Overly Concerned?

I have great concerns that my 20 month old grandchild does not seem to be reaching milestones. She didnt crawl till she was about 14 months old. She has been walking about 3 months but it seems to be a very "loose and floppy" walk, which looks very uncoordinated. I am told "you just worry too much" by the parents, who said her pediatrician says he doesnt see anything to be concerned about since she is walking now and can say between 6 and 8 words at this age. Their conception of words I guess is different from mine. She does say Dada and Mama, although it is very rare, and sometimes what does sound like Nana and Byebye. Thats it though - when she is looking at you and you say words for her to repeat all she says is "bah". For the past month or so she is now pulling her hair out and eating it. She had a full head of hair but is now totally bald on one side from this. She does it when she is in the car, lying in bed or gets really tired. Am I just being overly concerned or is there specific questions that need to be asked of her pediatrician? He only knows what he is told by the parents, like them telling him that she does say 8 or more words, and I sometimes feel that the parents are just telling me that I worry too much because they may be scared to hear that something might be wrong. A side note on her walking and movements being "floppy" - this term was used by her nurses right after she was born. When her mother asked if they were going to let her hold her they said that she would be able to shortly, that they needed to check her more thoroughly because she was "too floppy". This child is my heart and I might very well be just worrying too much but I would like to know if I need to just let it go.

[margypops]

May I ask who looks after the child during the day is her mom a stay at home mom or is the child in daycare ? The talking may just be a little late but the hair pulling out could be a sign of being upset, has her pedetrician checked her out?

[specialmom]

Oh goodness.  What a tough position to be in as the grandmother.  There are two things here that I must say---------- first, they've told you that they are not actively seeking your input on this situation.  That is hard ---------  you love her and them and want to help.  But you must tread lightly so as to not create a situation that makes them defensive.

Now, the second thing is that I agree, some of what you have written is concerning.  It is absolutely true that kids develop at their own rate.  Many kids walk late.  There is an old saying, those who walk early will talk late and those who talk early will walk late.  She was a little off with both.  But . . . as they have told you, not enough of a red flag has been raised for the pediatrician to want to act on it.  If I were the parent, I'd ask for an evaluation by a physical therapist.  She may have low muscle tone which they do fabulous work to improve upon or she may have motor planning issues and has a hard time coordinating muscle movement.  This would explain the lack of understandable words as well.  (motor planning involves muscles (dyspraxia when a child has significant issues with motor movement and apraxia when a child has significant speech issues)-------  a physical therapist, occupational therapist and speech therapist all work on motor planning issues.  By law in the US, if parents or doctors have concerns about a child's development, based on income----------- evaluations and services are provide for free to families under federal and state grants.  It is the birth to three early intervention program.  I'd have her evaluated if she were my child only because------------ well, why not?  Better to do that and find out nothing is wrong than to have her need some extra help and not get it.  

But, she is not your or my child.  She is theirs.  Some parents have a difficult time saying that something might be wrong and they wait until they can no longer deny it.  And a small problem can cause missed milestones.  A small issue can go under the radar for a while--------  and then blow up later.  Early intervention can solve some of these issues and often quite easily.  Again though-----------  your son or daughter and their spouse must come to this conclusion theirselves and you just be supportive and helpful when they do.

Now hair pulling------------  just pulling out hair is a sign of ocd.  OCD is under the anxiety umbrella and is a chemical imbalance.  Eating it falls under the category of PICA which is under the same umbrella.  This definately should be discussed with her pediatrician.  Eating hair in humans (unlike cats and other animals) is dangerous.  We can not digest a hair ball and it can block the intenstines and require surgery.  For a child so young, I do not know what the course of therapy is.  Some do believe it can also be caused by a vitamin definciency.  I think if this were my child, I'd look into that avenue although in adults, PICA usually requires psychiatric care.  Does she have a limited diet?  Anyway, her parents do need to discuss the hair eating with her doctor as that is dangerous.  

good luck