9 month old developmental concerns

[gmh33]

I have a 9 month old son who was 1 month premature and was diagnosed with a patent ductus arteriosis,ventricular septal devects and pulmonary hypertension a few days after birth. He has since had surgery to close the ductus arteriosis,the VSD's have closed on their own and Pulmonary HTN has resolved. We were told by his pediatrician and cardiologist that he might be behind in his development because of being premature and because of the surgeries that he has gone through. He is now nine months old has yet to sit upright on his own. When we prop him up with pillows he will quickly get upset and maneuver so that he topples over or slides down to his back. He can roll over from front to back in both directions and is very close to doing back to front. He can get into a crawling position with elbows down but doesn't really scoot, just rocks back and forth in that position. Socially he seems fine. He is a happy baby and interacts well with me and my wife. Makes good eye contact and laughs and smiles alot at us. He babbles and just started saying "da da". He does not seem to have an intrest in grabbing toys or other objects. He will follow them with his eyes when you dangle them in front of him but will not reach for them. I the rare instance that he does reach he will usually just bat at the object and not really grab it. When you put an object in his hand he will not try to put it in his mouth or study it he will just swing it back and forth or bang it against whatever is in front of him.

So my concerns are his:
1) Not being able to sit upright on his own at this age
2) Not being able to crawl at his age
3) Not showing interest in grabbing items or putting things in his mouth.

I know he may be behind on many milestones because of his pre-maturity and stresses of surgerys but should we be concerned that he is this far behind? Should we be concerned with autism or mental retardation?

[gmh33]

Thank you for your comments and sharing your experience. It has been difficult for my wife and me with everything our son has had to go through so far especially since this is our first child. Our son doesn't mind being hugged. When he is crying, picking him up and putting his head on our shoulder will usually work to comfort him. However, he doesn't initiate hugs. I'm not sure if he really knows the meaning of giving hugs and his age.

[meikman]

I was wondering if your son lets you hug him.  My son is almost 14 months and still doesn't give hugs.  He likes to be held only upright though and the only time I could rock him lying across my arms was while he was in the NICU.  Will your son lie his head down on your shoulders?  My son has done this maybe a total of 3 times.  I know for the longest time it was because of his stiffness but he still won't lie his head down on my shoulder.  He does like to put his face next to mine when he needs extra confronting and has to have me around constantly and most time he has to be by me otherwise he gets very upset.

[meikman]

My son was 8 weeks premature and you could have been explaining him. I believe he was almost 9 months before he started sitting up and didn't master it until he was 10 months.  He didn't start crawling until he was almost 12 months but could get around on his belly.  He would do what looked like to me the army crawl.  To are amazement he has started walking although he looks very odd the way he holds his body but he is so proud of himself.  He also wouldn't gap or hold anything for a very long time.  Then finally he would hold onto something but didn't transfer from hand to hand for several more months.  I know with my baby it seems to take him longer to master things but the older he is getting the easier things are getting for him.  

He will be starting First Steps this Tuesday for Physical Therapy for some stiffness in his ankles and feet.  He stills keeps his toes curled so much so that he can't get shoes on him.  The Dr is sending us to a Podiatrist to have him fitted for braces.  I too would suggest that you not worry too much some delay is expected and I was always warned that them may not be resolved until he reaches around 5 years. (which I don't believe that will be the case)  There was talk about CP with my son and very early and I wounder so much about everything that I forget to just enjoy him. It just resulted in wasted time my son is still too young to be label with CP and it wouldn't matter anyways if he has it.  He is alive, healthy, happy and with me.

[mum2beagain]

My son was 8 weeks premature, had a ventricular bleed leading to hydrocephalus and had surgery for a shunt at 3 months, he has been behind with alot of his developmental milestones, he didn't sit unaided until nearly 12 months, crawled at 18 months and only recently (2 1/2) began walking properly on his own (he was walking holding hands for 8 months and took a few steps in March). It is not uncommon for children who have been preemies and had surgey at a young age to be developmentally behind but it is important that you get your pediatricain to refer you to early intervention services to ensure that you son is evaluated. Although James has been delayed for some time now he is rapidly catching up and hopefully by the time he is 3 there won't be much difference between him and other children his age. Best wishes.

[mom@homenow]

Hey that's great. No one wants their kid to be behind and need extra help, but when you're concerned it's nice to know that there are ways to get it. My son (not a premie) was also referred at 9 months. He could sit up if you propped him but couldn't get himself there until 15 months, he never crawled (although he did learn to scoot on his bottom at a year), and took his first steps at 21 months. I was so thankful for all the help he got through the county, and the words of wisdom I received during that time did a lot to relieve my anxieties about his development and mental capacities.

I hope you get some reassuring feedback on your son from the evaluation, and some competent help if he does indeed need it.

[gmh33]

Thank you for your suggestion. We do have a program in our state which is run through the school system. They will be observing our son this week to see if he qualifies for the program.

[mom@homenow]

Are you in the US? There are early intervention programs for infants & toddlers in every state, and your son might qualify. As the doctor(s) including in this forum have said you should expect some delays but I wouldn't think that means you can't be pro-active in getting him some extra help. Start with the pediatrician next time you're in & ask if he/she thinks he'd qualify for early intervention through your county. The dr could give a referral if necessary to start the process. If accepted in the program, your son could receive physical therapy through the county free of charge. It's helpful on many levels and the therapist can help give you ideas as well on exercises & activies to do at home. FYI, In our county it's run through the health department.

[Kevin Kennedy, Ph.D.]

As you already know, your son is late in achieving the several developmental milestones you noted. Most, but by no means all, babies are able to grasp items and mouth them during the period from 4-6 months. Most, but not all, are able to sit at around the 6-7 month time frame. And most, but not all, are able to crawl around the age of 7 months. Now, this places your son from 2-5 months behind, depending on the particular task. This is not unusual with children who are born prematurely, particularly those with medical complications. Nothing in your description indicates either Mental Retardation or any type of Pervasive Developmental Disorder. It is likely you will see your son proceed in a fine fashion and close the developmental gap. From my point of view you needn't be alarmed.