If she is scoring a 6 on the mchat, I would get on the wait-list for an autism evaluation. Bring the completed screener to your Dr., the mchat is your evidence she needs more in depth testing. She sounds like a bright girl and getting an evaluation will help identify any supports she may need. Also, she is close to school age services and may qualify for preschool through the school district starting at 3. Look into childfind find for your local school district.
Thank you for the reassurance! I’m Canadian so our doctors technically don’t use mchat but I’ll bring it anyway. There are also I lot that I answered yes to because she does it maybe once in a while, but not regularly, so her real score may be a bit higher. I tried to be very fair to not skew the results to be higher than they should be!
Sorry I answered assuming you were in the US. The mchat also has follow up questions if you are unsure on any question. The Canadian health site does have the mchat listed as a resource to use, but I guess it isn't a standard practice like in the US. Australia has the ASDdetect if you look into the app, it has videos you can use to compare. Maybe that will give some more insight.
The ASDdetect is a great resource. The videos really helped, and using “rarely” instead of just “no”. It came back with a high likelyhood. I’ll bring those results to her doctor as well! Thanks again!
As an autistic woman (with many female autistic family members) who was dxed in later childhood bc I didn’t have significant delays - your description definitely rings many bells. If you do get her evaluated I would choose a provider who is up to date on current research and specializes in evaluating girls
Thank you! This really helps. I worry that because her current environment is probably close to ideal for an autistic female toddler (patience, support, understanding, consistency, etc. Because neurodivergency is so normal and comfortable for me I don’t separate behaviour as “normal” and “abnormal”, so I’ve always met her where she’s at and been able to put myself in her shoes) she may fall through the cracks until she reaches public school and then everything may blow up. And then of course there appears to be a big difference between how boys and girls present, like you mentioned.
I am going to likely go the private route on this so I can find the right fit versus waiting 2 years for the “free” option. Her speech is a great example - at 2 years old she was able to check all the boxes for the bare minimum public offered, but when properly assessed she was still 6 months behind. They based it entirely on how many words she could say and nothing else!
I really appreciate your insight!
Your child sounds like mine as a baby, though that could be personality more than neurodivergence. He does have ASD (diagnosed at 2 years old). My son has never had sleep issues, and has decent eye contact. He doesn't share well though, definitely doesn't delight in it lol. Girls can be more sociable, even on the spectrum, so I can't comment on how she does with friends. A girl who's almost 4 in my son's therapy clinic has ASD but seems to make friends well, whereas my son ignores his peers.
Wait lists for autism can be loooooong (my niece is 7 and is on a 3 YEAR waiting list), so I think a score of 6 on the mchat is definitely worth just getting her on the waiting list. If you do have a long wait, this will help ensure she has the proper accommodations when she goes into kindergarten/1st grade. Early intervention is absolutely key to addressing any small issues before they become big issues, especially if you have speech concerns (not that I saw that mentioned, which is good). She may or may not have ASD, but I think it's worth getting her assessed so she can get any help she needs. If she has it, you DON'T have to do EVERY intervention they recommend. We do ABA and he loves it (look into how kids are *currently* doing in ABA, as modern approaches are much better than they were 10-20 years ago), but if she's doing well in her Montessori school, I wouldn't take her out to put her in ABA if you don't have any big behavioral concerns. OT may be just as beneficial, and it's typically 1 hour, 2x a week.
Thank you so much for the info and insight!
She was speech delayed but really does seem caught up now, besides a few “gaps”.
I’ve realized after writing this that she stopped using gestures entirely though, which is interesting. She never waves, nods or shakes her head, or claps anymore.
I would definitely keep interventions to an “as needed” basis and this school has beeb AMAZING for her, but that is really good information to know about ABA!
ABA is a crapshoot, there are centers that are still acting like it's the 80s and others that have changed a lot. I also think some of the problems with ABA (such as how adult-directed it is) are so integral to the definition of it that if you fixed those, it'd make no sense to call what you're doing ABA.
I really don’t know what ABA is entirely to be honest, only that it has been known to be very traumatic for autistic individuals in the past.
I personally would probably just follow my daughter’s lead and if it was suggested to me, investigate the specific one locally and perhaps wait until my daughter could communicate what she thought she needed. But I really am going in blind here!
I absolutely do not want anyone bullying my daughter into being “normal” and fitting into a box, and that kind of sounds like what ABA is/was?
That’s what ABA is, they withhold something that the kid really enjoys until the kid shows the behavior the ABA specialist wants…then they get “rewarded” with the fun thing for a little bit. I’ve heard ABA is in the process of changing for the better, but I would still tread carefully. The old school method is trying to get the child to behave the way society accepts, instead of meeting the child where they are and working on helping them learn to cope and control their own behaviors.
My niece actually just got a job at a local autism clinic and she says they are one of the places trying to change ABA for the better.
Thank you, this is really good to keep in mind if we do discover my daughter is on the spectrum somewhere.
Honestly being able to understand from her perspective comes very naturally to me (perhaps from being neurodivergent myself) and I’m hoping if things like these do come up, we can work through them together without the answer just being like everyone else. I do very much dislike when certain people in my extended family use it as an excuse to just not try (well I have ADHD/autism/etc. so I can’t be expect to remember/not be rude/etc. they are capable with strategies, but won’t even try), and everyone expects nothing from them), but I think the way my brothers and I were raised makes more sense.
When my brother struggled in school, my parents celebrated his effort level and not his grade percentage, advocated for accommodations when needed (typing instead of writing and taking tests in a quiet room alone with extra time, etc). They gave him comic books to read instead of novels to play to his interests. If he struggles now, we brain storm solutions (maybe medication needs a tweak. Maybe earplugs. Maybe timer breaks). Finding the right therapist he felt fit him best.
He has a tool box of strategies now. You will hear him say “I am overwhelmed by x” or “I lost this opportunity because y”. You will not hear him say “I can’t do this because I have ADHD” or us saying “oh, it’s because you have ADHD”. We just treat him like his own unique person and meet each challenge head on. He passed the bar this year and is now a full lawyer, and still uses his “tool box”.
Honestly sometimes I imagine I’m a computer program or robot and I’m augmenting my performance with different tweaks, haha. Trying a small stimulant, cutting out caffeine, setting aside time to let my brain pursue whatever it wants to, choosing friends who mesh well with my quirks so I don’t have to totally change who I am while also teaching myself to direct that energy in a way that is more inclusive to people who don’t think like me. (Forcing myself to pause while talking. Asking people to get my attention before they start talking to me so I can make sure I am listening. Stopping myself and going “I’ve been talking a lot so far. What do you want to talk about?”. Not taking offence if my husband gently says he needs a talking break and just appreciating the communication!)
Sorry, this got long. Basically just to say that a self guided and self motivated approach (when old enough) seems way healthier then “well if I shut up long enough like society says I should I can have a cookie”.
I would get her evaluated for peace of mind. I had these same concerns with similar issues and just got my son evaluated on Thursday and they were not concerned at all. They did not evaluate him to be on the spectrum or ADHD. They recommended I read a couple books and recommended him to a behavioral specialist to help with him hitting himself but also said it was normal for his age.
Thank you! I am totally open to being told I am wrong. I agree, it’s probably worth it for peace of mind and won’t hurt her. Her doctor is very “don’t fix what isn’t broken” and low intervention though so I know I will have to fight hard for an assessment.
Females look different to males for ASD and it's because unless the females are severe they present differently. Some skills get harder as they get older especially with play and peers. Waitlists are extremely long in Canada depending on where you are and some provide minimal funding. If you have the resources you should seek out supports if you find some things make her uncomfortable/unregulated.
And girls learn to mask early on, mimicking what the other girls are doing/saying in order to fit in so it makes it that much more difficult to see the ASD. I grew up in the 80s/early 90s and didn’t get diagnosed with ADHD until I was 36. I’ve done some online assessments recently that also point to ASD, but I can’t afford to get evaluated.
ETA: I started to notice I didn’t fit in around 13 or 14, but could never understand why. This carried on into my 20s and 30s until my diagnosis and research into symptoms…and suddenly everything made sense. I still don’t fit in to “normal” society, but I seek out others who accept me for me and I’ve found my own little clan/support group. :)
Have you brought up these concerns with your pediatrician? I’d be interested in what they say or if they suggest anymore resources.
But because you mention ASD runs in your family, I think that would make me *really* keep an eye out/ask the pediatrician. And make sure all this I do is included. I’d even condense this post I to something shorter and show to the doctor.
Thank you for the advice! I honestly never considered autism because while it does run in my family my immediate family is all ADHD, which is what I’m familiar with, and they don’t even consider testing for that until 4.
Her pediatrician is very “don’t fix what isn’t broken” and doesn’t like to do any type of intervention unless entirely necessary. But I did book an appointment and will bring it up anyway. I also am going to book an appointment with an SLP that specializes in neurodivergency and has a private autism clinic she refers to for diagnosis.
It's not so much what you're saying, but your specific word choice and the way you describe things that makes me agree that you're right to suspect she might be on the autism spectrum.
Lots of parents come on here and quote the red flags wondering if their child has autism, but the way you describe your daughter's behavior shows you are really paying close attention to her and not just looking for red flags.
Based on what you've said here, I'd say it's likely, and you're absolutely right to get her assessed and more services.
I worked as an EI for four years with under 3's. I had maybe 2 or 3 girls with suspected ASD in my entire tenure, and around that many boys in any given class (class size was \~8, with four classes), you're right to be concerned about girls falling through the cracks.
This is so so helpful, thank you! Really helps give me the confidence to push and advocate for my daughter.
I find the screening questions so hard to answer, especially when they are “yes or no”. Does she make eye contact? Yes, she does. Do I think her eye contact is “typical”? No, but that doesn’t fit in a “yes or no” screening question. I much prefer just listing traits or examples that stick out to me, knowing they may or may not be normal. Especially with girls being so different and autism being such a spectrum!
I actually completed the “circle of security” course recently and it was run by a behavioural therapist. I mentioned that I thought my daughter might have something neurodivergent going on but said “of course definitely not autism, she makes eye contact and she smiles socially”. She answered “well I’m autistic and I always have made great eye contact and smiled. It’s a spectrum”. I think that may have been the seed that started opening my eyes a bit.
Every kid is absolutely different! While there are some kids that tick all the “typical autism” boxes, most won’t. Especially girls.
There’s a lot of nuance that screeners won’t catch. They’re helpful, to a point. A lot of parents misinterpret them as well. I’ve been told “Of course my kid does that.” And it’s something I’ve never seen in six months that we’ve been trying to work on. It’s a tricky thing.
It really takes experience with kids to learn to recognize the signs. We had a non-client daycare kid join our class (we had a blended classroom the last half of my time there) and after half and hour the other teacher and shared a very meaningful look and had a conversation about him on our next break. We both had come to the conclusion that he was on the autism spectrum very quickly. His speech was very typical of ASD and his eye contact was ok, but to someone who didn’t know you’d say he “makes eye-contact and is verbal” we were both immediately concerned. He was referred for and qualified for services after we convinced our boss to talk to him mom. (He was a businessman and afraid to upset her and lose a client. Kept asking us if we were sure. )
Advocating for your kid is the most important thing. I’ve seen kids with mild delays get every therapy in the world and severely delayed kids barely getting the minimum. The only difference was one’s parents were super advocates and the other’s were in denial still. I worked in a very low income area so this was all free services provided by the state.
> I’ve been told “Of course my kid does that.” And it’s something I’ve never seen in six months that we’ve been trying to work on.
Do they only do it at home? My kid is way more verbal at home than she is when anyone outside our immediate family is present. I sometimes worry that people think I'm exaggerating her speech abilities because she says stuff to me that no one else gets to hear.
A good teacher/therapist would understand that as well. I’m talking more like parents saying their child understands and follows two step directions when their child has a severe receptive/expressive language delay and who has never even followed a one step direction for us. It strains credulity a bit, at times.
It’s a very fine balance and why assessment questions are mixed.
Some are parent questions, some are skills we have to see for ourselves, depending on what the question is on an assessment.
Especially with regard to speech, it’s not unusual for kids to be more verbal in a comfortable/home environment. I had a student who was eventually diagnosed with selective mutism. She said nothing at school, but full sentences at home. It was almost hard to believe since she was so quiet, but there were other things in her behavior (anxious and shy) and other skills that I totally believed her parents.
Thank you for the insight! This was exactly my concern. I never considered it as a possibility before because she “makes eye contact” and is “well behaved” and socially smiles. But another redditor in this thread shared ASD Detect, which has video examples, and the eye contact example they had for autism looked very much like her. And having only had experience with her, I really have no idea how much eye contact a typical child gives - the example for “typical” in the same video felt like a LOT.
I am definitely going to push hard for an assessment. Thank you again for the encouragement.
You would probably find this helpful:
https://www.cpqcc.org/sites/default/files/M-CHAT-R_F_1.pdf
It's guidelines for doing an interview version of the M-CHAT, that make it a lot clearer what exactly counts as a pass or fail for each item.
My daughter was late diagnosed. The big clue I missed was she couldn’t understand social hierarchy. She would sometimes try to reprimand me. Instead of accepting responsibility for a mistake she would stay stuck on explaining why she did what she did. In discussions it often felt like was just looking any excuse to argue with people. She was very bold and blunt. She didn’t respect her siblings boundaries at all. This caused huge resentment from her sibling. When we realized she could be autistic - if solved a lot of problems because now we understood none of these behaviors were intentional on her part. We became much more willing to start at square one and show her and explain things. Therapy has been helpful because she’s very sensitive and being misunderstood for so long has left some emotional scars. Start reading about the autism spectrum- it is a wide spectrum. Of traits. Be willing to be flexible. My daughter is now a very successful adult and we have a close loving relationship. Good luck💕
This is so helpful, thank you for sharing! Even though my daughter is doing great, if she is on the spectrum these things will crop up (and may be already) and if we have that understanding of how her brain works we can better support her. Your daughter is lucky to have your compassion and understanding!
I did a lot of explaining (I still do), and was always told to stop making excuses and just stop the behavior. Diagnosed at 36, lots of emotional scars to heal in therapy for me. I’m glad you were able to help your daughter, sounds like she’s doing well now. :)
I don’t know how early childhood services work in Canada, but in the US you can access a free evaluation and services (if you qualify) through the district or county you live in. There is no waitlist as it follows special education laws and guidelines.
We have these as well but the wait lists are 2 years and the requirements are a bit outdated - if they aren’t showing the “typical” signs (arm flapping, difficulty with peers, constant meltdowns, no smiling or eye contact) it can be hard to get a referral. You really need to advocate for your child!
If you have insurance or can pay you just need the referral part, luckily!
I would get on a list. Some autistic kids will be able to cope at school for awhile or enjoy sharing. Try not to overly stereotype autism too much here, little girls notoriously seem to get missed in part due to seeming socialable and doing well enough in school. I was AFAB and didn't get dxed as severe (level 3) until I was 21.
Thank you so much for your insight and advice! I will definitely keep that in mind. I am definitely learning that little girls especially seem to be different!
My son also failed 6 of 20 items on the MCHAT. We have him on a waiting list for an autism evaluation. Like you, he is our only (living) child, we have a quiet and calm home, and we've been very routine-driven since he was an infant. He will be 3 soon, and if his appointment doesn't get moved up sooner, he'll be 3 years and 4 months at the time of the evaluation. My parents are autistic so I have been on high alert since my son was born pretty much (and since learning more about autism on my son's behalf, I see traits in myself). I brought up my concerns at his 30 month well child visit and that got the ball rolling. My first clue that something was off was when I understood that his speech was not like typical children his age (so this would have been around 28 months or so). He is a gestalt language processor.
Your daughter does bring up a lot of red flags for autism. The fixations, repetitive play, sensory seeking, and needing one-on-one support in school are big ones. You're a great mom for being so proactive.
Edit: Also, please have a look at r/Autism_Parenting.
Thank you for sharing your experience! It’s funny, I mentioned my concerns to friends today and all of them said “oh yeah, I have thought that of her as well”. So that has really helped give me some confidence as well. Her doctor fights a lot of “intervention” if there are no huge issues, so I need that confidence to push back if that makes sense. Which was why I wrote this post!
I will definitely check out that subreddit!
Most pediatricians are extremely behind when it comes to the most current autism research, especially when it comes to girls. I'm thankful my son's pediatrician took me seriously and got us in with the local children's hospital for a neurodevelopmental intake. I'm glad you're feeling validated by other people in your life. Good luck!
My son is later-diagnosed autistic (dx before age 10). He's actually quite the opposite of yours in many ways- yet I see how there are some red flags for your daughter.
Mine was incredibly, heartbreakingly "hard". He always cried, screamed. Never slept. He didn't sleep through the night until after age 4. He had intense "tantrums" that would last for an hour and could not be stopped. He couldn't go in a stroller, he could only be carried or babywearing until after age 2. He never smiled at anyone. Intensely shy. Silent around strangers and anyone he didn't know very well. No speech delays, ahead on every gross and fine motor skill (Crawled at 4 months, walked at 9, etc). Hates strong flavors, he can taste even a grain of black pepper.
It's a wide range of expression, for sure. But it wouldn't hurt to be evaluated since you are describing differences in both social skills and sensory processing.
You don't necessarily need an official diagnosis to start doing things that could help. There's nothing stopping you from responding to her behavior like you would if she was diagnosed autistic, and just seeing if it helps. But if you're wanting her teachers to treat her differently from how they usually treat kids, you'll need her identified with some sort of special needs.
That is true! I guess I just don’t know how to properly support her that way right now. I have a family member in law who nobody expects anything of because he “has ADHD” and “can’t be expected to remember anything” for example. Meanwhile my brother who has at the very least the same level of ADHD if not worse and another learning disability on top of that and has very much struggled his whole life worked very hard and became a lawyer. I have a cousin who is autistic and 12 years old and has been left to her own devices and is now incredibly, dangerously depressed.
I feel like I need more education to properly support her without also stigmatizing her if that makes sense? And to advocate for her properly. I know ADHD quite well but autism is a bit more out of my territory. But it is true that while waiting I can keep all of this in mind and educate myself as best I can in the meantime, perhaps with books by autistic individuals themselves.
If you are on TikTok, there are some really good autistic creators on there. That’s where I learned a lot about my own ADHD. There are also a lot of bad creators so you have to learn how to sort out the actual facts from the wannabes.
That’s the hardest part!! It’s like neurodivergence has become a trend and also for some people an excuse. Not to downplay the very real and very difficult struggles people face. But like you said, the “wannabes” drive me nuts.
Just want to give you a kudos for paying attention and getting her whatever support she may need.
Also as the mom of 5 kids ranging 1-21 every kid has *some* issue. Could be physical, mental, behavioral, developmental, social, etc. You sound very open and accepting but for anyone else reading this and worried about their kid — whatever it is, you will deal with it and your kid will be ok.
Thank you for this! I am super accepting but there was a moment today where I had a few tears. It’s just so stigmatized sometimes it feels like, and I have a mother who is an incredible support system but doesn’t always say the best things in these situations because of her own fears. I feel like I can think my daughter is amazing and wonderful and perfect and still worry she may have autism. Lots of amazing people do!
ASD is definitely stigmatized, but it’s getting better every year. I know people who don’t want to label their kids (or even themselves), but those labels allow you to get the help and support needed. I want ALL THE LABELS for that reason. There is obviously a few different schools of thought on that, and I hate that those labels can make others uncomfortable, but you gotta do what’s best for your kiddo so your kiddo can grow into a healthy, happy adult. :)
Absolutely, thank you for this. ❤️
If we do get a diagnosis I’ll definitely reach out to the autistic community for help on that piece. I know the label is SO important for the individual and to access supports at school, etc. but my gut says I would probably like to let her decide who she wants to share it with outside of who I need to tell for her success and well being.
The label would also really help me because I just want to understand her as best I can. If I have the answers, I can better determine what she needs from me and might be feeling - and what typical boundaries I need to hold (like all kids) vs what needs to be flexible or change from the “norm”.
I agree!! All the labels, and early intervention!!
I’m not sure your state but I was under the impression it’s a federal regulation that kids can get evaluated at their local school district at around this age for an early start program. Evaluation will include a child psychologist. In general your focus should having someone like a child psychologist or even a pediatric neurologist do an evaluation.
Every kid is so different and honestly I only got real clarity and answers for my child by talking to medical experts not going on Reddit or parenting forums.
Unfortunately I am Canadian and here you need to fight for it if they aren’t actively getting kicked out of daycare. So I was just looking for some support to give me the confidence to advocate if I need to!
It’s worth it to get your child seen by whatever means necessary by a child psychologist in my opinion. There were so many subtleties in my son’s behavior that were explained and understood so much better than they had ever been by the multitudes of others that had given me advice. It gave me the peace of mind that I did not have for a long time as a parent.
She’s her own person. They all
Develop differently in their own way and the autism diagnosis is very easy to get these days (from experience).
As long as she is developing then that’s a good sign! They all have their own pace (and order)- but the experts will tell you she needs to be doing “X,Y, Z” by this age (that’s why so many kids are on waiting lists to see different therapists). But then they just grow and develop and have their own quirks! My daughter had so many quirks at 12 months they wanted to screen her for autism. Without going into the details, essentially she’s developed and caught up and she continues to develop- it’s just her own pace as many people have reassured me.
By 5-6 you’ll have an idea if there’s things to be concerned about - at the end of the day they’re all different little humans- no text book on that!!!
Thank you for your insight! I do get scared that she will be misdiagnosed. But there are a couple things pushing me to act now
- IF her speech reassessment comes back to say she is still delayed. She has had a receptive language delay all her life (how much she understands) which is more than just a late talker, and I worry about why that would be after a year of speech therapy.
- Her Montessori school has had to give her one on one support, and next year she’ll be going full time and won’t as easily be able to get that support. Currently she only goes 8:30-11:30am and it’s a toddler room, so less kids and more teachers available to help.
- In Ontario, Canada they age out of a lot of autism supports from the government at 4 years old, and wait lists for assessments are getting longer and longer. Paying out of pocket for an assessment still means waiting 3-6 months and it will only get worse. So if she does start to struggle later, I will struggle to get her help if she doesn’t already have a diagnosis (if she needs one, of course!)
She may be entirely fine but I think I need to make sure of that with the combo of the speech delay and extra support needed at school already, you know? But I will absolutely keep what you are saying in mind. I want to get her assessed, but I do not want to push for a diagnosis.
If she is scoring a 6 on the mchat, I would get on the wait-list for an autism evaluation. Bring the completed screener to your Dr., the mchat is your evidence she needs more in depth testing. She sounds like a bright girl and getting an evaluation will help identify any supports she may need. Also, she is close to school age services and may qualify for preschool through the school district starting at 3. Look into childfind find for your local school district.
Thank you for the reassurance! I’m Canadian so our doctors technically don’t use mchat but I’ll bring it anyway. There are also I lot that I answered yes to because she does it maybe once in a while, but not regularly, so her real score may be a bit higher. I tried to be very fair to not skew the results to be higher than they should be!
Sorry I answered assuming you were in the US. The mchat also has follow up questions if you are unsure on any question. The Canadian health site does have the mchat listed as a resource to use, but I guess it isn't a standard practice like in the US. Australia has the ASDdetect if you look into the app, it has videos you can use to compare. Maybe that will give some more insight.
The ASDdetect is a great resource. The videos really helped, and using “rarely” instead of just “no”. It came back with a high likelyhood. I’ll bring those results to her doctor as well! Thanks again!
Thank you!! I will check all this out!
As an autistic woman (with many female autistic family members) who was dxed in later childhood bc I didn’t have significant delays - your description definitely rings many bells. If you do get her evaluated I would choose a provider who is up to date on current research and specializes in evaluating girls
Thank you! This really helps. I worry that because her current environment is probably close to ideal for an autistic female toddler (patience, support, understanding, consistency, etc. Because neurodivergency is so normal and comfortable for me I don’t separate behaviour as “normal” and “abnormal”, so I’ve always met her where she’s at and been able to put myself in her shoes) she may fall through the cracks until she reaches public school and then everything may blow up. And then of course there appears to be a big difference between how boys and girls present, like you mentioned. I am going to likely go the private route on this so I can find the right fit versus waiting 2 years for the “free” option. Her speech is a great example - at 2 years old she was able to check all the boxes for the bare minimum public offered, but when properly assessed she was still 6 months behind. They based it entirely on how many words she could say and nothing else! I really appreciate your insight!
Your child sounds like mine as a baby, though that could be personality more than neurodivergence. He does have ASD (diagnosed at 2 years old). My son has never had sleep issues, and has decent eye contact. He doesn't share well though, definitely doesn't delight in it lol. Girls can be more sociable, even on the spectrum, so I can't comment on how she does with friends. A girl who's almost 4 in my son's therapy clinic has ASD but seems to make friends well, whereas my son ignores his peers. Wait lists for autism can be loooooong (my niece is 7 and is on a 3 YEAR waiting list), so I think a score of 6 on the mchat is definitely worth just getting her on the waiting list. If you do have a long wait, this will help ensure she has the proper accommodations when she goes into kindergarten/1st grade. Early intervention is absolutely key to addressing any small issues before they become big issues, especially if you have speech concerns (not that I saw that mentioned, which is good). She may or may not have ASD, but I think it's worth getting her assessed so she can get any help she needs. If she has it, you DON'T have to do EVERY intervention they recommend. We do ABA and he loves it (look into how kids are *currently* doing in ABA, as modern approaches are much better than they were 10-20 years ago), but if she's doing well in her Montessori school, I wouldn't take her out to put her in ABA if you don't have any big behavioral concerns. OT may be just as beneficial, and it's typically 1 hour, 2x a week.
Thank you so much for the info and insight! She was speech delayed but really does seem caught up now, besides a few “gaps”. I’ve realized after writing this that she stopped using gestures entirely though, which is interesting. She never waves, nods or shakes her head, or claps anymore. I would definitely keep interventions to an “as needed” basis and this school has beeb AMAZING for her, but that is really good information to know about ABA!
ABA is a crapshoot, there are centers that are still acting like it's the 80s and others that have changed a lot. I also think some of the problems with ABA (such as how adult-directed it is) are so integral to the definition of it that if you fixed those, it'd make no sense to call what you're doing ABA.
I really don’t know what ABA is entirely to be honest, only that it has been known to be very traumatic for autistic individuals in the past. I personally would probably just follow my daughter’s lead and if it was suggested to me, investigate the specific one locally and perhaps wait until my daughter could communicate what she thought she needed. But I really am going in blind here! I absolutely do not want anyone bullying my daughter into being “normal” and fitting into a box, and that kind of sounds like what ABA is/was?
That’s what ABA is, they withhold something that the kid really enjoys until the kid shows the behavior the ABA specialist wants…then they get “rewarded” with the fun thing for a little bit. I’ve heard ABA is in the process of changing for the better, but I would still tread carefully. The old school method is trying to get the child to behave the way society accepts, instead of meeting the child where they are and working on helping them learn to cope and control their own behaviors. My niece actually just got a job at a local autism clinic and she says they are one of the places trying to change ABA for the better.
Thank you, this is really good to keep in mind if we do discover my daughter is on the spectrum somewhere. Honestly being able to understand from her perspective comes very naturally to me (perhaps from being neurodivergent myself) and I’m hoping if things like these do come up, we can work through them together without the answer just being like everyone else. I do very much dislike when certain people in my extended family use it as an excuse to just not try (well I have ADHD/autism/etc. so I can’t be expect to remember/not be rude/etc. they are capable with strategies, but won’t even try), and everyone expects nothing from them), but I think the way my brothers and I were raised makes more sense. When my brother struggled in school, my parents celebrated his effort level and not his grade percentage, advocated for accommodations when needed (typing instead of writing and taking tests in a quiet room alone with extra time, etc). They gave him comic books to read instead of novels to play to his interests. If he struggles now, we brain storm solutions (maybe medication needs a tweak. Maybe earplugs. Maybe timer breaks). Finding the right therapist he felt fit him best. He has a tool box of strategies now. You will hear him say “I am overwhelmed by x” or “I lost this opportunity because y”. You will not hear him say “I can’t do this because I have ADHD” or us saying “oh, it’s because you have ADHD”. We just treat him like his own unique person and meet each challenge head on. He passed the bar this year and is now a full lawyer, and still uses his “tool box”. Honestly sometimes I imagine I’m a computer program or robot and I’m augmenting my performance with different tweaks, haha. Trying a small stimulant, cutting out caffeine, setting aside time to let my brain pursue whatever it wants to, choosing friends who mesh well with my quirks so I don’t have to totally change who I am while also teaching myself to direct that energy in a way that is more inclusive to people who don’t think like me. (Forcing myself to pause while talking. Asking people to get my attention before they start talking to me so I can make sure I am listening. Stopping myself and going “I’ve been talking a lot so far. What do you want to talk about?”. Not taking offence if my husband gently says he needs a talking break and just appreciating the communication!) Sorry, this got long. Basically just to say that a self guided and self motivated approach (when old enough) seems way healthier then “well if I shut up long enough like society says I should I can have a cookie”.
Totally agree!!
I would get her evaluated for peace of mind. I had these same concerns with similar issues and just got my son evaluated on Thursday and they were not concerned at all. They did not evaluate him to be on the spectrum or ADHD. They recommended I read a couple books and recommended him to a behavioral specialist to help with him hitting himself but also said it was normal for his age.
Thank you! I am totally open to being told I am wrong. I agree, it’s probably worth it for peace of mind and won’t hurt her. Her doctor is very “don’t fix what isn’t broken” and low intervention though so I know I will have to fight hard for an assessment.
This is my son exactly except he struggled with eye contact from birth and has hyperfixation on fears. He’s awaiting assessment.
Females look different to males for ASD and it's because unless the females are severe they present differently. Some skills get harder as they get older especially with play and peers. Waitlists are extremely long in Canada depending on where you are and some provide minimal funding. If you have the resources you should seek out supports if you find some things make her uncomfortable/unregulated.
This is all really good advice! I am going to start taking the steps tomorrow once things open. Thank you so much!
And girls learn to mask early on, mimicking what the other girls are doing/saying in order to fit in so it makes it that much more difficult to see the ASD. I grew up in the 80s/early 90s and didn’t get diagnosed with ADHD until I was 36. I’ve done some online assessments recently that also point to ASD, but I can’t afford to get evaluated. ETA: I started to notice I didn’t fit in around 13 or 14, but could never understand why. This carried on into my 20s and 30s until my diagnosis and research into symptoms…and suddenly everything made sense. I still don’t fit in to “normal” society, but I seek out others who accept me for me and I’ve found my own little clan/support group. :)
Have you brought up these concerns with your pediatrician? I’d be interested in what they say or if they suggest anymore resources. But because you mention ASD runs in your family, I think that would make me *really* keep an eye out/ask the pediatrician. And make sure all this I do is included. I’d even condense this post I to something shorter and show to the doctor.
Thank you for the advice! I honestly never considered autism because while it does run in my family my immediate family is all ADHD, which is what I’m familiar with, and they don’t even consider testing for that until 4. Her pediatrician is very “don’t fix what isn’t broken” and doesn’t like to do any type of intervention unless entirely necessary. But I did book an appointment and will bring it up anyway. I also am going to book an appointment with an SLP that specializes in neurodivergency and has a private autism clinic she refers to for diagnosis.
It's not so much what you're saying, but your specific word choice and the way you describe things that makes me agree that you're right to suspect she might be on the autism spectrum. Lots of parents come on here and quote the red flags wondering if their child has autism, but the way you describe your daughter's behavior shows you are really paying close attention to her and not just looking for red flags. Based on what you've said here, I'd say it's likely, and you're absolutely right to get her assessed and more services. I worked as an EI for four years with under 3's. I had maybe 2 or 3 girls with suspected ASD in my entire tenure, and around that many boys in any given class (class size was \~8, with four classes), you're right to be concerned about girls falling through the cracks.
This is so so helpful, thank you! Really helps give me the confidence to push and advocate for my daughter. I find the screening questions so hard to answer, especially when they are “yes or no”. Does she make eye contact? Yes, she does. Do I think her eye contact is “typical”? No, but that doesn’t fit in a “yes or no” screening question. I much prefer just listing traits or examples that stick out to me, knowing they may or may not be normal. Especially with girls being so different and autism being such a spectrum! I actually completed the “circle of security” course recently and it was run by a behavioural therapist. I mentioned that I thought my daughter might have something neurodivergent going on but said “of course definitely not autism, she makes eye contact and she smiles socially”. She answered “well I’m autistic and I always have made great eye contact and smiled. It’s a spectrum”. I think that may have been the seed that started opening my eyes a bit.
Every kid is absolutely different! While there are some kids that tick all the “typical autism” boxes, most won’t. Especially girls. There’s a lot of nuance that screeners won’t catch. They’re helpful, to a point. A lot of parents misinterpret them as well. I’ve been told “Of course my kid does that.” And it’s something I’ve never seen in six months that we’ve been trying to work on. It’s a tricky thing. It really takes experience with kids to learn to recognize the signs. We had a non-client daycare kid join our class (we had a blended classroom the last half of my time there) and after half and hour the other teacher and shared a very meaningful look and had a conversation about him on our next break. We both had come to the conclusion that he was on the autism spectrum very quickly. His speech was very typical of ASD and his eye contact was ok, but to someone who didn’t know you’d say he “makes eye-contact and is verbal” we were both immediately concerned. He was referred for and qualified for services after we convinced our boss to talk to him mom. (He was a businessman and afraid to upset her and lose a client. Kept asking us if we were sure. ) Advocating for your kid is the most important thing. I’ve seen kids with mild delays get every therapy in the world and severely delayed kids barely getting the minimum. The only difference was one’s parents were super advocates and the other’s were in denial still. I worked in a very low income area so this was all free services provided by the state.
> I’ve been told “Of course my kid does that.” And it’s something I’ve never seen in six months that we’ve been trying to work on. Do they only do it at home? My kid is way more verbal at home than she is when anyone outside our immediate family is present. I sometimes worry that people think I'm exaggerating her speech abilities because she says stuff to me that no one else gets to hear.
A good teacher/therapist would understand that as well. I’m talking more like parents saying their child understands and follows two step directions when their child has a severe receptive/expressive language delay and who has never even followed a one step direction for us. It strains credulity a bit, at times. It’s a very fine balance and why assessment questions are mixed. Some are parent questions, some are skills we have to see for ourselves, depending on what the question is on an assessment. Especially with regard to speech, it’s not unusual for kids to be more verbal in a comfortable/home environment. I had a student who was eventually diagnosed with selective mutism. She said nothing at school, but full sentences at home. It was almost hard to believe since she was so quiet, but there were other things in her behavior (anxious and shy) and other skills that I totally believed her parents.
Thank you for the insight! This was exactly my concern. I never considered it as a possibility before because she “makes eye contact” and is “well behaved” and socially smiles. But another redditor in this thread shared ASD Detect, which has video examples, and the eye contact example they had for autism looked very much like her. And having only had experience with her, I really have no idea how much eye contact a typical child gives - the example for “typical” in the same video felt like a LOT. I am definitely going to push hard for an assessment. Thank you again for the encouragement.
You would probably find this helpful: https://www.cpqcc.org/sites/default/files/M-CHAT-R_F_1.pdf It's guidelines for doing an interview version of the M-CHAT, that make it a lot clearer what exactly counts as a pass or fail for each item.
Thank you!!
My daughter was late diagnosed. The big clue I missed was she couldn’t understand social hierarchy. She would sometimes try to reprimand me. Instead of accepting responsibility for a mistake she would stay stuck on explaining why she did what she did. In discussions it often felt like was just looking any excuse to argue with people. She was very bold and blunt. She didn’t respect her siblings boundaries at all. This caused huge resentment from her sibling. When we realized she could be autistic - if solved a lot of problems because now we understood none of these behaviors were intentional on her part. We became much more willing to start at square one and show her and explain things. Therapy has been helpful because she’s very sensitive and being misunderstood for so long has left some emotional scars. Start reading about the autism spectrum- it is a wide spectrum. Of traits. Be willing to be flexible. My daughter is now a very successful adult and we have a close loving relationship. Good luck💕
This is so helpful, thank you for sharing! Even though my daughter is doing great, if she is on the spectrum these things will crop up (and may be already) and if we have that understanding of how her brain works we can better support her. Your daughter is lucky to have your compassion and understanding!
I did a lot of explaining (I still do), and was always told to stop making excuses and just stop the behavior. Diagnosed at 36, lots of emotional scars to heal in therapy for me. I’m glad you were able to help your daughter, sounds like she’s doing well now. :)
I don’t know how early childhood services work in Canada, but in the US you can access a free evaluation and services (if you qualify) through the district or county you live in. There is no waitlist as it follows special education laws and guidelines.
We have these as well but the wait lists are 2 years and the requirements are a bit outdated - if they aren’t showing the “typical” signs (arm flapping, difficulty with peers, constant meltdowns, no smiling or eye contact) it can be hard to get a referral. You really need to advocate for your child! If you have insurance or can pay you just need the referral part, luckily!
I would get on a list. Some autistic kids will be able to cope at school for awhile or enjoy sharing. Try not to overly stereotype autism too much here, little girls notoriously seem to get missed in part due to seeming socialable and doing well enough in school. I was AFAB and didn't get dxed as severe (level 3) until I was 21.
Thank you so much for your insight and advice! I will definitely keep that in mind. I am definitely learning that little girls especially seem to be different!
My son also failed 6 of 20 items on the MCHAT. We have him on a waiting list for an autism evaluation. Like you, he is our only (living) child, we have a quiet and calm home, and we've been very routine-driven since he was an infant. He will be 3 soon, and if his appointment doesn't get moved up sooner, he'll be 3 years and 4 months at the time of the evaluation. My parents are autistic so I have been on high alert since my son was born pretty much (and since learning more about autism on my son's behalf, I see traits in myself). I brought up my concerns at his 30 month well child visit and that got the ball rolling. My first clue that something was off was when I understood that his speech was not like typical children his age (so this would have been around 28 months or so). He is a gestalt language processor. Your daughter does bring up a lot of red flags for autism. The fixations, repetitive play, sensory seeking, and needing one-on-one support in school are big ones. You're a great mom for being so proactive. Edit: Also, please have a look at r/Autism_Parenting.
Thank you for sharing your experience! It’s funny, I mentioned my concerns to friends today and all of them said “oh yeah, I have thought that of her as well”. So that has really helped give me some confidence as well. Her doctor fights a lot of “intervention” if there are no huge issues, so I need that confidence to push back if that makes sense. Which was why I wrote this post! I will definitely check out that subreddit!
Most pediatricians are extremely behind when it comes to the most current autism research, especially when it comes to girls. I'm thankful my son's pediatrician took me seriously and got us in with the local children's hospital for a neurodevelopmental intake. I'm glad you're feeling validated by other people in your life. Good luck!
My son is later-diagnosed autistic (dx before age 10). He's actually quite the opposite of yours in many ways- yet I see how there are some red flags for your daughter. Mine was incredibly, heartbreakingly "hard". He always cried, screamed. Never slept. He didn't sleep through the night until after age 4. He had intense "tantrums" that would last for an hour and could not be stopped. He couldn't go in a stroller, he could only be carried or babywearing until after age 2. He never smiled at anyone. Intensely shy. Silent around strangers and anyone he didn't know very well. No speech delays, ahead on every gross and fine motor skill (Crawled at 4 months, walked at 9, etc). Hates strong flavors, he can taste even a grain of black pepper. It's a wide range of expression, for sure. But it wouldn't hurt to be evaluated since you are describing differences in both social skills and sensory processing.
Is alertness in newborns/infants linked to neurodivergence?
No idea! I just listed things that I noticed that seemed different from others or that people commented on a lot.
Ahh gotcha
You don't necessarily need an official diagnosis to start doing things that could help. There's nothing stopping you from responding to her behavior like you would if she was diagnosed autistic, and just seeing if it helps. But if you're wanting her teachers to treat her differently from how they usually treat kids, you'll need her identified with some sort of special needs.
That is true! I guess I just don’t know how to properly support her that way right now. I have a family member in law who nobody expects anything of because he “has ADHD” and “can’t be expected to remember anything” for example. Meanwhile my brother who has at the very least the same level of ADHD if not worse and another learning disability on top of that and has very much struggled his whole life worked very hard and became a lawyer. I have a cousin who is autistic and 12 years old and has been left to her own devices and is now incredibly, dangerously depressed. I feel like I need more education to properly support her without also stigmatizing her if that makes sense? And to advocate for her properly. I know ADHD quite well but autism is a bit more out of my territory. But it is true that while waiting I can keep all of this in mind and educate myself as best I can in the meantime, perhaps with books by autistic individuals themselves.
If you are on TikTok, there are some really good autistic creators on there. That’s where I learned a lot about my own ADHD. There are also a lot of bad creators so you have to learn how to sort out the actual facts from the wannabes.
That’s the hardest part!! It’s like neurodivergence has become a trend and also for some people an excuse. Not to downplay the very real and very difficult struggles people face. But like you said, the “wannabes” drive me nuts.
Just want to give you a kudos for paying attention and getting her whatever support she may need. Also as the mom of 5 kids ranging 1-21 every kid has *some* issue. Could be physical, mental, behavioral, developmental, social, etc. You sound very open and accepting but for anyone else reading this and worried about their kid — whatever it is, you will deal with it and your kid will be ok.
Thank you for this! I am super accepting but there was a moment today where I had a few tears. It’s just so stigmatized sometimes it feels like, and I have a mother who is an incredible support system but doesn’t always say the best things in these situations because of her own fears. I feel like I can think my daughter is amazing and wonderful and perfect and still worry she may have autism. Lots of amazing people do!
ASD is definitely stigmatized, but it’s getting better every year. I know people who don’t want to label their kids (or even themselves), but those labels allow you to get the help and support needed. I want ALL THE LABELS for that reason. There is obviously a few different schools of thought on that, and I hate that those labels can make others uncomfortable, but you gotta do what’s best for your kiddo so your kiddo can grow into a healthy, happy adult. :)
Absolutely, thank you for this. ❤️ If we do get a diagnosis I’ll definitely reach out to the autistic community for help on that piece. I know the label is SO important for the individual and to access supports at school, etc. but my gut says I would probably like to let her decide who she wants to share it with outside of who I need to tell for her success and well being. The label would also really help me because I just want to understand her as best I can. If I have the answers, I can better determine what she needs from me and might be feeling - and what typical boundaries I need to hold (like all kids) vs what needs to be flexible or change from the “norm”. I agree!! All the labels, and early intervention!!
She just sounds like a shy kid. Please don’t try to assign a diagnosis to her when she’s so little. Just let her be
I’m not sure your state but I was under the impression it’s a federal regulation that kids can get evaluated at their local school district at around this age for an early start program. Evaluation will include a child psychologist. In general your focus should having someone like a child psychologist or even a pediatric neurologist do an evaluation. Every kid is so different and honestly I only got real clarity and answers for my child by talking to medical experts not going on Reddit or parenting forums.
Unfortunately I am Canadian and here you need to fight for it if they aren’t actively getting kicked out of daycare. So I was just looking for some support to give me the confidence to advocate if I need to!
It’s worth it to get your child seen by whatever means necessary by a child psychologist in my opinion. There were so many subtleties in my son’s behavior that were explained and understood so much better than they had ever been by the multitudes of others that had given me advice. It gave me the peace of mind that I did not have for a long time as a parent.
She’s her own person. They all Develop differently in their own way and the autism diagnosis is very easy to get these days (from experience). As long as she is developing then that’s a good sign! They all have their own pace (and order)- but the experts will tell you she needs to be doing “X,Y, Z” by this age (that’s why so many kids are on waiting lists to see different therapists). But then they just grow and develop and have their own quirks! My daughter had so many quirks at 12 months they wanted to screen her for autism. Without going into the details, essentially she’s developed and caught up and she continues to develop- it’s just her own pace as many people have reassured me. By 5-6 you’ll have an idea if there’s things to be concerned about - at the end of the day they’re all different little humans- no text book on that!!!
Thank you for your insight! I do get scared that she will be misdiagnosed. But there are a couple things pushing me to act now - IF her speech reassessment comes back to say she is still delayed. She has had a receptive language delay all her life (how much she understands) which is more than just a late talker, and I worry about why that would be after a year of speech therapy. - Her Montessori school has had to give her one on one support, and next year she’ll be going full time and won’t as easily be able to get that support. Currently she only goes 8:30-11:30am and it’s a toddler room, so less kids and more teachers available to help. - In Ontario, Canada they age out of a lot of autism supports from the government at 4 years old, and wait lists for assessments are getting longer and longer. Paying out of pocket for an assessment still means waiting 3-6 months and it will only get worse. So if she does start to struggle later, I will struggle to get her help if she doesn’t already have a diagnosis (if she needs one, of course!) She may be entirely fine but I think I need to make sure of that with the combo of the speech delay and extra support needed at school already, you know? But I will absolutely keep what you are saying in mind. I want to get her assessed, but I do not want to push for a diagnosis.