Worried about my toddler grandson

I think just keep monitoring for now. Lining up the cars as you describe is called a Schema, it's a natural part of child development.

Perhaps his going to the playgroup will show up his differences to his mother, she may not be aware of what is ‘normal’.
One thing to be aware of is the culture in their home country, and degree of education. It is possible that they have never heard of autism and their attitude to such a child may be different - anything from it’s being under the influence of witchcraft, to being very laid back and just loving him for what he is. This is not a racist comment, just what I have observed from living in a rural setting in an African country. Even so called primary education is about rote learning and did nothing to dispel superstitious ideas. Many adults died of aids because they preferred to consult the witchdoctor rather than take western medication.
If there are any appropriate programmes on tv about children with autism, I suggest you record them and when the time is right you could invite them to watch it with you, but meanwhile it sounds like you are doing a great job by giving him gentle, unthreatening stimulation. Is he interested in drawing/painting at all or is he too young? I must admit I am out of touch with young children as sadly, there aren’t any in my life.

I am really moved by the difference it makes to how I feel about this just by reading the responses and other peoples experiences and advice. I am very grateful grannies, thank you!
I'm still concerned - I've had a gut feeling since baby was very young but it's the total lack of response to any kind of talking to him that bothers me most. As well as lack of eye contact - or even face contact! Right from tiny he has never looked into his Mum's face when feeding and you don't realise what he's not doing till you see other babies doing it! I don't know if he understands or not, he just appears to ignore speech altogether, and doesn't even seem to know his name, but I know that wouldn't be a deliberate action at his age, as it can be later. Anyway I will observe and note, and hope and wish for him to have happy life whatever!

oldbatty that's why I was focussing on the social and emotional development stages rather than the language development. You are most likely to notice any significant delays in development when looking at personal /social / emotional development of young babies/toddlers. Children from some multilingual families may be slower to utter but they often do understand and respond appropriately as long as no other issues going on.

My grandson (5) has just been diagnosed with high functioning Aspergers but his parents had been aware something wasn't right from a very young age. 20 months is very young so I would think it best just to observe for the next few months and perhaps keep a diary of anything which seems a bit out of the ordinary. It's a difficult subject to raise with his parents if they are not aware but if he goes to pre-school it could become more apparent when they see other children of his age to compare him to. I wouldn't worry too much about the speech - some children speak very early and some much later especially with two languages to learn.

Just wanted to say that the research does point to children being taught two languages being much slower to talk so wouldn't be too worried about that. Does he understand you and instructions (go get a ball, clap your hands, for example) It's generally expected 2 words from 14months, but many are much slower. DDs 14 months and only makes animal noises.

The other things could be signs, but at this age there's so much variation it's could also be nothing. The lining up cars is always suggested as a sign, but it's quite common in lots of non-autistic children.

How was his early gross motor development? How long did he take to roll? sit up? Crawl? Stand? Walk? The recent research suggests that earlier indicators of autism are delayed development of gross motor skills.

If those are all in normal ranges I would not worry too much, but keep an eye, and focus on trying to develop his language and social skills. Lots of book reading, playing games that involve another person (chasing, throwing a ball to each other). They won't diagnose until 3, and the early intervention they would provide at this age is mostly focussed on language and social skills development, which is something you can do anyway.

(I work with autistic children).

Correct, they are very lucky.

I used to be a specialist nurse practitioner & health visitor. I think you are right to have some concerns, but a lot of your description fits within normal development.

The approximate rule about bi-lingual children is that their expressive language may be a bit late up to about 4-5; but their receptive language (understanding) and non-verbal interaction should be normal.

I am astounded that no-one picked up on concerns when parents requested a hearing test, and it shows now much has changed since I retired 8 years ago.

If you think that parents are meeting his needs, then I would simply observe. If you have the confidence (and as an ex-foster carer I'm sure you do!) I would track down the Health Visitor and say 'I know you can't discuss the family with me, but these are my concerns, are you able to do a follow up visit, bring a routine contact forward, or something similar to assess the family properly?'

This family are lucky to have you.

I'm not an expert, but sometimes if children are being exposed to more than one language at a time they are processing a lot.
I would be wary of attaching too much attention to the lining up cars and not reaching milestones. 20 months is very young.Isn't a rule of thumb at age 2......2 words?

Maybe next time there is a routine check up, you could go along and help the Mum?

No advice I would just like to send you and DH for being such great foster parents for this young man.

Thank you for your advice Lemongrove and Greenfinch, a good idea to write things down as I notice them. He doesn't point at things ever, or draw attention to anything in any way, but never seen him walk on tiptoe. I know I should share it with his parents but it's a difficult subject to broach isn't it, especially since they don't seem to register there's a problem. But good to know we're not alone, thank you.

Thank you for this PECS, it is very helpful but convinces me even more that there is a problem as he doesn't do most of these things. I will try following the recommended actions and hopefully might help a little.

Exactly the same as lemongrove.My grandson was was not doing any of the things you mention which I think are far more significant than not speaking.Look out also for not pointing at things and tiptoe walking.Please express your fears.Early intervention is so important and helpful.My grandson has had support all the way through and still has a full time TA at secondary school though how long that will last with all the cuts is another story.

Sounds exactly like our grandson Grannyris at the same age.He had a diagnosis of autism at aged 3.
Don’t think they will do this until aged about 3 as by then it could have proved otherwise.Keep monitoring his progress and get the family to read up on the subject, as no good closing eyes to this potential problem.Write down all the things you can ( including the lining up of cars.)

Do you see DGS regularly? below are the age related expectation for social interaction for children between 8-26 months. If you play with him and he is doing most of these things it may be a spoken language issue rather than a bigger worry.

• Seeks to gain attention in a variety of ways, drawing others into social interaction. • Builds relationships with special people. • Is wary of unfamiliar people. • Interacts with others and explores new situations when supported by familiar person. • Shows interest in the activities of others and responds differently to children and adults, e.g. may be more interested in watching children than adults or may pay more attention when children talk to them. • Plays alongside others. • Uses a familiar adult as a secure base from which to explore independently in new environments, e.g. ventures away to play and interact with others, but returns for a cuddle or reassurance if becomes anxious. • Plays cooperatively with a familiar adult, e.g. rolling a ball back and forth.

This link will take you to the document used by nurseries etc. to assess cbabies & children's development.

www.foundationyears.org.uk/files/2012/03/Development-Matters-FINAL-PRINT-AMENDED.pdf