Opthomologist says my 4.5yo presents as developmentally delayed.

[Pink Fairy]

I think he's right. :( I knew ds wasn't ready to start kindergarten, but during the eye exam he had to stop and think for about 10-15 seconds in order to identify a circle, square, heart, or house. This was each time. And about 75% of the time he called the square a triangle. The doctor had difficulty understanding him, and ds had trouble following the doc's simple directions. It was so weird watching this, realizing how limited my ds is for his age, and wondering why I didn't see before. He's so sweet, so snuggly, so lovable and perfect--to us--it just never occurred to me that there was something wrong. But now that I see it, it's totally obvious. :crying:

 

Btw, the eye exam was for ds's intermittent exotropia, and we were at the ophthalmologist's for about 2.5hours. Probably one hour of that was spent with the ophthalmologist himself. Ds's eyes are structurally fine, thankfully, and unlikely to be related to his delays.

 

So what's next? I plan to make an appointment with the pediatrician, but I have no idea what to expect, what to do, who else to ask for help--anything. Ds would be starting kindy this year, if I went by age (he'll be five in May), in case that makes a difference.

[Twinmom]

I have twin boys who are developmentally delayed. Probably the best place to start is with your ped and also with a call to your local Early Childhood Intervention program to ask what public services are available to children your son's age in your area. He may have aged out of their specific program, but they can tell you about local OTs, speech, etc that might be available either through the local public school and/or private programs that they would recommend. You are likely in for a variety of recommendations for OT and other supportive therapies.

 

With our twins, we started in ECI, used the local pubic preschool special needs program before we brought them home. We have tried all kinds of interventions both public and private, including OT work for sensory integration issues, regular speech therapy, a special preschool program for developmental delays, APD work with a speech therapist, etc. Everyone who has seen them has given them a different diagnosis, ranging from "brat" to attention deficit

disorder to APD to speech delayed, fine motor delayed, overly aggressive, etc.

They each had a point ( except the "brat" diagnosis!) and would focus on a

small area of delay and work from there. The results were good but we were

really running around doing a lot of different and expensive therapies.

 

The best therapy that we have done for the boys, however, is neurofeedback. Their brains have literally "matured" and they have developed self control at

an unbelievable rate since starting NF back in Sept. They are progressing through remedial school work at such a rapid rate that they will likely be on grade level by the end of next school year. If I had it to do over again, I'd have started with NF (which works on development literally at the brain level) and then gone from there to the other therapies as needed. Our NF therapist said that doing things in that order generally makes the others therapies more effective and can possibly eliminate the need for some of them all together.

 

Keep you options open and remember that kids develop at different rates...unless there is something serious going on, there is a real possibility his delays will not last forever!

[Twinmom]

Please forgive the crazy spacing in the my reply...typing on my iPad with kids hanging over me and now the system won't let me edit!

 

:001_rolleyes:

[Serenade]

I can't advise, but I do know that my youngest son often got shapes mixed up until he was almost 7. He does have dyslexia, I think, but I would not have called him developmentally delayed. He just had issues determining shapes, triangles in particular.

[Mergath]

I think an appointment with your ped is a good idea. Generally, the ped will determine if your ds needs further evaluation, and if so, will most likely refer you to a developmental pediatrician, who can figure out exactly what's going on and refer you to the right people for treatment, if needed.

[EKS]

I can't advise, but I do know that my youngest son often got shapes mixed up until he was almost 7. He does have dyslexia, I think, but I would not have called him developmentally delayed. He just had issues determining shapes, triangles in particular.

 

This is what I was thinking. I could actually see a professional thinking that my older son was developmentally delayed back when he was younger. He had a lot of trouble with language in general as well as sensory processing and motor skills issues. He has dyslexia.

[PeterPan]

I think when the opthamologist had trouble understanding the dc, that's expressive language, not something dyslexia accounts for. He's looking at the totality of things.

 

EI only services till 3, so you're off to the ps I think.

 

One l michele here on the boards is taking some time off, but you want to read her posts. Her youngest boy has a similar situation. I think it ended up being more like 2 grades back. I'm not meaning to scare you, just being honest. With that May birthday, he's on the young end anyway. Does he do things that have a 4 on the box like puzzles or Kumon tracing workbooks or... kwim? At some point, those ages on the packages give you a sort of general sense of where he's falling. It's just something to notice.

[Renee in NC]

This is what I was thinking. I could actually see a professional thinking that my older son was developmentally delayed back when he was younger. He had a lot of trouble with language in general as well as sensory processing and motor skills issues. He has dyslexia.

 

Same here. He actually tested as mildly MR the first time. A year later, with meds for his ADHD and OT for his motor and sensory issues, it was much higher. It was still held lower by his language issues. Now that his language issues are better, I bet he would test even higher.

 

Don't despair. And, don't take any prognosis to heart. The first psych told me that my ds would need to be taught life skills so he could live on his own someday and that he would never get past the 6th grade level.:glare:

[EKS]

I think when the opthamologist had trouble understanding the dc, that's expressive language, not something dyslexia accounts for. He's looking at the totality of things.

 

 

 

Dyslexia (particularly in combination with CAPD and it's a common combination) can account for a lot of odd language issues. But my point in posting about is was to let the OP know that there can be other things that make a child appear to be developmentally delayed.

 

And the other thing we must keep in mind is that the guy is an eye doctor, not an expert in child development.

[funnygirl]

:grouphug:

[Pink Fairy]

Thanks for all the replies. I was feeling a bit shocked and more than a bit guilty, but I know it's not the end of the world and whatever happens he's still our precious boy and the delight of the entire family. :001_wub:

 

He was six weeks premature after an extremely difficult pregnancy (I was on bed rest for most of it, including three months in the hospital due to PPROM). The fact that he is alive at all is something of a miracle.

 

At 2yo, he was diagnosed with a speech delay (his receptive language was fine, his expressive language was nonexistent), but after a year in speech therapy his speech was on track for his age. I think his speech is probably okay, but he's quiet and still struggles a bit with articulation, which might be why the doc couldn't understand him.

 

I was looking at kindergarten curriculum, and he is just so far from being ready to begin school that it's not even funny. He colors in the lines, and he's good at finding hidden pictures, but he can't count to ten and doesn't know his abc's. His memory is very, very poor. In the past, I was fine with waiting until he was ready to do formal school work, but now I can see that it's not a matter of just being a boy, or being young for his age. So here are the things I'm going to work with him on (beyond reading stories, which we already do a ton of):

 

Pencil grip (he holds writing implements like you'd hold a knife for stabbing)

ABC's and counting

Memory games

Sandpaper letters (tracing with finger)

Shapes

 

We'll work for short periods of time, and I'll spread them out through the day. What do you think? Is it a good start while I wait for the experts to diagnose whatever his specific issues are?

[Jennifer-72]

That sounds like a good plan! A book I came across not too long ago at the bookstore had lots of fun language games that might be useful to you as well http://www.amazon.com/What-Does-Lion-Say-Language/dp/0876591470/ref=pd_sim_b_6.

 

 

I think they also had a cute alphabet book with lots of games to play for each letter.

[Renee in NC]

At 5yo, none of my dyslexic boys knew colors, numbers, or their ABCs. Can he rhyme? Can he repeat sentences after you (and how many words?)

 

Has he had a recent speech/language eval?

[Pink Fairy]

At 5yo, none of my dyslexic boys knew colors, numbers, or their ABCs. Can he rhyme? Can he repeat sentences after you (and how many words?)

 

Has he had a recent speech/language eval?

 

He knows his colors, he can't rhyme, he can repeat sentences (up to 8 words) after me, but tends to drop words or change them. I've decided that I will probably enroll him in our charter school for kindergarten next year so that I can get the testing process started.

 

How old were your boys when they were diagnosed with dyslexia? Did you go through your school district for a diagnosis?

[EKS]

He knows his colors, he can't rhyme, he can repeat sentences (up to 8 words) after me, but tends to drop words or change them. I've decided that I will probably enroll him in our charter school for kindergarten next year so that I can get the testing process started.

 

How old were your boys when they were diagnosed with dyslexia? Did you go through your school district for a diagnosis?

 

Take a look at the book Overcoming Dyslexia. It has lists of symptoms for all ages (including younger than school age kids).

 

My son knew colors but couldn't rhyme. He also had trouble repeating things.

[Pink Fairy]

Does there tend to be a lot of overlap with certain diagnoses? My ds also has exhibited signs of OCD since he was around 2yo. Extreme reactions to things being out of place, i.e., screaming in terror because a door was open when it should be closed, etc. We've dealt with it by gently forcing him to tolerate these uncomfortable situations, and he's much better now, but we still have to keep an eye on it.

[PeterPan]

You're going to take him to a developmental ped for an eval, right? You don't need a regular. You need a developmental ped. That way they can check *everything*. He might benefit from some OT for sensory. You should read "The Out of Sync Child." It's part of a whole picture, not just one thing.

 

I wouldn't do isolated academics. Find games and toys aimed at kids at his functional level (look at the numbers on the box!!), and play those. That way you're getting social skills AND language AND academics, all in one activity. Anything from Melissa and Doug is good for this. Some games are really conducive to it. http://www.amazon.com/Can-Do-That-Games-Curious/dp/B001P4J01U Also the Richard Scarry games (Busytown and Airport) are wonderful. Even simple things like alphabet puzzles or shape puzzles work this way. (put the pieces in a bag and draw them to take turns placing) There are some really cooling fishing and truck puzzles, I think from M&D, that you do with a magnetic fishing pole. So then you're getting numbers or colors and turn taking and vision and... all in one thing. Just look at the numbers on the packages. I'm really dense about these things, so that's how I figure it out. I have a game I bought for ds a year ago (really cool, a Dr. Seuss game where you follow instructions are cards and do crazy stuff), and I could never figure out WHY he didn't like it. Well turns out it's recommended for ages 4 and up. So maybe start with Melissa and Doug things that say age 2 and up. It's not personal, just developmental. Just back that up till you find the right fit, kwim?

 

I go to the thrift store a lot for games and toys, just to keep things fresh and exciting. ToysRUs has a marvelous section with developmentally appropriate toys like that. Just look for things that can use language, turn-taking and social skills, and maybe sneak in a little learning (colors, numbers, shapes, whatever).

 

http://www.melissaanddoug.com/tow-truck-magnetic-learning-game?alt=1 Here's the link for that tow truck puzzle. M&D also makes a WONDERFUL pizza set with velcro pieces. http://www.melissaanddoug.com/pizza-party-play-food?alt=1 Great for language, turn taking, etc., and if you're sneaky you can even weave in colors or numbers. :)

Edited February 21, 2012 by OhElizabeth

[Renee in NC]

Does there tend to be a lot of overlap with certain diagnoses? My ds also has exhibited signs of OCD since he was around 2yo. Extreme reactions to things being out of place, i.e., screaming in terror because a door was open when it should be closed, etc. We've dealt with it by gently forcing him to tolerate these uncomfortable situations, and he's much better now, but we still have to keep an eye on it.

 

Yes, there is all kinds of overlap. I am of the opinion that it is because different specialties categorize the same symptoms into varying diagnoses. For example, one of my ds has the following diagnoses:

 

Auditory Processing Disorder

Low working memory

Low IQ

Mixed Expressive-Receptive Language delays

ADHD - Impulsive

Dyslexia

Motor control/motor planning issues

 

All those labels are applied to the same set of symptoms. Not only that, but some of those things most likely cause the others. The only reason for all those different labels is because each opens different doors as far as services available. Not only that, but the different specialties disagree with each other (the speech therapist says no way to the low IQ because his Peabody Picture Vocab falls into the average range, which is a good correlation with IQ.)

 

As you said in a previous post, none of this changes who your ds is. It's hard, and many go through the stages of grief regarding the problems.:grouphug:

[SKL]

I'm a little concerned that the ophthalmologist diagnosed your son so readily based on shape recognition and a few other things. I'd not only have him looked over by someone with a broader perspective, but also consider checking in with a developmental optometrist to confirm that the eyes are not part of the problem.

 

My dd's ex-ophthalmologist insisted that her eyes were not the problem, either. But he was 100% wrong. A half year of vision therapy made a huge difference. She is now accelerated in school and doing very well. Just six months ago, I would have said her visual memory was terrible, but it is improving rapidly.

 

I'm not saying your child's opthalmologist is certainly wrong, but I can't help wondering if he is a little too narrow if he thinks that shape recognition and how a child responds to a doctor in one visit are enough to determine a child's native intelligence.

[lisabees]

At 5yo, none of my dyslexic boys knew colors, numbers, or their ABCs. Can he rhyme? Can he repeat sentences after you (and how many words?)

 

Has he had a recent speech/language eval?

 

:iagree: My 15 year old couldn't do much of this until the age of seven. He, too, had speech delays. He was diagnosed with mild dyslexia and a low working memory/slow processing speed. Actually, I bet if I tested him now, his results would be far better.

 

OP - you're in the grand position of being proactive at this young age and having these wonderful ladies to give you support and knowledge. Listen to them and follow your heart! :001_smile:

 

I had the displeasure of fighting the school district for any help - and never got any. I brought ds home in 7th grade. He has now returned to school, reads on grade level and is in a honors math class. Next year, he is scheduled to take two honors classes. My son shows no signs of any disability. He has learned to work hard and compensate in many ways. I no longer worry about him.

 

Everyone's story is different. I just wanted to share our success story. Best wishes.

[Ottakee]

I've decided that I will probably enroll him in our charter school for kindergarten next year so that I can get the testing process started.

 

 

I would suggest that you call the school NOW and get the testing/evaluation process started. It can take several months and if you wait until fall, it could easily be Christmas or after before you get things done and a plan in place.

 

Depending on his needs and what the charter school offers, they may or may not be the best to meet his needs. I know many of our local charter schools don't have as much therapy offered as the regular public schools.

 

Given your son's early history, he might qualify now for a free special needs preschool just because he had such a rough start in life. That might get things rolling faster and he might really enjoy the program---again, depends on the teacher, staff, and other kids in the program.

[EKS]

Does there tend to be a lot of overlap with certain diagnoses?

 

Yes.

 

My son has been diagnosed with vision issues requiring VT, SPD, fine and gross motor skill problems, CAPD, Asperger's, dyslexia, and ADHD. I believe that all of these, with the exception of the Asperger's (wrongly diagnosed), are all part of the same thing and that thing is dyslexia.

[Pink Fairy]

I'm a little concerned that the ophthalmologist diagnosed your son so readily based on shape recognition and a few other things. I'd not only have him looked over by someone with a broader perspective, but also consider checking in with a developmental optometrist to confirm that the eyes are not part of the problem.

 

 

My dd's ex-ophthalmologist insisted that her eyes were not the problem, either. But he was 100% wrong. A half year of vision therapy made a huge difference. She is now accelerated in school and doing very well. Just six months ago, I would have said her visual memory was terrible, but it is improving rapidly.

 

I'm not saying your child's opthalmologist is certainly wrong, but I can't help wondering if he is a little too narrow if he thinks that shape recognition and how a child responds to a doctor in one visit are enough to determine a child's native intelligence.

 

I see what you are saying, and I agree that the ophthalmologist shouldn't be diagnosing him based on one visit, or probably at all, considering his specialty. But he just said that ds presents as being developmentally delayed, and recommended that we see his pediatrician about it. For me, it was more about the experience of watching my ds interact with someone outside his usual circle, realizing how different he is compared to my other four at the same age, and being reminded more of a young 3yo than an almost 5yo.

 

I would suggest that you call the school NOW and get the testing/evaluation process started. It can take several months and if you wait until fall, it could easily be Christmas or after before you get things done and a plan in place.

 

Depending on his needs and what the charter school offers, they may or may not be the best to meet his needs. I know many of our local charter schools don't have as much therapy offered as the regular public schools.

 

Given your son's early history, he might qualify now for a free special needs preschool just because he had such a rough start in life. That might get things rolling faster and he might really enjoy the program---again, depends on the teacher, staff, and other kids in the program.

 

That's what has me most concerned right now. If he does have multiple issues that need to be addressed (and I totally get that I don't really know anything yet), would that mean that homeschooling is out? Our local school district doesn't have any homeschool programs, and our current charter school doesn't have a lot to offer for special education.

 

My 9yo was just diagnosed with visual processing disorder, and we haven't even had the IEP yet, so I'm trying to figure out all that stuff too. Gah! I am feeling so stressed right now!:willy_nilly:

[Pink Fairy]

You're going to take him to a developmental ped for an eval, right? You don't need a regular. You need a developmental ped. That way they can check *everything*. He might benefit from some OT for sensory. You should read "The Out of Sync Child." It's part of a whole picture, not just one thing.

 

I wouldn't do isolated academics. Find games and toys aimed at kids at his functional level (look at the numbers on the box!!), and play those. That way you're getting social skills AND language AND academics, all in one activity. Anything from Melissa and Doug is good for this. Some games are really conducive to it. http://www.amazon.com/Can-Do-That-Games-Curious/dp/B001P4J01U Also the Richard Scarry games (Busytown and Airport) are wonderful. Even simple things like alphabet puzzles or shape puzzles work this way. (put the pieces in a bag and draw them to take turns placing) There are some really cooling fishing and truck puzzles, I think from M&D, that you do with a magnetic fishing pole. So then you're getting numbers or colors and turn taking and vision and... all in one thing. Just look at the numbers on the packages. I'm really dense about these things, so that's how I figure it out. I have a game I bought for ds a year ago (really cool, a Dr. Seuss game where you follow instructions are cards and do crazy stuff), and I could never figure out WHY he didn't like it. Well turns out it's recommended for ages 4 and up. So maybe start with Melissa and Doug things that say age 2 and up. It's not personal, just developmental. Just back that up till you find the right fit, kwim?

 

I go to the thrift store a lot for games and toys, just to keep things fresh and exciting. ToysRUs has a marvelous section with developmentally appropriate toys like that. Just look for things that can use language, turn-taking and social skills, and maybe sneak in a little learning (colors, numbers, shapes, whatever).

 

http://www.melissaanddoug.com/tow-truck-magnetic-learning-game?alt=1 Here's the link for that tow truck puzzle. M&D also makes a WONDERFUL pizza set with velcro pieces. http://www.melissaanddoug.com/pizza-party-play-food?alt=1 Great for language, turn taking, etc., and if you're sneaky you can even weave in colors or numbers. :)

 

These are great ideas--thanks. :001_smile: As far as the developmental pediatrician goes, I don't know yet. We'll start with our regular pediatrician, who is awesome and not afraid to say that something is outside of his specialty, and see where we go from there. From the research I've done, it looks like our medical group, which is huge, doesn't even have a developmental pediatrician. :001_huh:

[Ottakee]

NO, this does NOT mean that homeschooling is totally out. I homeschooled mine with special needs from K-6th grade and decided to send them in 7th for more social things and therapy that I couldn't match at that point.

 

You mentioned enrolling him in a charter school which is why I mentioned the other options. Even if you don't enroll him in the public school, start the testing process now to see what issues you might be dealing with and get a plan of action in place.

 

You might be able to bring him in for therapy to the local schools or have him attend a young 5s or other program just part time for therapy or find it privately or ????

[FairProspects]

 

That's what has me most concerned right now. If he does have multiple issues that need to be addressed (and I totally get that I don't really know anything yet), would that mean that homeschooling is out?

 

:grouphug: If anything, I would think this is an argument in favor of homeschooling. These types of kids get lost in the school system until they are very far behind (2 grade levels in our district).

[PeterPan]

A developmental pediatrician is a specialist. He can look at all the areas of your child's development and refer you off to other needed specialists. His eval could involve seeing a number of specialists. A neuropsych can also diagnose pdd-nos, etc., and you then get referred out for speech, OT, etc. I've read stories of the developmental ped catching things the regular ped and several STs missed. I think it's just that development is their SPECIALTY, so they can figure out why things are happening. In the case I was reading about, it was apraxia of speech that numerous STs has missed. Walked in and the devel. ped saw it right away. I think maybe the dev. ped is more toward scoping out the physical side of the delays not to miss stuff, and the neuropsych is just telling you what's going on in the brain (motor control, development, etc.).

 

I totally agree with getting the eyes checked by a developmental optometrist at some point. Usually these kids have layers of stuff, not just one thing.

[wapiti]

I totally agree with getting the eyes checked by a developmental optometrist at some point. Usually these kids have layers of stuff, not just one thing.

 

Quoting for emphasis here - I would not overlook this, particularly in light of the OP. www.covd.org

[Rod Everson]

I'm just curious. Have you ever had your son's vitamin D3 level checked? More and more, I'm wondering if that isn't going to turn out to be a big piece of the puzzle when a child shows various delays in development.

 

(And I'll second, or third, the suggestion to take your son to a developmental optometrist.)

 

Rod Everson

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