A nanny with concerns

[Anonymous]

Hi, I'm writing to post a question because I'm really not sure about this issue and the mother I work for always talks about the insightful responses people get on this forum.

For the past year, I've been babysitting and occasionally filling in as an all-day nanny for a 2 1/2 year old (we'll call her "Mary"). Mary warmed up to me very quickly and absolutely loves me, but she has tantrums and meltdowns (with myself and with her parents/other sitters) that concern me.

I have spent a lot of time working with 2-3 year olds with autism and other special needs, and I've recognized some warning signs in Mary (among other things she is not following point/joint attention, has antisocial behavior with peers and behaves oddly in a peer group, toe-walking, repetitive speech, etc). Things seem to be getting worse too. She will have a 2 1/2 hour meltdown for something as small as having her diaper changed (yes, she'll continue to scream for 2 1/2 hours straight and ask for her old diaper back).

I know its not really my place to say anything because I am by no means an expert, but I also know that early intervention/behavioral therapy is crucial to prevent issues in later childhood. Should I mention my concerns to Mom? Should I say nothing? Mom seems unaware that this could be more than "terrible twos." I really don't know what to do and it makes me sad because they are a lovely family and Mary is such a wonderful child, but I'm getting very nervous about what I'm seeing.

Thanks for any response you can give.

[Anonymous]

I have spent a lot of time working with 2-3 year olds with autism and other special needs, and I've recognized some warning signs in Mary (among other things she is not following point/joint attention, has antisocial behavior with peers and behaves oddly in a peer group, toe-walking, repetitive speech, etc).

Its hard to give advice without knowing the Mom. Since you seem to be familiar with special needs maybe you could have the conversation and leave out the word autism. Autism as a spectrum disorder has many facets. You are noticing development variations or delay in specific areas so maybe you could point those out by recommending OT or SLP eval services. The professional would then raise whether they observed enough to consider a spectrum diagnosis. All Moms love to hear the positives about their children so you could balance pointing out developmental strengths along with pointing our development issues.

I have noticed that Mary is an incredibly bright and loving child. When she is in a situation with mutliple kids though, her reactions don't fit her personality. Some kids can become overwhelmed with all the stimulation and there are therapies and groups that can help them work through this so that it doesn't affect their social confidence down the road.

[Anonymous]

I think you should say something but if you use the word autism you might be fired, sad to say. You might say socialization delays, tantrums, be descriptive. or take the risk and out with it, just know that even though they may thank you one day, it won't go over well.

[Anonymous]

Be prepared for them not to appreciate at first, especially if it is their first child. I only appreciated what my day care provider was telling me about my daughters anxiety when I had a second child and realized how different it could be.