Autism checklist?

I am becoming more and more concerned that one of my daycare kids may have some form of autism. Parents seem to be in denial and I don't feel I am qualified to come right out and say "I think he may have autism". i have raised concerns about his language and comprehension, but it is much more than that and yet I don't know where to begin to explain to them. I have been researching about autism online and came across some Youtube videos of autistic children about the same age as dcb and it was like watching a video of my dcb. None of this is scientific, I realize. I am not a doctor. BUT, I am increasingly concerned and I understand that the earlier it is diagnosed, the more therapy can help. I really feel sort of responsible for sitting here and watching this child displaying almost all of the signs and not being able to do anything other than pushing the parents to get him on the waitlist for speech therapy (which I did...though it took much pushing). I am wondering if any of you know of a good checklist for autism signs...something that I could send out to all of the parents maybe and hope that they take this seriously. Or would any of you actually come right out and state that you think he may have autism?? I am fine caring for him...he is actually very easy compared to most 2 year olds. It is really out of concern for the child that I keep trying to find a way to communicate this to parents, but without making diagnoses I am unqualified to make. Help please!

The speech therapy is a huge step, because an slp will have more experience on the matter and may be able to speak to the parents more directly, or refer them to a dr or diagnostic group specializing in autism.

I don't know what they have in Ontario, but here we have the ages and stages questionnaire. If you could find something similar, I'd suggest that. It goes through questions on what the child can do (it goes by age, so if you answer 'no' to a lot of them it's a pretty big red flag), that you fill out and have someone score it. They can tell you whether or not the child is behind in any areas (and by how much).

It can be a pretty big wake-up call for a parent to see, and might give them the kick in the butt needed to get into their pediatrician. You're right... The earlier kids get therapy, the better the outcome!

I have the Nippising screening tests...I plan to fill it out and give it them soon before their next First Words appointment. My husband thinks I shouldn't in case I offend them, but I almost feel like if I don't I am hiding important facts from them that they may not notice because they only have one child.

http://www.autismspeaks.org/what-autism/diagnosis/mchat

You could also fill out this screener and if you think it's likely that he has it, give it to the parents. I'd avoid throwing the diagnosis out there unless you're fairly certain that's what it is. It's a big bomb to drop unless you're sure. If you aren't so certain, I'd keep pressuring them to take him to the dr, and voice your specific concerns. Hopefully they will take the hint and get him into someone who can figure out what's going on.

I had this very difficult conversation with a parent before and it was not easy. I began it something like comparing it to "what if the child had signs of cancer" so for instance imagine if your child had even one sign of having cancer would you take them to see a doctor? Of course they would. What parent wouldn't? Why is Autism any different? Although the little boy in my care only had three signs I feel that it warranted me brining it up. Because what if he did have autism and I said nothing and the parents came back to me (their trusted provider/ teacher of their child) and said "but why didn't you say anything?"
I would have felt horrible. I brought it up just the one time and left it at that. At least I could go to bed at night knowing that I was a voice for the sweet little boy in my care. Sometimes parents of an only child don't really have any knowledge of ages or stages of any child and really rely on us. You are a huge part of that child's life.......and if you have a concern then you should voice it. Just the same as any health concern.
But that's just IMO :-)
You are so great to care and want to help. They are lucky parents to have you as a provider. If anything feel confident in that :-)

Problem with things like autism and other learning disabilities is that unless it is totally blatant and severe the doctor doesn't usually pick up on it either in the short in out visits parents make for immunizations unless they actually express concern to the doctor.


To say something directly to the parent if they are in denial usually results in them blaming the caregiver for the issues and think that a move to another home will solve everything so just keeping quiet is in our best interest.

What about contacting a local autism support program and asking to be sent some information and asking what the process is for a referral and why you are asking. There is a long waiting list for services so the sooner their name is on the list the better. Unfortunately the child I had that I suspected did not get referred until the spring they were starting school because the parents just kept saying he would catch up but by April of that year he was not catching up any more than he had. I didn't give it a name but just said he needs to be assessed or he will not be able to cope in school or words to that effect. Parents of course took it personally, blamed me for making no progress with the child in 2 years of care and moved on to someone else - presumably still in denial. Learned a few years later through another daycare parent that bumped into the family the child was referred for testing by the kindergarten teacher and as a result may be behind forever because of wasted learning/adapting time.

You say he has an appointment in the Fall over speech. They will identify him as behind and then look for causes and at that time autism will be suspected and investigated so in a sense you have gotten the child help - it just hasn't been done yet.

In the meantime I would try to get some info on autism and what you can do. Social awareness for sure working on what is appropriate reactions to stuff for one thing.

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Originally Posted by sunnydays

My husband thinks I shouldn't in case I offend them, but I almost feel like if I don't I am hiding important facts from them that they may not notice because they only have one child.

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If you're sure, tell them. They might be offended yes, but chances are if it's severe enough for it to be obvious, they've got to have seen the signs. Maybe they just needed a piece of paper to explain it to them, or explain that it's not typical of other kids.

Yes, I think they must know he is not like other 2.5 year olds...it is quite obvious and becoming more so the older he gets. My neighbour who is a daycare provider can see it too and said she has a hard time believing the parents don't know. I am proceeding cautiously...not using the word autism...but trying to push some of the concerns more now. They think it's just language, but it truly is not. He is so hugely different even from the 20 month olds in my care...I know the parents don't have that comparison and I want to make sure I tell them. If they still don't do anything there is nothing I can do, but I have to know that I did what I could. If they leave my care because of it, so be it. I truly care for this child as he has been with my since he was 9 months old and would hate to lose him, but I can't sit by and do nothing.

I cannot be sure he has autism of course...I am not qualified to diagnose that. I would not say that to parents. I just want to let them know all of the red flags I see...and there are many many. I was holding onto the fact that he makes eye contact and smiles and interacts with me and others, but after researching more and seeing some videos, this is not uncommon. Everything else fits.

One of the reasons it is hard for parents to recognize the symptoms is that a child with autism acts more "normal" around familiar people so what they might do in the home is different than what they might do in a more social setting. They are relying on the parent to show them how to respond rather than it being spontaneous.

The fact that you have others 20 months and he is now 30 months gives you a good reason to speak to the parents and to bring it up with the I am glad you have looked into getting some help with his speech but have you considered that this is not the only area that he shows delays in. I know it is hard for you to see since you only have him at home with you but here at daycare I see him interacting with children older and younger than him. Gradually as the girls/boys get older it is becoming more obvious that his development is not as balanced in all areas and speech is not the only area he is showing concerns with (note I didn't say the only area I am seeing concerns with - keep it all about the child and as much about you and your observations as distanced as possible).

Doing the assesement pages might help but you might get further if you start with the he just isn't keeping up to his peers concern as this allows it to be general and friendlier.

When it comes right down to it you may just have to blurt it out that there are developmental issues here and if they do not do anything about them they are setting their child up for failure for life. Ok so maybe not the way to go.

Personally I think I would wait till he has the speech assessment in the fall and let the professionals take the first lead. Autism is always suspected when there are speech/communication delays because it is one of the prime signs.

Then when the family comes back even if it is accusatory then you simply tell them you tried to tell them there were issues and they needed to get him checked out but that since you are not a clinician you are not allowed by law to put a label on a child and can only make the parent aware. What the parent does with the info is up to them and that you are sorry they waited so long in denial before seeking help. And then immediately change the subject and talk about how to help him going forward.

Music therapy is used with kids with autism a lot because singing is easier than talking, they tend to have an ear for music and music involves practicing the turn taking, give and take, etc.

The family I terminated earlier this year wouldn't listen to all my hints but I definitely suspected some form of autism. I never used that word with the family but I hope you can get through to your set of parents Sunnydays. I hope the next caregiver my dcfamily found is able to get through to them and they think back to all the things I was saying over and over and get their child some help.

That's the bottom line you know, we are not the children's parents and ultimately it is not our responsibility. But that was my answer to the problem, I quit trying because I couldn't help the boy and the other children couldn't take it any more so I hope somebody else talks the parents into listening.

I bit the bullet and had the conversation, partly through email and partly at pick-up. I did not use the word Autism, but did let them know that I am concerned about his overall development and his social interaction as well as some other things like that he walks on his toes and often covers his ears, doesn't respond to his name, follow directions, etc. It actually went really well...I think! Mom admitted she is having a hard time accepting that he is delayed, but she appreciated my care and the kind words I also used to describe her child...because he is really a little sweet heart and a great kid! I think I can now sleep easy knowing I did what I had to and the rest is up to the parents. I will also be trying to find more strategies to help him until he gets professional help. Playfelt, this child LOVES music and will do the actions to any song we have sung with great enthusiasm...doesn't sing yet, but does the actions.

PLayfelt or anyone else with experience with special needs kids and especially autism, do you have any suggestions of things I could be doing to help this child while we wait for professional assessment and help?

I had a boy just like the way you describe your dcb. I knew when I got him at 18months that something was up. I chalked it up to him being in a bad daycare. but as time went on and he got older, he was clearly different than the other kids. His first big thing was that he walked on his toes so badly, it was so bad at one point that he was stepping on any child or baby that was on the floor. When I would talk to him he would look like I had 2 heads, the obssession. The obssession of one thing over and over again. Then the biggest thing was the way he acted out in public. He would (at this point he was 4 or 5) ask strangers questions, embarressing questions to boot. He would just go up to them and ask them questions or talk to them. Also, the way he would interact with the kids, it was weird, nothing like I've seen before.

so I always hinted to the parents but they kept saying that he'll fix himself when he gets to school. Others started to notice too, even relatives started to notice, but one time gpa even asked me if I thought there was something wrong. Gpa knew something was up and he did mention it to the parents but they just said that gpa was a busy body.

so dcb starts school, he starts getting notes after notes, mom gets called in and nothing happens. (dcb got off the bus here and mom would gripe about the teacher) so dcb goes to kindy, grade 1 and then grade 2. Same thing, all mom does is gripe about the teachers that they are just awful that they don't know what they are talking about. At this time, since dcb was older he started to disturb the classes with his sound effects, his snorting, being loud.

but something happened in grade 2, I don't know what cause dcb stopped coming here (mom didn't want to pay 5 dollars a day so he can get off the bus here and be here for 45 min) but suddenly he started to go to all sorts of appointments, my kids even said that he is now pulled out of class to see certain therapists (my kids are older and are monitors for the little kids) mom won't say anything. ( I was watching the sibling)

but (omg this is long) do you know what the dad use to say to me--"maybe when the kids make fun of him then he'll stop walking on his toes" "maybe when the kids laugh at him, he'll stop acting the way he does"

I should add, that there are issues on the bus too. No one wants to sit with dcb, because its like he has a touchy feely thing for the kids, but sometimes he'll just start to punch the kids. Bus driver has talked to the family about this, but again parents then blame the bus driver (she's and awesome bus driver, one of the bestest we had)

what I did find was that even thou dcb goes for help (I hope he goes for help) the parents are still in denial, after years of this. Instead of trying to help him or fix some of his problems, they are just still blaming others and are not doing anything (instead of engaging dcb in activities, dcb will sit for hours apon hours playing video games)

another thing, I'm not sure if this would be related (but you never know) is dcb only ate processed food. His diet consistant of chicken nuggets, canned soup and french fries and lunchables. No fruit or veggies and colored juice, this was his whole life so far (don't ask how I know, I do, I just can't say how i know)

so I looked up aspergers when I had dcb and he had most of the syptems to a T. I never said that to the parents, but I have a feeling the school did.

I do hope the parents do something early before a child goes to school.

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Originally Posted by sunnydays

PLayfelt or anyone else with experience with special needs kids and especially autism, do you have any suggestions of things I could be doing to help this child while we wait for professional assessment and help?

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after you read my story then you'll know. I found that I had to have more control of the situations. Like when we went for a walk, dcb would walk next to me pushing the stroller. When a stranger would walk by, I would remind him "stranger danger" over and over again. When I talked to him, I would ask dcb to repeat it (I talked to him in short simple sentences, like "shoes on") I made sure that he wasn't able to sit and be fixated on one thing, I would rotate the stuff around. I also made sure that there was no touching of kids. it was a bit tiring, but with me, dcb learned to dress himself (the parents would dress him) learned to eat with utensils properly. Little easy basic stuff that many of us take for granted but dcb learned to do it. I treated him like the rest of the kids the only difference was that i had to be more rigid and controlled the enviroment. I rarley had outburst with him, once I figured things out.

I will PM you Littlefeet...I already do most of what you posted here. I sing about everything and he loves it and never has problems. He actually behaves really well...follows along...no tantrums. It's just that he doesn't communicate much and plays mostly independently. I think he does well with me because I follow a very predictable routine and he has been with me since he was a baby. He rarely gives me trouble ( unless I tell him not to do something and then he swats at me or scratches me). I would like to help him learn pretend play, social interactions, but it's tough because he doesn't talk much.

A few of my teaching manuals have sections on dealing with autism and adaptations. I also have some stuff saved on the computer from when I belonged to yahoo groups and they shared everything. I'll see what would best be adaptable to home daycare.

I do know that a visual schedule and use of PECS(Picture Communication Symbols) are two of the ways they work on communication. Children need to see what is happening, what is coming next. Routine and predictability to the day. Always using the same spot, same chair, order and routine is something they thrive on.

My daughter is a music therapist and works with some kids with autism but mostly after they have been diagnosed and the music is used to reinforce what they are working on.

Read up on ABA as that is used with some children but the idea behind it can be used with all children.

There are also courses at Algonquin college on working with children with autism and since it is becoming more and more prevalent might be worth taking an intro type course.

This might also be a good topic to suggest a workshop on for CCPRN in terms of strategies to use in care.

I was thinking about suggesting it to CCPRn...a workshop on the signs to look for, how to talk to parents about it, and what to do with a child diagnosed who remains in your care. I will do more research and will definitely look into the pictures for communicating. I used to teach ESL to beginners...we used tons of pictures and I tried to use photos when possible...this is quite similar.