DDBP

In following up with Sam's speech delay, we took him last week to the children's hospital's Department of Development and Behavioral Pediatrics. When his pediatrician initially referred us to the DDBP, she mentioned that it takes weeks (months, even) to get an appointment so go ahead and make it and then cancel if he seemed to be improving by then. We were very surprised, then, when they called and offered us to move our late-July appointment up. I briefly wondered if we were making mountains out of molehills again (remember the poop incident?), but we thought it best to not turn down another opportunity to seek advice and resources for Sam.

When you make an appointment for your child with anyone who specializes in development and behavior, it changes the game a little. Up til now we hadn't really been worried about him, figuring he'd catch up at his own pace, but being in a facility where most patients have mental disabilities or behavioral issues, I had to consider the possibility that his learning disability could be something more serious.

As a parent, you just want your child to be perfect. No, better than perfect. We want to show off his latest discoveries and abilities. Look what he can do/say! Isn't that adorable? And, oh, he can now do this, too! And here we were suddenly wondering if we'd been downplaying his inabilities as anything more than being simply delayed.

Sam was measured and weighed (32" long, 24.9 lbs) before a whole team came in the room -- the pediatric specialist, a nurse and a physical therapist with a suitcase. And they were all wonderful! So fun and kind and eager to play and interact with Sam. They quickly set to work unpacking all sorts of little objects and toys and began encouraging Sam to perform certain movements through play to analyze what he could and could not do while also noting his general behavior and tendencies in a booklet.

Sam, can you put this peg in this hole?
How about these blocks, can you stack them?
I hid a toy in this box, where did it go?
Can you fit these shapes into this puzzle?

The nurse and PT led the interactions and were noting his accomplishments and weaknesses in a chart. All the while the doctor was asking us general questions -- does he point to items, does he remove his shoes/socks by himself, can he follow simple commands?, does he make "vroom" sounds when he's pushing around a car?, etc.

Sam was a trooper. Five adults reaching for things, shaking objects, vying for attention, trying to get him to perform the various functions... for nearly an hour! After about 45 minutes of this stimulation (and nearly time for his standard morning nap), Sam went on strike. Ha! He did great.

As the team excused themselves to compile a report (unlike speech therapy, we actually leave with a report!), I felt really good about what Sam had been able to do. I never saw the team show any concern. I wouldn't be nervous about their findings.

The team had evaluated Sam using the Early Learning Accomplishment Profile (ELAP) which assesses his skills in six area of development:

• gross motor (crawling, running walking)
• fine motor (picking up small objects/holding a spoon/etc)
• cognition (following commands, learning, remembering)
• language (verbal and non-verbal communication)
• self-help (eating, helping dress, etc)
• social/emotional

Here are his results (chronological age 18 mos):

Gross Motor: 18 mos
Fine Motor:  10 mos
Cognitive: 12 mos
Language: 9 mos
Self Help: 15 mos
Social: 18 mos

I loved that they also noted his strengths -- affectionate, social, enjoys interaction, motivated to move, sought comfort from parent, non-verbal communication skills, healthy.  That's our Sam!

Overall, they were very optimistic about his current state and his ability for his skills to catch up to the developmental milestones. She didn't really recommend speech therapy as he may not get a whole lot out of it as his age, but we may try it and see how it goes. They prefer play-based therapy. She referred us to a federal program called Help Me Grow and the Parent-Infant Nurturing Group at the hospital, both offering therapeutic play with a specialist. She also suggested play groups, gymboree, kindermusik or other similar programs. Daycare is also an option because he would be in a learning environment with other children his age. The idea is that he already knows how to communicate with us, but if he is around other children he will need to find a way to communicate with them. Plus, seeing other children do skills is a great motivator for toddlers.

They were very complimentary of our boy and encouraging in his prognosis. With the right interaction and focused attention to his needs, they said to give it six months to see how far he comes in that time. We'll be back in December for a follow-up. There was no mention of a hearing exam.

Sam has rarely demanded of our attention, often playing by himself happily, and so, we often let him do so as we tend to Adam's more verbal requests. But now, in the three weeks since Sam's 18 month appointment we've had more intentional play with him, and we can already see progress. It's very exciting. He signs "All Done" now, he claps, he does the arm motions for Patty-Cake, he's working on new sounds and mimicking, and he is understanding commands better. Michael and I are reveling in all his discoveries, and we feel like first-time parents as we watch him in wonder as he accomplishes even the little things. Sam is clapping! Go ahead, ask him to clap! Watch him turn the light switch on and off. Did you see him sign "All done"? Isn't that adorable?

If nothing else, we left there feeling reassured that our instincts were correct. Sam is learning and developing at his own pace, and we have renewed intention to play and interact with him at every opportunity. We realized that he learns differently than Adam, and it's so fun now to approach his development in the way that he needs and to encourage him every day. Now the fun really begins -- watching him thrive.