Concerned about Playskills
Assembly_Reqd
member
I think Nate's play skills kinda suck, but I am not sure of who to turn to or if I even should deal with this issue now or let it go a bit.
He will play independently, however he will be using one or two toys in particular. I got distracted on the phone today talking to my sister while he was in his room playing with that damn ball ramp thing. 50 minutes later he was still playing with the ball ramp.
We also have one of those car ramp toys. It has two swirly ramps and about 8 little people cars. He will also play with this for an extended period of time, but not as long as the ball ramp. He will just continually put the cars at the top and let them ramp down. I have tried playing with him by showing him how to add gas to the cars or drive the cars under the arch at the bottom, but no dice. There is no imaginative play. He has a small playhouse toy which he doesn't touch very often. The duplo-ish blocks do not get touched. He has multiple stuffed animals he sleeps with but I doubt they ever have a "conversation" either.
We went to the local library here, called Storyville, which has awesome imaginative stuff to do. In the "store" he was throwing the fruit into the bins or mouthing the stuff. In the "Kitchen" I sat down at the table and asked him to make me something. He just wanted to stack ice cream scoops onto a cone. He found a parking garage toy with three cars and played with the cars by having them go down the ramp, over and over. He interacted with none of the 50 gazillion children that were there.
There is just no imaginative play and no interaction with children. Is this a function of his speech delay and inability to interact with people or toys because he cannot narrate the toys interaction/ or is it something else?
His eye contact also sucks. If I am talking to him he listens (most of the time) but never looks to me for joint attention stuff. If I hold a ball out of his reach he is totally focused on getting the ball, instead of trying to ask me for it to my face or even looking at me to get a clue as to why I am not giving it to him.
I guess I am trying to figure out if I should call EI and have them send over someone to assess him, get him an appointment with a neuropsych, or go to an autism center.
He is so not on the spectrum in many ways...eats everything, sleeps 11 hours a night with 2 hour naps, he has no problems with transitions, tantrums, or sensory issues. WWSND?
Thanks if you got though my novel.... 
Re: Concerned about Playskills
Thanks for your reply Auntie.
I have discussed some of Nate's issues to the dev pedi during an office visit. He diagnosed him by saying "nah, there is no way this child has autism" no testing, just based on the 30 minute visit. *sigh* The SLP who evaluated him and also worked at CARD at KKI said she saw some attention issues and lack of interaction, but told me to wait until he is a bit older before kindie to get him evaluated further for ASD. Both of these people made me feel a little better, but my inside alarm bells are ringing and I don't want to miss out on therapies and be playing catch up.
As far as the diagnostic criteria I get what you are saying. That is part of the reason why I haven't pursued this too hard.
I am planning on putting both ramp toys away. I feel bad though because he really enjoys them.
We are still on an IFSP and are actually eligible to stay until he is 5. I also am leery about having EI assess him due to my confidence level. I also am not sure I want the findings (If he is on spectrum) communicated to the school system yet, since we have not been officially accepted into the school for the deaf for schooling beyond pre-k. Having an autism dx is a disqualifier according to their handbook. I know there are kids on spectrum there, but Nate has so many other needs, that I am afraid a dx will tip the scales against him.
I am leery about going to an ASD clinic because I am afraid the hearing loss will skew the results or make them not able to pin down a dx. I am also afraid of them throwing a bunch of therapies at us and overwhelming me. There is a DREAM (Deaf Related Evaluations And More) clinic at KKI that we could go to but I think that would be big money. I need to call.
Thanks for listening and for your advice.
What you described is pretty consistent for DDs play and for FWIW the first developmental pedi spent an hour with her at 23 months and told us over and over there was "no way", "I have a real problem seeing Autism", "maybe delayed but I wouldn't even bother testing her" hmmmm... We retested for delays using their form of Bayley this spring and the CNP said before we even left from the appointment to address her delays that she was likely on spectrum, had a severe speech disorder, and gave her a generic label of encephalopathy.
One of the great arguments they have had was her "imaginative play", given the opportunity I could finish any of her "imaginary play" scenarios. It's all scripted with her, everything. She has an awesome kitchen set she "plays with" and sadly I thought she did pretty well, until I saw her cousin who was six months younger go over and start chopping veggies, using the oven mitt, putting cookies in and out if the oven, blowing on them. LO takes the kitchen play set cup and pretends to eat out of it with a spoon. She says "fry potatoes", "pan" then puts the pan on, then "no, pot.", takes pan off and puts on pot. Every. Single. Time..... In that order. I've shown her multiple ways to play with it and she will usually tolerate my intrusion but it always goes back to that.
I feel you on the not wanting to take toys away. I bawled back in December when I realized we had to do this. DD wasn't really interested in toys or much of anything until 15 months so I felt like she was just starting to enjoy them and I had to rip them away. But at that time she would obsessively hit the same button on her little people Christmas house and watch the tree light up and play music. Actually she didn't even hit it, she grabbed MY finger with her little hand and made me push it. We have been able to work some of the toys back in and have used them as "turn taking games" so she gets to enjoy them but not get lost in them although I suppose it's still somewhat rigid. Like Nate she can entertain herself for hours if I let her.
I think that it's harder for clinicians to see milder ASD if there are other delays or issues that may mask it, and it's easier to chalk it up to that issue or an over concerned parent. I remember the pedi telling me LO hand flapping when she was excited was normal and appropriate, she told me this at the end of our appointment. I had to gently remind her DD doesn't hand flap... And i never said she did. It was as if she already had her own little autism script prepared for me, I kind of wonder how much of what I said she even paid attention to.
It sounds like you are already a wonderful advocate for your son, I hope this isn't the direction you are heading but if you are anything like me you probably already came to the determination that whether or not the actual label gets enforced the deficit is still there. Floortime has been most helpful for us, along with some intermittent structure time throughout the day, I wish you luck finding what works best for your son.
This reminds me a lot of DS. He plays primarily with balls and cars. His favorite toy at ST is always the car ramp toy - he will play with it for a good 10 minutes or so, while he just throws most of the other toys. Don't get me wrong, we are grateful that he is at least playing with something, since before going to ST he wasn't playing meaningfully with any toys at all, but he seems kind of "stuck". We have yet to have our Developmental Pedi eval, though, so I don't have an actual diagnosis to share with you. DS also eats really well (actually, he is a great eater) and sleeps well, too. He has significant speech delays, but he does make decent eye contact. He does have a major stimming behavior that he does quite frequently and he does have inconsolable meltdowns from time-to-time. Even though he doesn't have all of the red flags for ASD, I have had a gut feeling/mommy instinct for quite some time that something more than just his genetic issues/vision are impacting him. So, I would say, trust your instinct, because you know your child better than anyone else. If you think there is something more going on, then definitely get him evaluated.
Why not take Nate for an eval by a behavior therapist, who may be able to work on the play skills? You have nothing to lose, do you?