What should she be doing? Is it AS? Advice please

Discussion in 'General Parenting' started by therese005us, Jul 2, 2009.

  1. therese005us

    therese005us New Member

    Okay, little cherub is 21 months. When I picked her up on Friday last week, she was very withdrawn/impassive. No eye contact, or engaging in peekaboo. No language. She's only been walking about 6 weeks, if that. Just a blob comes to mind. Over the weekend we were at my friends' place and they have lots of hands to hold a baby. Bubby was happy to be held anytime. Didn't squirm or try to take off anywhere. If she's let down, she just toddles around. Most of the weekend she wasn't investigating anything. We tried to saturate her with stimulation of one kind or another, talking to her. She ate well. We fed her, but she manages finger food. After a while it was clear she has some hand/eye co-ordination, she picked things up, and tried to place them. Sometimes successfully. Still no real eye contact. Oh, and she laughed for no reason, and flapped her arms. (just trying to remember some of these things).
    This week, still no language - I know she doesn't talk. bio mum had her one session to speech therapy.
    Not sure if she reacts to name. Doesn't come when called, or turn when called. Not interested in feeding herself. Can't drink well from a cup, but will drink from bottle (bio mum says she drinks from a cup - not so!) Eats finger foods well, have noticed that she will try to place something into hole etc. and with some success. Toddlign around and taking things out of shelves, tried to put on DS's underpants over head... (clean ones) will laugh if I blow on her tummy while changing her, is making some eye contact. Everytime I try to take a photo of her, she hides her face - isn't that interesting? Without fail.... she will go and turn her back!
    Still happy just to be held, but will toddle around if I put her down. Doesn't interact in play with others, but will pick up blocks, and anything else in pathway and carry it.
    Any ideas? I can't think what she should be doing for her age. Oh, she loves her tucker.... and opens her mouth for it when i start feeding her. Grunts a bit if I'm too slow.
    I would love to have her longer and get her to some speech therapy... what other Occupational Therapist (OT) should I be doing with her?
  2. Fran

    Fran Former Site Owner

    Simple picture books comes to mind. You pointing at the pictures and saying the words. Asking her questions even if she doesn't answer. "do you want to read book again?" or "is it time for you to eat?/nap/cuddle/play"
    Sensory type activities-sand play or shaving cream on a tray to play with. Stuff like that always seemed successful.

    Initiating interactive speech sounds like something she would benefit from.
    Listening to music may be something that pleases her also.
  3. DDD

    DDD Well-Known Member

    There is such a huge difference in young children that it is hard to figure out what is "normal" and what is not. When easy child/difficult child was a baby and lived with us I researched (maybe on Amazon??) to find a book that was a guide by age. It was really really valuable for us. The author was a specialist and stressed that each baby/child was different. on the other hand there was a guide by age of what usually happened developmentally and a range from slow to gifted. I gave the book to GFGmom when she had difficult child but I don't think she used it. Sorry I don't remember the name but I highly recommend having a similar paperback guide. Good luck. DDD
  4. nvts

    nvts Active Member

    Hi! You might want to look on the web for info. re: infant sign language. It works with kids that are "non-verbal" and allows them to let you know what they want. Otherwise, some kids get "stuck" on a phrase that prevents them from moving on verbally. My cousin was over two before he said a word. One day his mom was vacuuming and he looked at her and said "indescribably delicious". Aparently he got "stuck" on the Peter/Paul Mounds commercial on TV and wouldn't talk until he got that out!

    Truthfully, I'd be looking into AS info. This little one sounds like she's going to have trouble with bio mom soon if she doesn't shape up (1 speech lesson!).

  5. susiestar

    susiestar Roll With It

    I would first look for a copy of "What To Expect the Toddler Years". It will give you a general idea of what milestones could be expected. Then contact your County Health Dept and ask for a screening or developmental checkup. Or else contact a pediatrician and get her in for a screening as soon as possible with them. county Health Dept should be free, while the pediatrician may be covered by insurance or may not be. Around here the County is incredibly thorough. If they learn here that a parent refuses to take a toddler to appropriate therapy it quickly becomes court ordered. And then custody changes hands to a relative willing to help or at the least a guardian is appointed to oversee things. In cases of divorce, the judges will only remove custody from shared parenting if the child is abused or if they are not being given the therapy/treatment needed. It isn't done willy nilly, or easily, but for parents who flat out refuse treatment after being told and shown it is needed (and the County pays for ALL of this treatment - speech, Occupational Therapist (OT), PT, nutrition, shots, help with reading, ALL of it is available at ZERO cost regardless of income - and THIS is why the courts will give 3 or 4 warnings over six months and then take custody away from the parent who will not let the child have the therapy. It has been the only way some child abusers have lost custody if the child is too scared to point the finger at the abusive parent. It is NOT done lightly.)

    We also have a program called "Success by Six" that promotes good care in those critical early years. It isn't just about reading in our county - it is about all aspects of a child's development. They can be accessed and are part of the head start program.

    Actually, contacting Head Start might be the way to find help if hte county doesn't have it. I am NOT talking about the County Mental Health, but about the Health Dept.

    I would do my best to get a complete evaluation while she is with you. Then, if biomom will not take her to appts or therapy or checkups, you may be able to intervene.

    I also strongly suggest an Occupational Therapist (OT) evaluation for sensory issues and for problems like low muscle tone. It isn't always apparent to a parent what low muscle tone is. thank you could go and go and go all day nonstop but he also had low muscle tone. He didn't build up tone the way he was supposed to, and the Occupational Therapist (OT) helped with that quite a lot.

    Above ALL else, enjoy her, talk to her, keep her close to you (physically close, use a sling or carrier if needed, it can help sometimes. Worked wonders with the little girl a cousin adopted from China. She was put into a sling at 20 months and within six months was responding to verbal requests, had started to babble and coo where before she made no sounds vocally, there is something about the attachment that you build when they are close enough to hear your heartbeat that really helps develop a bond and stimulate development. I don't know why it works, but it seems amazing with the children I have seen it used with.

    Have a good time with her!

    oh, Tana Hoban has picture books (the kind on cardboard) that have great black and white pics and some with faces. They were something every one of my children and every child I gave a copy too came back to over and over and over. They seem to appeal very strongly to toddlers. I know one was called Black on White, another was White on Black. Here is a link to her books on amazon: http://www.amazon.com/s/ref=nb_ss_gw?url=search-alias%3Daps&field-keywords=tana+hoban&x=0&y=0.
  6. Marguerite

    Marguerite Active Member

    Trish, there are so many possibilities still, it could be anything. Certainly what you describe fits with autism, but it could also be global developmental delay, it could be simply lack of stimulation, it could be a hearing problem...

    What you need to do, is pretty much what you are doing, only you needto document it. Write it down. Observe her and make a list of what you feel needs to be queried. Anything she does cute is worth listing here too - we so often forget these things even when we are convinced it was so memorable...

    Other things you can do - test her hearing. What do you KNOW she will respond to? I tested te chocolate wrapper crinkle test, I knew my kids would respond to lolly wrappers at 20 paces! If she responds to her name - that is great, and a good sign. But if she doesn't - again, it could be a nuber of things. difficult child 3 at this age did not respond to his name, it was as if he didn't have a name or understand any meaning. His verbal utterances were repetitive and seemed like language because they included chunks ofwords from songs on the radio. I had him in occasional child care a lot which meant a lot of driving in th e car with the radio on; he learnt to sing entire songs but te words sounded 'blurred' and any incidental instrumental sounds in the songs were mimicked as well. Thinking back, he must have had a phenomenal memory to be able to reproduce such long strings of phonemes when he had no comprehension to help the memory along.

    What you need to do - intense play and stimulation. As much stimulation as she can handle across as many different sensory areas as possible. Introduce touch, sight, sound, smell and taste. Talk to her all the time about what you're doing but keep your sentences simple and slow. Reduce the number of your words. See how she responds to this - it was what we were advised with difficult child 3 by speech pathologists in a class situation. Other kids responded brilliantly, difficult child 3 responded with anger and hostility. It's supposed to make it easier for tem because tere is less for tem to concentrate on. Too much complex language can make comprehension too difficult and a kid can give up and not try. In difficult child 3's case he knew what language was supposed to sound like and when I shortened it he felt patronised, I think, and showed his displeasure by turning his back and being oppositional.

    Other things I did with difficult child 3 - this was from following my instincts and giving him more of hwat he responded positively to. He loved watching TV and DVDs especially if tere was writing on the screen - difficult child 3 turned out to be hyperlexic (from my understanding, hyperlexia is a subset of high-functioning autism and also Asperger's).

    If she has language delay, she would be more likely to get a diagnosis of autism rather than Asperger's. At least in Australia. But a diagnosis of autism doesn't necessarily mean a worse prognosis - I personally thiink difficult child 3 is more capable than difficult child 1, even though difficult child 1 never had any language delay. But he has other problems which difficult child 3 doesn't have. It's aspectrum and you can run the gamut in each diagnosis.

    Other things I did - I sat difficult child 3 on my lap while I played piano. Then I noticed how he tried to play NOT by bashing at the piano but by gently pressing the keys and choosing harmonious sounds. So I used his fascination for letters to help him learn to play a tune (ABC song, of course, which he already had learned to sing by copying me). He was still mostly non-verbal when he was learning to read sheet music - again, a step-by-step process using his obvious fascination for music and letters. And no, she's not too young if she shows an interest. difficult child 3 was an interesting mix - before we realised there was delay, we thought we had a child genius. we were getting ready to have him accelerated into school when we realised suddenly, he would be too delayed in other areas and pulled back.

    Problems difficult child 3 had - he didn't talk. He didn't know his own name, nor did he know anyone else's. He didn't even know "mummy". The usual baby games of "where is baby's nose? where is baby's mouth?" he couldn't play, he never 'got' it. He was slower than most to recognise his own reflection. But he was fascinated very early on (a week old) with the flicker of light through leaves on the trees (very similar brain effect to hand flapping). easy child actually found te key for difficult child 3 - a facial expression game (weird, considering the social learning problems in autism). We would sit by the large bedroom mirror and make different facial expressions and name them. Happy, sad, angry, confused, scared - we would make each face and name them. Of course, it's a single word. That fit with what the speech pathologists told us. And soon difficult child 3 would have a turn at making the face, copying the way we had done it.
    A follow-on from this - when he finally started school at age 5, he would at times say to his teacher, "I am angry," and put on his angry face from the game. very fake-looking, very stylised, but I had to emphasise to his teachers - just because the expression looks fake doesn't mean his stated emotion isn't very real. he wasn't acting when he told people he was angry, he was using every tool he had (his words pplus the older facial expressions game) to show them how he felt.

    If you can get your hands on the book "Son Rise" it can give you some ideas on what the father did in that book. But basically what he did was meet the child on his terms, instead of trying to program the child to the father's. So when hhis son was sitting on the fo=loor spinning plates the dad got his own plates and sat by his son, spinning plates. At first he did it to try to get his own head into what it must be like for his son, but what hapened was - he was showing his son that he really wanted to be with him and do what he did. This introduced the son to the concept of sharing and togetherness, and from there they began to build bridges to one another.

    if the problem is global developmental delay of some sort, stimulation is still the way to go. There is a developing brain in there which I strongly suspect has been under-stimulated. This can be a problem for ANY kid, but if there is an underl;ying disorder it just makes things so much worse. Brain pathways are being forged all the time, the younger the more. So utilise this and give those new pathways a direction and job to do. Make a textures box and as you get them out to touch them, tell her what they are. Squishy, wet, furry, fluffy, rough, smooth - it doesn't matter what you call them as long as you are consistent.
    Have a sounds box - bell, block, cymbal, squeak - whatever you can put together easily.
    We labelled things around the house - I printed words off the computer, cut them out and stuck them onto things around the house. Door, window, fridge, cupboard, TV, radio - whatever, wherever.

    I let difficult child 3 use the computer. We actually found one on the council clean-up and re-worked it so it had all the baby software on it, then let difficult child 3 loose on it from about a year old. I think he was actually younger. By 2 he was typing the alphabet and reading the toolbar text to make the computer do what he wanted it to do. The first word he learned to read was "quit" (Apple Mac) and the second, interestingly, was "exit". And "stop" (we think, from stop signs on the road).
    Numbers - teach her to count on her fingers. Only in English - it's important to keep all other languages away from her until she is fully verbal. Multi-lingual kids seem slower to talk because they're trying to assimilate more than one language at a time. But for 'normal' kids this isn't a problem. If there is a communication delay, a second language can really throw a spanner in the works, until the child can handle it. difficult child 3 has since learned German.

    I suggest you enlist the other kids to help with this stimulation. It will help them in so many ways also. They may be lacking some of this somewhere in themselves and it can help consolidate teir own progress, to be part of what you are doing for their sister.

    Something else I did for difficult child 3, I actually had started it for easy child when I was going through that ridiculous "Teach Your Baby to Read" stuff (babies will learn only if their brains are ready, but it doesn't hurt to try) - I set up a hard-paged photo album. These can be picked up for nicks at op-shops now we're all going digital. I printed out or drew a picture of the word (I drew my own face for "mummy") and wrote the word underneth, then put the picture and word on one page of the album. I then went through the album putting a single word and related picture on each page. Members of the family should come first, then pets, then any other words you want her to learn. Sit and read it to her often, get her to turn the pages. Encourage her to tell you what the words are.
    Because it's hard-paged, it's very difficult for a baby to wreck it. Because the'yre so cheap, it's easy to replace it.
    I also made small paper-only disposable books done the same way. Fold a sheet of paper in half; turn, then fold again. Turn, then fold again. Staple down one side, tape over the staples then cut the folds to release the pages. It by now should be small enough to fit into a pocket so the baby can read it whenever she wants. If she chews it up or feeds it to the dog, it's easy to make another. As she learns or needs a new word, it's easy to add one.

    You will find what works best for her, but whatever you do - tlak to her, stimulate her, spend time with her, work with her (and the other kids). Tell her what you are doing. And when you put TV on for her, try it with subtitles. Do this for the other kids too unless they specifically ask you not to. But where possible - push the subtitles. Because it adds anotherlayer to learning communication.

    Wherever you find a chink of progress or interest, work with it and try to make the chink bigger.

    And keep records. Note what you do, what she does and how old she is when she does it. Record her progress because it will seee to you that progress is very slow, but it won't be. A lot of stuff goes in inside their heads and you feel you're gettingnowhere, but then one day she will just leap ahead and you will wonder how it happened.

    difficult child 1 seemed to not be able to read. He made zero progress. Then one day he picked up a book and read it to himself, then got another book and read that. And another. He hadn't been able to read that morning, but by evening he was reading fluently.
    Sometimes progress can seem that freaky, but it's because of all the work that went ahead.

  7. Marguerite

    Marguerite Active Member

    Following on from Susie's thoughts - have you had her checked out or listed with Community Health Service in your area? Also since you've got fostering in place, will DOCS assess her for hearing and language? They stepped in with difficult child 3 until they realised that his reading and piano playing meant he would test out as above average IQ and they could only help if he was "retarded". Even splinter skills would not be enough.

    Also, the nearest capital city to you has some really good testing (neuropsychologist) which would be good to hook into for the other kids too. There is a wait but it's worth it if you can get neuropsychologist testing done on Medicare. You would need a GP referral but it shouldn't be too difficult.

  8. SRL

    SRL Active Member

    (Just a note to responders: this parent is in Australia so programs in the US won't apply)

    There's a pretty comprehensive developmental checklist here. Whether it's from lack of stimulation, some kind of delay, or she's just taking her time, in my opinion there are some red flags here.
  9. susiestar

    susiestar Roll With It

    My advice for where to go to look for help isn't as accurate because I didn't realize you are in Australia. Marg has added great resources to make it work in Australia (thanks, Marg).

    I want to add that the more of her senses you can involve in any activity the faster she will learn and remember it. If she hears it, the "it" will penetrate. If she hears "it" smells it, sees it and touches it and tastes it then she will be exponentially more likely to be able to use her knowledge about it. The more you can involve more of her senses, the faster she will make progress.

    I didn't make this up. I learned it in a college course on study skills that I took because I had no idea how to study (even though I had a major academic scholarship!) There is good research done that proves this, though I don't have the citations easily at hand.

    I hope you have lots of fun with her, figure out what is going on, and give her plenty of time and stimulation then in the end things will turn out well.
  10. therese005us

    therese005us New Member

    Thanks everyone for your advice, really helpful.
    Marg, I'm not officially fostering the bubby, though I wish I was. Bio mum is very receptive to suggestions at the moment, so perhaps I'll start there.

    Last night I was cleaning up and discovered some blank five year diaries, they have five spaces for each date. I thought I might start on one of those right away, and record about each child.

    I looked up what her milestones should be for the age, she is barely covering milestones for six months!

    However, since we have had her here, she has improved through stimulation, I'm sure of it. She's happier, smiles more, etc.
    She pulls things down, tries to put things into places;
    She turns when I call her name
    She will stop when I say no and turn to me
    She definitely hears.
    She will laugh if I blow on her tummy
    She says no, by turning her head, ever so imperceptibly
    She says yes, by nodding slightly - I was feeding her banana and asked did she want more, she nodded. Then when she'd finished the piece, she looked at me, and nodded again! it was so cute.
    She pointed to the food, when she wanted more.

    She doesn't know where her nose, ears, etc. are when asked.

    This family would make a great study. There are 7 adult children. Mom was 13 when she had her first child. They all have intellectual disabilities.
    The progeny - 13 of them - at least 8 that I know well, have severe intellectual/behavioural problems. There are 4 I have had nothing to do with thus far.
    There is one success - DD12 is biologically a member of this family. She is well adjusted, and extremely talented musically. Which proves that environment has a lot to do with how we turn out.

    I pray I can stay involved withthe family and help more. However, DD12 is not happy with this arrangement. She wants to forget she ever came from there......

    At least I can try to help little Cherub8 over the next twelve months. I can't change her intellectual disability, but perhaps I can help her reach a better potential.

    Keep the ideas coming.... I appreciate them.

    I've already typed this once,and it disappered on me.
  11. Marguerite

    Marguerite Active Member

    I think you're on to something with your observation that daughter is fine and the others are not - stimulation (or lack of it) can make a HUGE difference.

    My sister adopted a couple of kids as well as had three of her own. I was in my teens when she had her family, I remember both the adopted kids arriving. They were deferred adoptions, fosgtered first for a couple of years because they had problems. The boy was expected to be developmentally delayed, he was 10 months old and barely able to sit up; he needed to be propped up. He just sat and didn't respond. But with stimulation, he quickly made amazing progress; he was crawling within a week. He finally walked at 11 months, a couple of weeks earlier than my sister's natural child.

    We made the switch to actively playing with him instead of just letting hi sit. Apparently his grandmother had custody of him and was just too busy to spend time with him.

    The girl was 7 months when we got her. She refused to be held, wouldn't drink warm milk while being held, the only way she could be fed was with a cold bottle of formula in her cot. If you tried to cuddle her she would push you away. All the photos we have of her at the time, she was thin, pale and sitting away from the person holding her with stiff spine. She looked gorgeous because it gave her wonderful posture, but she never cuddled. However, her own children - no such problems. And she herself is a wonderful loving mother.

    A classmate of easy child 2/difficult child 2's had a profoundly autistic younger brother. WHen the girls were 13, this boy was 8. He was non-verbal and totally wild, like Helen Keller (before Annie Sullivan) in the various movies. The mother had simply given up, even with her daughter (who increasingly obviously had BIG problems). The boy was allowed to do whatever he wanted and whenever she could, she put him in respite. I had the girl over a weekend or two to give the mum a break and quickly realised she was using me. easy child 2/difficult child 2 rapidly found the girl too difficult, but the mother kept asking if the girl could come and stay. I had to start saying no, the girls were not getting on well any more and also the mother was asking at times when it just wasn't convenient. I later found that she had put the boy in respite for that weekend and wanted her daughter gone too so she could go away with her boyfriend of the moment.
    The woman dropped in on us a few times and would let her son wander round our house unsupervised and uncontrolled. Because difficult child 3 was so easily upset about his things being touched, I had to follow this boy around the house to supervise him, while the mother sat there and chatted to husband (who had a sprained ankle and was stuck in the armchair). In an effort to keep the boy from wandering, I got out an alphabet toy of difficult child 3's (I LOVE Leapfrog!) and whaddayaknow? This non-verbal boy knew his alphabet and could read simple words. His mother had NO idea he could do this, when I pointed it out to her she seemed to not care. I got a sort of "Yeah, can he? Well, perhaps, I hadn't noticed," then she went back to whatever she had been talking about.

    She later lost custody of him and didn't seem to even mind that - she had a new baby to play with, her daughter got pregnant at 14. But she did tell me that in foster care, her son was learning to talk and to do things for himself, something she had never thought he would do. Well, of course he won't, if you don't ever teach him anything!

    Some people make me so mad I could spit.