Should I be concerned?

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Hi,
This is my first time posting. Not sure of the etiquette so sorry if this post is not appropriate. I have a son who is 34 months old and is delayed in speech (but talking using 1-2 words at a time and he follows commands, he tends to just echo the last word of whatever you say to him so it's difficult to state what his vocabulary is). He has a lot of little quirks. Including hand flapping and toe walking which started about 6 months ago and is slowly becoming more frequent. He thorws a lot of tantrums, especially with any changes to his normal routine. He is resisting a toilet training and moving to a big bed. He loves fans and trains but he is scared of them at the same time. He covers his ears all the time. Am I right to be concerned? We are awaiting a pediatrician appointment and my husband thinks I'm crazy for being concerned, and that I'm going to "get our kid labelled for nothing.". What do you think?

We obviously can't diagnose from a few words in a post, but if you think you've seen signs it is definitely worth mentioning to your doctor. Even if he is on the spectrum, however, you may or may not be able to get an accurate diagnosis at this age. It will depend on how severe he is. If he is severe and they pick up on it, then early intervention will be important and helpful. If it isn't severe and they miss it, then do what all good mothers do: pay attention to your child, get him what he needs, and help him develop at his own pace. You will know better in a few more years.

I don't think you need to be concerned as much as aware. Parental instincts are very useful in helping a child overcome whatever challenges nature ends up giving them or putting on their path. Most children will end up with one challenge or another, so being observant and well tuned into your child will always serve you well.

As for labels ... well, my son needed one to get through school and reach his potential. We actually never got an official medical one, just a school use one, but my son identifies so strongly with it that he sort of wishes we had the medical one. It is part of who he is, he is proud of it (ASD comes with gifts and burdens, and the gifts for him are pretty cool), and he worries that pursuing a medical label at this point in time could take that from him as he is so well trained to adapt and work around his ASD. Point being, a label isn't always bad. And ... just so you know, my son is 20 years old and thriving. He is a computer science major at a very good school, he teaches programming as a part time and summer job, and is heading off for a year of study abroad.

My daughter is probably ADD but we never diagnosed it at all. The difference being that she was successful in school without a label, already maxing out honors courses and pulling straight As, and that gave her the luxury of learning to work with it in her own way. She is now facing other issues that we will, unfortunately, have to get labeled so she can get the help she needs. No regrets on leaving the ADD off to fate, but this new issue can't be given the same license. Ultimately you will do what you have to do to get your child what your child needs, once you have figured out what those needs are.

Meanwhile, enjoy your child. These are beautiful years where both you and him can probably enjoy the luxury of letting him be who he is. If he is special needs, real life will crash in soon enough.

Whatever they do or don't find, your child won't be any different because of a diagnosis (or without one) A can be diagnosed and not need a lot of support, or undiagnosed and be in the weeds. The need for support is independent of the diagnosis. A need for support obviously will indicate a more pressing need for diagnosis, but just the diagnosis on it's own is not going to box your child in unless you facilitate that. You can get a diagnosis and choose not to pursue therapies or support until you need it, but it will be easier to get if you decide that is what the child needs.

We did not use early intention services, because we were in denial about things at that stage and the screeners saw him as "smart." With his particular set of strengths and weaknesses I have no idea if it would have mattered or not because there is no alternate time line I am able to access to compare this one with. He was verbal, but economizing in his speech and clearly had very good receptive language.

So, my advice is see where this leads. Any kind of therapy/adaptations etc. that is suggested that seems un-necessary can always be declined. For many kids in the iffy category, you will know what your child does and does need based on what is going on in preschool/school.

The good thing is: he has some speech now. He's not oblivious to the world, like some kids with autism (and like I was as a toddler.). If autism is present, it's very likely that it is Level One.

Many kids have trouble with transitions at 34 months. Tantrums are common among even "normal" kids.

Like previous posters stated, we cannot hope to reasonably assess your son.

I believe an evaluation for autism is in order, based on what you've wrote, so he can benefit from early intervention services should he be diagnosed with it.

Even if he is diagnosed with autism, it's not a hopeless situation.

Yah. It's time to be concerned. Not panicked but concerned.

Maybe if you share with your husband some of the advances in early childhood education he'll be more comfortable. The truth is that even if your son has a mild problem, getting him help now can set him up for entering kindergarten feeling confident and ready for the challenge.

There are things you have to watch out for in early education. Don't listen to anyone who tells you that they are going to cure your kid by giving him a full adult work-week full of therapy. Kids need down time. And don't give him "therapy" that is really coercion. But there is plenty of non-coercive, play based speech and occupational therapy out there that could really do him well.

Three year olds should be using speech pretty fluently, not just repeating what you say back to you. My nephew is a little speech delayed. At 18 months, he was kind of repeating back words if you got him in the right mood, but he didn't really use words at all. At 21 months now, he's begining to use his toddler words to get stuff. So, for example, if his toy is stuck, he'll look at you and say, "Suuuf!" He means stuck. But he's using the words to get what he wants. That's what it looks to be a little speech delayed. If he's still doing this at 34 months, we'll need to get him help. You still see a lot of "creative" pronunciation in three year olds. And they say the weirdest things! It doesn't always make sense to adult logic. But it does have grammar. At that age, they usually intuit the basics of language. They use sentences. They can make up new sentences, not just use one's that you've drilled into them.

I'd start getting services now. Get the pediatrician to get speech and OT going immediately, diagnosed or not. ABA if you can get it. I'd also join myautismteam.com, which is a great parents site.

If he's resisting changes like toilet training and moving to a big bed that's normal; not that it matters... just provide an incentive for him maybe. But don't punish him for not doing it... don't be intimidating, don't make him have to choose between something he's scared of and a punishment (not that you do that, but I'm just saying not to, just in case). Maybe show him some videos of his favorite cartoon characters using the toilet and sleeping alone; there are videos out there of such things designed for that very purpose. Also, make sure he sees people he admires doing those things.