To say something or keep quiet, that is the question

2 is very young as it could be normal but just note things down and keep a watchful eye. Don't say anything unless they mention it. DD2's friend has a son same age as DGS2 (2 ½) and this child is not speaking very well but making high pitched noises. He is good at climbing and balancing and attends a forest nursery. DD2 is concerned as she works with under 12's and has studied autism but is not saying anything to her friend at the moment but will if the friend asks her. The friend is a bit worried because DGS2 chatters non stop, is very friendly and adventurous and communicates with other children of all ages but then they are all different and DGS2 would probably fall off a plank connecting 2 tree stumps whereas his little friend can happily negotiate this.

I know a lot of kids diagnosed at 2/3.

My son was diagnosed at 2 Ellan.

My son doesn’t really have any understanding of his diagnosis and tbh autism isn’t a massively helpful diagnosis for him now. But it was certainly helpful to access resources when younger and was helpful to me when he was younger.

My point really is that no-one is just trying to needlessly label a child and if you refuse to allow assessment for a diagnosis then the problems don’t go away. They just remain less understood by others. I think if people fit a diagnosis there is a lot of evidence that it is helpful for them to have it - either in terms of their own understanding of themselves (as oceanmama describes) or other people’s understanding of them.

People worry about misdiagnosis but I think that is a lot less common than delayed diagnosis

I don't think anyone would look for autism under the age of 4/5.

A label needs to serve a purpose. Support resourcing aside, the label can be helpful to the child, especially as they get older. It gives them the gift of understanding why they feel differences or struggle with certain things. That understanding can be very beneficial for their mental health and self image which can be hard areas for autistic people. Autism also comes with strengths. I think it's important to let autistic people know this and press into their own strengths, as well as telling them about well known autistic people and what they have given to the world.

Seems to be a case for not saying anything. if they asked you for advice it would be a different matter, or if they were starving her or something . But the child seems to be thriving.

You have misinterpreted what I said doodle.

I have said there may be situations when it is deemed reasonable to watch and wait. But developmental concerns can arise from neglect, so if a professional raises concerns, parents refuse professional ‘interference’ and don’t allow anyone near the child the professional would have little choice but to raise a safeguarding. You don’t get to choose when to raise one.

Diagnosis isn’t about ‘labelling’ either. It’s about the recognising when a child needs support. The ‘label aids in accessing support (although depends on the label - autism for example makes it easier to get support than developmental language disorder although the needs may be similar).

The process of diagnosing autism is slow - my son was diagnosed during a 6 week twice weekly multidisciplinary assessment - pretty quick. I know some people who have taken years to get the diagnosis going back and forth for various assessments. So it’s not really about labelling it’s about engaging with professionals and services.

In my experience autistic children who come under the 'gifted' category, or who are managing well, are less likely to be picked up too as they are so far ahead and don't fit the preconceptions.

I'm sorry you had that experience with your nursery school Nezumi. Not the right approach at all and, as you say, very cruel. It's obvious that you care very much. Good on you for taking initiative and starting the referrals yourself when you were concerned.

My elder son was a very quiet child, and even when he started school the teachers were concerned about it. But he grew up perfectly normally, he is still just a quiet person.
On the other hand, my autistic grandson chatted a lot from an early age.

If a child was showing very clear signs of needing an assessment and parents refused that & responded very negatively that could lead to a safeguarding - depending on the precise circumstances.
That seems (to me) over the top at the age of two. It is not compulsory to send children to school or nursery until the age of five, so for someone to have the right to interfere so long before that seems intrusive in the extreme. It could also deter parents who have concerns from sending their child to nursery at all.

There is clearly a dilemma when it comes to children with possible disabilities, as if their parents don't want to pursue help it could hold them back. All the same, I don't think that a two year old should be the subject of safeguarding measures because their parents don't want to label them. There is plenty of time for that later, and IMO it should be the parents who make those decisions, at least in the early years.

I have no idea whether the OPs GD has autism or (something else) or not. But she has clearly been concerned for a while and therefore it doesn’t really matter what an eventually diagnosis (of any) may or may not be. I think if she has concerns she is probably right to have them. Whether to say something or not a very difficult without knowing the relationship and the stage the parents are at.

I would have found grandparents saying something very supportive because I was really very alone with my concerns for a long time. But different parents may be at different places & leaving a space to discuss concerns can be helpful.

When nursery eventually raised concerns with me it wasn’t helpful because they just shouted at me that I didn’t seem to care (I told them I had spoken to the HV, referred him to speech therapy & was waiting for the initial appointment, I’m still not sure what more I could have done. I was lying awake worrying about it so to tell me I didn’t seem to care was very cruel).

Nezumi65

Oceanmama - there is a big difference between autism that can be diagnosed at 2 and autism that isn’t picked up until school age. If a child is unable to follow a point or point themselves after the age of 18 months they may not be autistic but it is a sign that there may be something going on and an assessment is wise.

It is wise to keep an eye on someone if you have concerns at whatever age. My friend’s grandson had a query of autism at 2. I made suggestions to his granny about how to access support for him and how to start the assessment process. He doesn’t have autism but does have very significant disabilities. Getting early support was essential for the family.

there is a big difference between autism that can be diagnosed at 2 and autism that isn’t picked up until school age

True but I've seen level three children not diagnosed until their early teens at times. There are huge variations across the spectrum. It's great if children are being picked up earlier more often these days as at least the families then have the option of accessing support if that will be of benefit to them in their own circumstances.

I agree with everything sarnia has said - my son’s play was very similar and he said and lost words (& sounds) as well.

When my grandson was coming up for 2, I started to have concerns about his development and autism sprang to mind for me. He was saying a few words but within a matter of weeks he had forgotten those words. He was obsessed with certain things, for example, most little boys with a toy car would run it along the floor but my grandson would sit for ages holding the car in his hand and spinning the wheels with his other hand. He saw the GP who arranged for a hearing test. When that came back as normal she set the wheels in motion with the specialist healthcare professionals such as pediatricians, speech therapists etc to observe my grandson at home and in their clinics. He was diagnosed with autism a few months after his 2nd birthday. As regards your GD, you may be right having concerns. By 2 there is usually the rudiments of speech but if she has a hearing problem, that could be the reason why she isn't speaking. It is the lack of interaction that can be a classic sign of autism. As this is your son & DIL's first child, they probably think her development is normal. On the other hand they may be wondering to themselves if anything is wrong. If she is autistic, it won't go away. It will become more apparent as time goes on. Once she starts at toddler groups, nurseries and generally mixing with others around her age, her parents will start to compare her development to them. I had a very good relationship with my DIL and she asked me if I had noticed anything with my grandson, so I was able to discuss it with her. However, you don't appear to have that type of relationship with your DIL. Tread carefully, because no parent wants to think anything is amiss with their child. It may not be autism but if it is then the earlier it is diagnosed the better. I will tell you now. Her parents will have to fight her corner. Finances and cut backs mean that educational statements are not as straightforward to get as they were. These statements are legal and binding and set out the provision, tailored to that child's education. It opens doors and is worth fighting for. I hope all turns out well for your GD. and your family whatever the future holds.

Oceanmama - there is a big difference between autism that can be diagnosed at 2 and autism that isn’t picked up until school age. If a child is unable to follow a point or point themselves after the age of 18 months they may not be autistic but it is a sign that there may be something going on and an assessment is wise.

It is wise to keep an eye on someone if you have concerns at whatever age. My friend’s grandson had a query of autism at 2. I made suggestions to his granny about how to access support for him and how to start the assessment process. He doesn’t have autism but does have very significant disabilities. Getting early support was essential for the family.

Nezumi ? Good post!

Nurseries have specialists in and out usually so may ask for an opinion. There are also sometimes different referral routes for parents vs nurseries. Of course they will talk to parents but they won’t just ignore and wait for the parents to raise concerns.

If a child was showing very clear signs of needing an assessment and parents refused that & responded very negatively that could lead to a safeguarding - depending on the precise circumstances. If a parent said they wanted to leave it a couple of months to wait and see while they tried some other things I suspect that would be seen as entirely reasonable.

My mother decided my first born was blind when she was a day old because she didn't seem to focus. She has perfectly good eye sight.

Some of the things it's been suggested you be concerned about here my autistic children could do. It's something only a developmental specialist (as in developmental/education psychologist) can determine after a comprehensive assessment.

My neighbour had long intrusive tests on her 2 year old who wasn’t talking. My 5 and 7 year old told me he talked to them. We invited him to tea and I eavesdropped. Sure enough he spoke clearly to them. She refused to believe me when I told her . Never found the reason for his selective mutism, maybe he couldn’t get a word in edgeways.

I probably would say nothing unless asked. The parents will have noticed anything you have, and will have decided how they want to deal with it (or not). Not everyone wants to have a label put on their child, whilst others feel that it is important to have any conditions recognised as early as possible - their choice.

A couple of posts have suggested that the little girl might be referred when she gets to nursery. Are nurseries able to refer without a parent's consent? This seems presumptuous to me, as at the age of two children are all very different.

Nezumi I agree with your comment about anxiety. It's like a mutal appreciation society .

All joking aside, I do believe instinct and intuition are important. On many an occasion, I had a gut feeling about a child, but couldn't quite put a finger on it.

My friend was told she was an anxious mum. Her daughter is now an adult who requires 24 hour care. Not sure that suggesting anxiety here is at play is all that helpful.

I agree with marydoll that keeping some notes may be helpful (I did that myself).

I'm thinking with my support for learning hat on. What may be helpful for the future, is quietly writing down behaviours/incidents which have caught your attention. If the time comes when a referral needs to be made, the evidence you have, may be helpful for the assessment. I would be discrete, as could cause problems for your relationship, if you came out with a list of what you think is wrong. The parents need to think it is their idea.

However, I was very much involved with children with autism and fought long and hard to get them an initial referral to the joint support team and access the support they needed. It was not easy and the more evidence we had, the better.

None of us are experts and we don't know the child. We all have varying levels of knowledge and different experiences, one size does not fit all. I suspect that there are probably more incidents than you are telling us about, which is why you have come here for help.

You sound a lovely caring and loving gran.