Jul 31, 2013  •  In Aerin, Motherhood, Parenting, Personal

Aerin’s Developmental Assessment

Yesterday, two ladies from the state early intervention program stopped by our home.

NJ’s early intervention program assesses a child in the following areas of development:

  • Gross Motor Skills
  • Fine Motor Skills
  • Communication, Speech, & Language
  • Social/Emotional Development
  • Cognitive Skills
  • Adaptive/Self-help Skills

In order to be eligible for early intervention services, the child must have delays of at least:

  • 2.0 standard deviations below the mean in one developmental area; or
  • 1.5 standard deviations below the mean in two more more developmental areas

Aerin scored below the mean in every category, with the exception of fine motor skills. (She actually scored well above average in this area.) While her gross motor skills and social/emotional development were just below average, her cognitive skills and adaptive skills were about 1.5 standard deviations below the mean. Particularly alarming was her communication & speech, which was 2.2 standard deviations below the mean.

So it was confirmed: Aerin is developmentally delayed — enough so that she qualifies for our state’s early intervention program.

aerin_sprinkler

The woman who was in charge of the assessment observed the following things Aerin should or should not be doing at this age (currently 20 months old):

  • She should not be screaming when she is displeased
  • She should be able to feed herself an entire meal (in our defense, we usually end up feeding her because she won’t eat enough on her own)
  • She should be able to take off her shoes by herself
  • When asked, she should be able to do tasks and chores that are more complex than just pointing things out
  • She should be more social and wanting to play with other kids
  • She should be able to play with one toy for more than 15 minutes at a time (I’m not sure what the ideal period is, but the 15 minutes I told them was apparently not enough.)
  • She should be pointing at what she wants, not just handing things over to me or gesturing
  • She should be able to put together simple puzzles
  • She should not be using sippy cups (this is my fault — she knows how to drink from a regular cup and use straws, but it’s so much easier to just hand over a sippy cup and let her drink whenever and wherever she wants, instead of sitting there supervising her while she drinks)

She noted that Aerin’s attention seemed to wonder often, and that the way she acts around, and interacts with others (i.e., wanting to do things her way rather than follow others or the rules that are set out for her) is at a level that is low for her age.

She asked me how often we participate in “structured play” and group lessons. I told her how I take her to the park and playground almost every day, how we’ve been attending arts & crafts sessions organized by the community center, how we schedule playdates, and how I do my best to teach her at home.

She replied that’s not enough.

She said that kids like Aerin need more activities like Mommy & Me classes — and that daycare would be beneficial too.

She told me a bunch of things that we could do to help Aerin along the way, and we scheduled an appointment for August 19th. That is when they will make a shorter, second assessment to see if she has made any progress, set goals for her, and start scheduling therapy sessions.

I’m not going to lie. I cried quite a bit last night.

Everyone tells me that kids progress at different rates. They tell me that it’s not my fault, that Aerin will catch up soon and that I shouldn’t worry too much.

But when you’re in the thick of things — when it’s just been confirmed by experts that your child is delayed and needs therapy to catch up to her peers — it’s difficult not to question just how this could have happened.

It’s difficult not to blame yourself.

DSC00641

I know that it’s not fair to compare Claire to Aerin, but I feel like we lucked out with Claire because she is so bright and intuitive; she was able to learn so much and pick things up quickly and easily without too much involvement from me. And only now is my bad parenting manifesting itself by Aerin being delayed.

(For example, I tend to talk to my kids like they’re older than they are — not just with the words I use, but by also not talking all the time in hopes that they will learn the implied meaning between words. But the early intervention lady told me that I should constantly point out, explain, and narrate.)

Additionally, because our daughters are so close in age, I’m more paranoid than ever that neither of them are receiving the attention they deserve. My mother tells me that it’s not unusual in a family with kids that are just a year apart to have one child, or even both children, to present some difficulties as they mature. Is this true? No matter the answer, I’m now wondering if it would be more beneficial for both kids if I start working again while they attend a good daycare.

Then there’s the cost. I know money should always take second place to the well-being of our daughters, but Claire is starting a Montessori preschool in September so our budget is already tight as it is. (Northern NJ has some of the highest preschool rates in the country. The preschool I really want to send my kids is $3k a month!) The state will subsidize a good portion of Aerin’s therapy, but from looking at the paperwork I received, it looks like each session will be in the mid-$20 range. So it is likely that our out-of-pocket costs will be $200-$300 a month. We will definitely need to re-work our budget and cut back some.

I’m sure I’m probably over-thinking and over-stressing, as I tend to do in situations such as these. I’ll probably feel much better about it next week or even tomorrow. But for today, I’m letting myself be a worrywart, overanalyzing everything and be an paranoid, over-concerned mommy.

Then I will look forward. I will try my best to do everything the early intervention lady suggested, such as dividing toys into clear bins so that Aerin will be forced to point. To always guide her gaze to my mouth so that she can see what I’m saying. To constantly place my hands over hers and teach her to better interact with her world around her. To not to baby her so much.

(Gosh, now I’m getting worried that Claire will start to resent Aerin for all the extra attention she will be receiving!)

It won’t be easy, but I’m willing to help her however I can.


ETA:
I forgot to mention that when I asked about autism, they told me they’re not qualified to give a diagnosis. They said that I would need to get a referral from our doctor for a developmental pediatrician. Umm…where did the miscommunication occur? Nonetheless, they advised me to try to get an appointment right away if I was concerned, because the wait for a developmental pediatrician can be as long as 6 months in our area! 8-O

23 Responses to “Aerin’s Developmental Assessment”

  1. Rae:

    I’m not yet a mother but i do sometimes worry all the what ifs when i have kids on my own… I’m sorry you have to go through this, this is one of the nightmares and yes you are absolutely right about how difficult it was not to blame yourself. i’m in no position to say anything but keep your chin up and stay positive!
    fighting!

  2. Jan:

    I am sorry to read about what you are going through. I think you should laud yourself for catching the signs early and following through with it. As I was reading your post, I kept thinking “Wow would I do all this?” You are a fantastic mom!

  3. dd:

    Great job getting her into therapy so early! Noticing a problem and acting on it means you’re doing fine, seriously.

    Also, a Speech-Language Pathologist can also diagnose autism, so you could find one of those instead of a developmental pediatrician.

    • Thanks! We have an appointment with our pediatrician later this week, so if the referral with the developmental pediatrician doesn’t work out, or if the wait is too long, we’ll look into a speech-language pathologist.

  4. Hello Hyojin/Jenny. I wandered onto your website because of something related to makeup. Then I started to read your short bio and realized we have a lot in common (generation, career, interest, personality), then I wondered to your about page and saw that you were a Christian like me as well so I felt led to lift you up with this:

    1. I want to encourage you that God is with you (Matt 28:20). I don’t think your brave posting today is by accident and I don’t think I bumped into your website by accident. Be so submerged in the reality and promises of God today and have sweet rest (good night sleep v rest) in the name of Jesus (Psalm 127:2).

    2. Take a look at John 9:3 : ” Jesus answered, “Neither this man nor his parents sinned, but that the works of God should be revealed in him. (NKJV)”

    3. I intercede for your daughter:

    Father, in the name of Jesus, I come before You asking You to heal Aerin.
    It is written that the prayer of faith will save the sick, and the Lord will
    raise him up. And if anyone has committed sins, they will be forgiven. We let
    go of all unforgiveness, resentment, anger and bad feelings.

    Aerin’s body is the temple of the Holy Spirit and Aerin desires to be in good
    health. We seek truth that will make us free – both spiritual and natural
    (good eating habits, medications if necessary, and appropriate rest and exercise).
    You bought us at a price, and we desire to glorify You in our spirit and body-
    they both belong to You.

    ThankYou, Father, for sending Your Word to heal Aerin and deliver Aerin from all
    destructions. Jesus, You are the Word Who became flesh and dwelt among us. You
    bore our griefs (pains) and carried our sorrows (sicknesses). You were pierced
    through for our transgressions and cursed for our iniquities, the chastening for
    my well being fell upon You, and by Your scourging we are healed.

    Father, we give attention to Your words and incline our ear to Your
    sayings. We will not let them depart from our sight, but we will keep them in
    the midst of our heart, for they are life and health to our whole body.

    Since the Spirit of Him Who raised Jesus from the dead dwells in us,
    He who raised Christ from the dead will also give life to Aerin’s mortal body
    through His Spirit Who dwells in Aerin.

    Thank You that Aerin will prosper and be in health and even Aerin’s soul prospers.
    Amen.

  5. Angela:

    I’m so sorry you’re going through this. Absolutely let yourself sit in this and cry as much as you need! You are a FANTASTIC mom – so intuitive and aware and getting Aerin the help she needs! I don’t know if I completely agree with what they said about you not doing enough and needing more mommy and me classes or interacting with her 24/7. Granted, I’m not an expert and all of what I’m saying is anecdotal, but so many generations before us raised kids without the kind of structured forced learning that we impose upon our kids these days. How can you not take any credit for Claire’s achievements and take all the blame for Aerin’s delays? You’re too hard on yourself mama… I’ll be keeping your family in prayer. Thank you for sharing so candidly with us. I just want to emphasize one last time before I go that you are doing a PHENOMENAL job. It is not easy raising two kids so close in age all on your own!

    • I keep thinking about that too, how so many generations before us did just fine without all this extra stuff we force upon our kids these days. My husband says that he barely spoke until he was 2 (obviously he still thinks I’m overreacting), and he even has a friend who was practically mute until he was 4! They, and tons of other kids like them, did not receive special therapy growing up and they all managed to catch up fine. I guess with modern conveniences and better living conditions, we also get more pressure to be perfect, and raise perfect kids too.

      I also noticed that about the lady who was assessing Aerin, that she seemed VERY pro-daycare. Not to say that daycare is bad, but she practically made it seem like my children would be stunted, antisocial, and damaged if I didn’t: put them in a good daycare with tons of structure activities; or, if I decide to remain as a SAHM, sign them up for tons of classes and organized activities.

      Thank you for your kind thoughts and prayers. :-)

  6. Wow, I have to say I’m very surprised at some of the developmental milestones. What type of shoes are they supposed to be able to take off? Some of them can be pretty tight with laces and such. I also have a very shy and reserved child, and it takes her a long time to warm up to others, as in hours. At 23 months, she’s not much older than Aerin, and I’ll admit to still using sippy cups as well. Like you said, it gives them independence without having to clean spills off of every single surface. And I’ll have to admit I’ve yet to see a toddler who DOESN’T scream when displeased!

    All that to say, you’re not alone. I’m by no means downplaying delays that professionals have assessed. I just want you to know that there are other children and parents out there who have children at these levels of development. I’m so happy for you that you have the resources to help give her a great start. It’s not like any of these activities or therapy sessions will hurt her, and may end up setting her on a path to advanced development once she gets older. So bravo to you for paying attention and being proactive! I agree with Angela that you are taking too much of the blame and not enough of the credit. You are parenting two little individuals and helping to guide and teach them. They will be different from each other. They will be different from you. They will be different from everybody! That’s the beauty of it all.

    • Thanks for sharing your daughter’s development! There were honestly times during the assessment when I would think to myself, “But I hardly know any toddler who does that.” Especially about the screaming when they’re mad! She did say that the standards for the categories are based on the 100 most recently tested kids in Aerin’s age and sex….maybe there were just a bunch of very advanced kids who were tested right before us? Who knows? (Oh, and about the shoes, I should have clarified that right now we only have shoes with velcro straps for Aerin, so I think she meant those.)

      And thank you so much for your well wishes and kind words of encouragement. I really appreciate it. :-)

  7. T:

    Man I must have made my parents crazy, I didnt start talking more than a word here or there until I was 4 and I was just learning 1 language, lol. So kids definitely develop differently, although my wife would say i never caught up in language :). Oliver definitely cant do a lot of that list, especially the playing with other kids, he is terrified of other kids, loves other adults though.

  8. Mina:

    i echo the others–you are a fantastic mom. you didn’t do anything wrong. but i would cry and worry too. it’s great that you had the assessment and are taking the next steps–i know it will all help aerin so much.

  9. Cathryn:

    Don’t have time to write as much as I like but my 26 month old screams sometimes when she’s not happy, she cannot take her shoes off, and I think 15 minutes is her maximum with one toy. Hugs to you, momma! You’re doing a great job.

  10. amy:

    Jenny, I am so sorry that you are dealing with this stress. I don’t have kids but I can see how this is very frustrating for you. I would caution that you should by no means ever blame this on yourself. You are not a bad mother. You are a very kind and loving mother of two children with different needs. So the same good parenting you’ve done for one child, just hasn’t had the same effect on another child. This is by no means any fault of your own. We are all created differently, and thus, your two daughters are different. I hope that with early intervention as you’ve identified, will foster the growth that will make Aerin the person she is suppose to be.

  11. I’m sorry about the stress! It seems like a lot to deal with all at once. 1.5 deviation is just barely out of the “normal” range (I know, small consolation.) She’ll catch up very soon.

    The 6 month wait for an autism eval is normal and frustrating too. Are there an universities you can call to see if you can get her into a study? We got our daughter in sooner because and they’ll sometimes pay you for your time.

  12. Arlene:

    Awwwwww… first, I just want to give you a big hug! I don’t have kids of my own (yet, but one’s one the way!), but my sister have sons that are very, very close in age (10 months apart only!), and I think it really happens that the second child has some delays (even until now that they are 5 and 4 years old), he’s turning out fine, he has his own personality and has hobbies and likes much different from his older brother. He’s still behind with language (both of them had to go to speech therapy classes because we are tri-language at home, and they had a hard time learning how to talk), but he’s getting there. :) Please try not to worry too much about your parenting skills, the mere fact that you are alarmed and very much looking into the welfare of your kids means that you are a good mom. :)

  13. I know you are having more tests on Monday, but I needed to say that my 20 month year old can barely do most of these things- and she’s a pretty verbal and physical kid! For gosh sacks- she still uses a bottle in the morning and afternoon. Sure we could give her a cup every time she wants a drink- but she’d be drenched all day. She screams at the drop of a hat- what toddler doesn’t? And as for shoes- what a random test? Velco – maybe. AND she has been in day care since 4 months- so day care is not the answer.
    Just sending you love and hugs. Aerin is a fabulous little lady. Glad that you are getting support, but take it for what it is- extra parenting help. This means nothing for her long term learning- as an 8 yo I was in remedial math- by HS I was an AP math student. She won’t walk down the aisle with a sippy cup!!

  14. Ok ok I have to comment- Luca is 20 months old and is constantly screaming when he is upset, and as I read through the list of qualifications they sound obsurd. Seriously. You’re a GREAT mom and Aerin isn’t going to be behind at all. I really don’t want to question the professional assessment, but I think the expectations are a bit high for her age. Keep us updated, and please know that you are not alone!

  15. I know this post is an old one, but I’m just now catching up with your blog! I am quite baffled by the milestones they have listed here. To suggest that a 20 month old needs more “structured” play and that letting them just explore around the playground isn’t “enough” makes me a bit peeved actually. I did attend a free trial mommy and me class at My Gym, and was so turned off by the sheer number of structured activities they crammed into a 60 minute class, at such a fast rate and with very little time to let the more introverted kids (like my Siena) warm up. All the very loud cheesy songs where we were encouraged to force our kids to do the moves like puppets also bugged me. The whole time, Sisi just wanted to get away from the chaos and explore the gym on her own. I think I would have wanted the same at her age! After, they asked me if I wanted to sign up for classes, and I told them that we might consider signing up for the free play hour each week, since that was more our style and pace. They told me this “wasn’t enough, and that the important stuff happens during the structured classes, like learning to socialize and follow instructions.” My mommy instinct is telling me that those “milestones” they have listed may be based on our extraverted American ideal, and perhaps Aerin is just exploring the world in her own way? Of course, I don’t think therapy will be harmful, and I applaud you for digging into her development early instead of ignoring it. But I do worry about how all the “shoulds and should nots” affect our kids’ perception of themselves, and our attitude toward them as parents. Maybe this website will be a helpful way to balance what you are being told by the evaluators? http://www.janetlansbury.com/

    • “My mommy instinct is telling me that those “milestones” they have listed may be based on our extraverted American ideal, and perhaps Aerin is just exploring the world in her own way?”

      This is EXACTLY how I’ve been feeling over the past few weeks! And thank you for the link — I’m going through it right now.

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