Relative’s toddler- concerns he might have autism

My husband’s niece has a 3 year old son who, in our opinion ( we have 4 adult children) is not developing in a typical manner. We are not doctors but we are seriously concerned the child has some form of autism. ( does not speak much, no eye contact, arm flapping, angry face most of the time, won’t nap ever, overtired and rarely seems content in his skin….)  The concern is that the parents (mother is loving, father an alcoholic, seemingly unhappy home life,  very cramped living quarters, parents young and uneducated ) don’t  seem to notice. The child does not go to any sort of group activity nor has he ever had a babysitter or been in a play group or preK. They are quite isolated so I don’t think they have other toddlers with whom to compare development. When they do venture out the child is incredibly difficult so I can see why they may not get out much. They lose their temper with him and we have  seen them smack the child in plain view.  We have read that early intervention is best for autism or autism spectrum and we are concerned they are missing out on this. It’s such a delicate matter and this is a family who does not discuss difficult topics with ease. Does anyone have advice on course of action? So far we are just hoping that their pediatrician notices or perhaps when The child starts public school the teacher might notice but that is  still two years away. 
please respond with kindness and not judgment as our sole aim is to be helpful. 

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Hi there, I hear your concern about this child and based on the information you've provided, as a child therapist, my first thought is that the child's behavior is a reaction to his environment. If his parents are frequently losing their tempers with him, yelling at him, physically abusing him (smacking is physical abuse), and he has no interaction with children his age, it makes complete and total sense that he wouldn't speak much, "rarely seem content in his skin", and have an "angry face most of the time". These are normal reactions for a toddler who does not have a safe and secure home environment. I believe that your main concern shouldn't be if the child has autism but if he is physically and emotionally safe, which it seems he is not. He is not developing in a 'typical' manner because he is not being parented in a 'typical' manner. Do you think this family would be open to going to family therapy? Would they be open to having a discussion about the effects of their parenting? Are you in frequent contact with this child and can you be the safe adult that he needs in his life? Can this family receive some sort of outside support so they do not continue to abuse this child? Since this family is quite isolated, you and your husband may be the only people who have the ability to alter the course of this child's life for the foreseeable future. I know this may be frightening to realize and upsetting to hear but this child deserves better. If you feel that you are at a loss for what to do, you can contact the child's pediatrician (if you know who they are) and report these concerns to them. 

Good for you for trying to help in this tricky situation and you are so right about early intervention. If they live in California you could connect them to the state agencies called Regional Centers, which work with children who are experiencing developmental delays. Their services are free and they would be able to connect the family to other free services too. So you could kind of pitch it as: here is a nice free resource that might help you out with some things.

I can tell that you care. I think the only thing you can and should do is be a loving presence in this child's life. If you can, offer to spend time with the child to show them play and attention and love and patience. 

The child is lucky that you are concerned :). It could be autism but it also could just be understimulation due to lack of socialization, being spoken to etc etc.  Can they get into a head start program? Where do they live? 

Also, All 3 years olds are horrible in public lol and I think many parents shy away from the world when their kid is that age. 

Given the child's environment, his demeanor and behavior doesn't seem abnormal. It sounds like he lives in a highly chaotic environment, and toddlers generally don't do well, especially with the physical abuse :( I really feel for him and for you, this is a terrible place to be in!

Does the child go to his well checks? Honestly, the pediatrician should have picked up on something being amiss at the 2.5 year appointment.

Is there a way you could be his safe space? Regularly take him out, in the guise of giving the parents a break, to just be there for him? Show him that he can be a kid around you. It might help him open up. 

I recognize your dilemma but realizing that time is of the essence in dealing with autism, I would try to find a way to suggest that they talk to their pediatrician or get an evaluation.  Autism is not caused by any thing that parents have done.  Starting with a regional center evaluation, they will get help and learn to appreciate their child.  Please approach them out of love.

It sounds like such a difficult situation! I wonder if your husband's niece, being a young mom (and a first-time parent?) with an alcoholic spouse, might be feeling overwhelmed herself. If she is feeling overwhelmed, then she might not be providing positive interaction to her 3-year-old on a consistent basis. Would it be possible for you to help her enroll her son in a preschool? That way, the child will have structure, routine, opportunities to play with other kids, consistent positive interaction with adults, etc. Preschool will also give the child's mom a break during the day. Many school districts around here offer subsidized preschool if a family's income falls within a specific range. Once the child is in preschool, his teachers will be able to give you feedback about the child's development, socialization, behavior, and whether they see sign of autism spectrum disorder.