9 month old delayed?

[swesselpa]

I have concerns regarding my nine month old daughter. I have spoken with her doctor who feels that she is "slow" but still OK.  She didn't want to see her between her 6 and 12 month appointments.  I was 42 when she was born, but had a normal pregnancy and repeat C-section delivery.  Apgars were 9 and 10.  Feeding hasn't been a problem at ALL!  She seemed a little slow to coo and smile and we have yet to hear a real belly laugh.  She is pleasant and smiles a lot now.  Will coo vowel sounds but no consonants.  She is very attached to me and is afraid of strangers to the point she will scream if anyone tries to talk to her.  She has gotten better with the immediate family.  Interestingly this doesn't apply to kids (she loves and responds to them!)  She will get excited to see us and stiffens her arms and legs in response, but I see no other abnormal muscle tone.  She cuddles and makes good eye contact. I have no concerns about her sight or hearing.

Gross motor development seems delayed. She hates being on her stomach and will not roll from back to stomach but rolled the other way at 7 months with lots of coaching.  Now if we try to do tummy time she immediately rolls over.  She will sit well when placed and has since 6 months.  She does not crawl or pull up to things, but will stand for quite some time if placed there and seems to understand holding on. She will even lean on the couch and play with a toy while standing.  She has great head control, passes things from hand to hand and is developing a pincher grasp.  She'll feed herself cheerios and crackers. I have seen her drop things on purpose and look for them. A month ago she was doing "so big" but has now forgotten how.

While I know that children develop normally in a wide range, I just have this gut feeling that something isn't right.  Our 3 year-old was quite precocious and my husband thinks I'm just overreacting.  Do you think it's time to see a developmental pediatrician?  I know that early intervention is important and want the best for my child!

Thank you!

[Kevin Kennedy, Ph.D.]

Your descrition does not indicate a cause for worry. I would take the pediatrician's reassurance at face value. Now, I also understand that a parent's worry may well not go away in the face of advice such as this. Be that as it may, even if mostly for your own reassurance, it would no do harm to seek a second opinion. But nothing in your comments indicate a cause for alarm. Development does not proceed in one steady, continuous slope in all the various areas. All children have their aspects of unevenness.

[tomel]

Sorry I know I'm answering before the doc but coming from experience.
The Biggest thing is keep an eye on her communication. Not words but gestures pointing (this is the biggest one) nodding the head for yes or no, clapping, waving. These should appear by 12 months old,especially the pointing. These may not seem like it but they are big.

Get a DEVELOPMENTAL pediatrician or specialist, not just a regular ped.
Heres from the CDC watch for early signs for 1 yr.

Developmental Health Watch
Alert your child's doctor or nurse if your child displays any of the following signs of possible developmental delay for this age range.

Does not crawl
Drags one side of body while crawling (for over one month)
Cannot stand when supported
Does not search for objects that are hidden while he or she watches
Says no single words ("mama" or "dada")
Does not learn to use gestures, such as waving or shaking head
Does not point to objects or pictures
Experiences a dramatic loss of skills he or she once had

[D99G03]

I just want to mention that my son, now 7, was very similar in some areas --- except he loved ALL people, was ridiculously happy literally ALL the time and was very social from the get go.

Funny that I read this tonight, because today we were looking through his scrapbbok and these details are fresh in my mind ... he did not sit up without support until 9 months old.  He rolled belly to back at 3 1/2 months but did not go back to front until 8.5 months.  He crawled around a year or so (I can't recall), and walked at 15 months.  He was extremely vocal, but only said a word or two a few times, around a year.  And then stopped.  He did not speak another "real" word until after his 3rd birthdy, once I had him in special needs preschool.

Amongst other concerns, I just (as you do) knew in my heart something was not right.  I knew from before he was a year old. When I questioned things like motor stuff, or speech development, my Pedi. put me off constantly saying "oh boys" "they develop slower that girls" and blah blah blah. He was my first so what did I know?  I believed him ... kind of, hopefully, but I truly knew otherwise.  Finally, after seeing an Autism documentary on PBS, at 33 months old I put my foot down and found out about Early Intervention programs from the doctor.  My son was very similar to the boy profiled in many areas.  He is pretty "typical" but has some issues today with ADHD and language based issues with processing etc., but far from the Autistic-like behaviors he originally exhibited.  

I have learned so much from the years of stuff that I have gone through with him and I have taken away one big lesson ... basically what I want to impress is the bottom line, that you are the mother here and GO WITH YOUR GUT!!  If your Pedi. puts you off, go it alone.  It's a lot of work but well worth it if it turns out she needs help in any areas.  And if she doesn't, then so be it, but at least your not saying "if only I ..."  My only regret is that I  waited so long to put my foot down, because you are right ... Early Intervention in KEY!!

Best of luck.  Your an excellent mom for even aknowledging there may be an issue!!  Go with your gut and you won't be sorry!!

[swesselpa]

Thank you both for your advice.  I just have this fear of getting laughed out of the dev. peds office.  You are right though, I don't want any regrets and if she is normal, just developing at the beat of her own drum....well, silly me and no loss!  I appreciate the CDC list!  Thanks again for speaking to me out of your experience!  It's so relieving to hear from people that don't think I'm overreacting!  Tomel, is your child autistic?

[tomel]

My son has never been diagnosed because I started him in early intervention at 19 months and because he has made ALOT of progress. He also never exhibited all the symptoms needed to meet the criteria for "diagnosis".
I like you knew there was something a little off when he was 1 yr. old. I found a great Dev. Specialist who kept a very close eye on him and got me in to see a Dev. Psych. who put him "at risk" so he could get services. He has pretty much had every service under the sun. I also started gving him Omegas at around 20 months or so. At age 3 we were told he is still "At risk Pddnos" but never given a full diagnosis.
If you find a dev.ped. who laughs at you well you find another one then. Anyway I dont think that that will happen and that should be the least of your concerns.
One word of advice and it is something that can never hurt. Start teaching her sign. they can learn it at a young age. It will help alot if she doesnt learn to communicate on her own.
When they get older if they cant communicate they can get VERY frustrated.
I am guessing (although Im not an expert) but had a very good OT your daughter might have mild hypotonia.
Is your daughter using any gestures?

[tomel]

heres the CDC website


http://www.cdc.gov/ncbddd/autism/ActEarly/milestones_1year.html

[swesselpa]

She may have some hypotonia.  At four months old, she would push up off her stomach for a little while then would lay her head down as if exhausted.  She still will just lay there sometimes if I lay her on her stomach and although she will roll over to her back, still has trouble at times doing so... (and shouldn't at this age).  As far as gestures, she will attempt to clap her hands if we say "yeah" (both arms go up and down and toward midline but don't always connect) and will splash in the tub if we just say "splash".  She still likes to bang things on her high chair tray and will bang toys together.  I know they talk alot about flapping...I'm not sure if this is what they mean? She doesn't wave bye bye or point at things.  She will lean over if you hold her like she wants down if there is a toy or something of interest. The other weird thing she does is kick her legs in unison and flop them on the floor.  She doesn't seem to do it to move herself along and it's something she'll do as she is falling asleep and sleeping.

We taught our 3 year old to sign as a means of early communication and it was so wonderful.  Much less frustration.  I am starting with this one as well, but she hasn't picked any of it up yet.  I need to be more persistent with it, don't I?  

This is my 5th child.  We have no family history of anything, but my husband did have "trouble" in school. I'm so worried about her I can't sleep.  I think I will make the appointment with the Dev. Ped tomorrow.
Thank you so much!

[tomel]

With the sign do it with her hand over hand. If you have to improvise some of them to make it easier for her. Even if its only a sign that you and your husband understand. Ex for my son we improvised the sign for help, instead of what it is normally we just taught him to raise both his arms if he needed help.
Some of the signs of are to hard for some kids who dont have the motor dexterity.
We dont have a history of anything in my family or my husbands. Of course alot of things werent under such srutiny yrs. ago as they are now. In fact on my mothers side some members of the family are members of MENSA.
You are doing the right thing by nipping it in the bud now. And it is very tru the earlier the better. If there is nothing wrong , Great, If there is she will make wonderful progress with the right intervention.

[tomel]

One thing about hypotonia is when you pick her up is she like a bag of "wet noodles" does she just just kinda sit in your arms, not using alot of her body or arms to hold herself. That is usually a good indicator.
If you think your daughter might have this I would be happy to tell you some things we did with my son to help strengthen his trunk. My son had a very dood OT from 19 months to 3 1/2.

[tomel]

Sorry its me again.
Another question does your daughter imitate things you or anyones else in the family does? This is also a language builder.
With the pointing you can even start doing it with her hand over hand so she gets the idea.
Another thing (dont want to scare you more) alot of children with delays have seizures. This may be something else you want to mention to the doctor.
My son has had an EEG to check this. It has kind of become a common practice with alot of "delayed" kids.

[swesselpa]

Actually, Ellie will hold herself up when you carry her and has been hooking her arm around my arm to support herself for about a month.  It took her longer to learn this, though.  I'd be happy to try some exercises with her...it couldn't hurt.

So far, I've tried to get her to imitate us, but she just doesn't seem to get it.  She may do something once, like put a block in a little tower, but then won't do it again.  She will imitate facial expressions and mouth positions (like O) and will blow raspberries if you do it.  My older daughter has an Aquadoodle toy and she'll imitate us drawing with the marker in her hand.  Can't tell though if it's imitation or the noise she likes.

Thanks so much! It is so nice to have someone so resourceful to talk to!

[tomel]

Then she may not have hypotonia.
But the best thig to do is get her to a good dev. doc. Let them know your concerns, mention these things to them. Make a list so you dont forget anything. If they poo poo you , just dont let them. Be firm and stand your ground and have them take you seriously.
If you have had 4 other children you know what is and isnt "normal".
I only have 1 child and I knew. Probably cause I read so much about dev. and "compared" him to other children with him being my first.But also finding a good dev. specialist really helped me alot.

[tomel]

Another thing a forgot to mention about my son along with being put in the "at risk PDDnos" he also has apraxia. Apraxia/Dyspraxia is a motor planning speech disorder.
Keep in mind not ALL delays are Autism, But also Autism is also a spectrum disorder where there are alot of things on that spectrum. It is usually referred to as ASD.

[D99G03]

I just wanted to add that when I watched the documentary I mentioned before, the HUGE thing that resonated was hand flapping.  My son did it constantly, all the time.  That and the fact that unlike your daughter, he did not understand anything we said, like "splash" etc., or maybe he wasn't even "hearing" us as he appeared to be in his own happy little world most of the time?  But either way, he was severly delayed iin all areas ... technically "Globally Delayed with PDD-like Behaviors" ... he was (like Tomel said) my first and I "just knew".  

2 things here:  My son will have to deal with the ADHD, Language based dealys and other learning issues the rest of his life.  He is very smart, we just are working to retrain him to live with his issues and work around them.  We live in the Boston area and I have had so many professional services/evaluations available to me.  I am working on getting Neuro Psych testing approved through our health insurance as a very respectable developmental center in the area has recommended ... but he is in a regular classroom as of last year and is "keeping up" with the support of an IEP.

I did not know she is your fifth .. and I say you should just get her evaluated based on your concern.  I wouldn't wait, as you have been insytructed to do.  You have nothing to lose and so much to gain. I do not look back, but do wish I had gone with my gut and started all of this earlier.  Learn from my mistakes!!  Chin up and keep writing if I can help in any way.  My email is ***@****

[swesselpa]

I have done an intake with the Regional Children's Hospital and am waiting to hear about an appointment with the Dev. Pediatrician.  Thanks for the input!  I'll keep you all posted.

[ehoberg]

Enough with the micromanaging of development.

My preemie daughter didn't laugh until she was 10 mos old.  Not a sound from this kid.

She is a straight A student and read To Kill a Mockingbird in the 2nd grade.

be patient.  Be a good parent.  Nature doesn't need such interference.

A delayed 9 month old.  There is a whole range in which something can occur.  Be Patient and quit micromanaging!

[tomel]

Consider yourself "lucky" that you never had to "intervene" with your childs development. Alot of parents are not fortunate enough to let things go in their childs development and everything be ok.
Alot of people fear that if they let something go that they might have missed a vital opportunity to help their child when the childs brain is absorbing the most.

[swesselpa]

We took Ellie to the dev pediatrician Oct 3rd and she is somewhat delayed in speech and gross motor, but stil within the low range of normal.  The doc feels that she has mild benign hypotonia of infancy and reassured us that she should show no signs of it by age 2.  We have a follow up to check on her progress in six months.  

I don't feel that this was micro managing at all.  Wow! Why should you ignore something if there are ways to help intervene early.  I don't feel that I've interfered.  There are too many studies with supporting evidence for early intervention! I get what you are saying echoberg, but I really don't think all delayed development is a wait and see situation.

We do have exercises and things we can do to help her.  She was getting so frustrated with not being able to get places and is now FINALLY crawling and a much happier baby.  

Most of all, I feel that as a mother (and I'm also a health care provider) that I have been validated in my concerns (she is delayed) and know what it is we are dealing with.

Thank you all for your support and suggestions.