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Need a little bit of advice re: early autism diagnosis

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  • Need a little bit of advice re: early autism diagnosis

    I apologise in advance if this sounds like I am trying to armchair diagnose but I would be really interested in any opinions on this.

    My nephew is the same age as Sophia (22 mths) and in my (limited) opinion I think he is showing signs of being somewhere on the spectrum. My brother and SIL are aware that he is "different" to Sophia but they have no concept of or knowledge of autism and are putting it down to shyness.

    My dilemma is that I have googled a bit and it appears that it is better to get a diagnosis early rather than have it picked up at school. However I really, really need to be sure before I mention it to my brother.

    So, are the following things an indication at 22 months or is it just fussy, toddler boy?

    Only eating White food - or baby food from a jar
    No eye contact at all
    No affection even for parents
    Doesn't answer to name
    Plays repetetively, will spin wheels on car for 2 hours
    Will not or doesn't know how to interact with other children, plays in isolation, completely in own world
    Has not spoken a word yet
    Repeats noises endlessly for half hour at a time, usually accompanied with some sort of physical movement I.e foot shuffling

    His baby brother also has massive sensory issues, won't be held at all etc and mum has battled with OCD although I have no idea if these are of any relevance.

    I just wondered if anyone else recognised behaviour like this in their toddler and went on to have a diagnosis.


  • #2
    Re: Need a little bit of advice re: early autism diagnosis


    We had a child like this in a large scale study and the mother was adamant that nothing was wrong. It is very hard.

    For me the most telling things are the very delayed behaviour (the repetitive play, as most children should be playing creatively at this age - babies love to bang and flap but not toddlers of this age) and the lack of language. Lack of language (both understanding and speaking) is probably the best way to get an assessment, as it's a red flag for HV/GP etc.

    I don't know if it will work (after all, I am a professional in the field and we did a full developmental assessment and the mum still wouldn't let us write to her GP with the results), but is it worth saying that he is far behind any children you know on the language and that you know children can be helped if it is picked up early? So worth asking GP/HV for a proper assessment on that? They will always ask questions relevant to autism at any speech/language assessment.

    and just to also say some of these things are not that unusual (e.g. the food), I'd say "different" rather than delayed (which the language probably falls under).


    • #3
      Re: Need a little bit of advice re: early autism diagnosis

      I think it's very difficult to make a sweeping autistic spectrum diagnosis based on your list.
      The communication things you point out could be due to hearing problems.


      • #4
        Re: Need a little bit of advice re: early autism diagnosis

        I agree with the above. I'd frame it as a possible hearing/speech problem. Then you don't need to bring up autism just yet, but maybe say you've noticed he doesn't answer to his name, have they thought about getting the HV to check his hearing?

        Will he have a 2 year check? That should pick it up.

        It sounds to me like the family need some help in general, if the mother has OCD, one child has sensory issues and one potentially has something going on. What are they doing with the younger brother? Have they accessed any help at all?


        • #5
          Thanks all that's really helpful.

          If they had any idea that it was anything other than shyness they would access all the help they could, however, it is just not on their radar at all. They are quite naive in general with regards to parenting and tend to adopt a head in sand approach. They do come to me for advice but only hear what they want to.

          Afaik she has tried to control the OCD herself with varying degrees of success over the years. The baby is only 6 months old but alarm bells are already ringing for me - he doesn't seem to be displaying what I would describe as usual baby traits. Has never smiled :(

          The hearing idea is a good one, I think I may also push her toward the health visitor on the basis of the food issues as that is all they are seeing at the moment. My mum and I are seeing red flags all over the place but are worried to flag it up in case it is nothing, they would be so hurt if they felt we thought their child had developmental issues or were discussing it behind their backs. It is so hard.


          • #6
            Re: Need a little bit of advice re: early autism diagnosis

            Hmm it's a difficult one, I don't think strange at all to not speak at 22 months, particularly in a boy. Does he have any non-verbal communication? Does he wave, point, nod or shake his head? These would mean more I think than actual words, some children just don't talk at this age.
            also the food and repetitive play, again, 22 months is really young, my nephew is still unbelievably fussy with food (I think down to the issues SIL has with food) and still is at almost 12... Around 2 he literally just ate cheese sandwiches for about a year.

            The problem is, his 2 year check is unlikely to be with a HV unless something has previously been flagged, it'll probably be form filling so I think it is worth a visit to the HV. The only problem with looking at hear first is that, that could then detract from everything else and waste precious time. This is what happened with Thomas, because he had slight glue ear at 2, it's all they focused on for almost a year when we could've had a year more to get to grips with diagnosis and get the support we needed. So I think it is worth picking up on hearing but suggesting it is much more than that. Does he go to a nursery? Our nursery were fantastic in extra support and I think having their backing helped us to get taken more seriously.

            Being really honest here but if my sis in law came to me with a list and pointed out that Thomas was all of those things and couldn't do certain things, I would've been devastated... I think you may be better phrasing it that you know some one that has it, or read an article that you stumbled across.
            I know you're trying to help but I know it would have upset me (not because you're doing anything wrong, just when you have a child like this, you already feel like you're getting it all wrong)


            • #7
              Thanks Peridot

              I am glad I posted because it sounds like a lot of these traits could be down to his age rather than anything else, I think I will have a general chat with her about her concerns and gently suggest a HV visit.

              He doesn't go to nursery and she is very socially isolated so he doesn't mix with other children apart from once a fortnight when he sees mine for a couple of hours. That doesn't help, either his development or the potential for her to spot other areas he is struggling.

              Thanks so much all

              Eta - he does nod and shake his head but does so as part of his repetitive behaviour not as communication. He does wave and point in context.


              • #8
                When he waves and points it sounds like he is not making eye contact? These are good skills for a pre-verbal child to communicate and request objects but they don't work in the same way without eye contact.


                • #9
                  No he doesn't make eye contact, he has this thing where he lowers his head and hides behind his fringe - it looks like extreme shyness and he uses it when you try and engage him.


                  • #10
                    Re: Need a little bit of advice re: early autism diagnosis

                    If he was making any form of non verbal communication I would be worried but if he is nodding and waving in context that sounds not too bad...

                    Only going by my experience with DS who is that age, he pretty much ticks all those boxes apart from baby food, he loves his food. The bit that made me worry with ds is that although he doesnt speak there is NO communication whatsoever. He will not acknowledge when you call his name and he doesn't understand instruction or offers like "dinners ready" for instance. To make him understand dinner is ready we unfold the highchair and he comes running

                    If the parents aren't concerned theres not much you can do really? maybe leave it 3/4 months and see how he gets on as kids that age often have a massive burst of development and if he doesnt then casually suggest it? My DHs side of the family were certain something was up with DS very early on. They didnt mention autism but were concerned about his hearing and were supportive of me getting it checked and encouraging. My family however were in complete denial!


                    • #11
                      It does not sound like he is nodding in context, and to point effectively you more or less have to check back to the person you want to pay attention, does he do that? And is the waving when someone says "bye-bye" or when they wave? Or just randomly?

                      I have to say the repetitive behaviours worry me more, especially if there is no other type of play, but it's the communication that usually worries parents.


                      • #12
                        Re: Need a little bit of advice re: early autism diagnosis

                        My DS is Autistic. If you were my SIL I would have taken major offence if you even suggested that my child was less than perfect.

                        But when he got diagnosed it was such a bolt out of the blue. When I rang my Mum and In laws, they all said they had suspected but they didn't want to upset me. I really wish they had.

                        I'm not saying of course that you should blast in and announce your suspicions. But maybe a gentle easing approach towards the HV.


                        • #13
                          Thanks everyone who responded to my thread. It appears my SIL may be a Damsels lurker :whoops:

                          Either way my brother called last week to ask if I suspected nephew to be autistic and if so what the next step is.

                          I asked what their concerns were, rather than telling him what mine were and he repeated most of what I wrote above and then booked a GP appointment. The GP has concerns but has asked them to go back when he is 2 if he still isn't talking.

                          So, thanks all - will keep you updated


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