early indicators of aspergers - are there any? am worried about my niece

[emeraldgirl1]

She is two and a half and I have noticed a habit of very repetitive behaviour, but more importantly she gets very upset when her fixed routines or habits are altered in the slightest. Even down to the way she is taken out of the car (if her side is blocked in and she has to be taken out the other side, she is very upset), or having to see the very end credits on a DVD (she doesn't mind about watching the whole DVD, but if she is taken away before someone has fast-forwarded to the end credits she gets quite agitated and upset). She is not self-feeding yet (much later than the other kids I know, but I could be wrong about this, it's just my personal experience) and has to have certain songs sung to her in a certain order otherwise she will not sit down to be fed.

Her father, arguably, exhibits some of the characteristics of Aspergers, but is undiagnosed, so it could just be his personality, learned/inherited by his little girl!!

I am just worried because it seems to be becoming a real issue in her day to day life, the agitation is not like that of my godchildren or other nieces, which makes more 'sense' iyswim - they get upset if a favourite toy is taken away or if they are told to stop watching TV to go for bathtime. There seems to be little rhyme or reason to my niece's form of agitation, only relating to how her patterns and routines are disrupted.

Am I over-reacting, is this just a normal part of toddler behaviour?

I think it can be normal toddler behaviour, but worth keeping an eye on. What does her mum think?

Oh and I should add that her speech seems quite delayed, she is very hard to understand and does not yet use any real phrases, just a few unconnected words.

And she is very unusual around new/different people, won't communicate with them at all. I have seen shy children before, but this also seems different, she just totally ignores people to the extent that her mother gets a bit desperate, just to try to get her to even look at them.

And finally, she is quite out of control sometimes with her physical movements, again I am trying to compare like for like with the other babies and toddlers I know - there is sometimes just random hand-flapping and head-shaking, and she is extremely strong and breaks things a LOT.

Sorry for the random list of things, as I say, maybe this is all just normal stuff, but if not, maybe early intervention is a good idea? I don't know what to do really, obviously you don't want to pathologise totally normal behaviour, but I have a friend with an autistic child and she will say how much she wishes they'd realised before he was 4 or 5 as they would have felt much better about their parenting etc etc.

Her mum seems to have noticed at one point but now does very OTT covering-up of the behaviours iyswim - when she ignores people or throws a wobbly over the routine being interrupted, her mum goes out of the way to pretend it isn't happening - which makes me think she is concerned but trying not to big it up. My niece's other grandma - ie not my mum - seems to have noticed and is mildly concerned, she tries to encourage her against the obsession with routine.

There are other issue going on in the family with regard to the parents' relationship, so maybe this is all just the signs of an unsettled child.

Obsession with routine could be normal for a toddler (DS2 NT like to control events by repetition but he is not remotely ASD). However, the level of speech (as you report it) sounds below the norm for 2.6 - How is the non verbal communication? How does she get what she wants and how does she involve others in her interests ? You have to let parents go at their own pace, suggesting to them that there is a problem could make things worse. Has she had any developmental check up ?

Thanks cyber for your reply!! I would say that the non-verbal communication is OK as long as there is either her mum or grandma around to translate, there is no way of understanding her when they are not, and anyway she really barely communicates with people who are not in her immediate family circle ie those she sees every single day.

No developmental check-up has been done.

She is still watching DVDs that are meant for new-borns, those waving hand shapes and colours etc that I remember my godson watching at 3 months and then discarding by the age of about 8 months to move onto more stimulating things. She watches them over and over and is 'frightened' of new DVDs being introduced.

When I put it all down, it doesn't sound very good, I have just realised

I'd be concerned about the speech too.

Is she deliberately ignoring people, or doesn't seem aware of them at all?
Toddlers often ignore people but ds1 at that age jsut didn't seem to register other people at all, they didn't seem to exist for him. He would often literally try to walk straight through them.

I'd be looking for patterns in the flapping too. ds3 (NT) often twirls about or fidgets. ds1 has specific patterns, it is a comforter for him normally, rather than playing. He taps his chest or flutters his fingers on his face repetively.

I agree though, you can't push it with the mum. I'd maybe suggest the speech and see where things went from there.

Thank you chops!

I think it's hard to say about the ignoring, I think it's much more that she isn't aware of them at all. Certainly this is the case for total strangers. With me though, for example, she seems unaware of me when I first show up, then I really persist (her mum seems desperate for there 'not' to be any issue with her communicating with me) and after a while she seems to be aware of me but ignoring me in favour of her mum/grandma. Then after much more persistence she will react to me, but it is very hard work to keep her attention, she will often just 'drift off', it seems.

I can't tell whether I'm reading too much into the flapping, it does happen but not as often or as pattern-heavy as you describe. There is wild head-shaking too, but again not in a specific pattern.

I think the biggest things I have noticed are: the delayed/incoherent speech; the repetition of very age-inappropriate DVDs; and the strong tendency not to react to people.

haveyou tried the CHAt screning list for toddlers? Its notperfect but is the one HVs usewhen they do (not allareas do that).

Its ahrd totellwith toddlers; I ahve a bit of knowledge about ASD, two diagnosed and yet I cant work out if ds4's oddities are toddler behaviour or not.

Speech delayes btw would be autism but many kids get a dx of ASD these days and a child with an autism dxcan developlangauge as wellof a child with AS, its a technicality as much as anything when it comes to verbal kids,thats why many do the ASD dx thing now.

Just wondering, has she had her hearing checked?

The main things you jsut said could be due to poor hearing.

Hearing was checked at birth, there was no problem with it. And she reacts instantly to any kind of music, so I'd be surprised to learn there was any kind of hearing impairment. Maybe I am wrong about that possibility though. She gets very upset indeed when there are crowds of other children; I do have a friend who has a hearing-impaired DS and this was one of the first things she noticed. OTOH I think hating crowds is also a sign of Aspergers?

DS4 got 49% on CHAt,that'shelpfulthen

(that testmisses a lo tdoesn' tit? Anything that could be listed as 'sometimes'for a start.Still,its considered to have good follow up reliability. Somehow.

thisis the other test in the field,it used to be called the childhood asperger test so might be more geared up to verbal kids but thats a random guess

Thanks Peachy, I tried this and the score came out at 67%, mind you it is a very tricky test, I agree, it is quite broad!!

Its supposed to be ascreening tool,so just an indocator.

HAve youmlooked at the triad of impairments on the NAS website? A very good place to start IMO, and a usefulway to broach with Mum if you have to.