmes. I'd like to opt for something naturalistic and play based like ESDM or Hanen, but from what I've seen these are parent-led, hence my dilemma about sending him to nursery full time. But it looks like in the UK early support is generally difficult to secure, even privately.

I certainly wouldn’t make a decision on nursery before speaking properly to the nursery. If it is required, support can be provided at DS’s age. If 1:1 is required, funding can be pursued. If therapies are required, you can go down the EHCP route and that can fund therapies. Not easy or quick, but possible and a nursery can help with that.

Independent therapies are certainly possible to secure in the UK. Although some therapists have waiting lists.

In some areas, nurseries can refer to SALT and OT, which could be a reason to stick with the nursery plan. There is more to OT than sensory difficulties.

Was the hearing test after speaking to the HV or GP? If so, it is normal for that to be the first step. Speak to them again. If you don’t feel you are being listened to, is there another GP in the practice you can speak to?