autism and interaction with other children / sharing attention

[firsttimer08]

I was wondering if any of you could give me examples (from experience) of the kind of limited social interaction do children with autism generally have and what doe sharing attention mean?

DS is only 14 months, but we are seeing several red flags cropping up. He does not:

• share much attention and plays independently mostly. He does interact more with dh and sometimes brings his balloon or ball over to him to get him involved.
• He does not engage in any pretend play at the moment.
• tends to watch other children in groups playing, he generally does not get involved as much "with them". He will play independently with his instruments etc.
• language comprehension is very poor and does not really understand us very well.
• no words, only babbling.
• respond to his name when he is involved in play, so it can take 1-2 times to get him to look up.
• does not show much interest in his books or would rather look at them himself than with me. He used to really enjoy it before.

He does however:

• point when he wants something (started at about 13 months)
• point when he sees the bus or train or tube door opening (started at about 12 months). Don't think he turns around though to show it to us.
• looks at us fairly well and generally observes all adults and children a lot. Prefers adults to objects.
• he gets excited around other children but can indulge in physical play with them (like pulling them).
• he does try to kiss or cuddle other children and sometimes us (with me its more of a biting kiss !).
• can follow a point / whenever i point somewhere he will look up and look at it.
• loves to play peekaboo behind the curtain (without our initiation).

We are planning to get a private diagnosis for him, but just wish to find out more from other mnnetters.

Thanks !

oh and he always puts up his arms to be lifted and loves being carried around in general.

He does have weak attention span and will only play with some toys for few minutes at a time.

Conflicting symptoms are common and it's impossible to say from what you describe if it's ASD or not - the next 6 months should give you a better idea.

This article is quite good though www.mugsy.org/pmh.htm and describes what parents may see in an ASD child even at a young age.

When you look at other 14 month babies do you observe any big differences ?

Thank you for the link. Being optimistic I think the gaze and hearing is probably a non-flag. Even with the hearing - he does 'usually' or 75% of the time respond to his name. The social development and play is probably the most concerning. The most clear difference I see between him and other children is that he does not get as involved in nursery rhymes or songs. He does not move along to the music at all. Also at times he is less hesitant to go for the bag of toys while other kids will just jump for it. I am not sure if that is because he is just shy. I was an extremely shy and clingy child myself - always used to stay with my mother while other kids would be out there playing (i remember that up to school years that I behaved like that) - so maybe just clutching at straws but hoping his social behaviour is more to do with family trait

On sharing of attention - I didn't not really even pick up on that. I haven't really compared him with other children on that front so far, but will try to see how he behaves. I had understood that most younger children tend to play on their own generally rather than in group activities at this age. Is it true that a 14 month old should be getting involved in active play with other children?

I think at 14 months play is not full engaged play with another child (obv. a lot depends on what you mean by play). All I can think of is that when DS2 (NT) was 14 months, he would play on his own but had a high degree of interest in what other babies were doing and enjoyed bing prompted to join them - but I think the fact that he had normal cognition and normal functional play skill was more of a giveaway that he was NT

thank you for sharing that! yes at the moment it seems ds is more on the outside of the play and prefers to watch than get involved

I probably need to stop myself from getting overanxious at this stage, as any private diagnosis that we can get will also be a few months away, but its just really hard to focus on anything except this at the moment.

Yes I think the best thing is to focus on all the good things and positives and work on joining what he is interested in and prompting him to get him to share with you. It's easy for parents like me to think it was obvious in retrospect that DS1 was autistic but when I think more about it, actually there were developmental signs that pointed away from autism as well. So the younger the age, the easier it is to misread signs.

I would try sitting him on your knee and sing interactive songs eg row your boat, horsey horsey etc and see if you get a good reaction eg eye contact and a gesture (does not have to be speech) for more. Also just mimic back his babble and see if he replies - you can have a conversation just with babbling, its the to and fro which tends to be missing with autism. You can also do this with rough and tumble / tickles - pause and see if asks for more.

I suspect even if you got a diagnosis that you would find it hard to get much in the way of intervention. I have found it hard to get much for a child under 3 - autism intervention is counted as education and so falls to the local authority not the NHS (except for speech therapy and OT). I would think you would probably end up with some very woolly advice as few people in UK are really geared up to autism treatment in under 3's (or even under 5's!) Local Authority tend to think he's not in school yet - mine actually told me to go away and wait until he was three and entitled to free nursery place. I didn't go away but 8 months later we are still arguing over provision.

As you don't know if it is autism or not, then you could try following the child's lead which is a key part of Floortime a therapy originated by Stanley Greenspan. It isn't scientifically proven but for a young child about whom you had concerns it would not hurt - his book The Special Needs Child is worth reading. If you are in London you might want to contact MIndbuilders they have a Floortime therapist who I know has written a book about helping a young child with autism. I would suggest you get in touch with her for practical strategies. I'm not saying don't push for a diagnosis, just don't expect it to open any magic doors. Most parents of under 3's with autism end up with just a portage worker and some woolly ideas about singing songs and playing on their level. If you were fairly certain it was autism - and to be honest there are many positives on your list which my son does not do at 3 - then you might want to look at therapies with a good evidence bases such as applied behaviour analysis which I know someone on here started a child on at 18 months with good success - but you would have to pay for those privately to start off with and battle with the LA to pay for.

I would almost suggest you talk to Mindbuilders people first as they would be able to give you some play strategies and would probably be experienced in knowing what signs to look for.

My (non ASD) children did not play with their siblings until they were 2 (both were early talkers and very bright and no social concerns with either of them) and did not play interactively with other children until nearer 3. Its more whether the relationship with you is missing that I would be concerned eg if does not care if you left him in a room of strangers, did not notice when you cried etc. Also children can be delayed with play and social skills but not have autism. My nephew had speech and play therapy from 2-2.5 and is just a different child. At 2 he just carried toys around and looked at his parents like he had never seen them before. Now he is the most social child going.

I wouldn't say ignore your instincts but I would say just read up on strategies yourself - nothing you will do to encourage play skills and shared attention will harm a child.

Does he have any sensory issues? Most children with autism will be over or under sensitive to smell, taste, light, noise etc and tend either to be very easy passive babies or very overwrought cry all the time babies.

I saw your other thread. I have not used them myself but the London Childrens Practice do assessments and are part of Eagle House which runs autism schools.

I really appreciate your supportive advice here. I just thought that somehow all doors would open once we had diagnosis, but it seems not likely. DS already goes to nursery twice a day and has a nanny for the other days. I checked out eagle house group and they seem to have nursery and school for special needs which is great. I didn't realise they were linked with LCP - I had checked them out online too but wasn't sure if they only focused on speech or broad autism related assessment too.

I hope the 'positives' I have listed are not a figment of my imagination and that he can just turn out with a speech delay (which is what we had thought initially). I think its the imitation aspect in him that is missing, he definitely does not do a to and fro babble with us i.e. when we say something he just listens but does not join in. Nor does he try and make animal sounds even though we've been doing those for ages now. I'll try with the tickles, I know he generally enjoys that, but not sure if he really asks for more.

On the whole he is in the middle of the spectrum, hasn't been a very passive baby, nor is he extremely difficult. He does get upset when I leave the room and will follow me around. Even sometimes when he goes off on his own to the stairs or another room, he keeps waiting and turning back to see if I have followed him or not. Otherwise he will not venture on his own - i think he is scared of falling off the stairs. He definitely does not have any sensory issues. When the vacuum cleaner is on, he reacts normally to see where the sound is coming from, but will not really get distressed.

I am surprised that despite all the talk of early intervention, NHS/LA will not do anything until the child is 3.

The mindbuilders website looks really useful - i have to look at it in detail, but it seems they have lots of workshops and also can do a home visit. I'll get in touch with them in the new year - thank you sooo much i really appreciate this.

When my DS was 14 months, he did babble a lot but his sounds were total gibberish never real 'word sounding'. He said mama ( but not to me personaly) when he was 10 m, and waved bye-bye but stopped doing it for a while. The babbling didn't evolved into real speech, in fact when he was 2.5 he spoke only about 15 words very unclearly. He is now 4, has SLI, and mild asd.

He started lining up objects obsessively when he was near 18 m, and had great difficulty responding to his name and simple verbal instructions.
He did no pretend play, no imitation of action gestures in nuresry rhymes, he followed his own agenda most of the times, he was aware of people and other children but chose to ignore them most of the times, he had many unexplicable tantrums, and had sensory adversion for loud noises and textures inc. food.
But he was acutely aware of his environment, and did enjoys cuddles with me particularly.

At age 14 m, there were some asd red flags (which we missed) but i doubt anyone could have said for definate whether it was asd or not at the time.

I will add in my own experience with my DS, the asd signs were the most obvious and strong between the age of 2 and 3.5.

mysonben your description of your ds sounds exactly like mine. Does babble but doesn't sound like a real word. He also used to wave bye-bye before but has stopped doing so now and only does it randomly/occassionaly. He does no imitation of action gestures either or any pretend play. I've tried encouraging him to play with his doll but he just ignores it or through its away and would rather play with the blocks.

He is also slowly getting obsessed with taking things out and putting them back in, possibly an asd red flag. Sometimes he will not respond to his name either unless i raise my tone.

At the moment i feel convinced that it is asd, but also hoping that i'm wrong.

Perhaps as you sugest we will find just find out from the assessment that there are areas of concern but nothing beyond, but i'd rather know now and start preparing myself.

I'm also about to change jobs (i work full time) and just wondering how I would handle a new job with the news of possible asd. Sometimes I think whether I should just not move at the moment, b/c once we have a dx we will need to give ds a lot more extra attention....

mynsonben when did the sensory adversions and tantrums start? was this after 14 months?

The most clear thing happened yesterday when I went to drop ds at nursery. He started crying, which prompted another child to cry. I remember before he used to get distressed with other kids crying, but yesterday the moment the other child started to cry, he went back to eating his breakfast and behaved as if nothing was happening around him.

I need to still do a lot of reading on asd - but do most of your dc's go to specialist schools or can they function in a normal school environment with help? I am wondering whether I would still be able to send dc to nursery.

There are more questions than answers at your stage - in fact at all stages, certainly up to 4.4 (my son's age). Let's assume for a minute that he "has ASD". That tells you almost nothing about how he will cope at school, how many friends he will have, whether he will marry and have children, or whether in your old age you will rely on him or care for him.

What you can do is buy "It Takes Two to Talk" published by Hanen (www.hanen.org) and also the DVD "Teach me to Listen and Obey" (better than the title makes it sound - go to www.teachmetotalk.com) and start work now on his understanding of language. Always plan to improve his understanding as a priority rather than making him "talk".

Greenspan looks for an ability to solve problems using techniques such as gesture by 18 months. ie, child wants something, child can't speak, child doesn't know the word for it, child can't reach it because it's in the fridge. What does child do? Does child just scream? Or does child go and get parent, bring parent to kitchen and point at fridge grunting? If the latter, the problem may well take care of itself.

I think maybe you are running on too far ahead esp. as a lot of what you describe is not strongly indicative of autism and 14 months is young when the signs or possible signs are so confused. I know it's hard to stop thinking ASD but he does sound much more interactive than my DS1 at that age. Why not just try to work on shared attention games ?

agree with cyber - try and keep an open mind, a degree of obsessive behaviour is normal at this age (opening/closing doors, playing with lightswitches etc). if he's not into the doll, try other things to encourage pretend play - he may be more interested in toy animals/dinosaurs/cars/trains. may be worth you getting private SALT alongside the ASD assessment if it's not included, even a one off assessment can be helpful, if coupled with a scheme of work for you to do with your DS

thank you very much for the references linglette - since DS's comprehension is v. poor, it will explore these resources, ASD or not. I also spoke to mindbuilders who use the floortime techniques here in London. She similarly adviced me that ASD or not, what matters is to help ds in his understanding and ways of communicating first. DS has not yet started to take us to the kitchen, but when we go follow him there, he will point to what he wants or to his highchair if he is hungry. which is good.

cyberseraphim & totalchaos - i hope you are right and that it is me jumping the gun.

He has never had an interest in stuffed toys. We used to go to a singing and signing class and many of the children would happily play with the stuffed cat but ds would be more interested in looking at the instructor's face and engaging with her. We have a toy (soft) duck and dog, but he'll be interested in them for one day, try and feed them and then the next day he just wants to push them away.

We are trying to get help through mindbuilding - we spoke to the lady there and she seemed really v. good. I hope it works out. Otherwise I guess the place I am going to go for an assessment can probably suggest resources for SALT too.

also what is the link with adhd - DH has adhd and dyslexia - though his is fairly mild and has not hindered him in both academic and professional life so far.

It is hard to recall exactly when did the sensory issues started, it's more when did we start to really notice them iyswim.
By the time DS was about 19 months i started to ask myself a few questions, he was still refusing to eat most family foods, he was still on pureed or very mashed bland baby food, he screamed excessively at noises (covering the ears started near 2.5y), he was still a bad sleeper, and i recall myself thinking and saying "what is wrong with this child! I'm not getting him at times!"

When i had dd and was in hospital for a while, my mum came to look after DS who was 2.6 then, she said DS was a difficult but loving child, very very stubborn and set in his own little ways! Yes we did notice some behaviours on top of the speech delay, but it didn't cross our mind it could be asd until nursery raised concerns too and the paed got involved when DS was 3.
My sis who has a ds 4 months younger than my ds , thought something was amiss with my son (but kept it to herself at the time) when we had a holiday together. He was 17 months then.

But one thing is all children with asd are different, and although they share various delays, behaviours , sensory issues,...they do not all fit the same mould , and do not develop the behaviours at same age,...iyswim?
What i'm trying to say is one size doesn't fit all.
So if you have concerns and worries that won't go away, then do seek advice.
Good luck.

I guess most mothers of kids with ASD had a nagging feeling around 14 months that something was "not quite right".

But it does not follow that most children aged 14 months whose mothers have this nagging feeling will later turn out to have a significant ASD.

Glad the Mindbuilders thing was helpful, I went to a talk there which was good, but unfortunately live too far away to use them. But they seemed interesting and better than the portage you would get I would think. None of my kids have been into stuffed toys so I would not worry too much about that. Thats good he's looking at the instructor and engaging. One thing to watch is whether he is looking at peoples's eyes or mouth. DS tricked us for a while as we thought he was looking at us but actually he was just looking at our mouths which is common with ASD apparently.

Did he like the signing? You could carry on with that if it was something he enjoyed. Can help with comprehension to emphasise the word with a sign.

Loss of speech at any stage is a red flag for autism eg the not waving goodbye. If you want an NHS referral I would push that aspect with the GP / HV as that should guarantee you a referral to a paed if you say you think he has lost speech / gestures. Unless you have a very good HV I would go via the GP.

You might find it useful to keep some data - you can look at Early Years Foundation Stage for charts a nursery would be using to measure progress and there's also a developmental journal on Early Support. That way you can see if he is going forward or not and meeting milestones.

havent read anyone elses replies so sorry if I repeat or say something that doesnt fit with others.

But 14months is very young and it is very normal for a 14 month old to parrell play. They rarely "play" with others if it all at this age. They tend to play alongside others, sometimes engaging adults but very rarely other children.
It is a normal stage of development. theyt start playing alone, then they start parrel play, then shared play and then play with others. these are all normal and happen between birth and 2/3 years. I hope this helps.
however, i would always say if your worried check it out

yeah i think the signing classes were good, but he was always trying touch the other kids or trying to snatch their toys and we had to keep pulling him back. Today we went to the playground and he was looking at the other children and similarly trying to hold hands with a few of them.

I didn't even think of the waving goodbye until it was mentioned here. I'll just write down all my concerns and visit the GP again (don't really trust the HV much - though GP sent me back to her). I was probably not very coherent and persistent the last time around. He'll wave whenever he knows he's going out, but won't do it when asked to. Its like he just does not understand us.

If i were not for his receptive language /understanding, I probably would not even have got worried and started to study his behaviour.

I spoke to a paed/psychiatrist couple we know in NY and they also tried to explain to me that a full diagnosis is not possible before 2 years if that. They were concerned about his receptive language and so an assessment may be the way to go, but would certainly not resolve 'all' concerns (as all the other posters here have said)

btw thank you for the suggestion to keep a developmental diary.

i'm going to buy a washing machine or a kitchen, maybe that will bring out the pretend play.........

Looking back to when ds was that age:

He failed the old style hearing test several times so had to see a speacilist.

He was too good at meal times never tried to climb put of his high chair or car seat.

He would empty his toys out of the box and sit in the box-didnt seem to know what to do with them or would line them up.

He would scream if offered a broken biscuit-it had to be a whole one.

He put his hands over his ears at certain sounds.

He didn't answer to his name.

He did have a few words but it wasn't until he was 3 that he joined words together at all.

He liked letters, numbers, computers and could read simple words at 2 and by 3 was fluent at reading.

He sometimes smeared his nappy contents fav was all over the tv screen

He screamed if the light was bright-hates having a night light on.

Hope this helps a bit as you are obviously very worried but all ASD kids are different just like NT kids.

Some ASD kids can be bright, loving, academic and quite easy going aside from their interests or quirks it is not the worse thing that a child could have by a long shot.

I hope you get answers soon either way.