2 1/2 year old... concerns

LegacyUser

Going unreg for this one as it's a bit personal.

I know a child who's just about 2.5 years old. I've been concerned about him for a while and I just wanted to get other's opinions on how he is. I'm a primary school teacher with quite a few years experience but this child is a bit closer to me that just a 'parent from school's kid.

This child doesn't speak much. He has a few words that are clear sounding. When he wants something he just whinges and flaps his arms around, comes over and grabs you by the hand to bring you to what he wants but still can't say what he wants or what's wrong.

He sleeps a lot. He prefers to lie in his room and watch tv. If his brother comes in he goes crazy and wants to be left alone. He babbles away in his own language but none of the "words" sound like words. He has ZERO patience and rarely answers or engages when he's being called by his name even if you are standing in front of his face to block the tv. It's as if he's on a totally other planet.

I've noticed for quite a while that he shakes or is quite, jerky like a new born sometimes. Like if he's eating or walking his arms will jerk

Lately, he has tantrums very regularly over nothing in particular. I think that his lack of communication causes these, the frustration of knowing what he wants or what has upset him but he's unable to get it out and of course the terrible twos however, I can't help but think to myself that his parents are in denial of something else that could be on the cards. I honestly don't think that he's just going through 'normal' 2 year old behaviour.

Any advice??

Moonbeam

What stood out to be there is that he is 2 with a tv in his room .
Is he put in front of the TV instead of getting human interaction ?

AnCatDubh

Came across this thread randomly on the front page (not a topic i'd normally pitch in on), but you may find an interview Tubridy did with a mother of triplets with autism interesting from the mother's perspective. She describes how an extended member of the family flagged concerns to her, but honestly admits that she didn't want to know, however also by her own admission it being raised with her did sow a seed of doubt in her mind and even though in denial that there was anything wrong, she did watch out with a heightened sense of awareness as to the issue. That is probably a result for the individual of her extended family who took the trouble and brave step and mentioning it. It's a cracking interview btw - the bit referred to above is about 2.5 to 3 minutes in.

The only thing I will pitch in on, is IMHO to be sensitive and not overbearing on the matter. Know your role & responsibility (if any). I'm making an assumption that you have 'form'/are experienced with understanding children and developmental stages by virtue of your employment remembering that if a newbie to such employment that you may be enthusiastic but not experienced. That said, i'm assuming you know what you are talking about.

As per the interview linked above, certainly sow the seed of doubt should you feel that there is something there to be made aware of or concerned about, but I'm guessing that though you haven't stated the closeness of the situation to you personally, that you'd need to be on cordial (or better) terms with these folk into the future, so you don't want it to be any point of antagonism. Parents are quite likely to do the natural thing and be protective of their offspring which includes any perception that they are being singled out as being different by anyone. Not logical I know and it shouldn't be like that but that's parents for you (how you do your actual job will remain a mystery to me!).

Know when to engage and more importantly when to back off if required. Don't expect anything out of the engagement and you won't be disappointed. Depending on the folk involved you may be told very quickly to back off and I sincerely hope it doesn't go pear shaped on you but be prepared that it may and have your exit strategy in your back pocket for such an eventuality such that you'll exit remaining cordial with the folk. You should get a sense very quickly if someone is receptive to your message.

Not an easy one either ways. Good luck no matter what you decide.

LegacyUser

I suppose I should have mentioned that myself and this child's mother have spoken about his behaviour it's not being denied as such.
She asked me out straight if I was worried about him and I told her that I was. His mother is also trained in childcare and has been open with me about what she would probably advise parents to do if she had a child with his behaviour in her care.
I was asking on this forum to see if it would actually be too early to detect some sort of autsim spectrum disorder or is he just a little bit slower developmentally and will be fine? (The latter I don't see to be true).

He has total freak outs for what we can see is no reason what so ever. Like yesterday, we went to the beach and I noticed that he only wanted to scoop sand up into his bucket that wasn't already messed up/dug up or that had footprints on it. His brother was digging beside him and of course the place was destroyed. He was getting so frustrated that once he scooped some up he had to move to another patch and walk back.

Moonbeam, he isn't put in front of the tv at all. His extended family is large and there are always people coming and going, he has lots of cousins he meets everyday and they all run and play outside. He loves to be outside generally but recently he has come in bawling in total meltdown mode and the only thing he wants to do is lie on the bed watching tv or begs for Peppa on the iPad.

I must have a listen to that An CatDubh, it sounds very interesting and I just want this wee fella to be happy, he just looks so unhappy and frustrated more than he is happy and playful. I suppose the biggest signal for me too another thing is that you could be calling him by name, right in front of his face but he's just not present... at all. Won't react, won't look up, won't react at all.
Thanks guys

January

Early Intervention was designed especially for children around that age to be assessed for autism spectrum disorders. He's not too young to be assessed.

lazygal

Whatever else children should not have televisions in their room. Mine are like zombies if they watch it and it's limited enough.

Moonbeam

I would advise her to take him to the PHN and request and assessment of need.
http://www.hse.ie/eng/services/list/4/disability/Disability_Assessment/

dori_dormer

Some of those things I'd consider normal 2.5 yr old things. Others MAY be indicators of autism or similar

My boy has a speech delay. We cut out tv 100% and it has improved massively over the past 6 months. But he still doesn't have many words, and will come and tug your hand, point to what he wants, whinge etc.
My boy is also a bit of a perfectionist. Likes matching things, lining things up etc. I mentioned it to phn and she said as long as it didn't seem compulsive then it's just normal behaviour.
I also think he's 'introverted' for want of a better word ( as I think it's silly to label 2 yr olds) he gets overwhelmed with too many people, will isolate himself for a time out. He knows himself and his needs so I let him. He'll come back 15 min later and join in again though.
My boy also sleeps loads. 3 hour nap in day and 11-12 hrs at night. It's just what his body and mind need at the moment.
Tantrums over minor things I would also class as normal 2 Yr old behaviour.

I think it's all relative and very child specific. Your friend should contact the phn in her area and tell her her concerns. She'll let her know if they are red flags, or just a phase etc. or in the normal range. She should have seen the phn nurse when child was about 2, and mentioned the speech delay at least.

Basically everythign in your first post , could be used to describe my boy ( other than the volume of tv) and my boy is considered perfectly normal. Your second post is more detailed and may or may not have some red flags. Only a professional can tell you I think.

yellow hen

Wow dori, my son sounds alot like yours! We're currently going through the AON process and so far it's looking unlike ASD and more likely global development delay. In addition to poor s&l, he has some sensory issues such as tactile and gross motor skills... Eg. He hated the texture of sand on his feet but is used to it now. His spavial awareness is also terrible so leads to a lot of accidents etc. lately he tantrums a lot but it's just it's a combination of a new sister and delayed 2yr old tantrums. These tantrums are short lived and usually because I with old something such as TV. Be aware of the difference between normal toddler tantrums and sensory meltdowns. To be honest, a lot of what you describe could be passed off as normal toddler behaviour but I think it's a case of having to see the child and his behaviour.

dori_dormer

yellow hen wrote: »

Wow dori, my son sounds alot like yours! We're currently going through the AON process and so far it's looking unlike ASD and more likely global development delay. In addition to poor s&l, he has some sensory issues such as tactile and gross motor skills... Eg. He hated the texture of sand on his feet but is used to it now. His spavial awareness is also terrible so leads to a lot of accidents etc. lately he tantrums a lot but it's just it's a combination of a new sister and delayed 2yr old tantrums. These tantrums are short lived and usually because I with old something such as TV. Be aware of the difference between normal toddler tantrums and sensory meltdowns. To be honest, a lot of what you describe could be passed off as normal toddler behaviour but I think it's a case of having to see the child and his behaviour.

Exactly. Seeing things in context and the overall picture is very important. It all depends how often and why something happens. How long the meltdown is etc. you can't relaly lump all children who don't like large volumes of people into the autistic bracket etc.

We also moved to Germany for 8 mths when little fella was 18mths and the dual language contributed to his delay I think also. My SIL is now 8 and she had a speech delay too, mainly because everyone in teh house was much older than her and did everything for her, she never had to ask for a thing! Also she ended up needing grommets.
We had an informal meet with an American speech therapist in Germany in nov, and her simple tips really helped! My boy wasn't gesturing either at the time. Now he has about 5 words in baby sign language that he uses every day, points and raises his are with 'I dont know' etc. I think he just needed to be 'taught' these things. They weren't natural to him, he didn't really know how to use his body to communicate. But now he's flying at it! Just a gentle nudge was all he needed. No sensory issues with him thankfully!
I think the phn nurse also took into account how fast a pace he was improving and learning. I think that makes a big deal to a natural delay and somethign else underlying. In the uS they intervene around 18mths old for speech or younger. Ireland is the 2 yr mark, and in Germany they don't think there's a problem until the child turns 3 and still has issues. So it's all relative too!

_Brian

Got to "tv in his room" amd stopped. Child is badly parented and spoiled. Pity for him and the first teacher has to deal with him.

Keane2baMused

_Brian wrote: »

Got to "tv in his room" amd stopped. Child is badly parented and spoiled. Pity for him and the first teacher has to deal with him.

Absolute rubbish. You have no basis for this, you're not a medical professional so have no right to maintain the 'tv is the problem'.

Keane2baMused

OP I have read your post carefully.

I think it would be a good idea to go to your PHN and ask him to be referred for an assessment of need (there will be forms for you to fill out)

It is absolutely not too early, the sooner you get the ball rolling the better. These assessments take a lot of time.

Best of luck

IvoryTower

Sounds similar enough to my son, I would have thought the rediculous tantrums are standard for that age. He's in a good creche and they seem to think he's fine albeit a but behind on speech to most his age

Keane2baMused

OP does he walk on his tippy toes? Does he point towards things he likes or wants? Does he nod his head for yes and shake it for no?

Does he have any fixations or repetitive behaviours? Does he understand simple instructions? for example, get your shoes/ coat?

These are all things for you to consider, and it would be a good idea to start recording anything you can think of.

Also getting a video of him in a tantrum/meltdown is a good idea as you can show those involved should you need an assessment.

LegacyUser

Not an expert here, but I have an almost 2 year old. She's very articulate, but that's not what I'd consider normal for her age.

Meltdowns over nothing have started lately here. My little one is with older kids at the minders and I think she finds it hard to keep up - and she hasn't quite got the language to cope either. That could be causing his meltdowns and the TV thing is probably his way of "relaxing" or having a time out for himself. I know she asks for TV too if she's not well or very tired or overwhelmed.

The only other thing I will say (and I say it as the daughter of a primary school teacher) there are a lot of kids who are older and who completely ignore their names being called. Surely you'd notice that in a class? Mainly because they've just never been told to respond when their names are called, they are used to being called 3, 4, 5 times before paying attention. Listening is a skill kids have to be taught too - maybe he's just never been told to answer when his name is called. My little one could be on another planet watching TV and would completely ignore you too, multiple times, even though I make sure to keep telling her to answer when she's called.

As others have said, a lot of that behaviour could be normal two year old stuff. Mind you, I'd take the TV out of his room. Also might be worthwhile having a his hearing checked and bringing him to the nurse. If there's nothing there at least you've covered all angles, and to be fair, you see the child yourself and we don't, so you'd have a better idea.

LegacyUser

Wow, thank you all so much for your input except of course for _Brian who needs to hop on out of here and stop trolling.

The child's mother has mentioned his speech to the PHN and they've decided to refer him to a Speech/Language specialist which I think is fantastic but it's even since then that his behaviour has become more demanding and draining (for his mum anyway).

I haven't noticed any repetitive behaviour as such, as for taking direction like get your coat/shoes etc... most of the time he never responds to such things and even his name. You could wave his favourite food in front of his face and he won't pay attention to it whether he's watching tv or playing with a toy. If he's looking at the dog he won't even turn his head, it's as if he just has zoned out completely.


Someone mentioned nodding for yes/no... He can say 'no' and he says it very well. I've never heard him say yes or nod for yes/approval. If it's something he wants he'll either stop whinging once we've realised what he wants or smile and clap his hands.

There are other things that he doesn't like which to me are a bit off for a 2+ a bit year old. He HATES having his sleeves rolled up or his trousers. If by chance his sleeve gets slipped up his arm either by doing it himself or when he's playing, it's a meltdown. The sand I don't think bothered him too much at the beach the last day because he was throwing the ball for the dog and it was absolutely encrusted with sand.

Thank you all x

dori_dormer

Guest_2yrold wrote: »

Someone mentioned nodding for yes/no... He can say 'no' and he says it very well. I've never heard him say yes or nod for yes/approval. If it's something he wants he'll either stop whinging once we've realised what he wants or smile and clap his hands.

x

My boy doesn't nod for yes. He shakes his head for no, and I think has said no a few times this week. I think yes comes later, mainly because when we as adults say no, we instinctually shake our heads too. But yes often goes without the head movements, so can take longer. Again the whinging will just stop when you get to the right answer!

Roselm

Guest_2yrold wrote: »

I haven't noticed any repetitive behaviour as such, as for taking direction like get your coat/shoes etc... most of the time he never responds to such things and even his name. You could wave his favourite food in front of his face and he won't pay attention to it whether he's watching tv or playing with a toy. If he's looking at the dog he won't even turn his head, it's as if he just has zoned out completely.

There are other things that he doesn't like which to me are a bit off for a 2+ a bit year old. He HATES having his sleeves rolled up or his trousers. If by chance his sleeve gets slipped up his arm either by doing it himself or when he's playing, it's a meltdown.

I'd be the most worried about the lack of reaction when you're right in front of him. Some kids are language delayed but they usually respond and engage nonverbally.
The sleeves thing sounds sensory.
You also mentioned he's jerky. Are his motor skills delayed do you think? He sounds suitable for an Early Intervention Team if there's one in your area.

Roselm

Meant to say it'd be worth getting his ears looked at in case he has glue ear and can't hear you when you call him. I know you said he doesn't reapond even if you're in front of him but hearing difficulties certainly wouldn't help...

Keane2baMused

Roselm wrote: »

I'd be the most worried about the lack of reaction when you're right in front of him. Some kids are language delayed but they usually respond and engage nonverbally.
The sleeves thing sounds sensory.
You also mentioned he's jerky. Are his motor skills delayed do you think? He sounds suitable for an Early Intervention Team if there's one in your area.

I agree with this.

I understand posters are trying to be helpful with the 'kids being kids, my kid is the same etc' but it was exactly these kind of helpful comments (sincerely meant as people do just want to help) that kept me from getting my son assessed for longer than I should have and than my instinct told me to.

From both personal and professional experience it's unwise to ignore or put concerns on the back burner.

It may be something, and it may be nothing. The something could be something very very small, or something more significant, or nothing at all.

Right now I'm watching a family member passing concerns off as 'kids being kids' & phases all the while I can see the fear in their eyes. I have tried gently steering them in the direction of getting help for their child but it has to come from themselves.

No harm can come from getting a professionals opinion.

laserlad2010

If I received a referral like this I would be extremely concerned about autism spectrum disorder.

Sometimes children can be too young to diagnose in cases of mild autism, but this sounds more than mild.

Above not to be construed as medical advice but I would strongly advise the mother applies via PHN for Assessment of Need. This can take months, up to a year in some areas.

The earlier the diagnosis the better IMO, in some cases.

Edit: There may be another genetic/developmental cause for the behavioural issues. Everything needs looked at

Keane2baMused

OP just to add if the referral to Speech and Language is through the HSE be prepared for a very long wait. Over a year in many cases.

It is quicker to go through the assessment of need process as legally this has to be completed within a specific timeframe. You will then meet with a HCP (we met with a speech and language therapist) initially to discuss your concerns and an initial assessment and they will decide if further assessments are required.

You can stay on the list for SLT and still go for the assessment of need. If your child is accepted into and requires services then early intervention takes over.

Dravokivich

Keane2baMused wrote: »

OP just to add if the referral to Speech and Language is through the HSE be prepared for a very long wait. Over a year in many cases.

Just as an FYI,

I had gone through a Speech Therapy workshop hosted by the HSE, initially things seem to done with the parents without the child present to review how they are interacting with the child and out lining expectations.

After doing the workshop, it was clear I didn't need to pursue it further for my son, who's about the same age as the child referenced in the OP. So I recon there's no harm looking into it, to at least be informed. I feel they should have the details of the workshops and exercises referenced more accessible. It'll allay a lot of concerns people have about speech development.

Keane2baMused

Dravokivich wrote: »

Just as an FYI,

I had gone through a Speech Therapy workshop hosted by the HSE, initially things seem to done with the parents without the child present to review how they are interacting with the child and out lining expectations.

After doing the workshop, it was clear I didn't need to pursue it further for my son, who's about the same age as the child referenced in the OP. So I recon there's no harm looking into it, to at least be informed. I feel they should have the details of the workshops and exercises referenced more accessible. It'll allay a lot of concerns people have about speech development.

Of course and I didn't state otherwise. There's never harm in attending any/ all sessions offered.

The issue arises with waiting lists and in Dublin especially these are excruciatingly long in many cases. The assessment of need may actually rule out the need for any further action in itself and tends to be quicker.

_Brian

Keane2baMused wrote: »

Absolute rubbish. You have no basis for this, you're not a medical professional so have no right to maintain the 'tv is the problem'.

Your absolutely right.
The parents are the problem, not the tv.

Orion

Brian - be helpful or stop posting. There is no need to be abusive towards the parents.

SEPT 23 1989

Don't wait for the state to do anything for your child go private beg borrow and steal to pay for it

you have picked this up at the right time and intervention now(if there is something there) will make a huge difference to your child's life going forward

Dravokivich

Keane2baMused wrote: »

Of course and I didn't state otherwise. There's never harm in attending any/ all sessions offered.

The issue arises with waiting lists and in Dublin especially these are excruciatingly long in many cases. The assessment of need may actually rule out the need for any further action in itself and tends to be quicker.

Yeah I was just explaining what happens at the start, from my own experience.

Keane2baMused

Dravokivich wrote: »

Yeah I was just explaining what happens at the start, from my own experience.

In reality these should be readily available options for anyone with concerns. But of course in this country even jumping through hoops often doesn't get you too far.

LegacyUser

Thank you everyone.
It's grand for us so called 'professionals' to be trained in such things but when you don't have children and it's a child who's close to you that you're worried about it's good to get some insight from parents who have gone through these thoughts and used the services available.

The PHN did mention his hearing and with regards to the Speech&Therapy she's waiting for an appointment to come in the door. I'd be on the side that his hearing is fine because he could be in the bedroom (their house is small) and used to repeat sounds that we'd be making to the baby from the other room and that was an indicator for me (and his mum) that his hearing is probably ok. No harm in getting it checked though.

Hopefully she won't have to wait too long for an appointment but if he gets worse or doesn't improve she won't hesitate about taking him back to the GP to get him seen to.