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Special Needs
What does a good friend do? Long Re: ASD
Okay, I'm in need of some advice/help. There is a lot of background to go with this, so here goes. First, I'm now a SAHM, but I was an elementary school teacher for 5 years (2nd grade for 1 year; 5th grade for 4 years). I have worked with ADS kids, but am, obviously, not a doctor orcounselor and have no business "diagnosing" kids...but I do know a lot of the "red flags" from working with so many ASD kiddos in school.
My son is Alex (A). He has two "best friends," J and M. We are all Americans living in the UK.
A is 25 months old. J is 23 months old. M is 21 months old.
J has ALWAYS been developmentally ahead of A & M. J walked first, talked first, developed more sophisticated sentences, etc. J's bigger physically, but maturity wise, pretty "on target" for his age. Now at 23 months, he has a huge vocabulary, speaks in 4-5 word sentences, plays appropriately with other kids/toys, complies with parental/adult requests, etc. J has hit most milestones at the early end of average.
A has not been far behind J. Even though A is older, he's still hit most milestones within the "average" range. Now at 25 months, he talks in 2-3 word chunks, plays with other kids/toys appropriately, is very responsive to adults, is pretty "tender" and senses other's emotions well (ex. if I'm visibly upset/frustrated, he'll come up and say, "Mommy need hug" and hug me), etc.
M is the youngest. Early on, it looked like M was right on target for milestones. He was pretty vocal as an infant and babbled appropriately (with repetitive consonant sounds like dadada, mamama, bababa, etc.). However, he has digressed verbally a great deal. He no longer has any babbles except for "ah-dee," which he repeats constantly and it does not appear to have any set meaning. The only "word" that we can get from him is "duh" - duck with consistency. He does not repeat sounds from adults, but will, on occasion, repeat a sound in the house (like DING DONG, but not articulated perfectly, after the door bell rings). Also, he does not use gestures to ask for things. He will grunt or say "ah-dee," but rarely points. He does wave "bye bye," but does so with his fingers facing him (like he is waving to himself). M fell in the average range for walking (walking independently at 15 months), but then, and now, much prefers pushing things (he loves pushing his stroller, pushes all of his ride on toys, etc.). He will walk (and run) independently, but given the choice, would rather push things. M plays with toys appropriately, but not other children. On playdates with A & J, M almost always removes himself from the toy room and opts to sit with a toy in the hallway or kitchen. He does not share his toys well (what 2 year old does?!) and often becomes fixated on a toy that either J or A is playing with. M's face usually is serious, but he does giggle, laugh, and smile when horsing around with mom or dad.
Anyway, so my question is...I see a lot of ASD red flags in M. The verbal digression, lack of gestures, tendency to not desire to be near other toddlers, etc. all kinda make me curious if something more is going on than just normal toddler stuff.
BUT, like I said, I'm not a Doctor or anything and I am having a really hard time figuring out if I should say something to M's mom or not (she's a good friend of mine). She, seemingly, does not see any of these differences. She knows he's delayed on speaking (but Dr's here in the UK show no concerns until after 24 months), but does not seem worried.
I know that kids diagnosed early that receive interventions can make HUGE strides in coping with ASD and learning skills to make them the most successful in the future.
Does a good friend keep her mouth shut and hope that a Dr's brings it up after he turns 2 (note, here in the UK, they don't have "well baby" visits, so he'd have to be sick or his mom/dad would have to have concerns, etc.)? Does a good friend say something because they might not see the Dr. for quite some time? If you think I should say something, how in the world would I bring it up?
Thank you so much in advance for whatever words of advice you can offer.
My son is Alex (A). He has two "best friends," J and M. We are all Americans living in the UK.
A is 25 months old. J is 23 months old. M is 21 months old.
J has ALWAYS been developmentally ahead of A & M. J walked first, talked first, developed more sophisticated sentences, etc. J's bigger physically, but maturity wise, pretty "on target" for his age. Now at 23 months, he has a huge vocabulary, speaks in 4-5 word sentences, plays appropriately with other kids/toys, complies with parental/adult requests, etc. J has hit most milestones at the early end of average.
A has not been far behind J. Even though A is older, he's still hit most milestones within the "average" range. Now at 25 months, he talks in 2-3 word chunks, plays with other kids/toys appropriately, is very responsive to adults, is pretty "tender" and senses other's emotions well (ex. if I'm visibly upset/frustrated, he'll come up and say, "Mommy need hug" and hug me), etc.
M is the youngest. Early on, it looked like M was right on target for milestones. He was pretty vocal as an infant and babbled appropriately (with repetitive consonant sounds like dadada, mamama, bababa, etc.). However, he has digressed verbally a great deal. He no longer has any babbles except for "ah-dee," which he repeats constantly and it does not appear to have any set meaning. The only "word" that we can get from him is "duh" - duck with consistency. He does not repeat sounds from adults, but will, on occasion, repeat a sound in the house (like DING DONG, but not articulated perfectly, after the door bell rings). Also, he does not use gestures to ask for things. He will grunt or say "ah-dee," but rarely points. He does wave "bye bye," but does so with his fingers facing him (like he is waving to himself). M fell in the average range for walking (walking independently at 15 months), but then, and now, much prefers pushing things (he loves pushing his stroller, pushes all of his ride on toys, etc.). He will walk (and run) independently, but given the choice, would rather push things. M plays with toys appropriately, but not other children. On playdates with A & J, M almost always removes himself from the toy room and opts to sit with a toy in the hallway or kitchen. He does not share his toys well (what 2 year old does?!) and often becomes fixated on a toy that either J or A is playing with. M's face usually is serious, but he does giggle, laugh, and smile when horsing around with mom or dad.
Anyway, so my question is...I see a lot of ASD red flags in M. The verbal digression, lack of gestures, tendency to not desire to be near other toddlers, etc. all kinda make me curious if something more is going on than just normal toddler stuff.
BUT, like I said, I'm not a Doctor or anything and I am having a really hard time figuring out if I should say something to M's mom or not (she's a good friend of mine). She, seemingly, does not see any of these differences. She knows he's delayed on speaking (but Dr's here in the UK show no concerns until after 24 months), but does not seem worried.
I know that kids diagnosed early that receive interventions can make HUGE strides in coping with ASD and learning skills to make them the most successful in the future.
Does a good friend keep her mouth shut and hope that a Dr's brings it up after he turns 2 (note, here in the UK, they don't have "well baby" visits, so he'd have to be sick or his mom/dad would have to have concerns, etc.)? Does a good friend say something because they might not see the Dr. for quite some time? If you think I should say something, how in the world would I bring it up?
Thank you so much in advance for whatever words of advice you can offer.
This discussion has been closed.
Re: What does a good friend do? Long Re: ASD
I had two friends tell me that they thought DS1 was autistic (just off the cuff, not very kindly comments) and I was LIVID! I still don't talk to them much or spend time with them. Now, the comments were made long before he was ever tested and diagnosed with ASD. Yes, I was in complete denial and I didn't want to believe that he was autistic. It was just so hurtful to me at the time.
If you are going to say something, two things I would suggest, #1 only say something if your friend brings up her concerns (if she shows concern about lack of development etc) and #2 be REALLY gentle about it, don't come across as an expert, just gently suggest "have you thought about having the pediatrician do an eval?".
I had to come to grips with my son's diagnosis all on my own. It didn't take very long, once we had the diagnosis it was like we had an explanation and for me it got better. I hope your friend realizes that something else is going on and will either come to you and allow you to help her or to her pediatrician and start an evaluation process. DS1 was just over 2 when diagnosed and with the last 8 months of therapy has made some great gains. Whether you say something or not, I hope that you can be a great support to her whatever happens. Good Luck!
DS has ASD, he was diagnosed at almost 14 months. No one said anything to me, but I knew all along that he had it. I would have really welcomed any help/advice at the time.
Personally, I would tell M's mom1:1 a story about your former 'student' who was very bright and got some help with speech and it really worked well! It is not a real story of course, but the goal is to show your friend an option to get M evaluated and recieve services. I think it is free in the UK but I do not know what the ECI-type agency exists there. Maybe you coudl research that and casually drop it in the conversation. That way your friend will be left with a tangible next step.
GL!
Thanks for the responses guys. I definitely want to be helpful/supportive no matter what, and I really don't want to lose my friendship with M's mom...which is why I'm looking for advice!
I know she is definitely getting more concerned about M's (lack of) speech and I hope she's moving toward the idea of an eval. I wish the Dr's here were more proactive.
I just feel like I'm really in a sticky spot. If my son was showing any signs, I think I'd recognize them enough to get an eval...but not everyone has been around ASD kids or know the "red flags" to look for. Knowing that she's getting more concerned makes me think I should just keep my mouth shut a little longer...and that they'll "figure it out" soon...and if they don't, maybe the suggested "story" from PP is a good idea.
I'll admit I had no idea of the red flags. It wasn't until after his EI eval (for what I thought was a simple speech delay) that I googled and kinda was like "huh, yeah I can see that". I know they meant to help but it was just how they went about it that was hurtful.
It sounds like she is getting there on her own and hopefully she'll come to you and you can help her.
I have 2 children with ASD and lived in London for about a year when my older DS was 6m to around 18m (before he was diagnosed), so I know what you are talking about on the lack of well checks. Do the health vistors stop coming before age 2? I remember ours asking some developmental stuff when we first moved to the area but I'm wasn't sure how much of a role they play.
Basically she's going to have to get a referral from the GP to see a pediatrician. I too would put it under the guise of "I know a friend" and you have it easier because unless expats have changed I know we used to spend a considerable about of time whinging about the NHS. Could you tell her that you have a friend with a child that had a speech delay and they did additional screenings here to make sure nothing else was going on and that its standard here? It really is pretty standard to do a M-CHAT here and they seem to use something similar there as well (see here). It's really hard because depending on the GP I'm sure you know how difficult it can be to get a referral. They may just convince her there is nothing to worry about yet. I couldn't get a dr. in the UK or Australia to really not brush me off until we moved back to the US and I was pretty insistent I thought something was going on. Honestly, I would be hesitant to utter the word "autism" unless she brings it up first and even then tread lightly.
The other option if she has private health insurance like we did is to go to a pediatrician that way, although some still won't give you an appt. without a referral. We had expat insurance so it was a bit easier and required less hoops to jump through but it seems like as a culture they prefer the wait and see approach.
She's lucky to have a good friend even if she doesn't know it yet.
THANK YOU! Yeah, the health visitors stop coming before 2...you always have the option of going to "baby clinic" at your surgery...but it's not mandatory.Technically, the HV's are supposed to look after the child's care until the child is 5...but home visits stop within the first year unless you request one (which I'm sure M's mom wouldn't request one -- she's not a fan of her HV...I wish she could see ours....we LOOOOOVE her, but they are assigned by surgery/postcode - go go NHS!).
Your comment about the expats sitting around complaining about NHS is spot on! Cracked me up!
We all have access to US Air Force medical care about 1.5 hours away and M's mom has (in the past) had most of M's medical care done there (most of the local expats just switch to NHS because it's more convenient). I know she didn't have an 18 month appointment for him and I'm crossing my fingers that she'll schedule a 2 year one. If she doesn't...and she doesn't take action through NHS, I'm going to try the "My friend had a kid with speech delays" route.
Hoping for the best with all of this. Thanks again to all who have given their 2? or in the UK their 2p!
Thanks Auntie for your response. I am definitely afraid of offending M's mom...which is why I'm sooooo hesitant to say anything. At the same time though, I'm terrified that somehow it will get missed while we are living here and that if there are services that M could be receiving (regardless of whether he was diagnosed ASD or some other speech-related issue) that would put him in the best place for the future. It's just really a sucky spot. Like I said, I really wish health care here was more proactive and preventative.
We kinda have special circumstances here. None of us are military, but we all have access to US military health care. It's just not super convenient since it's 1.5 hours away (car rides w/ toddlers = SUPER fun
).
M's parents are smart though...and I can't help but think that they must know things aren't quite "normal" - and that they WILL inquire about it. It's just so much on my mind now...every time we are together (which is a lot), more and more "red flags" scream at me.