Although you can't officially diagnose until 3, you can start to see behavior that may be of concern. In this case, however, the situation may seem worse than it is simply b/c his sister is ahead, which is not at all uncommon with boys/girls. So the boy may be delayed in certain things (e.g., eye contact, following your finger, etc.), but the girl may be ahead and that makes it seem worse. Do you attend the well child visits with the family? Are these the only kids?

When our youngest was born, we had some developmental concerns, and we raised them with our dr and he gave us a list of things to watch out for and to keep notes. I would mention this to your MB, not as a concern, but in a "I know that girls/boys develop at different stages, but I've noticed that boy does x, y, z. Have you noticed that?" Our nanny mentions stuff all the time. She's with our kids 8 hours a day during waking hours and she might be the first person to see something come up. Candidly, if my nanny didn't say something to me, I'd be annoyed.

You can only fully determine if a child is deviant at the age of 3 and above. Some of these things that you see in him are just pseudo delays. I am a nanny/ special ed. Professor. The best way to find out is to go to a developmental pediatrician.

I watch twin 18-month-olds and I'm concerned that the boy is exhibiting some autistic tendencies. I'm not a diagnostician but I have experience with Autistic children on all schemes of the spectrum, including my much younger half-brother. He is just miles behind his sister in devepment, while she is using 20+ words he only grunts. He has minimal eye contact, he prefers to play with blocks, or shoes for hours, obsessively and melts down if the activity is interrupted. No interest in others, non verbal and more alarmingly often anganes in self stimulation (hand flapping and rocking). I see so many red flags that the parents just ignore and pass of as "him just being a boy". I am concerned, and know the best thing for him is a proper diagnoses. How do I address this with my bosses? I know it can be a Sensative subject. I don't want to come of like I know better, or that there is something wrong with their parenting.