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Toddlers: 24 Months+
2 yr check up. Pedi freaked me out.
Yesterday we went to my son's 2 yr check up. I thought everything would be normal- NOT!
So they asked me all the normal 2 yr questions:
Stack up to 7 blocks- Yes.
Jump- Attempts to, but doesn't get off the ground yet.
Can follow two step directions- yes.
He uses about 150-200 words. Mostly naming.
His speech quality improves daily.
He is starting to recognize letters. Can recognize his own name.
Fake counts to ten. Can say it, but certainly doesn't understand the concept of quantity.
HOWEVER He doesn't answer yes or no questions freely. He automatically says no to everything. Randomly he might say "ok" to some question or statement-very rarely. After lots of practice, he now will say "I want milk please" or "I want down please".
I realize there's a functionality piece of language and he's just not totally there yet.
The pedi pointed at Autism and said if he doesn't improve in three months. She wants a full evaluation. She suggested I read to him every night.
Now clearly I appreciate some reservation, but I didn't think he was that much out of the range of "typical" development. Second, we read countless books EVERY DAY since he was 4 months!! I was offended that she assumed I don't read to my son ( not as important, but I had to vent that). Now the evaluation doesn't bother me whatsoever. I'd love that information. Even if he was autistic, he's my son and the most brilliant person on Earth. I am just taken back and freaked out that I haven't been doing enough for him. He is just developing at his own pace.
OR maybe I'm in total denial? I don't know. HELP!
This discussion has been closed.
Re: 2 yr check up. Pedi freaked me out.
THIS.
I think he sounds good to me. My ped told me communicating is what is important and it sounds like your guy communicates just fine.
One of the questions they asked us at 2 years was "is her favorite word no"?.
I think it would be abnormal at that age to be answering anything more than that. Not a bad thing...but not normal.
I appreciate everyone's feedback.
My DH was really upset by the visit. We are both teachers, so last night he was practicing saying yes with him like mad. I finally had to put my foot down and tell him to leave the poor kid alone! My gut kind of tells me she's being a tad preemptive, but I'm certainly not a doctor nor do I pretend to be. It's nice to hear other two years are very similar!
Most of those things sound very typical. But I can tell you that my DD1 struggled with yes-or-no questions at two, 2.5ish, and we got her autism diagnosis at three. She was never behind on gross motor or most typical skills, and was doing all the things on that list at two, as well as knowing all her letters by 21 months. She has always been affectionate, and eye contact wasn't a big problem until closer to three; her language was in the normal range until around 2.5 when it became highly repetitive. And BTW, I read (and still read) to her daily and talked constantly to encourage language development.
Your pedi might be jumping the gun a bit, but personally I'd rather have a super-watchful pedi at that age (when a child still qualifies for Early Intervention services), than miss something. There's a long stretch between the two-year well-check and three-year, when some signs of autism can become more obvious. At two, my pedi had zero worries about my DD1. At our three-year well-check, after observing DD1 and hearing some concerns from me, she was very confident (and correct) that our evaluation would tell us that DD1 was on the spectrum.
Pay close attention. Is he answering no because he's reflexively repeating the last word you said? Does he often repeat the last word or few words you say, just out of habit and not because he's confirming or exploring the language on his own? That's called echolalia. It's part of typical development as well, but kids on the spectrum do it far more often and for longer than a typical child.
Your child is most likely fine, although it's stressful to wonder and second-guess. But the differences between a typical child and a high-functioning child with autism at this age can be subtle, and it sounds to me like your pedi is on top of it and very watchful. That's not a bad thing.
DD1, 1/5/2008 ~~~ DD2, 3/17/2010
Ok, putting my special ed background to use here...
She may have jumped the gun on mentioning Autism, but if it happens to turn out that way at age 3 or so, at least she has prepared you for the diagnosis. I would be more concerned if he doesn't understand what you are asking him/can't follow simple directions. Such as, if you ask him to put his cup on the table, does he understand? Or maybe to put a toy in a certain place? If he doesn't understand things like these (not just choosing not to do it because he's 2), then I'd be more inclined to say go for a speech eval for receptive language skills even though his expressive language skills may be on target right now. Sometimes there is just a language barrier that can be improved upon with therapy vs. an Autism diagnosis. Either way, early intervention is key.
I don't think any pediatrician would just throw that out there if they didn't have some sort of reasoning/concern. OP, there is no way from your description here that anyone can confidently rule out autism. None of us have seen or met your child. Your pediatrician however, has. I am going to bet that she used all of the info she has (prior, current questions, AND OBSERVATION) to decide that she needed to suggest that to you. Obviously I don't know either, but when I read a bunch of internet strangers sassing that the pediatrician clearly doesn't know what she is saying and claiming that your child is not autistic based on the 15 descriptive sentences you offered and their opinions of what is normal based off of their child, I get a bit annoyed.
Also I think that when a doctor suggests that you read to your kid, they aren't saying that you DON'T read. They are just telling you what they think you need to be doing. So since you do it, keep doing it and don't worry about it. And FWIW, reading or not-reading does not make any child autistic or make autism go away, obviously.
I really hope that the pedi did not suggest Autism based on just the fact that your son doesn't answer yes/no questions appropriately. My own DD doesn't answer any question correctly consistently, but I have no fears of Autism with her at all (and I'm a speech therapist). At 2, there are many factors at play... stubborness, the fact that they are still learning language, an attention factor, etc. The fact that he can follow 2 step directions indicates that his language processing is developing appropriately (which would be part of the concern with not answering yes/no questions, along with the functional component of language)
If this is truly the case, you should consider switching pedis. However, I'm guessing that maybe there is more going on than you have included in your post because Autism is based on many factors, not just an ability to answer questions.
HUH????
My son turns 2 on Sunday and he has delays in speech/language, cognitive ability and social/emotional development. He's behind. I'm aware of that and he cannot do most of what you've said above.
I don't see how, based on language alone, your pediatrician feels Autism is even a possibility. Does your son have any red flags? I don't know... I really feel that in most cases a parent knows if something is off.
It seems odd to me.
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Fire your pedi.
Your kid as as normal as can be. Don't freak out and find a good doctor.
Here is a reliable screening tool for autism that you can take online. https://www.m-chat.org/mchat.php to see if he has any of the other signs of autism. Its possible the doctor noticed some things besides the yes/no questions.
If it to shows concern, I would ask for a referral to early intervention in your area- I wouldnt wait the three months. If it doesnt show concern, I would wait it out!
DD1, 1/5/2008 ~~~ DD2, 3/17/2010
I reread the responses and is it possible you are overlooking something your doctor noticed? If in your gut you feel your LO has never displayed anything that makes you wonder and the pedi's comments threw you for a loop, I stand by my previous comments.
If in the back of your mind you felt something is "off" then talk to your doctor. I second guess everything DD does becasue of DH's aspergers but in my gut I know she doesn't display any signs (yet). Good luck to you!
and anyone claiming to have knowledge w/ autism & confident that this descriptions rules out autism, clearly doesn't have as much knowledge as they like to think
OP, did the pedi do an autism screening or was it just a developmental screening? Not sure if this is the case in all states, but here in TX pediatricians are mandated by law to do an autism screening after a child is 18mos. If your pedi didn't do this, I would call them and make an appt and ask them to do an M-CHAT. Or call your local EI and have a developmental evaluation completed. I'm sure he's fine, but if anything it will help ease your mind.
I think the only reason to consider another pedi would be that your pedi didn't convey everything to you or just flippantly threw out the idea without any real explanation or rationale, which is not really acceptable when proposing a diagnosis like that to a parent. But, perhaps you didn't hear everything- when someone starts to talk about diagnoses like that, it is easy for us as the patient to really not hear everything or not recall it all b/c you're reeling from having heard the word & your mind is going in 10 different directions. Another possibility might be that your pedi could have said something like "just to be safe & rule out autism" which is a different concept than insinuating s/he thinks your LO actually is autistic. I would suggest making an appt to go back in, w/out LO if possible so you're not distracted, bring a list of questions, find out exactly why the pedi was thinking in this direction during the assessment, etc. Then you may understand a little more about his/her thinking & approach & you will feel a lot better about it all I'm sure!
GL !
Stack up to 7 blocks? I'd of fired that pedi at that question. I mean what if he only can stack up to 5?
Three months time he wants improvement? Seriously? Also isn't 2 pretty early to start evaluating for Autism? Maybe other things but not Autism. Not to mention isn't it more of the fact that they regress not not advance when they look at Autism? I'd be looking for a new doctor.
Neurotypical 2 year olds make insane amounts of developmental progress in 3 months. Yes, seriously.
No, 2 is not too early to start screening and evaluating for autism.
No, it is not "more if the fact that they regress not not advance."
Obviously I am getting SO fired up by this post and the lack of knowledge. No no, that isn't it. I am not at all bothered by the lack of knowledge. But I am really really bothered by the people CLAIMING to have answers when they clearly have a significant lack of knowledge on the subject at hand.
And what is up with "firing" pediatricians? Soooooo dramatic
Well duh the 'customer' is always right and so is WebMD, didn't you know?
I gave up trying to argue this point on here awhile back- when I was pg and responded to posts where women asked about what other ppl's OBs were doing about XYZ, I tried to talk about different providers having different training, experience, styles & approaches with assessment & treatment and the importance of talking to your own provider about why they do things they way they do before jumping ship, the women jumped all over me about it...but not those with any kind of healthcare background of course...I guess it's hard to get unless you understand the job/role & what is actually involved. Not to mention the liability cuz I'm willing to bet many of the same women would freak out in the other direction if the pedi 'missed' the diagnosis or potential diagnosis at the 2 yr appt....
This is why I phrased my post in questions. I wasn't sure of the answer. I can only give an opinion based on what the OP said. With what she said it sounded like it was a bit premature to be talking autism.
I would also fire fire my pedi if I didn't agree with them jumping to conclusions. Pediatricians are not perfect & do make mistakes. You can mock me with the WebMD comment. I didn't claim to be an expert on the subject. I do believe that doctors of any kind over diagnose certain disorders in children who are just developing differently. If I went by how other kids developed vs. how my own child did I'd drive myself crazy. I know there are guidelines but no child fits into the exact mold set forth by the medical field.
Also if you want to mock people who don't work in healthcare, therefore don't have a place to state their opinion, maybe you shouldn't use "cuz" in the argument. It detracts from your reliability.
I think your pedi may be a little alarmist, approaching whackadoo levels. There is a significant difference between autism-spectrum disorders and a regular 2 year old exercising his independence and ability to say "no." My DS just turned three and he STILL answers almost every question with "no," and then changes his mind.
Are you and DS appropriately bonded? Does he make eye contact, give hugs, interact and connect emotionally with you and others? In my limited experience (working for a psychologist as an office manager for 2 years and typing hundreds of dictated reports), those are much more classic indicators of an autism-spectrum disorder.
No doubt! I am a big believer in following your gut and that the pediatrician is not the end all be all of parenting and child related information.
What tends to be more common, are pediatricians who have the "wait and see" approach when there is truly an issue. And that is detrimental. So seeing a pro-active physician is fabulous, IMO. From what I read with the OP, that pediatrician wasn't diagnosing autism. She had something during her assessment and time with the child that raised a red flag in her mind, thus she was suggesting that perhaps they should seek a full assessment by someone trained to assess and diagnose autism...she likely wouldn't be the one to do it. I think most pediatricians shy away from that task (as I think they should) and refer out for a diagnosis.
MegGary - I am by no means mocking anyone not "in the field" but (and I know I am now beating a dead horse) and trying to counterbalance all of the uneducated, emotionally charged commentary in this post by people WHO HAVE NEVER MET THE CHILD nor truly know what autism is and/or how it presents.
It's possible your pedi went to a professional seminar last weekend and difficulty with yes/no, which is common on the spectrum AND in neurotypical 2 yrs old. and now is scaring every parent whose kid is 2.
Or maybe your DS reminds him too much of a kid he had a few years ago that he missed the signs and his knee-jerk reaction is to scream the 'A' work from atop the exam table.
Or it's possible just something intangible rang an alarm bell in pedis head. A momentary far off gaze, or maybe a slightly monotonic quality to his responses. Or something he can't put his finger on. Maybe he noticed a slightly repetitive motion he used. Who knows. Do you? Did he say more?
Nothing you say indicates autism. Nothing you say rules it out. Are there sensory issues? Does he have a long history of ear infections? There's so much. You are absolutely right to feel freaked out- not because of autism- so many unknowns and optimal outcomes- but because you were just broadsided with a tanker truck when you were expecting a breeze. That's normal.
If I suspected autism at that age, I would self refer to EI. I would start to research social skills groups in my area- not just play dates, but groups designed to help kids with developmental disabilities.
My son is in EI for speech delay with this organization https://www.achievebeyondusa.com/
Take a look just to begin to familiarize yourself with different types of screenings. Your pedi may be so far off the wall, or maybe intuitive. I might call back and ask for a follow up appt. to hear all of his concerns so when you contact EI you have a clear picture of what the concern is.
Odds are your son is fine, even if not like everyone else, but it doesn't hurt to follow up. Good luck.
Thank you for this. What a kind, informative, and well written response.
It is not always true with high-functioning children that there are significant differences between typical and ASD at age two. They can look and act a lot like their peers and fly under the radar (sometimes for years) unless a pedi or parent is particularly attentive, or until they start having problems in school.
And all those things you mentioned are associated with autism, but they are not rule-outs: a child can do all of them and still be on the spectrum. My DD1 has always been hugely affectionate, gives hugs and kisses, and is very bonded to DH and me. She asks us to play, and plays with her younger sister. She warms up quite quickly to visitors, sitters and her grandparents (whom she only sees a couple of times a year) and loves their attention. She doesn't have problems transitioning from one thing to another, or have huge tantrums, walk on her toes, or many of the "classic" symptoms. She still has ASD. And just because a child makes eye contact does not rule out autism.
There is a huge range of ability and disability with autism. That's why it's called a spectrum disorder. High-functioning presentations are not always obvious, and a proactive pedi is far more desirable, IMO, than one who is too laid back about development milestones and may miss kids who would benefit a lot from receiving therapies at a young age.
DD1, 1/5/2008 ~~~ DD2, 3/17/2010
I've been thinking about this a lot and want to amend one thing in my novella post. If your LO has 150-200 words and is primarily using them to name objects, that's a little alarm bell in my head. Some kids on the spectrum use millions of words to label things in their environment but don't use them to really communicate. When my DS was evaluated at 23 months, he had 8 words. Or rather sounds that consistently represented words. And with those 8 sounds, he would label, ask for comfort, show excitement, offer help, offer comfort, express affection. With 8 words only he was able to communicate a wide array of things. If your LO has 150, 1500 or 150,000 words and is only naming objects, that could be a reason for concern, or it could mean you anticipate his needs or that you don't notice some of communicative attempts. Or it could mean he isn't using his speech abilities as language with communicative, social intent, and that's what an aware pediatrician could be picking up.
I obviously am not qualified to diagnose a child, much less one sight unseen, but from the little info you provided, that is something that may point to a communication concern. Again, get an eval. Even they are not fool proof- I have a client who did not qualify for EI services at 2, didn't qualify for services at 3 with ChildFind and now at 3.5 they want to put him in a full-time special ed. preschool because his needs are "so great."
You're the momma and know HIM best, now work with the experts that know needs best to get a full pic of your son's strengths and weaknesses.
Hey MegGary sorry I was not directing any of that at you- I didnt realize the poster had actually responded to/quoted someone, I thought she was making a broad statement about the whole post so it was in no way 'mocking' you. People DO use webmd & other sites as the ultimate authority in anything & constantly diagnose themselves & family with no real understanding of the many aspects of assessment, it is a useful tool but too many ppl think they know everything that goes into diagnosis & treatment b/c of what they read on the internet. You can imagine how frustrating that can be for healthcare providers.
As for 'mocking' ppl who don't work in healthcare, I really didn't think my post has a mocking tone related to that, I was just stating that the people who refrain from making statements about how a provider 'should' or shouldn't' be doing things tend to be ppl who work in the field b/c there is more of an understanding of how it works. No different than the people who work in education who reply to posts about learning & milestones w/ more knowledge/understanding of how things work in that field. Or any other issue.
And seriously, re the 'cuz' comment? It's a message board. I'm not writing a professional paper here. I love how when people on here like to point out typos & misspellings constantly to try to make other poster feel stupid if there is nothing else they can say. It's a casual conversational setting FGS.