Developmental Pediatricians

[Anonymous]

It has been a while since I have posted: Taylor has been doing well with her reflux, I keep her on Prevacid 15mgs once a day until she is done teething. She is doing well with all foods, that we can tell but you never know if there is something more to it. Anyways, she is 2 years old and very speech delayed she only says a few words, DaDa, Go, Down, Again (really Gain), town, ten but that’s about it. She also is still a toe walker and very unstable, tends to continue to fall down a lot. So the MD wants her to see a Developmental Peds MD, I just wondering for all the parents out there that saw one, what should I expect? Our MDs does not feel she has Autism but that she is truly developmentally delayed but she feels too close to Taylor and does not want anything missed. The OT and Speech therapist that work with her currently feel the same way but they too both adore her so much I really think it is hard for them to call it autism as well.

[Anonymous]

Hi Sue,

Saw your post and wanted to respond since we’ve been with a dev. ped for 1 1/2 years now. We also saw a neurologist prior to seeking the dev ped. In my personal experience a dev. ped. seems to be more interested in the whole picture that makes up the child where (again just our experience) the neuro only wanted to look at the behaviors Aidan had that mimic autism (and after 2 years of therapy all those behaviors are gone! –but unfortunately our speech problems are still there to an extent) the neuro didn’t even want to hear us out and was offering a sedative for a 2 year old! I would recommend a dev ped over a neuro any day if your dealing with developmental issues. We also had bloodwork and genetic testing with the docs to rule out Fragile X, check for lead, and a few others. We decided against the MRI because while Aidan’s apraxia MAY have shown up or may not, it wouldn’t have changed our treatment so we felt it wasn’t in his best interest to put him through it at the time. Hope this helps and hope you find a great dev ped, we love ours! Good Luck!!

[hellbennt]

I posted about this a while back…again, for my work, I like to try & recommend what I think will help people…I just don’t know of any (yet!)…but from all I keep reading it does seem like a good way to go…

[Anonymous]

We just had Ben assessed by a developmental pediatrician last week, after waiting 6 months to be seen. Since Ben is 3, they may have used different assessment tools than they would for a 2 year old, but I’ll tell you of our experience so you have an idea.

First, she had him sit at a little table and gave him a bowl with 10 little blocks in it, to see what he would do with them. She was observing and making notes throughout, assessing fine motor, appropriate vs. inappropriate play (lining things up, etc.). Then she asked him to do various things with the blocks to see if he was able to understand exactly what she was asking of him, and if he would understand what was expected of him. For example she put two blocks side by side on the table, then put a third block on top. Then she gave him 3 different blocks and asked him to do the same thing with his blocks (not giving him any physical cues of what to do with his blocks). It wasn’t a test to see if he could physically do what she was asking, but rather testing to see if he was fully understanding that she was asking him to re-create what she had done and seeing if he understood what her expectations were through interpreting language. This is something that most children on the autistic spectrum have difficulty with. They often need verbal directions to be very simple and very specific, and often need some physical cues to understand what is being asked of them.

She also gave him a blank piece of paper and a crayon and asked him if he would like to color/draw, then observed what he did (she wanted to see how well he could hold the crayon, fine motor skills, what type of pattern he might draw, what his capabilites were, etc.). Then she showed him a piece of paper with a circle on it and asked him to draw a circle on his page, again to see if he was able to interprete language well (not to see if he was actually capable of drawing a circle).

She also gave him a very simple block puzzle to see if he would know/understand to put the blocks in the holes on the puzzle and to assess fine motor skills. She gave him a children’s book and asked him to tell her what was in the pictures. She wanted to see if he could identify the pictures on the page, if he could understand what was happening in the picture (like, what is the boy doing?), and if he knew how use a book (would he flip the pages, look at the pictures, show interest in it, etc.).

She asked him a number of questions like: are you a boy or a girl? what says meow? etc. I believe for younger children, the question might be more like: “what does a cat say” instead of “what says meow”. While most 2-3 year olds know a cat says meow, children with autistic spectrum disorders might have difficulty interpreting the question, or difficulty understanding what is being asked of them. They may just get stuck on the word cat, and if asked “what does a cat say” they might repeat “cat”, for example.

She also played with him a little bit to assess his gross motor skills. She tossed a ball and had him run and bring it back, and threw it to him to see if he could catch it, etc.

I think overall, she was observing his use of language (words and how he used them), his ability to interpret things being asked of him, watching for “stims” (common stims include tiptoe walking, hand flapping or tapping, rhythmic movements, spinning), looking for eye contact, focus/attention, inappropriate play (lining up the blocks), echolalia (scripting or repeating), fine and gross motor skills, etc.

Hopefully this is somewhat helpful! I think it is a good idea to have Taylor assessed by someone who doesn’t know her in order to have a completely unbiased opinion. And if they do notice some specific delays or symptoms that would suggest an autistic spectrum disorder, then that could help fine tune her therapy to meet her specific needs. While Ben doesn’t have an official diagnosis, he meets much of the criteria for Asperger’s Syndrome. Now that he has been assessed, many more avenues have opened up for us in terms of what therapies he is now eligible for, and for that I am very thankful.

[Anonymous]

Thank you so much! I really appreciate the responses. Thank you for giving an insight into what to expect! I guess I’m really just nervous, for the “BIG DIAGNOSIS” but definitely have to get the ball moving in the right direction. I don’t officially have an appointment yet, they are sending me a packet to fill out and send back to them so they can review it prior to making an appointment, so she can see how much time she needs to spend with Taylor and what testing she needs to do.

[Anonymous]

just to give you some hopeful thoughts, i thought i’d tell you about ian. i talked about him on the other thread that was asking about speech delays. ian had a really difficult delivery (emergency c-section without anesthesia–no time to get someone—-major freeway accident had everyone tied up) he had the cord around his neck twice and it was a short cord—doc said the monitor saved his life—before monitors he would have been stillborn. fussy, fussy baby and toddler. spit up tons and cried for 2 years. he had a few words, but really didn’t start talking normally. he would ramble on and on in gibberish with all the intonations of regular speech—-just no words. eventually he would start adding a word at the end of a giggerish sentence. people at church just loved him and his own little language. they had names for it. he also had echolalia. if i walked in the room and said “hi ian” he would say, “hi ian” back to me instead of “hi mom”. he also had self-stimming behavior. if you turned on the vaccum, he would rock back and forth on his knees almost like he was in a trance. as soon as you turned the vaccum off, he would stop. he would do this with a toy car with flashing lights, also. when we took him in for testing for the developmental preschool it was just after we had recently been frog hunting. no matter what question the psychologist would ask him, the only thing he would say was, “spots on frogs.” when he started school, a bus would come and pick him up. when he got home and i asked him what he did at school, all he would say was, “i ride bus”. he seemed to be bothered by the sound of the bus as it pulled up. my neighbor, (worked in special ed) noticed him in class once when they were watching a movie and he seemed bothered. she told them to turn the sound down—-she hit it right, that is what was bothering him. his best buddy for years was also in this same preschool and diagnosed as autistic. ian was never given a formal diagnosis. we did some “patterning” with ian. we put his arms and legs through crawling motions and other various things in hopes of “retraining” his brain.

these two boys are graduating this year. ian has been very active in drama and his buddy was a star on the high school basketball team.

molly used to spend hours lining things up, but she has officially been labeled gifted and talented——so lining things up isn’t always bad.

also, when we picked daisy up from her mission, there was a missionary leaving at the same time who had asperger’s syndrome. daisy said that he had made it through five transfers and that most of the asperger’s missionaries only made it through one transfer.(i think a transfer is a 6 week period) i would not have known this boy was autistic. when he stood to bear his testimony he spoke so eloquently.

there is just a lot of hope for some of these kids with early problems.

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