Nursery says DS may be autistic, I really don't know and am feeling a bit lost, would appreciate some advice

[Sputnik]

DS is 2.9 and started nursery in january, he goes 2 mormings a week and settled in ok. Then a couple of weeks ago he had a couple of tantrums at being told he couldn't play with certain toys. Next session was fine then last thursday he had what sounds like a massive tantrum because some other children disturbed his play. Apparently he was throwing things around and going absolutely wild for about 1/2 an hour. I have never seen him do this at home, at most he will throw himself to the floor and scream a bit, nothing beyond usual toddler stuff, I thought.

The woman that runs the nursery then told me she thought DS may be autistic, as some of his behaviour reminded her of 2 other boys she had taught who had been diagnosed. However, they were both 5-6 years old, as she used to be a year 1 teacher. She said not to worry for now, but to write down any incidents.

What concerns me more than the tantrums is that DS is still not really speaking, he does have some words, for foods, animals, bye bye etc, but just doesn't seem that interested in communicating. He doesn't often spontaneously point at things but will do it along with me if I point something out in a book or whatever. He often ignores you if you call his name or ask him to do something, though he'll come like a shot for meal times or to put his shoes on to go out.

He can however count to 12 and (bizarrely!) knows the alphabet and phonic equivalents as a result of following stuff DD is doing. He also makes a good attempt at singing along with songs and often copies words or other sounds he hears, as well as actions.

He just seems happy as he is most of the time, he plays happily on his own or with his older sister, who he copies a lot. He does make eye contact, and is also very affectionate, infact one of he few words is "kiss", accompanied by a big sloppy one! He doesn't have sensory issues beyond being a fussy eater.

I just feel at a loss really, he certainly doesn't tick all the boxes for autism, on the other hand we've had a niggling feeling something is up for a while and what the nursery said has brought it all into focus a bit.

The situation is complicated by the fact that I live in Italy, we speak English at home and the nursery is English, as well as DD's school. Which would complicate looking for any help out there. I am at home most of the time though so have been trying to engage him more, if anyone has any ideas for what we could do that would be very helpful.

To top it off DH is away at the moment and I haven't discussed this with him yet, prefer to wait til he comes back in 10 days. I have had no one to talk this through with and would really appreciate any help or support.

Must be a worrying time for you, especially having no one to talk to.

Do you have a HV? or perhaps you could talk to your GP about your concerns and issues the school have raised?

Although the teacher is right to bring her concerns to your attention, she really shouldnt be trying to diagnose your ds, she is simply not qualified.

Thanks for replying.
No HV's in Italy, and we've recently moved so yet to change doctors, I should get on to that. No sure how much use any help available would be to us as presumably it would all be in Italian. DH and I are fluent but DS would be lost, he responds little enough in English!

Just wondering really how much should be worrying, whether I should wait and see for a while as the nursery suggested or start seeing what help may be on offer. We do have health insurance, thogh not sure what may or may not be covered.

Sputnik hi sorry you came over here to sn but glad you did, there loads on here to help you!

as you know my ds as aspergers, i think it is early to tell but if the nursery is concerned they should help not try to dx him

and can i just say dont worry i know its hard but he is still your loving son no matter what, nothing will change that!

sorry am not much help.

Oh Trace, thank you for you kind words, that means a lot to me and you are so right. And for reminding me that many people go through far worse than I am.

I kind of agree about the nursery but on the other hand it has been a kind of a wake-up call for me which is appreciated if there is anything I can do in the meantime.

Hope you and your family are doing ok Trace.

I would have a few concerns given your description. The red flags for me are the not pointing to things other than on your request (although it is good he is doing that), the slight speech delay, ignoring you calling his name, and the ease with which he is picking up counting and alphabet/phonics. I'm just picking out those as those would be the things I would want to talk to a pro about.

I think if you have concerns you have to follow them up really. It is not too young, and if there is a problem the earlier diagnosis is made the better chance of decent early intervention which does make a difference.

I have a few posts in the pre-diagnosis section on my blog that might be useful. Probably the most helpful for you at this stage is the one at the bottom if you scroll down- first signs. You can take an online test as well- the link is given in the post.

oh and of course if problems are ruled out early then you don't have to spend months watching and worrying (did that and it was hideous). Good luck! It's a tricky time

It sounds like your DS has some good skills there but I would be slightly concerned about the lack of consistent response to his names and following instructions. That could mean he is having difficulties in understanding (receptive language). In the UK I would suggest a hearing test and a referral to a Speech and Language Therapist - may be worth asking the teacher if she knows how you can access a SALT who can assess your son in English.

You may find the Hanen books helpful with what you can do to increase his engagement at home. I've only read More than Words which is about ASD but It Takes Two to Talk is supposed to be very good too. With DS1 we did things like putting his favouite toy in a box he couldn't open so he had to engage with us to get it open, giving only 1 chocolate button at a time so he had to indicate in some form he wanted more. All the time reinforcing it with "you want the box open. mummy open the box. box is open". or "more chocolate. you want more chocolate. here is more chocolate" though those are probably bad examples as more can be a bit of a catch-all and the box one is possibly a bit over complicated but hopefully you get the idea.

your ds sounds quite like my ds at this age. our speech therapist said that his interest in counting was because he was latching on to the pattern that the sounds made rather than the meaning of the words and we have found this to be true, as ds does seem to learn language by repeating the sounds over and over.

as time has gone on (now aged 4) and ds's language has improved, we've had fewer tantrums and his communication has become more two-way. it is unlikely that we will be seeking a diagnosis at the moment, but we are trying to get more specialist speech therapy and occupational therapy for sensory issues/problems with attentiveness.

to be honest, most of the work we did with ds between the ages of 3 and 4, we did ourselves, rather than as part of any therapy we received. we tried to encourage turn taking games and used Hanen's "It Takes Two to Talk" for ideas on improving ds's communication. it may be that if your ds accesses speech therapy at this stage, it may be enough for you to ask the therapist for tasks to do with ds at home rather than requiring a speech therapist to be able to work with your ds in english.

best of luck.

Thanks for all your replies and good wishes, I think I'll order the Hanen book for starters and see where that takes us. I think I'll also ask at DD's school if they know of any English speaking SALTs, hopefully they do as they are supposed to have provision for special needs.

Saintlydame, your blog and the links look very interesting, thanks for posting that. Off to take a closer look at those now.

just to add another voice saying "buy the Hanen books".

Advantage of "It Takes Two" is that it doesn't talk about autism (or anything else) so can be shown to Italian MIL (if you have one), DH, and anyone else you fancy etc without starting a debate with them along the "oh no there's nothing wrong with him" line...

"more than words" starts from the assumption that child hasn't yet reached the point where he always understands that communication is the best way to get something - it digs a little deeper IYSWIM.

good luck

Well, according to the test I took he is at high risk

I would start now researching what the options are in Italy for assessment and advice. If he does pick up and develop more language, you won't have lost anything esp as it may take time to get appointments. You can always cancel if you don't need them.

Oh Sputnik . Is that the Forepath test from my blog?

You can use that result to push for whatever is available (or to give you the confidence to research and see what you can put together - i foundered for about a year when ds1 was 2 because no-one else saw what I saw and I thought I must be imagining things- had the forepath test existed then it would have given me the confidence to demand more of those around me I think).

Although should add it is a screening, not diagnostic test - agree with cyber about cancelling if not needed being easier than trying to get something in place after a wait.

Yes that was the Forepath test.
Although tbh it was hard to answer yes or no to some of the questions. For example he will hold a phone to his head but not seen much else in the way of pretend play, and he will point if prompted but not spontaneously, as I posted above. He'll respond to his name sometimes but not most f the time, etc etc.

Have you had hearing checked? I know you said he hears some stuff ok but akways worth getting a hearing test done whilst waiting for other appointments.

Your ds sounds a lot like my ds when she was that age. She didnt speak much and she used a lot of babytalk. She mainly played on her own and she always sat routinly in the same spot every day. She didnt socialise or communicate her needs. She was very good at numbers and letters and at 3 she was able to spell her name. She tip toed always and when she got excited she would jump a little and flap her hands. She has sensory ( textures in food, sounds) problems too. In nursery last year the teacher advised us to have my ds seen by a speech and language therapist and we agreed. It took 8 months before she was seen. They assest shes not developing as well as the other children, so she was seen early this year ( due to waiting list) by HV, child psychologist, peadiatrician. They said she has complex social communication disorder. She now recieving speech and language therapy and in 6 months time theyll review her development again and hopefully well get a final diagnosis. In the meantime Im reading a lot about the subject and talking to other parents.

Sputnik I really feel for you. The dawning realisation that my DS1 was not developing typically was a difficult time. In hindsight I spent too much time trying to prove he was NT which would have been time better spent finding ways to help him.

I hope you manage find some help to access the services you need.

Hi there,

you situation sounds similar to where we were pre-diagnosis. Our DS didn't tick all the boxes, and we agonised for months - is he/isn't he (with me mostly in denial saying 'he can't be!') and TBH the not knowing was the worst thing of all. It was like being on a roller coaster - some days we would think everything was OK, then something would bring us down with a bump.

I'm not saying your son is on the autistic spectrum, but I think if you have concerns and your DS's nursery teacher does, then I would certainly get him checked out, then hopefully you will know one way or another.

It's not an easy place to be in, and I know it must be extra-tough with your DH away, but hang in there. He's still young, and by the sounds of things he has a lot going for him.

HTH a little

Thanks everyone for all your support and advice, it really is appreciated.
I'm feeling a little more positive today, and trying to focus on the things he can do and build on them. I am really going to make an effort to play with him a lot more to work on his language skills. I feel guilty tbh that in the past I have tended to let him get on with things on his own much too much, he is very undemanding compared to his older sister.

Sputnik i just told justabout on an other thread do some picture cards to help him .

please please dont feel guilty its not any of your faults

went through similar with my DS at that age. Agree with justa - that children with these sort of language difficulties can be quite self-contained because of difficulty communicating - it's human nature to prefer easy stuff to hard stuff! - if you think about if, if someone tries to say something lots of times and you don't understand, or if you are in a foreign country and can't make yourself understood you tend to withdraw a bit, and resort to other methods, such as getting visual clues about what to do.

try backing up what you talk about with visuals like photos, or pointing/gesturing to make it clear what you are talking about. He may also have a delay in understanding language, that's something a speech therapist is likely to look into.

Thanks everyone. He definitely does have problems with receptive language.
I have got hold of a number for an english speaking SALT, she wasn't in when I rang but should be there in the afternoon, so hopefully I'll be able to get an objective and informed opinion soon.