It’s about to get pretty vulnerable up in here. For those that don’t know, I’m a mother of two. I have a 4 year old daughter and my son will turn two on July 18. From the moment my son was born – at 40 weeks, 5 days after an induction – his pediatrician made an educated guess that our dates were wrong and he was actually born at 38 weeks gestation. He was on the small side, especially for his gestational age, but regardless, he was healthy, beautiful, and perfect.
He met milestones within the normal range, though slightly later than his older sister. Boys – right?! He could roll in both directions, but didn’t do it often. He didn’t love tummy time and in hindsight, I didn’t do it enough. It seemed I was always shuffling him somewhere in order to get his sister to an activity. That, or he was napping. Second kid problems to the fullest! He was able to sit up by himself at 6 months, but never got there on his own and didn’t move out of a seated position on his own. He struggled to learn to drink from a straw cup, despite repeated exposure. (My daughter did it at 5 months literally the first time I gave her a straw cup!) Although he crossed midline with numerous toys, he never put anything to his mouth (except his pacifier) and didn’t self-feed – but he loved eating! Isn’t it funny how we assess crossing midline in our own children?!
From about 8 months on, I realized his gross motor skills should be progressing more than they were. Well-meaning family members assured me that “he’s healthy and thriving” – as if the only reason a child would not learn to crawl or walk on time was if they were sick. Yes, he was happy, engaged with others, was clearly learning new skills, and overall a healthy child. I think they thought I was worrying for no reason, or that I was worried about some scary, alphabet soup-filled acronym of sorts that meant my son had some underlying condition that would have taken me to doctor’s appointment after doctor’s appointment, only to be told he was fine. Because to them – he looked fine, so he must be fine. Obviously there can be delays or reasons for struggles that we can’t see – even if we never truly know the reason for them after they’re long gone.
Now, this isn’t going to be a post about how you shouldn’t be afraid to get your own child evaluated; you’re still a great SLP if your kid needs services; you didn’t do anything to cause this; etc. I know you know all of that.
This is a post about how we, as SLPs, know that evaluating too early or too late is a real concern. You know you’ve gotten a referral and a kid has shown up a few days before their fourth birthday, only to miss qualifying by a couple points. If only the eval had been done a week later! We, as SLPs, know that those scoring charts according to years;months matter GREATLY in terms of qualifying or not qualifying. One day could literally make ALL the difference. I knew this all too well.
When Daniel reached 11 months old and wasn’t even close to crawling (not even able to go into a quadraped position) I knew he was behind. But I struggled so greatly with whether or not he would score low *enough* to qualify for my county’s EI program. I also struggled with whether I’d already waited too long. If I have him evaluated a little too early, then I’ve got to wait another 6 months for another evaluation. That could mean 3-5 months of wasted time! In his short little life so far, that would be a lot of time! Or what if he qualified by a landslide? That would mean he could have probably been in therapy already. More wasted time. After going back and forth in my SLP brain for months about too soon/too late, I decided that I’d make the call to EI at 11 months old. (I had already asked a friend to show her PT friend a video of him. That PT recommended an eval. Thank goodness for all of these connections!)
The PT and special educator came to my house to evaluate my son. When I told them all of the strategies I’d been doing to encourage his skills, they asked if I was a therapist! I shared that I was an SLP and I had no concerns with his communication. Though, as part of the general developmental testing they asked if he responded to “No.” And, come to think of it, for what reason would I tell a baby would doesn’t move on his own and doesn’t bring things to his mouth “no”? I don’t think he’d ever heard it, therefore had no reason to respond to it! He never crawled toward a step, put something tiny in his mouth, stood to grab something hot off a counter, etc. It’s something I, even as an SLP knowing language and developmental milestones, had never thought of.
It turns out that my son did not qualify for Early Intervention services. His gross motor skills were within the first percentile (see?! Maybe I had wasted some time?) but his fine motor skills were average. My county had recently decided, within the last year, that fine and gross motor skills were going to be viewed as one – “physical development” – and therefore both must be delayed in order to qualify. It seems criminal to me that babies in the first percentile for gross motor skills do not qualify, but such is our education system, I suppose.
Luckily, my family and I had the means to pay for private therapy via a health savings account from my husband’s job. I was confident my son needed PT and so thankful that we had this account to use, because our insurance didn’t cover PT services.
He started outpatient services, once per week, in early July, 2019. I participated in all of the sessions in a near-empty gym. Thank goodness that most clients didn’t want that 12:00/12:30 slot, but that was the sweet spot between naps for him! And on December 2, 2019 Daniel took his first steps. (We actually were able to catch it via our Nest camera in our living room!) From December 13 on, he started walking for real and didn’t stop. He was just 5 days shy of his 17 month birthday.
I can tell he’s still a bit behind his cousins (who are each a few months older and a few months younger) as far as gross motor skills go, though now he’s within the normal range. However, he doesn’t take off running so much so that I can barely catch him like his cousins do to their moms. I’ll take that as a plus right now!
Being an SLP and a parent brings knowledge that not all parents have. It can come with its own unique challenges, as well. I don’t have any inspiring words for you, like “go with your gut” or “you’ll know when the time is right”. I will say to utilize all of the resources you do have, like friends and colleagues, to get their expertise in your specific area of concern. And most of all – love your kid and all of his cute milestones when they come <3 (It also wouldn’t hurt to wire your entire house with cameras to capture everything 😉 Did I go too far on that suggestion?)