Developmental Delays?

proserpinaApril 17, 2007

I have to start off by saying that I am the most fortunate aunt of MANY nephews, each one with very unique characteristics that have me smiling all the time.

That said, as much as two of them warm my heart, they also have me concerned. I'll start with the older one and if any one of you has a bell go off or knows anything about what I'm saying, please do share as we are all doing our research.

OK, so he is 6.5 and has been held back in kindergarden because of his difficulties in school. The little guy still relied on "baby talk", could understand what we would say but couldn't really express himself with words (it was more, as I said, like baby talk). He wasn't able to write letters of the alphabet unless copying them and even then his hand would shake and the mark was very light.

His parents have him going to a speech therapist as well as to a motor skills therapist. While he is now a self proclaimed artist (his control over a pencil and a paintbrush has improved greatly) and has built a vocabulary that allows him to express himself to his own greater satisfaction (he would get so discouraged when nobody could understand him before), he still can't learn the alphabet, has trouble remembering names, and just can't figure out numbers. So, while he will be going to summer school this summer to see if he can get to where he needs to be for first grade, there is debate again as to whether or not he should be held back... and he would be 7 when school would start up again. There is suspicion of apraxia as well as of goody old dyslexia... Is any of this sounding familiar to anyone else? The child has a great sense of humor and is very social....

Then there comes his little brother who, by age is 2, but developmentally seems much much younger than his birth age (he wasn't premature). Muscularly, he was behind: lifting his head, sitting, pulling himself up, crawling, walking... That's when the first alarm bells went off. He is a very happy quiet boy, but he seems disengaged from the world. He might do the things that younger kids do, i.e. find amusement in emptying out boxed and pulling books out of shelves... but then he walks away, uninterested. He could stay in his high chair for hours and not make a peep, just staring in blank space. While he can say words, if he wants to ask for something, he will make noises instead of using words. Unless you actively ask him, "can you say cookie" (or whatever word), he will not use words to express himself.

The boys' parents are very involved, trying to do all they can, but now that the younger one is showing even more "acute" signs that they dismissed with the older child, they are beginning to get alarmed. If you have any ideas, please let me know; as much as I believe that eventually all children learn how to speak, write, and count, I am beginning to wonder if there isn't something else going on. Is it just a developmental delay, or is it something we still haven't figured out?

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It could be so many things. I hope the parents will seek professional advice, then weigh it carefully before labelling these children. I have seen so many kids, my own daughter included, make amazing progress after we were told she would never graduate from high school and now she is in college, majoring in geology. Gather all the good advice you can, then keep on having reasonable expectations. If I had just gone with what I heard in middle school she would not be where she is today. They were so wrong.

    Bookmark   April 17, 2007 at 2:53PM
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Beginning with the 6year old, holding him back is not the answer. Actually both need to be tested. It might be possible that the older child id ADD. The second child might have autism. I dont know but i have many friends with children with developmental issues. My best advice is for mom to keep screaming at the top of her lungs till a doctor listens. No child should be held back twice. Thier is something more wrong. A good friend of mine finally had her son diagnose with autism. It took her 4 years of searching and complaining. I wish both the boys wellness and happiness! Good luck!

    Bookmark   April 17, 2007 at 3:07PM
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Yes, I'm sorry to say that it sounds like both boys have some developmental delays. (My oldest is dyslexic, and my youngest has apraxia and was diagnosed with high functioning autism or PDD-NOS.) The types of problems you're describing are absolutely typical of what you would see in a child diagnosed with apraxia and PDD-NOS. A dyslexic pre-reader would more typically have trouble with rhyming or sound games than learning letter names, numbers or even letter-sound correspondance.

How close are you to the mother, and is the subject 'safe territory' for discussion? Some parents are dying to talk about it with someone who will listen and not blandly tell them not to worry. Other parents are in total denial, and will be mortally offended if you imply there's anything wrong with their precious darlings. If you can take an interest and ask her the right questions, or maybe refer her to some sources 'a friend told you about', that might be the help she needs.

The good news is that the older boy is getting speech and occupational therapy. If the therapists are good, they will treat LOTS of kids with PDD-NOS and will know what to look for. And while they aren't 'qualified' to make a diagnosis, in my opinion, (again, assuming they work with children, not adults) they'll probably have a better idea than most doctors could get in a 15-minute exam. I would suggest the mom talk to the sspeech and occupational therapists and ask them if they see signs of PDD or autism. Or if not that, then perhaps what diagnoses she should research. Maybe get the names of some Developmental Pediatricians or Pediatric Neruologists the boys should go to for testing.

The younger boy is still eligible for 'Birth to Three' programs. They should diagnose and provide therapy, assuming she can get him in before he 'ages out'. The older boy can be tested through the school, but because of their 'hold him back' philosophy, I'd hesitate to put much faith in their evaluation or interpretation of results. A private evaluation would probably be much better (not always), but it's expensive, and may not be covered by insurance.

The world's best website for parents of young kids with speech problems? Absolutely send her there...

    Bookmark   April 17, 2007 at 9:04PM
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I don't know what state you're in, but in Texas, the public schools are obligated to test children even before they are school age. That being said, I think you have some serious problems on your hands. It sounds like the youngest child is autistic. Are you sure his hearing is okay? What does the pediatrician say? Mother needs to start w/ the doc and if she finds no help there, she needs to go to another one. Early intervention is vital. In the meantime, she needs to spend lots of time interacting w/ these children--reading to them, talking to them about what is happening at the time, i.e. going to the grocery and talking about veggies and fruits. In the car talk about what they're passing, etc. etc. They will have a bleak future w/o some help now.

    Bookmark   April 21, 2007 at 9:21PM
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This could also be a sensory problem.My son was diagnosed with having Sensory Disentigration Disorder.He has always been a very smart and loving little boy but unfortunetely school has beeen a problem.Especially with writing,and his small motor skills.The noise level in the classroom was also a major problem for him..Since he was unable to focus and ignore any background noises.He also had speech and occupational therapy which helped a whole lot! I had to fight the system for years until i was able to get him into a private school.Once he was in a smaller class he was able to really make outstanding improvements.Not only academically but also socially.His self esteem soared and he was able to actually enjoy going to school verses "dreading" getting out of bed in the morning.His teachers all are very happy with him and enjoy having his sense of humor in their classrooms.when he was in public school-i was getting calls on a weekly basis.It was a living nightmare....

So my suggestion would be to try and have a certified occupational therapist evaluate them.Even if they have something else...they still sound as if there are some sensory issues with them.Regardless, it would benefit to have an occupational therapist give you her input and opinion.
I hope this all helps.Good luck and if you have any questions about SDI,feel free to ask=)

    Bookmark   May 19, 2007 at 2:38PM
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First let me preface this by saying that I am a speech-language pathologist who works with very young children (18 months up to age 5).

It is good that the first child is getting some help. He may need additional help to succeed in school, however. His parents need to keep an eye on his progression and seek additional services if he needs them. That may even include some special education as he tends to have some memory retention issues. He sounds dyspraxic, but the learning issues are altogether a different thing.

Both children should be seen by a Pediatric Neurologist to get an official diagnosis. ADD, ADHD, Dyslexia, Dyspraxia, and autistic spectrum disorders tend to run in families. They are now finding a genetic link in autistic spectrum disorders.

The second child needs to have a complete early intervention evaluation completed. This is usually a free evaluation. He sounds to be on the autistic spectrum with sensory disorders and like his older sibling may have some motot planning issues, as well. His social skills are lacking and his ability to communicate are hindered. The sooner his treatment begins the better. I have worked with children as young as 18 months with communication disorders.

Sensory integration disorders can be specifically diagnosed by an Occupational Therapist who specializes in these disorders. There are tests that can access this area. These are the kids that may walk on their toes to avoid touching sand or other surfaces, dislike certain foods or textures, may have trouble sleeping, may be very active getting into everything or avoid touching things altogether. These are the kids that may crash into things or people or have trouble keeping their hands to themselves. They may have trouble controlling their emotions. They often have trouble playing appropriately with toys, too.

ALL children in the autistic spectrum have sensory integration disorders, but some children can be diagnosed with only sensory integration disorders and have no autistic symptoms. (generally the autisist child tends to be less social with others).

Autistic children also can be dyspraxic, but some children are ONLY dyspraxic. Dyspraxia (sometimes called apraxia) is a motor plannning disorder mainly that needs specific treatment for the child. These are the children who cannot imitate words or sounds, but may come out with words spontaneously at times. Some cannot hum, blow bubbles or imitate funny faces. These children eventually do learn to speak. But have more troubles with longer utterances and multi-syllabic words. They may always have some difficulties learning new fine motor skills. I have often seen a number of dyspraxic children with normal intelligence who have above average gross motor skills, but poor fine motor and speech skills.

Any child who is having suspected difficulties should be fully tested as early as possible. A parent ALWAYS knows there is a problem, but may not always seek help right away due to denial. PLEASE KNOW that early intervention is very effective. The earlier I get my hands on a child with speech delays the better it will be for that child. The same is true for any child with sensory integration difficulties.

    Bookmark   June 3, 2007 at 3:01PM
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Dear Prosepina. I have a mild form of autism and what helped me the most was repetition and structure and the time my mother and my father, mostly my father, spent with me. My parents held me back in the first grade and it was good for me. I was a year older but still seemed younger but I was more comfortable with the kids than the older ones that was my age. At the end of first grade the second time I could read on level. I could not do math. I am 24 now and I can add subtract and multiply but I have to have silence to do it in my head. I was in speech therapy for several years and then I was fine. I also had reading and math remedial but the math did not help. The reading did. My father focused on what I did good and worked hard with me on those things. They accepted that I can not do math. It took me all high school to finish Algebra but I did finish it.

    Bookmark   June 5, 2007 at 4:30PM
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