Suspected Autism - Parents in serious denial

I have worked with children in all different capacities fo over 12 years. Most of that time was as a child and youth worked and I have worked extensively with children who have mental illnesses and are exceptional (disabilities)

I have a little girl who is turning three in January

This is the second time I've had her. The first time was just after she turned two. She was behind but me and the parents attributed it to learning two languages (English with me and russian at home) as well as the fact that they babied her to the point of disabling her.

She progressed a lot in her time with me. Then her grandmother came over to help with care and she left me.

She was brought back two months ago after grandma left. She is at the same point mentally now as when she left.

I've done extensive screening and she is functioning at about a 22 month to 2 year level. Zero speech other than repeating, no interest in other children, it took me a lot of work to get out eye contact back, I could go on.

I know what is going on here. the child is in desperate need of testing. If they caught it now this child could live a normal life. I would help with her treatment. I'm trained.

I had a meeting with parents and tried everything other than saying the word . . . autism . . . they wouldn't hear me and kept making excuses as to why she is the way she is.

The other day I caught the child self abusing . . . she rubbed her face in the dirt until her nose was all scratched up . . . she laughed while she was doing it.

I told her parents . . . frig. . . I even started tearing up a bit . . .

They think I'm crazy and asked if I was able to keep caring for the girl

I really don't know . . . I cant watch a child deteriorate and watch her parents do NOTHING!!!!

thoughts?

The parents are probably in denial. She needs intervention therapy, but probably won't get anything done until school starts and the school steps in and suggest an evaluation.

In the meantime, if you feel you cannot care for her or if it takes away from the care the other children are receiving then you might want to rethink keeping this family on as clients.

How old is this child now?

I can care for her just fine. I just cant run intervention therapy and a daycare program. she will be three in early January. she is a just over a year behind mentally.

I don't know whether I can care for a child that I know needs more than she is getting. it hurts my heart

The other way to look at it is that at least with you, you understand what is going on. What happens when she goes somewhere else and they chalk the issues up to behaviour and punish her for non-compliance and that is exactly what is going to happen. By keeping her and doing the best you can do you are doing the best for the child even if it doesn't seem like that. The road to get services is so long that the sooner she gets her name on the list the better I get that. What did the parents say when you showed them the assessment you did.

Can you drop other less subtle hints such as having some signs of autism and what to do brochures handy and show them that you identified an issue and found a way to deal with it using this same technique. Again you didn't say the word just used the treatment plan. Hopefully when they see the brochure they will realize she has all of the signs on it.

Sometimes there comes a time when honest and blunt needs to happen and it is not diagnosing to put the bee in their bonnet that on many days she reacts the same as a child that has autism and I have been using this brochure for information on how to handle the issues and then hand it to them.

Sometimes the parents just won't hear it. You have told them and now I'd leave it alone. Part of the problem is that we are just "babysitters". My only other suggestion is the next time they have a doctors appt for the child suggest that they mention it. Sometimes parents just can't see problems in their own child. I have been through this twice, and both times after being ignored the child was eventually diagnosed with autism. Being a dcp can be so hard sometimes

I have no experience with children with special needs. I can't imagine how hard it is to watch a child not progress and know nothings being done about it.

Something I've learned in this business is that I can only control what I can control. If the parents aren't doing anything and you feel that you've done everything you can then you either need to make the choice to continue caring for the child, or not.

Why not be blunt about it and say the word...AUTISM. You have the qualifications. If it were me, I probably wouldn't go that far because I have zero experience with special needs but someone like you I think could get a bit more " in their face" about it, and I think you should. Stress the importance of early intervention and what could happen if they DONT do something about it. Just my two cents.

Thanks everyone!

I feel better

need to think more. I'll probably just let it go

Her doctor suggested she begin tests (always start with hearing tests) and the parents shot it down because she can hear . . . sigh . .. .

I'll continue what I'm doing which is using techniques for autism intervention and she is slowly progressing. I just have to realize that I cant 'treat her' the way I want and its not up to me

thanks again

I would also tell parents that I suspect their child has autism. You have nothing to loose if you are considering terming the family and maybe by being open with them could make the difference for the girl.

I think even if you do say Autism, the parents will ignore and leave your care.

Would children services be able to help? I am not thinking about the child being removed from parental care, but could this agency help with a diagnosis and subsequent assistance for these parents? Their denial that there may be a problem is further disabling this child.

I have a bit of experience with autism and when I thought one of my previous dcb's had it, mom and I discussed it. He was the oldest in my care at the time and the farthest behind so mom saw the difference between him and the other children every day. He had multiple ear infections as a baby so during one of his doctor appt's she brought up how he was 3 and still wasn't speaking. They hired a speech therapist to come into their home a few times. She mentioned autism to me once and I jumped on it. I told her my experience with autism and some of the more typical symptoms. It put the idea in mom's head and I sent her a couple of articles to read over. Shortly after mom lost her job and ended up staying home with him until he's in school so I'm not sure what came about it. I am almost 100% sure he is autistic though.

Do the parents know you have experience with autism? I know because my dcb's mom knew that I did she trusted me and took what I said serious. I would explain to the parents your qualifications and go from there. If they decide to stay in denial there isn't much you can do but at least you know you did everything possible to try and help the child.

This has got to be so hard. One of my kids is on the spectrum and even now that I know...its hard.

id say contact your local gov funded centre for treatment and development i.e.: Erin Oak Kids. they will gladly help you approach discussing with parents so they will listen. Some ideas may include Showing them brochures and explaining that help in ontario is FREE until the child is 6 yrs old and there is usually a long wait list. i know in Peel we have PEP Start Program not sure what Toronto has. i'm sure you have done all this but explain that its better to have their child assessed and find nothing wrong than to not have them tested and find out later that early intervention would have been better. Tell them how much you love their DD and want her to excel just as they do.
She may not have autism she may just be way too babied especially from being home with grandma. Plus cultural differences could be to blame too. But I fully understand the concern especially given your work history.
You're doing a good job and i would suggest doing what you can to keep her with you because if she goes somewhere else she may just fall through the cracks.
Keep it up sounds like you are the only voice she has. speak loud and clear.

Yikes I'm going to disagree !!! You mentioned you were trained in autism and had done extensive testing ? To my way if thinking unless dkp sent her to your Dayhome because of your experience then you had a right to screen her but other than that I do not agree with her being tested.
I know you would notice the behaviours and I think if you were asked you could fully go into it but it seems like they are not interested in you diagnosing their child . I am a mom with experience (25 yrs) of child care I have a dcg right now who I totally suspect has autism . She try's to hurt herself as well . My friend works with special needs and we have discussed her similar behaviour but I would never tell the parents I suspected it. Of course I'm not qualified to do so which I can imagine is hard for you given your knowledge !!! But I still don't think you should broach the subject unless it is brought up to you by parents . My dcg is leaving because I told dcp I am not comfortable with the self hurting and it was awkward because we all knew there's a problem but obviously they are not ready to admit it let alone get help ! Sad ? Yes !!!!! But I feel not my business !!

Update Needed!

The parents came back to me worried because I had gotten a bit emotional when they were dismissing the self abuse.

I told them what I suspected. They have gone to the doctor, scheduled hearing tests, signing her up for speech therapy and having a social worker from citykids over. the worker will be coming to my house too. Im ecstatic! the parents are grateful and my little DCG is doing WONDERFULLY!

Here in Ontario with the new ELECT program they are encouraging it's use in home daycare as well - agency homes will be required to use it and privately it will be our choice but it includes screening the children according to a developmental checklist such as the Nippising Screening test and reporting to parents if we see discrepancies. Now in theory this is what is supposed to happen and in a school or daycare centre where the director deals with the parents I can see it but I see a lot of chance for turmoil in home daycare if we start telling parents the results. That doesn't mean it isn't a good idea to do the screening for our own benefit to know where the child is at and what skills they need to work on. There is nothing wrong with screening - testing if a child knows their shapes or can jump over a rope is what we do all the time to plan curriculum. The screening device just lets us know what they should be doing.

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Originally Posted by Secondtimearound

Yikes I'm going to disagree !!! You mentioned you were trained in autism and had done extensive testing ? To my way if thinking unless dkp sent her to your Dayhome because of your experience then you had a right to screen her but other than that I do not agree with her being tested.
I know you would notice the behaviours and I think if you were asked you could fully go into it but it seems like they are not interested in you diagnosing their child . I am a mom with experience (25 yrs) of child care I have a dcg right now who I totally suspect has autism . She try's to hurt herself as well . My friend works with special needs and we have discussed her similar behaviour but I would never tell the parents I suspected it. Of course I'm not qualified to do so which I can imagine is hard for you given your knowledge !!! But I still don't think you should broach the subject unless it is brought up to you by parents . My dcg is leaving because I told dcp I am not comfortable with the self hurting and it was awkward because we all knew there's a problem but obviously they are not ready to admit it let alone get help ! Sad ? Yes !!!!! But I feel not my business !!

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I had the parents total blessing to do the screening and testing. I asked them before I started.
With autism, the earlier you catch it the better the chances of the child living a normal healthy life. why would you be ok with watching a child deteriorate right in front of your eyes? The children ARE your business so their mental health is a big part of that. I really don't share your opinion in the least. I'm willing to put parents in turmoil and even willing to let our business relationship dissolve if it means that a child in need of help GETS THE HELP THEY NEED. Turning a blind eye to it is neglectful

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Originally Posted by Cadillac

With autism, the earlier you catch it the better the chances of the child living a normal healthy life.

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I would have done the same Cadillac even if that have meant to loose these clients. You did the right thing

Probably because I am not qualified to make any diagnosis on a child . I am glad you had permission to test . I do not feel in any way I am turning a blind eye , I do however feel without any training it is not my business to approach a parent . I'm ok with you disagreeing with me , I feel strongly about what services I offer and those I don't . It's not about losing the client for me , it's realizing someone else may be more qualified to help . I'm not sure what you mean watching a child deteriorate or whom you are referring to . As I said I gave notice because of the self abuse , I was not asked my opinion so I did not volunteer any ,and having no area of experience in special needs I am very comfortable with my actions .

I am not trained or qualified to diagnose anything either, but I do feel it is part of our job to let parents know if we see any potential signs of their child not developing "normally". Sometimes parents don't realize their child is different because they don't see the child with other kids. We are with the child 9-10 hours per day in a group of children and most of us have a fair amount of experience with children. I will also risk losing a client rather than keeping my mouth shut and saying nothing about the problems I see. Now, I would never say "I think your child may be autistic" because I am in no way qualified to make this judgement. But, I have said "It seems you child's speech is not where it should be fo his age" or "Have you noticed that you child does XYZ?". After that if parents choose to ignore, we have done what we can, but to say nothing at all seems wrong to me.

Again I disagree , I think coming to a dcp with 'oh have you noticed dck speech is not where it should be for his age ' is wrong . Children develop all over the spectrum. If someone said to me about my child not being in the 'normal ' category of development , I would be wanting their credentials ! What gives you the right to question my child's development ? Did I send her to you to be diagnosed ? I feel my job is to care for the child to the best of my ability I do not feel even though I have experience with children it gives me that right .
My services are to provide a safe , caring , educational , interesting , place for a child to be when their parents are at work .
I do not charge for diagnosing and I do not feel unless a parent comes out and asks for my 'opinion' I have a right to say any child in my care isn't progressing at a 'normal' rate.
I'm not saying you need to change your views or practises and I certainly won't be changing mine .

I had a dcg that I suspected of having selective mutism. I suggested several times for mom to take her to the doctors to enquire about it. She never did. whenever I approached the subject mom would agree that something was not right but mom never acted on it. I called our local Child Developmental Center and enquired about this. The worker then had a discussion with Mental Health. The worker suggested I pass along the phone number for Mental Health. I knew mom definitely wouldn't call there so I gave her the number for the Child Developmental Center. She never called.
This girl is now in kindergarten so she isn't in my care any longer. I talked to the mom about a month ago and asked if she's getting any help at school. She said since the girl is doing so well in all other areas, she isn't getting help.
I also wouldn't want to diagnose a child. I just told mom about my suspicions making it clear that I don't have the qualifications for a professional opinion. But it comes down to the fact that it's up to the parent as to whether they're going to pursue it or not.

We are not qualified to diagnose but we absolutely should report our observations. I cared for a child and followed the nipissing screenings assessments and handed them to the parents. It is a screening based on the expected developmental milestones for a specific age. It is a government issued form and each answer is a yes or no and the forms clearly state that if any answers are no that it does not mean something is wrong but that it is a good idea to meet with your family doctor to discuss these things.

I wrote a report of my observations firstly zooming in on positives about the child, highlighting his strengths in order to start things off on a positive note. I followed on with areas needing attention. Not wrong, delayed or anything else negative. Nowhere at any point in my report did I inject my opinions or feelings. I did however make them aware of everything that child and family services in Ontario do not recognize as being "normal" (not the word I used) or a noted behaviour issue that they needed to know about. It is my job and my duty to do this as a caregiver for the child and is not overstepping the mark. It is all daycare providers jobs to look out for the child's best interests and by keeping our mouths shut just adds to the problem. When nobody asks for my opinion I don't give it but I will not ask permission to notify a parent of problem areas which require their attention. Denial is a common first response for parents but they still need to hear what's going on. Eventually once more and more people bring it up to them they will actually hear it and it will get through to them to seek out help. It does not mean they don't care, it means they are human and are scared to death that this may be happening to their child so the easiest thing to do is deny it and defend the behaviours with excuses.

As a parent with a twice exceptional child both an LD and Gifted, if I found out my daycare provider was WITHHOLDING information from me, I would see red. How detrimental it is to not tell a parent because you are worried about how they will respond. I am a caregiver so will give 100% to each and every child...that is my job!

I have two children with autism, my children where diagnosed at an early age. One of the signs is speech, eye contact, hand flapping. My children have come a long way and frankly unless I told you, you wouldn't know, early intervention is key. You are in a very tough position, any parents does not want to know that their child has something wrong with them. I would express my concerns to the parents, suggest that they see their doctor, they will need to see a psychologist and he/she will run a series of test and they will determine the diagnosis. Best wishes to you and your daycare family.

I agree with Bright Sparks. You are with their child all day. Even without training, you should be able to notice if a child is exhibiting differences from others his age. I think it is all in the way you present it to the parent. I just wrote an email to a parent about a child I had concerns with. I framed it in the sense that I was wondering how dcb was at home because I had noticed here that x, y and z. Did she see these behaviours at home?

She responded well to that approach. I'm not sure what she will do with the info. I don't know if this child has autism, or anything else. I am not qualified to diagnose a child. I wouldn't attempt to. I have no formal training on any of these conditions. I DO have experience with children and I just know that what I was seeing was unusual enough that I wanted to let the parent know. If I was the parent, I would want to know. And that is how I frame all my "is this something that needs to be discussed with the parent?".

When a parent only has one child they do not know what is "normal". It is when the child starts daycare and does not fit in with the group as expected that the caregivers starts to wonder why. Sometimes it is just lack of experience, extreme shyness, stress, unused to lots of noise and busyness so shuts down, etc. Other times you just know that while the other children are moving through the normal milestones that a particular child is struggling. Early intervention is important and it takes so long that the sooner a child is referred for services the better as wait lists can me months if not years. Waiting till the child is in school and the teacher - who is not qualified either says you know this child just isn't keeping up as expected it is too late and many years of learning are wasted.

From having countless children through our homes even without any special training other than observation of all those children we learn what is normal and what strays from the expected.

I get what your saying , and I can appreciate your point of view . I will say maybe I haven't encountered a child yet who has fallen so behind that I feel I need to discuss it with a parent . I don't want to argue a point just to argue .
I do still believe in what I said , but I get what you are all saying as well .

Just adding that I think it really, REALLY depends on the situation and the individual child.
I have cared for a child in the past that I am absolutely certain had/has a sensory disorder. I waffled on telling the parents. I did not in the end, only because although there were some "quirks" to his behaviour, I did not feel that he was not progressing.
One of the hardest things to deal with in this job can be drawing the line between what WE deal with on our own, and what we need to turn to the parents with, and ask them to address.