I would for sure keep a written record of your observations. Only ever record your observations, never an opinion on them. I think if this is a special needs issue it would be detrimental to the child to just be terminated. If you could bare with things for 2-4 weeks with meticulous record keeping and then hand a copy to the parents with an explanation that you have raised issues with them previously and as they are growing in frequency that your duty in the best interests of the child was to keep a record. You can also download the nipissing developmental milestones checklists which are a yes or no checklist and clearly state that if anything is checked no that it is recommended that a parent take the child to the doctors just to discuss the issue. If after presenting all of this info in a formal way, that really makes it clear that this needs to be taken much more seriously than just conversations at the door, and they don't seek out extra help and support, then I think it would be time for this child to go elsewhere. At that point it would be the best thing as some parents need to hear these things over and over from several different people before they want to hear the truth. You'd think with already having a high needs child that they would be on high alert for things or catch things early so it might be that their seemingly lax attitude is not something you can do anything about or work with. Its a shame for the child, but the fact that he is digressing and clusters of behaviors are coming up, it seems like this is not an attention thing and likely a Special Need which needs to be addressed. All you can do is your part which is to gather information in writing and pass it on to the parents and ask them take it to the doctors for discussion. I think you are well within your rights to insist and request this as his behavior is becoming disruptive to the group and you would like to have a professionals feedback so you may be able to implement some new strategies in your daycare setting that would benefit their child and make for a much happier day all around. Whether you do or not is entirely up to you, but putting it like that to the parent may really help them see things for what they are which is that you care about their child and want to work with them, not that you are right and they are wrong or anything else they may twist your words into as a result of not liking what you tell them and getting defensive.
I had a situation where I cared for a boy for a similar amount of time and he had all sorts going on and I took this approach but in addition wrote a statement which initially highlighted this childs strengths, not just in milestones but personality too. I then listed areas requiring attention, not weaknesses but areas inwhich I wanted to work on helping him improve. Mum was very reseptive and loved what I did but dad was a defensive arguementative pain in my ass even arguing that psychology is subjective and that child development models could quite easily be very wrong and resulting in many misdiagnosis' in special needs. I'm not talking about misdiagnosed ADD and ADHD which happens more often than not for gifted or 2E kids but his arguement was for the fact that it was perfectly okay for a 3 year old to pick up branches and chew them because he was exploring his senses. Excuse me!! He has full use of his other senses at age 3 and isnt a one year old who explores things with his mouth which is normal. Eating all the appliques off my wall...not normal, lying on the ground chewing chair legs for the duration of the morning...not normal.....okay so off topic a bit but you get where I'm going with this I'm sure. Some parents just aren't open to hearing these things and can be very defensive, even delusional. Best to stick to the facts and hopefully the parents will work with you but if not then maybe its time for another caregiver to have him and report similar things to the parents before they get whats going on.
Good Luck!

































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