We provide private autism assessments for 2-year-olds at our clinics across the UK. Our team of autism specialists has extensive experience conducting assessments for young children and have a thorough understanding of the barriers parents face when they have concerns about their child’s development.
Unfortunately, many parents are not supported when they raise concerns about their 2-year-old and are often advised by professionals to ‘watch and wait’. In this article, our Director and autism expert, Jo Condon, highlights the red flags for autism in 2-year-olds, explains broader signs of autism in 2-year-olds, the importance of an early autism diagnosis and what to expect from the assessment process.
Red flags for autism in 2-year-olds
Autistic children present with a distinct pattern of behaviours, which we discuss in more detail later in this article. For some children, these patterns of behaviour are not observed by parents at the age of 2, whereas for others, the differences are more obvious. Red flags or major indicators for autism at the age of 2 are:
- Speech delay
- Lack of interest in others
- Repetitive play or repetitive actions with objects
- Repetitive hand or body movements
- Sensory seeking or sensory avoiding behaviours
If your child is showing 3 or more of these behaviours, they should be screened for the likelihood of autism. We offer free autism screening for children.
Is it wrong to label a child with autism at such a young age?
Many parents are concerned about ‘labelling’ their child at such a young age, and may have faced unhelpful comments from others in relation to this.
Autism is not a label, it is a clinical diagnosis which explains a child’s different neurology. An autism diagnosis is vital in order for others to recognise, understand and respond to a child’s needs.
Early identification along with support and intervention improves outcomes in later life.
Is it wrong to label a child with autism at the age of 2? – we would argue that it would be wrong not to.
The importance of early recognition and diagnosis
Autism is a neurodevelopmental condition, this means that autistic children process information and engage with their environment differently to their neurotypical peers. These differences impact the way a child communicates, learns and understands. An autism diagnosis is the first step in ensuring a child is correctly understood and supported.
Research indicates that early identification, support and intervention can significantly improve outcomes for autistic children.
Early recognition and diagnosis of autism will:
- Ensure that parents have a clear understanding of their child’s strengths and needs
- Help wider family members to recognise the child’s differences and the reason for these
- Make the child’s early years setting aware of their needs in order to provide appropriate intervention
- Enable the future education provision to be secured based on need
- Support the development of social and communication skills
- Aid families to demonstrate the child’s needs to be able to access additional support and financial assistance
Common difficulties associated with autism in 2-year-old
Differences in the way autistic children process information and relate to others and their environment, can lead to some significant challenges in daily life. Children can become easily overwhelmed and dysregulated and parents often find themselves exhausted. Many parents find that the advice offered by frontline professionals or family members does not seem to help their child; this is usually because the advice offered relates to neurotypical children rather than children who are neurodiverse.
Common difficulties in autistic 2 year olds include:
Sleep issues: difficulty settling to sleep, night waking or seemingly only needing a few hours of sleep to get by
Difficulties regulating emotions: experiencing meltdowns which appear more frequent or more extreme than other 2-year-olds
Disliking changing or wearing clothes: removing clothes, distress when being dressed or having nappy changed
Eating problems: eating a limited amount or range of food, refusing to eat or only eating with much encouragement
Distress around certain people: struggling around unfamiliar people or seeming to take a dislike to particular people, refusing to stay with others and distress on separation from main carers
No sense of danger: needing constant supervision due to climbing and jumping off things, running off, placing non-edible objects in their mouths and / or not appearing to feel pain
What are the signs of autism in a 2-Year-Old?
Autistic children present with a pattern of behaviours which includes:
- differences in social interaction and communication
- repetitive behaviours
- repetitive body movements
- sensory issues
Difficulties with communication and interaction
A common sign of autism in 2 year olds is delayed speech. Neurotypical children who have a speech delay will often compensate through other behaviours, however autistic children show reduced verbal and non verbal behaviours and a decreased interest in others. The characteristics include:
- Not using words and / or phrases
- Using only words and phrases that are repeated from others, television programmes or videos
- Not responding to name
- Not smiling socially
- Avoiding eye contact
- Not using gestures such as blowing kisses or giving a thumbs up
- Not pointing to indicate needs or interest
- Being unable to follow a point
- Hand leading and using another’s hand to complete actions on objects as a way of getting needs met
- Being unable to make needs known through verbal or non-verbal means
- Lack of interest in other children
Repetitive behaviours
By the age of 2, typically developing children will be beginning to use toys and objects in an imaginative way. They will enjoy ‘pretending’ that toys are real life objects. Autistic children tend to enjoy using toys and objects in a more concrete, repetitive way and you may see you child enjoying repeating the same actions or activities over again. Repetitive behaviours include:
- Not engaging in pretend play, such as feeding a doll
- Only engaging in pretend actions that are copied or demonstrated by others first
- Making patterns with toys rather than engaging in typical play, such as lining up cars or teddies
- Enjoying sorting and organising, emptying and refilling boxes, ordering numbers and letters
- Engaging in repetitive play, such as pushing buttons or stacking blocks and knocking them over
- Becoming focused on part of a toy or object, or wanting to take toys apart to understand how they work
- Being interested in sensory aspects of toys, for example, turning cars over and spinning the wheels
- Choosing to always play with the same toys or engage in the same activity
- Watching a limited range of television programmes or watching the same video over again
- Enjoying a TV programme or character, but showing no interest in the associated toys
Repetitive Body Movements
Autistic children can often be observed to engage in repetitive body movements, which may be brief in duration or may go on for long periods. The behaviours might only occur when the child is stressed or excited, or may occur consistently throughout the day. Repetitive movements may involve the hands or the whole body such as:
- Moving fingers in a repetitive way
- Twirling, clenching or flapping hands
- Making repetitive noises or sounds
- Tapping or pinching own or other’s body
- Jumping or bouncing
- Spinning self
- Posturing – holding body or parts of body in a tense way
Sensory differences
Sensory differences are common for autistic children. A child may engage in sensory seeking or sensory avoidant behaviours such as:
- Difficulties with loud noises or busy places
- Dislike of certain fabrics or textures
- Dislikes wearing clothes or changing clothes or nappy
- Fussy eater, or lack of interest in eating
- Watching lights or light patterns
- Distress at having hair washed, brushed or cut
- Resistance to having teeth brushed
- Chewing clothes and other inedible objects
- Licking or sniffing people or items in the environment
- Climbing excessively
- Jumping or bouncing off objects and furniture
- Constantly wanting to be swung or rocked
How much does a private autism assessment for a 2 year old cost?
The cost of a full autism assessment with us ranges from £1,995 to £2,195, depending on your chosen clinic location.
Autism assessment process for 2-Year-Olds
Our private autism assessment process involves multiple steps to ensure a comprehensive assessment, clear outcome and robust report are achieved. Our process follows the NICE guidelines, and meet standards for acceptance by the NHS.
Background information gathering
We will gather information about concerns, behaviours and some aspects of development from you, and also your child’s early years setting, if they attend one.
Detailed Diagnostic Interview
Using the Autism Diagnostic Interview – revised (ADI-r) we will meet with you to ascertain what behaviours and characteristics your child is showing and has shown in the past.
Observation
We will use the Autism Diagnostic Observation Schedule (ADOS-2) to complete a semi-structured observation of your child in one of our clinics across England and Wales. For 2-year-olds, we use the Toddler Module which involves lots of play activities. You will be able to stay with your child for the session.
Multi-Disciplinary Review
When we have completed our sessions and have gathered all the information we need, we will meet as a team to consider whether your child meets the diagnostic criteria. We then complete an extensive report, outlining all the information we have gathered and recommendations for next steps.
Report and Feedback
We will then issue your report and diagnostic outcome and arrange a feedback session with one of the clinicians who was involved in your assessment.
In this session, you can ask any questions you have in relation to the assessment and report, or seek advice about specific issues such as sleep, eating or behaviours.
Why choose a private autism assessment?
Opting for a private assessment offers several advantages, including reduced waiting times, a personalised approach and clearer communication throughout the process.
With 212,964 people waiting for an NHS autism assessment in England and over 10,000 children waiting more than a year for an autism assessment in Wales, families are facing years on a waiting list for an NHS autism assessment. By choosing a private autism assessment, the waiting times are reduced to as little as two weeks.
Private clinics offer a more personalised approach to your assessment. You will be able to speak to an expert ahead of arranging an assessment who will be able to complete autism screening for your child.
From start to finish, your assessment will be coordinated with you, and the team will take your preferences into account. You will feel listened to and will be able to get your queries answered in a timely way.
Many parents have concerns before the assessment, common concerns around autism assessments for 2-year-olds include worries about the child not engaging in the assessment or typical behaviours seen at home not being observed in the clinic. You can discuss concerns with the team before your assessment sessions so that you are reassured, and your child’s assessor is aware of your concerns.
An autism assessment not only provides a diagnostic outcome but also summarises a profile of your child which can help you and others around you to respond to their needs and support their development. Following an assessment with us for your 2-year-old, you will be provided with recommendations about approaches that will help your child on a day-to-day basis.
Conclusion
Investing in a private autism assessment for a 2-year-old can help parents understand the child’s strengths and needs and can be the first step in ensuring the child gets appropriate support.
Children who present with the specific pattern of behaviours outlined above should be assessed for autism, screening tools are also a useful way of understanding whether an assessment is needed.
By choosing a NICE-compliant autism assessment service for an autism assessment for a 2-year-old, parents can be assured of a timely assessment that can be relied upon by public bodies, such as the NHS.
Early diagnosis, understanding and support can make a significant difference in the child’s long-term outcomes, helping them reach their full potential.
For further advice or information, contact our friendly team
