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Old 02-25-2020, 03:04 PM
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Default Ignoring Red Flags

I'm sorry if this is long. This is my first time posting but this daycare forum has been a godsend for me over the years. I'm finally to the point where I don't know what else to do. I have been taking care of children since I was 11 years old, I'm a mother of four and have been doing in-home daycare for the last 13 years. Last August I got a new DCB who will be 2 in April. From day one I noticed that there was something way off. Child is nonverbal, doesn't even say one word! Doesn't point at things, does not respond to his name or anything for that matter, doesn't interact with the other kids and is very much in his own little world. He makes strange faces, flaps his hands, plays with his tongue and ears, No eye contact whatsoever..won't even look at himself in a mirror. He's extremely sensory seeking with literally EVERYTHING! He wants to rip, break and throw everything. Puts everything in his mouth, eats dirt(a lot)smells everything! He is so destructive! I have tried to teach him basic signs like more and all done. He can't even do that. Does not communicate in any way shape or form other than crying and he doesn't even do that a lot. I don't know how to communicate with him, he doesn't understand anything I'm saying (other than no or food or eat) he can be very happy in his own little way, he does enjoy us hugging and squeezing him. Pediatrician didn't give 18-month ASD checklist. He told the parents he's just a little delayed but he's still young. He has had his hearing checked and it's fine. I have tried on several occasions in conversation with dcm to mention some of the red flags, Mom just blows it off but not in a denial way, more of a uneducated ignorant way. So last week mom and I finally had a talk about concerns because dcb is starting speech therapy. Mom asked if I think it's autism. I told her I'm not an expert but there are definitely some red flags and asked her how his ASD checklist came out. That's when she told me the doctor never did one. When Mom gets home she sends me a long text about how she knew it was hard for me to talk about this and how thankful she was that I was honest and she knew that there was something wrong but everyone told her he's fine. When I heard that I was floored! There's not one single thing this kid does that is within the realm of typical toddler. So parents see pediatrician yesterday and pediatrician tells them he doesn't think he has autism because he's somewhat social and that it's probably just sensory issues. I'm beyond frustrated! I've been trying to work with this kid for the past 6 months. The only time I can get him to calm down is if I dangle him upside down. I'm willing to do what it takes to help him but I can't do this on my own and it doesn't seem like the parents even try to correct any of his behavior. If there's nothing wrong with him than I feel that I should hold him to the same standards as the other kids but I know deep down he's not like the others. This kid is difficult and if nobody's going to help him I don't think I can keep doing this. What should I do?
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  #2  
Old 02-25-2020, 04:24 PM
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Welcome to the forum. If a child or family is not working out you should term. Create the business and clientele you want. Itís your business and livelihood at stake.
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Old 02-25-2020, 04:46 PM
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I also would term.It is not fair to the child,you or the other children. I would give a two week notice.You have done your best.
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Old 02-25-2020, 05:06 PM
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I have been there many times. 2/3 children I had to terminate because parents were not willing to take them for assessments, had DRs who were out to lunch and I canít do it on my own. 1 of the 3 kids, the parents did take her to speech for an assessment and the SLP told them everything
I told them and she is getting some help now. It took me 6 months of continuously telling them their kid was delayed for them to finally get her checked out. I also suspect autism and so does the SLP but the SLP wants to do a second evaluation to be sure...still waiting for parents to bring her and its been two months.

I feel your pain. To me it is the biggest sign of disrespect in our profession. No one takes our assessments seriously and we are the ones that know more than anyone else because we have the most experience.

I would give an ultimatum to mom. The kid gets an evaluation or you will have go terminate care. I feel that keeping a child like this will further delay the diagnosis because you are the only one saying anything and are being ignored. If you term, the next person will say the same thing and maybe if they hear it twice it will urge them to see someone.

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Old 02-25-2020, 06:22 PM
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Would the parents respond or the doctor to a ASQ or a ASQSE? These tools screen a childs development based on age and emotional development. The center I worked at used these every 6 months and would refer the children to early head starts intervention if they were even close to the cut off. I was suprised how many parents just didnt "get it" till they saw it on paper.
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Old 02-26-2020, 12:42 PM
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Thank you so much for your responses. I have a hard time talking to parents about this because I took care of my niece a few years ago and she had some serious learning difficulties and sensory issues . Mom was an OT and would just sugarcoat everything! I'm so tired of not being taken seriously and then continually second-guessing myself.
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Old 02-26-2020, 12:59 PM
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Iíve heard of so many pediatricians who say everything looks fine. Honestly, I donít think they typically spend enough time interacting with the children to really see whatís going on.
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Old 02-26-2020, 02:14 PM
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I'm not an expert in autism, but I believe sensory issues are part of the spectrum.

We have Birth to 3 here, but the parents have to contact them and request an assessment. If mom is beginning to have concerns maybe she'll contact them?
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Old 03-03-2020, 01:52 PM
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Speech therapist is taking this seriously and they put him on the waiting list to be tested for autism.. it's a year-long list, so.. we'll see what happens.
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Old 03-03-2020, 02:36 PM
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I have one who's receiving speech therapy. His therapist and I both think he should be assessed for autism, but since the school district did a language assessment in the fall they won't assess again until next fall. Even though the assessment was only for language and we're concerned about autism.
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Old 03-03-2020, 08:14 PM
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Quote:
Originally Posted by AmyKidsCo View Post
I have one who's receiving speech therapy. His therapist and I both think he should be assessed for autism, but since the school district did a language assessment in the fall they won't assess again until next fall. Even though the assessment was only for language and we're concerned about autism.
Meanwhile everything you read about autism and research around it says the earlier it is detected, diagnosed and treated the better the outcome for children.
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Old 03-04-2020, 05:08 AM
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I am not understanding the year-long waits. Is that for the free testing or getting an appointment with a specialist through their pediatricians?
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Old 03-04-2020, 08:13 AM
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Quote:
Originally Posted by Cat Herder View Post
I am not understanding the year-long waits. Is that for the free testing or getting an appointment with a specialist through their pediatricians?
IME, most regular pediatricians will not diagnose but will refer out to developmental pediatricians to screen/diagnose things like autism. Usually the year+ wait is for an appointment to see a developmental pediatrician.
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Old 03-04-2020, 08:38 AM
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Originally Posted by Baby Beluga View Post
IME, most regular pediatricians will not diagnose but will refer out to developmental pediatricians to screen/diagnose things like autism. Usually the year+ wait is for an appointment to see a developmental pediatrician.
I knew they would need the referral but the timeline seemed crazy long.

Then I checked our parent resource and the waits are just as long now. They used to take less than two weeks to begin. When I further looked it was because many providers simply could not afford to continue it that field. Most who stayed no longer take Medicaid because they could not afford to.

That happened fast. The grants have already dried up as the need was too great. This is some of what I found:

"Problem: Many families are unfamiliar with where or from whom to seek services when their child is referred for evaluation. There are relatively few providers who have specific training in autism spectrum disorders and many providers do not accept Medicaid. As a result, this may increase the time between initial referral and the completion of a diagnostic evaluation, thus impacting whether or not a child receives early intervention services and possibly negatively impacting developmental outcomes for children with disabilities. Referral and diagnostic services later in life are difficult to access. Eligibility rules for medical and educational services often prevent children from receiving collaborative and comprehensive interventions in schools and childcare facilities.

Data Driver: Early identification of developmental delays, combined with appropriate early intervention supports, improves outcomes for children with disabilities. Although people with autism can potentially receive services under Medicaid waivers in some states, many do not because they do not meet eligibility rules or because the states limit enrollment."
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Old 03-04-2020, 10:40 AM
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Quote:
Originally Posted by Cat Herder View Post
I am not understanding the year-long waits. Is that for the free testing or getting an appointment with a specialist through their pediatricians?
ASD mom here.

Yes. They are THAT long. To get the eval took us 8 months in 2002, now it's over a year for the eval. Then 6-12 months for services. It's even more serious (and dangerously slow) for adults on the spectrum as there are VERY few providers willing to even see them. It took us over a year of calling PRIMARY CARE DOCTORS to find one who was willing to see our ASD adult for preventative and sick health visits, completely unrelated to ASD.

OP- I have never heard of an autism checklist. There is an ages and stages eval, if you want I can email you a copy of that in 18m-5 years.

The pediatricians here WILL NOT DIAGNOSE. You must see a developmental pediatrician or receive a full evaluation to be diagnosed according to our school district (who handle age 3+). A full evaluation took us 3 full days, including medical testing (fragile X), ST, OT, PT, Neuro & psych. It was also not covered by insurance and ended up costing over 5,000.
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Old 03-04-2020, 10:44 AM
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It is the same here. The provincially funded autism programs have HUGE waitlists but it is free so parents either have no choice or they donít want to pay for the service. Healthcare is ďfreeĒ here so everyone has to wait to see a developmental paediatrician. After a diagnosis though you can pay out of pocket to get therapy or get on the giant waitlist for free services.

It is getting better though!
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Old 04-21-2020, 08:49 PM
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Quote:
Originally Posted by daycarediva View Post
ASD mom here.

Yes. They are THAT long. To get the eval took us 8 months in 2002, now it's over a year for the eval. Then 6-12 months for services. It's even more serious (and dangerously slow) for adults on the spectrum as there are VERY few providers willing to even see them. It took us over a year of calling PRIMARY CARE DOCTORS to find one who was willing to see our ASD adult for preventative and sick health visits, completely unrelated to ASD.

OP- I have never heard of an autism checklist. There is an ages and stages eval, if you want I can email you a copy of that in 18m-5 years.

The pediatricians here WILL NOT DIAGNOSE. You must see a developmental pediatrician or receive a full evaluation to be diagnosed according to our school district (who handle age 3+). A full evaluation took us 3 full days, including medical testing (fragile X), ST, OT, PT, Neuro & psych. It was also not covered by insurance and ended up costing over 5,000.
Maybe it was the ages and stages, I just know we both have the same pediatrician and with all 4 of my kids, I was given a checklist around 18 to 24 months. It was super simple asking about eye contact, how many words...
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