Early Intervention Evaluation for Children

[UGG]

Has anyone ever gone through an "early intervention evaluation" for their child because they have been categorized as "developmentally delayed"?

We have one scheduled for my son who will be 16 months next week-this was on the recommendation of his pediatrician.

My son is very affectionate, gives hugs kisses, makes eye contact, walks great, sleeps good, likes to watch sesame street, loves our family dog, recognizes family members etc...

The pediatrician is very concerned however, because he has never pointed at anything (like...ever), he has never waved hi or bye, is not saying any words (not even mama or dada) and has never responded to the sound of his name. He does babble constantly though.

I am...very beside myself-scared and seriously feel like i have done something wrong or should have done something else or..idk...but I am freaking out!

Anywhoo-I know many posters here are knowledgeable on a variety of topics so was looking for any insight one may have on these symptoms, early intervention, what I should think about the fact that he does not point or wave (no more googling for me!).

Thanks for anyone who has any thoughts or first had experience on this topic

[numbers123]

This is easier for me to say because I am not emotionally involved, but my experience with early intervention programs is that they do an assessment of the child's developmental level and help you with things like speech therapy.

Has anyone tested his hearing? I am not someone who does diagnosis but it appears that many of the things that you are describing could be part of a hearing issue.

Good thoughts for you and your son

[TheGirlCanSkate]

I can't say don't worry, because you will worry no matter what. It's usually fun for the child and not scary at all. I would ask about testing hearing as well, but I'm sure you have noticed if the vacuum bothers him or a siren startling him. Are you a bilingual household?

[UGG]

No-I was told they do not test hearing until 18 months. My pediatrician did say we can do tests, like shut the door loud to see if he responds or when our family dog barks, how does he react? As far as I can tell, he can hear-he does react to the dog, and when we put on sesame street, he recognizes the theme music, and also gets excited when "Elmo's World" song starts.

But I did bring that up because I was thinking the same thing. He has also had about 6 ear infections since birth.

Thank you for your thoughts.

Oh we are not bilingual.

I appreciate the responses.

[Aceon6]

One of my grand nephew's was placed in an early intervention program at about 18 months. He had some ongoing issues from his premature birth. The program was great and he caught up with his peers well before kindergarten. He will be entering regular 1st grade next year and, by what I can see, is doing very well.

[GarrAarghHrumph]

My daughter went through an evaluation, because she was delayed in speaking. She really had fun in the evaluation, and we learned that although she was late in speaking, she was also very smart and understood everything around her beyond her young age.

She did start speaking soon after, so she was just a bit behind.

She also later (age 7) failed her hearing test in school. She does have narrow ear tubes, like I do, and we and her doc suspected allergies were clogging things up, so we gave her Claritin for a while before the next test, and she passed it.

The feelings you are having are completely normal, but the evaluation is a good thing. If there is an issue, it can be identified early, which means it's more likely that there can be a positive outcome. And it may be the case that, as with my daughter, nothing is actually wrong.

[Angelskates]

UGG, I have never had one done as I am not a parent, but I have been part of a team who does them. Before having one done with our team, we have a (long) form that needs to be filled out, requesting information like term and details of pregnancy (complications etc.), dates and results of last hearing and sight tests, milestones, family history etc. If you have not done this (or something similar) yet, it will either be part of the evaluation (we don't do this as we like to know specifics to tailor the evaluation, if possible) or you are at the very beginning stages. You can do simple hearing tests at your son's age. Does he respond to his name if you are not in front of him?

Our team includes me (I'm a special ed. teacher), an occupational therapist, a speech and language therapist and a psychologist at minimum and we are usually referred to by a paediatrician. Not everyone on our team is always needed, which is why we get the intake form.

I work with many developmentally delayed children, and some have global delay (in all areas) and some just in specific areas (speech, fine and/or gross motor). One I have just "graduated".

Don't freak out! I know it's easy to say, but honestly, no matter there result, there are things to help your son, and some may even be short term. It could, as numbers said, be something related to hearing, though with my experience with deaf or those with hearing issues, pointing is still done, and so is waving, as these are ways to communicate without speech (and those with hearing issues have speech issues).

My sister was born blind, and my parents went through what you went through more than 30 years ago. My sister was initially diagnosed as retarded and then autistic, as she also had hearing impairment (she wears hearing aids). If there were a diagnosis for global developmental delay back then, she would have had it. Once correctly diagnosed as blind with a hearing impairment, my parents were able to find help, both for her and for them. A lot of my job is supporting parents through the stages of diagnosis. My sister is now happily married with three kids, and is a pianist.

Here and here are some handouts that may or may not be useful, just for information about what to expect. (There's also some great tips to encourage the skills your child appears to be delayed in, at home.)

As others are saying, the evaluation is really just play at this age Be sure to ask any and all questions though - take a list if you need to. Many of those who are diagnosed with a delay at your son's age are caught up by the end of first grade. Ask all questions from the "why?" (keep in mind here, that "why" is only for interest, sometimes there's no reason, and there's usually nothing you can do to undo the reason anyway) to "what now?" The "what now?" is the most important thing to ask.

[reckless]

It's interesting about the ear infections and hearing issues, because a hearing issue was the first thing I thought from the description. What is described sounds a lot like what happened with my cousin. She also reacted to noises and some specific sounds, but was not speaking. She had had a lot of ear infections as a baby and it resulted in speech delays. At first, the doctors thought she had aphasia, but further investigation revealed that hearing issues were impairing her speech development. I think she had a stent placed in her ear and then she underwent very aggressive, early speech therapy and quickly reached normal proficiency.

[mag]

I'm with numbers on the hearing testing. I also think it is great that you are being so proactive. If there is a problem, the earlier it is diagnosed, the better. That said, kids are weird, and I mean that in the nicest way! Developmental guidelines are just guidelines and every kids develops differently and at their own rate. I won't tell you not to worry, because I know that is impossible, but do take some comfort in the fact that you and your doctor are all over this early on. The only suggestion I will make, is to take someone with you when you go to review the results of the evaluation. We parents are so emotionally involved with our children, it is often difficult to hear what is being said and to process the information. Do you have a friend or a sibling who could go with, take notes, remind you of questions to ask? Also make sure you are not trying to look after your son while you are talking to the doctor about the evaluation. You need to be able to focus on what the doctor is saying ... Not what your son is putting in his mouth!
Finally, try not to blame yourself. When you think about how children are brought into this world, how complicated the whole egg to baby thing is, it is a miracle there are any babies at all. You sound like a loving parents who is doing their very best. That is all we should expect of ourselves. I've been down the blame road, and it leads no where good.

[Hannahclear]

It probably depends on the state, but I found the evaluation really useful. It confirmed that my son was average or above in all areas, except expressive language. They don't have a diagnosis or anything, but because there was a gap between his skills in that area and everything else, he is getting speech therapy.

Is it helping? Um, not sure. He's talking more, but still below average for his age. He does really like the playgroup.

Based on what you're saying, I think an evaluation is merited. The earlier they try and figure it out, the better for your son. Plus, they age out at 3, so if you wait till 2, you'll have less time.

Don't be scared. It will be ok. Getting evaluated won't hurt anything.

[UGG]

Thank you so much for all of the responses and kind words. I am sitting here all teary eyed LOL.

Angelskates- you asked if he responds to his name if we are not in front of him? He does not-he actually has never responded to his name which was a concern. I can stand in front of him and say his name and he does not even look at me. But if the dog barks, or there is a noise or something, he seems like he hears it.

[Badams]

I agree with those who say hearing evaluation. My niece was about the same age as your son when she started early intervention. It didn't help her one bit until my sister INSISTED on getting her daughter in to check on her ears because she had had so many ear infections at that point. She needed tubes put in and had so much water built up that she was basically deaf. She's 4 now and talks a lot better, but still not perfect.

[Angelskates]

Thank you so much for all of the responses and kind words. I am sitting here all teary eyed LOL.

Angelskates- you asked if he responds to his name if we are not in front of him? He does not-he actually has never responded to his name which was a concern. I can stand in front of him and say his name and he does not even look at me. But if the dog barks, or there is a noise or something, he seems like he hears it.

This definitely sounds hearing related then, and may be something easily (and possibly quickly) fixed. It doesn't sound like he's deaf, but he may have a hearing impairment from which the other things stem, or the other things may be unrelated. An evaluation will give you more information from professionals, more useful than us, and definitely more useful than google!

[Hannahclear]

Yeah, some hearing impairments can be certain frequencies, so they may not hear speech, but can hear other things.

[agalisgv]

My youngest went through an early evaluation because of speech delays. Our case was trickier because we had a bilingual household. We were promptly told to stop that .

Anyhow, unlike others here, the issues with my son turned out to be more extensive. One delay triggered further testing, and other issues were uncovered. He just kept getting further and further behind . He also couldn't properly socialize with other children because he couldn't communicate. For us, hearing was included as part of the screening process.*

Long story short, we went through many years of supportive services, adding on whatever was needed to address his delays.

Eventually, not only did he catch up, he passed his peers and was skipped two grades ahead (which has presented another whole slew of issues). Anyhow, he is exceptionally strong academically now, and is very sociable with an active social network. You'd never know he received supportive services of any sort at one point.

So even if the delays identified are significant and multiple, a tremendous amount can be done to maximize your child's potential.

Fear not

* One thing I was taught to do was to sit next to my son, and behind his back place a small rattle to the back of one ear and shake it. I would keep him focused by looking at me, then shake the rattle. A child should turn towards the sound. You do that to each ear to check for hearing (the rattle should be small and placed behind the ear and shaken quietly). If he isn't turning towards either side when you do that, there may be an issue.

[numbers123]

It might be that he only hears noises at a certain level. I was in the ENT office with my granddaughter after her ear tubes were placed. I was surprised at the chart they had in the office about speech/words etc. at different ages - not as many as I thought.

I also have a step granddaughter that I was quite concerned about her lack of language development. Besides not speaking and very little babbling, she would hold objects very close to her eyes (she is almost 2). In the last 2 weeks, she has begun to say "two" and a few other words. (the word two is very interesting - my other grandchildren would go down our steps from the bedroom to the living room and I would count 1, 2, 3, 4, 5), Then yesterday started saying push, dada, maaaa. She also had many ear infections. And they attribute her wanting things close up as wanting to study them intently as her vision testing is normal

Like everyone says, the evaluation will include an extensive history and it will be fun for your son.

[manleywoman]

Add me to the list of wondering about hearing.

One of my kid's friends was still not walking at 15 months. Not even trying. Turned out he had fluid in his ears and therefore no balance. And it also explained why he had other problems too. As soon as they put tubes in his ears and they drained, he was running in a week.

[barbk]

UGG -- Child Find is a great program; besides some very thorough evaluation at no charge to you, if needs are identified they can begin providing services right away, even during the summer. Our school building hosted a developmental preschool that was half-enrolled with Child Find students (whose families did not have to pay) and the growth and development during the course of the year was fabulous to watch. The kindergarten teachers also loved it because kids who need support get it rather seamlessly in the transition from Child Find to kindergarten; kids who are identified as possibly needing support in kindergarten often don't have IEPs completed until nearly 2/3 of the school year has passed.

One of my girl scouts was identified as substantially hearing impaired through child find, and the speech therapy and sign language instruction she got from toddler age on was hugely helpful.

And, they may well find nothing at all. Kids do develop at different paces. Best of luck!

[UGG]

yeah for some reason-hearing is not checked until 18 months. I probably should have asked why...but I was so taken a back when our pediatrician mentioned "development delays" and was trying to process that whole thing in my brain. I guess when we do the evaluation, the evaluators will be able to tell if he needs further hearing testing?

I did a 20 minute phone interview late yesterday afternoon and they asked tons and tons of questions about my pregnancy, family history-all sorts of things.

It was so so so stressful.

I really appreciate everyones kind words-it means a lot.

And please keep experiences, perspectives, and knowledge coming, I truly do appreciate it.

[Angelskates]

UGG, hearing isn't checked until 18 months unless there is a problem. I would go back and ask, because there are most definitely checks for those younger than 18 months. The evaluation will definitely be able to tell if he needs extra testing, but actually they probably won't be able to tell if the problem is exclusively due to hearing without tests. They can see the result or symptoms of the issues (problems with hearing, speech etc.), but only a hearing test can result in a diagnosis there - and even that may not happen, sometimes there is no obvious reason, and you either have to wait and see (urgh!) or get even more testing. Either way, treatment for the current issues should commence immediately; your son is the perfect age for early intervention, regardless of the diagnosis or cause.

20 minutes sounds mild for the interview Ours are an hour, in-person, if we don't have the intake form already, and usually at least 30 minutes if we do. I'm sorry it was stressful for you, parents don't usually have a reason to think of the things asked, because they just think everything is "fine" or have never really considered or known what "normal range" guidelines are. Background information is always important, it will help them evaluate better.