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Developmental delays?
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amother


 

Post Thu, Jul 03 2014, 10:16 am
My 18 month old is ka'h happy and active. But she does not do some things that I would expect her to do. For example, she knows how to clap her hands and she does it sometimes on her own, but never when I try to get her to do it. She doesn't wave byby either, although she has done it in the past and maybe still does it on her own but not when I try to get her to do it. The same thing with pattycake - she sometimes likes it but almost never does the right thing with her hands.
Also, she doesn't say any words yet. She constantly babbles and looks exactly like she's trying to say things but she doesn't say any words, not even "mama" or "baba". But she does lots of signs and motions to try to get me to do things, like reaching toward something and squeeling or yelling angrily with no words, just sounds when I put her in her crib.
All of my other children were saying at least a few words by that age. I googled and found that babies of this age should be saying ten words. That sounds right for my other kids. They also waved byby when you asked them and did all the other things I wrote earlier.
Should I be concerned about this? If I was concerned about it, what should I do? Someone mentioned that I should take him to an OT or a speech therapist, but I can't really afford to spend a lot of money. How much should something like this cost?
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amother


 

Post Thu, Jul 03 2014, 10:22 am
Hello! I am an SLP specializing in early intervention. Trust your gut -- from what you write, it sounds like your child could benefit from an evaluation by a qualified early interventionist. If she qualifies, services will be covered under your state's birth-to-three program. I don't know where you are located, but if you search your state government's website (usually under the dept. of ed. or dept. of health and human services) for your state early intervention system, there should be contact information for your city, county, or region.

In my opinion, it is ALWAYS worthwhile to have things checked out, if only to get the reassurance that everything is alright. In your case, it does sound like there are some delays, but take heart -- a great EI team can teach you the skills you need to work with your daughter at home during daily routines to help her catch up. You are the #1 factor in your child's development -- you can do it!
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amother


 

Post Thu, Jul 03 2014, 10:29 am
amother wrote:
Hello! I am an SLP specializing in early intervention. Trust your gut -- from what you write, it sounds like your child could benefit from an evaluation by a qualified early interventionist. If she qualifies, services will be covered under your state's birth-to-three program. I don't know where you are located, but if you search your state government's website (usually under the dept. of ed. or dept. of health and human services) for your state early intervention system, there should be contact information for your city, county, or region.

In my opinion, it is ALWAYS worthwhile to have things checked out, if only to get the reassurance that everything is alright. In your case, it does sound like there are some delays, but take heart -- a great EI team can teach you the skills you need to work with your daughter at home during daily routines to help her catch up. You are the #1 factor in your child's development -- you can do it!

Thank you for answering. I hope you can answer a few more questions. What does an evaluation mean? How can they tell any more than what I tell them?
And when I say that I can't afford expensive therapy, I still don't think I would qualify for government programs. I am above the cut off for all the other ones like HUD and welfare. Is the income qualification for this much higher?
Also does this mean that she will be special needs forever?
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amother


 

Post Thu, Jul 03 2014, 10:46 am
You're welcome!

Generally, an evaluation for early intervention does include a lot of parent interview (getting information from you about all areas of her development -- gross and fine motor, eating, communication, cognition, self-help skills like dressing, feeding, etc.), but the evaluator will also be observing your child and looking at her through "therapist eyes" -- she may see some things you are not seeing. They may also have some simple tasks for your daughter to perform that, to her, will seem like play, but can give the evaluator a lot of information about where she falls developmentally and what she might need to work on.

Birth-to-three early intervention services provided by the state are free for all families regardless of income. If you have private insurance, they will bill that first, but any copays that you might be responsible for, or anything above and beyond what insurance will cover, the state will take care of. It's a good investment of public monies because spending on early intervention pays off big time down the road by helping children get the best possible start.

To answer your question of, "Will she be special needs forever?" -- first of all, she may HAVE special needs, but that doesn't mean she IS special needs. Do you see what I mean? We all have strengths and weaknesses, but that isn't WHO we are. Who your daughter is, and who she will be, is the same beautiful, unique, wonderful, precious gift she was before and after any diagnosis she may receive. Attitude is key -- whatever she may be facing, big or small, focus on her as a child first. As for how long she may need therapy -- it really will depend. The evaluators may be able to pinpoint a specific diagnosis (autism, cerebral palsy, just for example, not that this is what your daughter has) that is a lifelong thing, or it may be just a developmental delay of unknown origin. Either way, whether or not it can ever be 100% "fixed," it is always possible to make progress and to help her get a great start to becoming whoever she was meant to be in life. The earlier you start, the better, because she is less behind her typical peers now than she would be if you waited 3, 4, 5 years to intervene.

***Another important point -- make sure she has a complete hearing test by a qualified pediatric audiologist (pediatric is key -- go to a children's hospital, not some storefront hearing aid shop -- there is a HUGE difference in quality and expertise) to rule out any hearing issues. Many children with hearing loss present as having developmental delays, and early intervention for children with hearing loss is crucial.

Keep breathing -- everything will turn out alright. It might take a while to see that, but it will!
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amother


 

Post Thu, Jul 03 2014, 10:50 am
Also keep in mind that because she IS making progress albeit slower than you expected, there are very good chances that she will outgrow her delays or be able to overcome them quickly with intervention.

I had a 3yo who was barely talking - today at the top of his class.
A friend told me none of her kids spoke until 5 (!).
An 18mo with almost no words - two months later he has hundreds.

No need to label or make predictions for your child!
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amother


 

Post Thu, Jul 03 2014, 10:54 am
Different amother here, but my kid gets services. It has nothing to do with income. You could be Marc Zuckerberg's kid and it is still free at least until age three, possibly longer depending on the child's needs. Evaluation is free- they meet the child and perform some tests, ask to do stuff, etc and then make a decision as to what they recommend. It does not mean special needs forever, especially if its a mild delay.
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MaBelleVie




 
 
    
 

Post Thu, Jul 03 2014, 11:07 am
Nothing you wrote sounds especially concerning, aside from the lack of language. An evaluation will give you more specific information regarding which areas are delayed, and how significant the delay is (mild, moderate, etc). Being specialists in child development, they may also piece together information to raise awareness on issues you may not have noticed or realized were related to your child's development.

Be aware that depending on your location, the evaluators may be excellent or they may be terrible. If you feel as a mom that they are missing the boat, I would strongly recommend paying privately for an evaluation to find out the truth. If you have medicaid, they will cover it fully. If you have private insurance, you can call them to find out what's covered.
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amother


 

Post Thu, Jul 03 2014, 1:50 pm
Thank you everyone who weighed in. I appreciate your help, especially the first amother who does early intervention.
amother wrote:


To answer your question of, "Will she be special needs forever?" -- first of all, she may HAVE special needs, but that doesn't mean she IS special needs. Do you see what I mean? We all have strengths and weaknesses, but that isn't WHO we are. Who your daughter is, and who she will be, is the same beautiful, unique, wonderful, precious gift she was before and after any diagnosis she may receive. Attitude is key -- whatever she may be facing, big or small, focus on her as a child first. As for how long she may need therapy -- it really will depend. The evaluators may be able to pinpoint a specific diagnosis (autism, cerebral palsy, just for example, not that this is what your daughter has) that is a lifelong thing, or it may be just a developmental delay of unknown origin. Either way, whether or not it can ever be 100% "fixed," it is always possible to make progress and to help her get a great start to becoming whoever she was meant to be in life. The earlier you start, the better, because she is less behind her typical peers now than she would be if you waited 3, 4, 5 years to intervene.

***Another important point -- make sure she has a complete hearing test by a qualified pediatric audiologist (pediatric is key -- go to a children's hospital, not some storefront hearing aid shop -- there is a HUGE difference in quality and expertise) to rule out any hearing issues. Many children with hearing loss present as having developmental delays, and early intervention for children with hearing loss is crucial.

Keep breathing -- everything will turn out alright. It might take a while to see that, but it will!
Thank you for your advice and particularly your chizzuk. I know that you're right but I'm kind of freaking out about this and I'm hoping it's the kind of thing that will take just a little while of therapy to catch up.
Is the hearing test something that a evaluator would notice if it was necessary? Or should I do it by myself regardless of what an evaluation says?
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amother


 

Post Thu, Jul 03 2014, 1:59 pm
amother wrote:
Also keep in mind that because she IS making progress albeit slower than you expected, there are very good chances that she will outgrow her delays or be able to overcome them quickly with intervention.

I had a 3yo who was barely talking - today at the top of his class.
A friend told me none of her kids spoke until 5 (!).
An 18mo with almost no words - two months later he has hundreds.

No need to label or make predictions for your child!
OP here again. The funny thing is that she is not behind or slow in anything excpet what I mentioned and she has done everything on a very random schedule. She crawled very late even though she had lots of tummy time, and then she walked a month later. Crawling was much later than my others, and walking was much earlier. She does lots of things that are almost like talking. She sings "twinkle twinkle" in a way that we can recognize the tune. She invents games that she plays again and again, like throwing a block into a box and yelling "oooh" again and again, and it's obvious she's doing it on purpose. When we copy her, she knows that we're playing her game and she giggles along. But we still can't get her to say any words or motions like clapping or by by on demand. I would worry that it's an autism type problem, except that she is obviously interacting with us in other ways.
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amother


 

Post Thu, Jul 03 2014, 2:46 pm
SLP amother here: Because, as previous posters have said, the quality of EI professionals can vary widely, I would take it on you own initiative to have her hearing tested by a pediatric audiologist at a children's hospital ASAP.

I'd also like to respectfully disagree with those who share stories of children who didn't do xyz for years and years and then turned out just fine. I'm not arguing with you -- I'm sure the children in your experience did. But those are anecdotes, not evidence. They are exceptions to the rule... and most children are the rule, not the exception. While it very well could be the case for OP's daughter (or any other child who seems to have a delay), it is just not worth gambling futures on the hope that they'll be that one child who seems to catch up overnight. Stories like that may provide comfort, but they also scare me because they provide a lot of false hope. I'm not accusing the poster who shared them, I think she did so with 100% good intention, I just want to share my two cents as a professional in the field -- I see these types of stories circulating and doing more harm than good, because terrified parents naturally want to believe them and then sometimes end up delaying services for their child.
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amother


 

Post Thu, Jul 03 2014, 3:18 pm
amother wrote:
SLP amother here: Because, as previous posters have said, the quality of EI professionals can vary widely, I would take it on you own initiative to have her hearing tested by a pediatric audiologist at a children's hospital ASAP.

I'd also like to respectfully disagree with those who share stories of children who didn't do xyz for years and years and then turned out just fine. I'm not arguing with you -- I'm sure the children in your experience did. But those are anecdotes, not evidence. They are exceptions to the rule... and most children are the rule, not the exception. While it very well could be the case for OP's daughter (or any other child who seems to have a delay), it is just not worth gambling futures on the hope that they'll be that one child who seems to catch up overnight. Stories like that may provide comfort, but they also scare me because they provide a lot of false hope. I'm not accusing the poster who shared them, I think she did so with 100% good intention, I just want to share my two cents as a professional in the field -- I see these types of stories circulating and doing more harm than good, because terrified parents naturally want to believe them and then sometimes end up delaying services for their child.
OP here. I understood that post differently. I thought she was saying to get the intervention because with intervention she can catch up.
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amother


 

Post Thu, Jul 03 2014, 10:14 pm
OP, my child was also only speaking a couple of words, so I had her evaluated around age 2. She qualified for speech therapy, OT, and developmental intervention. At age 3 I placed her in a prekindergarten for children with special needs, and she received PT, OT and speech therapy there until she was ready for pre1A. In the couple of years since, she's been in mainstream Jewish schools and doing great B"H.

Her EI therapists told me that she had significant cognitive delays, but it seemed to me that she understood everything going on around her, and interacted with us as best as she could without words. She started talking much more in preschool. After about 1.5 years there she learned how to read--her teacher taught her ABCs and basic phonics, the rest she picked up on her own and from watching her siblings do their homework at home.

She still needs speech therapy for poor articulation, as well as OT and PT. Her teachers sometimes find her hard to understand (though her friends don't have trouble). She sometimes still has trouble writing neatly and hasn't mastered tying her shoes or throwing a ball properly. But she has friends at school, and her teachers tell me that she's very bright.

I don't believe that my daughter would be doing as well as she is today if I hadn't gotten her EI intervention services and sent her to a special needs preschool.
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amother


 

Post Thu, Jul 03 2014, 10:28 pm
amother wrote:
OP here. I understood that post differently. I thought she was saying to get the intervention because with intervention she can catch up.

Thank you OP for understanding, that was exactly my intention. There is no good reason NOT to go for an evaluation. It may be a hassle but the potential benefits are priceless.

My intention with sharing these anecdotes was to prevent you from making my mistake and projecting an entire future based on an early childhood delay - a lot of unnecessary anxiety. I guess for me "special needs" had such a strong connotation that I automatically assumed the worst.
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miami85




 
 
    
 

Post Fri, Jul 04 2014, 12:06 am
I would definitely get her evaluated. I am an early-childhood special education teacher, EI provider, and a parent of a child with Apraxia. From your description She sounds SOOO much like my son at that age--and though I haven't seen your daughter it sounds like it could be Apraxia (which my son has). A lot of key phrases such as: "knows what I'm saying but can't say it" and "does it when she wants" are classic signs of Apraxia. EI in NYC is a free evaluation, if you're not in NYC then most places EI is highly subsidized with a minimum co-pay.

I was in a very similar situation when my son was 18 months old. I had a inner feeling that something wasn't right and most people were telling me that "he'll be fine" and my DH was skeptical. B"H we got him evaluated when we did and got him all the therapy that he did. Please PM me with any further questions.
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bnm




 
 
    
 

Post Fri, Jul 04 2014, 12:17 am
miami85 wrote:
I would definitely get her evaluated. I am an early-childhood special education teacher, EI provider, and a parent of a child with Apraxia. From your description She sounds SOOO much like my son at that age--and though I haven't seen your daughter it sounds like it could be Apraxia (which my son has). A lot of key phrases such as: "knows what I'm saying but can't say it" and "does it when she wants" are classic signs of Apraxia. EI in NYC is a free evaluation, if you're not in NYC then most places EI is highly subsidized with a minimum co-pay.

I was in a very similar situation when my son was 18 months old. I had a inner feeling that something wasn't right and most people were telling me that "he'll be fine" and my DH was skeptical. B"H we got him evaluated when we did and got him all the therapy that he did. Please PM me with any further questions.


and I should warn you that they officially can't diagnose Apraxia till the kid is 2.5. they can say it LOOKS like it.

my 3 year old has Apraxia and some other stuff going on, EI is the best thing that ever happened to him.
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working hard




 
 
    
 

Post Fri, Jul 04 2014, 9:41 am
I also saw a couple of red flags with my daughter. Around 8 months we had her evaluated and she was given Speech and PT. About 2 months later, everything flared up and got much worse. Because I already had a professional in the house, it was caught right away. We were able to get increased services immediately. She is 14 months now and is doing beautifully. She is still delayed but as things are going now should catch up to age level at around age 2. B'H it was caught right away. Please evaluate now without delay.
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amother


 

Post Fri, Jul 04 2014, 9:59 am
amother wrote:
You're welcome!

Generally, an evaluation for early intervention does include a lot of parent interview (getting information from you about all areas of her development -- gross and fine motor, eating, communication, cognition, self-help skills like dressing, feeding, etc.), but the evaluator will also be observing your child and looking at her through "therapist eyes" -- she may see some things you are not seeing. They may also have some simple tasks for your daughter to perform that, to her, will seem like play, but can give the evaluator a lot of information about where she falls developmentally and what she might need to work on.

Birth-to-three early intervention services provided by the state are free for all families regardless of income. If you have private insurance, they will bill that first, but any copays that you might be responsible for, or anything above and beyond what insurance will cover, the state will take care of. It's a good investment of public monies because spending on early intervention pays off big time down the road by helping children get the best possible start.

To answer your question of, "Will she be special needs forever?" -- first of all, she may HAVE special needs, but that doesn't mean she IS special needs. Do you see what I mean? We all have strengths and weaknesses, but that isn't WHO we are. Who your daughter is, and who she will be, is the same beautiful, unique, wonderful, precious gift she was before and after any diagnosis she may receive. Attitude is key -- whatever she may be facing, big or small, focus on her as a child first. As for how long she may need therapy -- it really will depend. The evaluators may be able to pinpoint a specific diagnosis (autism, cerebral palsy, just for example, not that this is what your daughter has) that is a lifelong thing, or it may be just a developmental delay of unknown origin. Either way, whether or not it can ever be 100% "fixed," it is always possible to make progress and to help her get a great start to becoming whoever she was meant to be in life. The earlier you start, the better, because she is less behind her typical peers now than she would be if you waited 3, 4, 5 years to intervene.

***Another important point -- make sure she has a complete hearing test by a qualified pediatric audiologist (pediatric is key -- go to a children's hospital, not some storefront hearing aid shop -- there is a HUGE difference in quality and expertise) to rule out any hearing issues. Many children with hearing loss present as having developmental delays, and early intervention for children with hearing loss is crucial.

Keep breathing -- everything will turn out alright. It might take a while to see that, but it will!



I think it depends on the state. In NJ, it's on a sliding scale (still, very very low - often less than the cost of a babysitter).
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miami85




 
 
    
 

Post Fri, Jul 04 2014, 10:05 am
bnm wrote:
and I should warn you that they officially can't diagnose Apraxia till the kid is 2.5. they can say it LOOKS like it.

my 3 year old has Apraxia and some other stuff going on, EI is the best thing that ever happened to him.


I'm not a speech therapist, just special education, but my son's therapists diagnosed him at just before 2, I got him evaluated for EI at 19 months and at his 3 month progress report they put in the Apraxia diagnosis.
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amother


 

Post Fri, Jul 04 2014, 10:26 am
amother wrote:
I think it depends on the state. In NJ, it's on a sliding scale (still, very very low - often less than the cost of a babysitter).

I'm the amother who posted about my daughter going through EI and special needs preschool. NJ does have cost-sharing, but I found the scale to be quite generous. I think families earning less than 300% of the FPL have no cost share at all (so if you qualify for WIC in NJ, you probably won't have to pay anything). My DH was earning a good income, we didn't need any programs, yet we paid less than $18 per session.

There was no charge for the evaluation itself. I think the evaluators asked for insurance information, but didn't charge us at all, not even a copay. And our insurance wasn't that good.

To see the cost share tables for NJ, you can google "NJ early intervention cost share". Here's a site that gives information for a few other states:
http://ectacenter.org/topics/f.....s.asp
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bnm




 
 
    
 

Post Fri, Jul 04 2014, 12:02 pm
miami85 wrote:
I'm not a speech therapist, just special education, but my son's therapists diagnosed him at just before 2, I got him evaluated for EI at 19 months and at his 3 month progress report they put in the Apraxia diagnosis.



we where debating spectrum related stuff so took him to a developmental ped, he was VERY delayed, got put at 6-9 months at 15 months. She said it doesn't think its spectrum anymore at that point (after a few months of therapy) but probably apraxia. She and the speech therapist who is one of the best evaluators in Brooklyn both told me that they aren't allowed to use Apraxia as a diagnosis before the kid is 2.5. They can write apraxia like symptoms.


OP, get your daughter a hearing test and a full eval. If she qualifies for services ask about a center based program once she turns 2. My son benefited from that a lot.


My son got evaluated at about 14/15 months. He also saw the eye dr. After a few months of therapy we started with an ent. He was barely making progress for MONTHS and the hearing tests all came back fine. We tought him sign language because the DP said at this point its more important for him to communicate than to talk. At one point we put in tubes because he had frequent ear infections and other times it was just fluid. As soon as he got the tubes he started babbling, he hadn't babbled before.

He is 3 now. He talks in sentences. He understands when we talk to him, other people sometimes understand when he talks. He plays with kids now and makes friends. This week he actually told me about his day at the babysitter without me prompting him. This is the kid who 1.5 years ago sat in a corner and threw toys and banged his head.
We actually got told he is too high functioning for a certain special ed school that I really wanted to send him to.
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