concerned about 3 year old

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Hi all,

I am a newcomer to this forum, so thank you very much for reading my question! Let me start out by apologizing if any of my terminology is offensive or not the preferred terminology. (After delving into this issue I really just hate the "normal v ASD" dichotomy - if it does turn out my kid as an ASD I will still consider him normal! I've never been a conformist so it just rankles that normal = good. Anyway ... )

I have some concerns about my 3 year old boy's development, but I am not sure if they point to an ASD or to non-spectrum issues, or just being a 3 year old, and I was hoping to get some insight or direction to online sources or articles to read about it. On the one hand I want to push to get him help and evaluation if he is on the spectrum, but on the other hand, I don't want to overreact to normal developmental stuff.

The gist of it is that with adults, he is very engaged and interactive, and emotionally perceptive; but seems inhibited/scared/confused with other kids.

To me (although I realized that I don't see the full range of 3 year olds) he seems to have good joint attention. However, he does seem to make less eye contact than other kids, and this seems to be correlated with stress. When he is relaxed and having a good time he makes a lot of eye contact.

His play seems typically developing to me. He engages in an increasing amount of pretend play these days (e.g., this morning he was pretending that a book was an elevator and his toy turtle was going up in it to visit the doctor). He has never been super into toys, but when he plays with toys it seems to be typically (e.g. pushing a car like a car). The only noteworthy thing is that sometimes he will "adopt" a non-toy object (a straw, a stick, a bottle cap) and want to carry it around for a while. But he always forgets about it after a day and has no issues if I take it away from him.

No language delays. The only potentially different thing about his language is that sometimes he can speak very slowly and exaggerate the question pitch/intonation, but that quirk seems to be disappearing. He seems to me to converse in a mature way, but socially typical. He really likes to have conversations (with adults!)

No stims/repetitive behavior/perseverations as far as I can tell. Notably, his father stims! When his dad is very stressed he paces and does a finger shaking gesture. But it's very brief and minimal - I'll see him do it once very few weeks when he's thinking about something stressful at work.

Physically, he is definitely on the lower end of the scale. He has always been slower on gross motor skills, but still within the typically developing range. He is definitely sensory seeking in some ways - loves tight hugs, spicy food, etc.

As I wrote earlier, with adults he seems totally engaging, warm, and socially typical. EVERY adult that I have spoken to about my concerns says "he is totally fine!" But with kids in his new preschool class it is very different - he seems withdrawn, kind of confused, and like he is not socially interacting at the same level that they are, and sometimes lashes out at the other kids. He is one of the youngest in his class, and all the other kids have older siblings, though. This behavior has drawn the attention of his teacher who has told me that she has concerns (although she was extremely vague about it).

Because we were concerned with the new teacher's report, we took him this week to a child psychologist, who initially said that he does not have any concerns wrt his development. But he has not seen him interact in class yet, though.

Thank you for any insight! My #1 concern is that my boy get any help he needs to develop socially and not feel ostracized, so whether this comes via an ASD diagnosis or something else, I want to help!

I should add! He has always been a pretty flexible, easy kid. Sleeps well, eats well, adjusts to changes in routine. The only notable difference might be that he has always wanted attention - wanting to be held as a baby instead of being put in a stroller, for example. He does have some tantrums here and there and can be stubborn, but nothing that seems out of the ordinary to me.

Hi and welcome!

Yeah, the terminology is tricky, and I find I use some verbiage I don't really like on occasion, myself, because I don't know how else to say things clearly, and that is the terminology that is used.

So I am going to use "higher functioning" in that way as a proxy for the longer thing I really mean which is really the ability to function with less difficulty in an NT world.

Anyway, if a child is especially high functioning sometimes the alarms don't go off until 6 or 8 years old because that is when the other kids' social skills tend to develop much faster than an aspie's. So often a kid on the spectrum will blend fairly well until then. In addition, if a child is lacking certain stereotypical aspects, he may not be on people's radar. People, even people who should know better, like pediatricians tend to look for very specific things, and one can be autistic without those particular things.

At three, it can often be hard to get the full picture either way, which can be frustrating and anxiety provoking. In addition to professional assistance, the mean thing to know in that regardless of whether your child fits a clinical diagnosis, you can see if your child has particular weaknesses that stand out. Issues with peer-to peer interactions seem to be the thing you find most concerning, so i would start with that. My son has always been very, very poor at this, and initially unwilling.

If your child is not just shy and has issues with how to approach, and be reciprocal, and is also willing, I think I would start with some heavily scaffolded play-dates -- one on one with a very patient child his age. See how they interact and see if practice helps.

Thank you! Can you suggest any resources for how to "scaffold" playdates? I would like to share with my husband and our after-school babysitter.

I Googled and found this to give you an idea. http://www.friendshipcircle.org/blog/20 ... -playdate/

The main thing I think though is always to figure out what your individual child needs. If an exact-age peer is not practical b/c the other child will resent the lack of reciprocity, go higher or lower in age.

An older, willing, child can model how play works, without getting mad at the younger one, often because they are more tolerant of a younger child. If your child is sufficiently patient with younger kids, but wants to be in charge, often a younger child will look up to your child and let him teach him skills.

My son loves younger kids, doesn't get upset when they do things that would upset him if a peer does it. He also likes to feel like an expert, and likes to teach younger kids things. Again, it has to be the right kid, because they have to be willing to let your kid show-off, if that is what he likes to do.

You also have to be aware of how much time is too much, and be prepared if your kid wants to terminate the play early. So make sure if your kid is "done" you have ways to entertain his playdate partner and make sure you can make sure the other kids' feelings are not hurt. If you think that is an issue, and a younger kid will be more hurt, then you may have to go with an older kid.

I don't really have anyone to schedule playdates with per se, but there are social situations at the park and library that I can often rig to suit some of these goals. But if I had willing kids that is what I would do, and my observations come from those impromptu situations and what seems to work, and what does not.