Is This Normal? Irritated at DCM

[MotherNature]

I've been caring for a little boy for about 7 months now. He'll be 3 this weekend. I'm sure there's some delays going on, which I'll get into, but first-Is it normal for a 3 yr old to sit in a poopy diaper with no word about it? I had changed him & was laying him down for a nap & I smelled him. I asked him if he was poopy. He said yes. Sure enough, he was. This kid was content to sleep in a dirty diaper! Good thing I change before naps. Both my older kids potty trained by 3, & my 2 yr old does go to the potty when you take him, but he tells you when he's wet or if he's pooped. Is it normal for a 3 year old to not care that he's dirty? It's not like he doesn't notice, b/c if you ask him, he'll usually tell you, but he doesn't volunteer the info. He's played before for a while w/ a poopy diaper, so it's not a rare occurrence. I find myself checking him more often than what I would normally check a 3 yr old for. I'm not even getting into the potty learning readiness..

OK, so, a few months ago, I gave DCM the number, address, website for the local early intervention program & explained that I was worried DCB was having some delays. I asked her if she noticed. She kinda blew me off & hurried out of there. I stressed to her that my own son had some gross motor delays from being a preemie & they saw him a couple times & were great. She's a low income single mom & I'm trying to help out. I've waived late fees left & right, but after this week am not going to. I've cracked down & made a handbook & am enforcing some new stuff. Hopefully now, she'll stop texting me to find out HER schedule. Yeah...call your workplace!!! Mainly, it irritates me that she won't take advantage of a FREE service..just to see. If it's nothing, great, but when the person who's with your kid for 50 hrs a week says they've noticed speech regression, & she admits no one can understand him, at least go look!

The behaviours I've noticed that are worrying me:
Very delayed, slurred speech. He talks a lot, but it's extremely hard to understand. A lot of it is quotes from movies & cartoons. Or he'll just repeat what you say.

avoids eye contact 75% of the time

hand flapping/jumping up and down/fidgeting frantically/stomping excessively
These are excessive constant things. 75% the time has no indoor voice & is always making odd faces. About 50% the time he has an odd expression on his face, even when engaged in another activity.

Toy snatching/crowding others out/ getting in their personal space...constantly daily have to explain this one to him, though sometimes he'll share & get very loving.

Will not answer when you call his name half the time.

Seems to like to just hold something in his hand. There have been days where he'll hold a block for hours.

Lining things up a certain way.

Habitual whining

Thanks for reading my novel. Any way to gently tell mom that I really think he needs to be evaluated? Or do I let it go since I already said something & gave her info? I'm worried that if he's ASD or SPD I won't be what he needs. Mom herself..She's been a problem from the get go. I'd term, but I need the cash & she's my only family right now. She told me no one sticks around for him for long during our interview. They get annoyed b/c he's high energy or a runner/bolter. Well, he's gotten A LOT better about running off. I'd like to work with him, but am worried I'm in too deep if she won't pay attention. WWYD?

[KDC]

I have this same kid. He's now 4 1/2 and FINALLY the parents had him evaluated and he's now attending early preschool intervention through the state. He hasn't been officially diagnosed with anything, but the school considers him to have a Sensory Processing Disorder, he's behind on speech, gross & fine motor skills. He's flapped since 6 months of age, but has recently become much worse with circle walking, NO inside voice, needing stability in routine, and head/eyes rolling back and 'checking out' here and there, mainly while eating? He would always flock to certain toys and hold onto them for dear life.

I told her about his developmental delays, but he's a 'fluffy' kid, so putting on shoes was difficult, putting on his own clothes was difficult, she would make excuses for him time and time again saying she didn't want him 'labeled'. he could barely run, or jump like normal toddlers. I think others were noticing and I kept it up. She had him evaluated finally. I'm glad he's getting the help he needs. He's still not potty trained fully (no #2, and still has #1 accidents when he's too busy playing). I just want him to get all the advantages and help necessary as early as possible, but we're not the parents and it's sooooo hard. Hang in there, be his advocate and don't give up! I would put together a letter, and attach a list of milestones from the cdc website http://www.cdc.gov/ncbddd/actearly/m...tones-3yr.html
and point to the things you are seeing. Maybe it'll sink in that she needs to get him some help.

Best of luck!

[preschoolteacher]

From my experience, it sometimes is normal for a 3-year-old to go about with a dirty diaper and not say anything. I had a highly intelligent, very social little 3-year-old boy once who was doing great in every area except his parents had the hardest time getting him to stop pooping in his Pull-Ups. They worked really hard with him, and eventually he got it, but it took several months until he was ready.

If that was the only issue, I wouldn't worry. But the whole list of things you wrote suggests greater concerns for this little guy's development.

I had an experience when a child at the preschool showed many, many signs for ASD. I refuse to diagnose any child, even in passing, because I'm not an expert. What we did was point out to the parents were some clear delays their son was experiencing--no verbal communication, for example. We were able to get them to focus on these smaller, easier to accept delays and get assessed for them. At that assessment, the doctor noticed other problems and referred the child to an assessment for ASD. That way, the diagnosis/suggestion that their child may have ASD came from a medical professional. It was easier for the parents to accept. However, it took several months to get the diagnosis, and during this time, the child required constant one-on-one attention. Thank God we have volunteers and interns at that school. Otherwise, I don't know if we could have kept him safe.

[Blackcat31]

You can't force a parent to have their child evaluated. All you can do is give them information as to where to have it done and mention anything you have witnessed that concerns you.

The rest if up to the parent. Some parents are receptive, some will say their child doesn't or does do certain things at home (even if you KNOW they can't or don't) and some refuse to even acknowledge that there may be an issue for fear of it being true....kwim?

Bottom line is that you can only give out information but can't force a parent to act on it. You can also discontinue care if you feel the child is requiring more care and attention than you can provide without having to decrease the level of care and attention you give the other kids in care.

It's a slippery slope to navigate and I feel for providers when this happens but there simply isn't much you can do.

[NeedaVaca]

Poor kiddo definitely sounds like a candidate for an evaluation. It's really hard with some parents and very frustrating for us when they are in denial and won't get them the help they need.

I honestly would try to broach the subject again with the printed materials and milestones so she can see where he is delayed and just tell her how important early intervention can be for him. If he can get the help NOW it can make a huge difference for him when he starts school and later in life. I might even go as far as to question why she hasn't done something yet when it's clearly in his best interest. Not getting him help is a form of neglect IMO.

[MotherNature]

OK-Thanks everyone! I think I'm going to print out the sheets w/ a detailed checklist of things I've noticed so we can discuss them and/or she can take them to the doctor. If she chooses to ignore it a 2nd time, then it's on her unfortunately.
If it becomes an issue where I feel like I'm exhausting all my efforts with no progress, I'll have to term, but I hope we can resolve it amicably & that he gets evaluated.