You may be the first person in your grandchild's life to notice they do not have a typical development pattern (especially if it is your son's or daughter's first baby, as they will not have the same experience of child development as you do).

A child with autism can have erratic development, being advanced in some areas but behind in others. For example, they may have delayed language development, yet have the fine motor skills expected of a child of their age, or advanced computer skills.

Knowing if, when and how to broach the subject with your own child can be tricky. It is important to come across as caring and supportive rather than as interfering and judgmental about their parenting skills. It may be that they are already worrying about their child's development but hoping that the problems will go away.

There are usually three main reactions you can expect when broaching the subject of autism:

  • denial: their child does not have any problems
  • confusion: they have never heard of autism
  • relief: they have thought their child is different and that autism may be a possibility.

It may be that you are not the best person to broach the subject of autism and it would be better coming from a different family member, friend or professional. 

Case study

Manoj had a grandson, Nijan, who was four years old. Manoj had noticed that he did not say many words and often jumped up and down, flapping his hands when he was excited. He would not use the toilet and had a woollen Bob the Builder hat since he was two years old which he would not leave the house without wearing - no matter what the weather.

Nijan was in the nursery class at the local primary school, due to be moving up to the reception class that coming September. Manoj was really worried about Nijan not being able to keep up with his new classmates and being left even further behind. He spoke to his son - Nijan's dad - about this, but he did not want to hear anything of it, insisting that Nijan was to go to the reception class and was fine.

Six months into the reception class, Nijan's teacher spoke to his parents about the possibility of perhaps seeing a professional about autism.

Nijan's dad then spoke to Manoj and explained that he needed to give Nijan the chance in a mainstream school. He had begun to think about the possibility of autism when he had been to the Christmas school play and seen the other children in Nijan's class. He had always known that Nijan was different but had not realised his true difficulties until he had spoken to the class teacher.

If you have tried to gently broach the subject with your son or daughter and they do not want to listen, it may be that you will just need to wait. Be supportive, but perhaps don't mention the subject again. When they do have to consider it in the future they will be able to turn to you for advice and support.

If your grandchild is young, you could mention a difference in speech development - rather than autism - as a way of broaching the subject.

You know your own child best and how to approach them. Have some information about autism that you can pass onto them which they can read in their own time. Our Autism Helpline can send you information relevant to your situation.

"After receiving the diagnosis we felt a bit better. It was a relief, because we could actually say he was autistic. It was a relief to actually be able to use the diagnosis. We'd known what was wrong before he was two, but it was a good three years before we got the diagnosis and could actually say it."

Mother with a child with autism 

Diagnosis

Clinical psychologists, psychiatrists and paediatricians who are experienced in autism can all diagnose children. These professionals may work alone or as part of a multi-disciplinary team, which includes other professionals such as speech and language therapists or educational psychologists. 

There are two routes to diagnosis: through the NHS or privately. It is usually best for a child to have an NHS diagnosis to make sure that any local authority services they may be eligible for are provided.

To get an NHS assessment, your grandchild's parents will need take them to their GP and ask for a referral to a professional who can diagnose autism. If their GP does not know who to refer them to, you can search our Autism Services Directory for NHS professionals in your area who are able to diagnose. Alternatively, call our Autism Helpline and we will search for you.

Some NHS professionals need a consultant referral rather than a GP referral, or need to know that primary care trust funding is secured with the referral. A GP can tell you more about this.

To get a private assessment, you can approach professionals directly, although some do prefer a GP referral. You can search for private professionals on our Autism Services Directory. Costs for assessments vary. There is often a short wait for a private assessment, whereas there can be over a year's wait for an NHS diagnosis. Some families choose to have a private assessment for their child but stay on the NHS waiting list.

If your grandchild hasn't yet started school, you could suggest your son or daughter talks to their health visitor, who can do a screening interview for autism at 18 months called CHAT (Checklist for Autism in Toddlers). This is not a diagnosis but health visitors can use it as a guide to see if a referral for further assessment is needed.

You can find out more about CHAT on our website: www.autism.org.uk/chat

"I'd been concerned about [my child] from about 18 months, and when he was due his three-year check the health visitor, who's been a wonderful support, referred to us to a specialist at the hospital. I didn't really know too much about autism when we got the diagnosis. Obviously I'd heard of it, but we hadn't come into contact with anybody who had it. Initially it was a bit weird. At least I know what's happening now, and looking back it's obvious. It's meant we can stop worrying about the things he's not doing and start focusing on what he is doing.

"Obviously it was a shock initially. My husband got to grips with it a lot faster than me. It's difficult to know how you feel because you're just so tired all the time. Getting the diagnosis has given me a lot more confidence, though. If somebody wonders what's happening I can explain what's going on, that there's a reason behind his behaviour. Knowing what was wrong made life a lot easier."

Mother of a child with autism