How/when do you know if your child has developmental delays? I mean beyond something that's obvious from birth? I know there's a HUGE range of "normal," but I also know that early intervention is the best course of action if there is a problem. Catherine has been on the slow end of normal to hit her gross motor milestones, but she can't wave bye-bye, has no words, is no where close to walking.

Is the Denver II Developmental Assessment still the measuring stick for young children? Trey had it done by his ped when he was 33 months, and he measured between 5-6 years on everything. I want to ask Catherine's ped about it at her 12mo check-up in a couple of weeks. I wish I could find Trey's report (it's in one of our 200 moving boxes in the garage) and I could do a quick and dirty assessment of her myself.

I'd like to know the same thing, Lesley. Good question.

You know Lesley, I was just thinking the same thing after reading one of Sara's posts. I've never heard of the Denver II? Is it something that peds do or do you have to take them somewhere else?

Sandy,

I don't know who would "normally" administer it, and it's not a standard part of any childhood check-up. We just did it with my son because he was exceptionally bright. I'd never heard of it before then. I imagine it's something you have to ask for.

Here's some info I just found online:




Cognitive Milestones
Month 3-5: Attends to and Reaches for objects
Month 4-8: Pulls string to secure a ring
Month 8-15: Imitates patting doll
Month 14-20: Finds Hidden Object
Month 18-28: Completes simple puzzles

Language Milestones
Month 1.5-3: Squeals
Month 3.5-8: Turns to locate a voice
Month 9-13: Says Mama or Dada
Month 14-24: Combines two different words
Month 21-36: Uses plurals

Social and Emotional Milestones
Month 1.5-4: Smiles at others
Month 4-9: Seeks primary caregiver
Month 8-15: Stranger anxiety
Month 10-15: Displays 2 or more recognizable emotions
Month: 11-20: Exploratory play by self
Month 21-36: Cooperative play in small groups

Gross Motor Milestones
Month 2-4.5: Rolls Over
Month 5-8: Sits without support
Month 10-14: Stands Alone
Month 14-20: Walks up steps
Month 21-28: Pedals tricycle
Month 30-44: Balances on one foot
By age 6: Rhythmic skipping
By age 8.5: Alternates foot-hop in place
By age 10: Holds tandem stance for 10 sec (eyes closed)

Fine Motor Milestones
Month 2.5-4: Grasps rattle
Month 4.5-7: Transfers cube hand to hand
Month 8-12: Has neat pincer grasp
Month 15-20: Builds tower of four cubes
Month 18-24: Imitates vertical line
Month 28-36: Copies circle
By age 5 years: Draws a square
By age 5.5 years: Tripod pencil grasp
By age 7 years: Draws diagonal line
By age 9: Draws cross with same dimensions
By age 12: Draws three dimensional cube

Self Help Milestones
Month 4.5-8: Feeds self crackers
Month 10-14: Drinks from cup
Month 13-19: Removes clothes
Month 18-28: Washes and dries hands
Month 30-42: Dresses without supervision
Attained on average by age 4.5 years
Rides a Bicycle (http://www.fpnotebook.com/SPO4.htm) with training wheels
Cuts paper with scissors
Colors inside lines
Attained on average by age 5.5 years
Ties shoelaces
Prints first and last names
Attained on average by age 6 years
Rides a Bicycle (http://www.fpnotebook.com/SPO4.htm) without training wheels

References
Frankenburg (1990) Denver II Developmental Screening
http://www.fpnotebook.com/GoInfo1.gif Blondis (1999) Pediatr Clin North Am 46:899-913 (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=search&db=PubMed&term=Blondis [AU] AND 1999 [DP] AND Pediatr Clin North Am [TA])

Uhhhh ... under gross motor, where is actual walking? LOL

We go from standing to walking up steps????

Sam was enrolled in our infants and toddlers program --He had obvious issues from the start--the referral came from the NICU social worker. It can also come from the ped. He was evaluated by a special ed teacher to determine what services he needed. I would talk to your ped if you have concerns.

Lesley,

The 'normal' range for walking goes up to 18 months. With Evan, I knew that he was delayed long before the doctors did. Sad, huh? When he didn't sit when placed at 9 months, I knew that something was wrong, but since it falls within the range of normal to sit when placed at 10 months, we had to wait even longer for intervention.

What is Catherine doing developmentally as she heads towards her first birthday?

Gross Motor Milestones

Month 2-4.5: Rolls Over
Month 5-8: Sits without support
Month 10-14: Stands AloneSee, Zac can do all those thigns, just cannot "get into those positions" unless he's placed that way. That's waht puzzles me, I guess maybe it IS just his big head/balance issue. All the other areas he seems well at or advanced in according to this.

Thanks, Janette. I was hoping you'd pop up this morning!

Catherine seems advanced in some ways and behind in others. For example, she's been able to participate in playing ball, purposefully rolling it back and forth to me, for over a month. She tries to stack blocks. She seems like she can take in and process information; she just can't reproduce a lot of it or seem to know that she ought to try. Like waving bye-bye. She doesn't mimic. She doesn't talk. She makes a lot of growling and "sssssss" and "zzzz" noises, like buzzing. There seems to be a disconnect between input and output. It's hard to describe what makes me think there might be a problem because she IS still within the range of normal albeit at the low end.

Often kids with an older sibbling speak later, b/c they have someone to do the talking for them. If she's drops off the lower end of normal, I'd certainly get the speech especially checked, and just to set your mind at ease, you might want to have an evaluation done anyway.

I thought about that, Janette, and I can see it happening with siblings that are closer in age. Like a baby and a preschooler, maybe. Trey doesn't spend enough time with her, I don't think, for it to have any impact on her speech. We've been working on a few single, simple words for a long, long time (months!) with no impact. Words like "up" and "milk." She knows what things are because if I say where is Baby Bear, she'll go get it (her fave stuffed bear).

I had always thought it would be the other way around. I attribute the other girls in Lauren's daycare class to be so advanced because they do have other siblings. I just wish Lauren did because she loves other kids, and especially loves playing with her 3 yo niece, Addison, they'd stay up to the wee hours of the night playing.

I think that is true of gross motor skills, Sandy. They acquire gross motor skills faster in an attempt to keep up with the older sibling.

Maybe I'm really stupid, but could someone explain the different classes of skills to me. Gross, motor?? Lesley?

Gross motor: Large muscle movement/skills...balance, running, bouncing, etc.
Fine motor : small muscle skills...writing, tracing, pincer grasp, etc
cognitive: thinking/brain problem solving, etc
what else is there?

I think I said this is another post, but my brother was SOOOO far behind in all the normal milestones, but my mom also claims that he was extremely intuitive and curious and spent all of his time checking things out. She took him to several specialists after the ped actually worried about a delay. He didn't walk or talk until between 18-24 months. He is now 25 and a sucessful architect. (He still doesn't talk much, but we all know he's very smart!)

I thought about that, Janette, and I can see it happening with siblings that are closer in age. Like a baby and a preschooler, maybe. Trey doesn't spend enough time with her, I don't think, for it to have any impact on her speech. We've been working on a few single, simple words for a long, long time (months!) with no impact. Words like "up" and "milk." She knows what things are because if I say where is Baby Bear, she'll go get it (her fave stuffed bear).
Have tried adding signs in with the words? Just keep on keeping speech really simple for her, as in one to two word sentences.

Gross motor: Large muscle movement/skills...balance, running, bouncing, etc.
Fine motor : small muscle skills...writing, tracing, pincer grasp, etc
cognitive: thinking/brain problem solving, etc
what else is there?
Oral motor: the mouth area--speech and eating

Lesely, understanding of language (receptive) and use of language (expressive) are not equal in the early development. Young children should understand more than they can express. Using true words at 12 months is not considered a delay. There are other things to consider- ability to follow simple commands, is the child producing sounds or trying to imitate sounds or actions, the child's social interaction with others, does the child make communicative intents like pointing or reaching for things they want and persist so that an adult will meet their needs. Try not to focus on single milestones but the big picture. Like Janette said most parents know when something about their child is not just right. Do you feel something is not right or just concerned about the numbers? If you truly think she has a significant developmental concern by all means speak to your ped b/c parents know more about their child than anyone else and should go with their instincts when they think something is wrong. I would be more concerned if she had no words by 18 months than at 12 months or if she did not understand directions or if she wan't socially interacting with you or using communicative intents. I hope this helps set your mind at ease a little. Take care.

There are other things to consider- ability to follow simple commands, is the child producing sounds or trying to imitate sounds or actions, the child's social interaction with others, does the child make communicative intents like pointing or reaching for things they want and persist so that an adult will meet their needs.

Thanks, Pam.

Imitates sounds - no
Imitates actions - yes, after a lot of practice with her
Interact with others - maybe, not affectionate, hits a lot to get you away from her
Pointing - no
Reaching for something she wants that she cannot get for herself - no

I know it's early yet. Just trying to be proactive with these niggling little doubts.