to be a bit down over a development review?

[Botherations]

I was fine, but now I'm dwelling...

Dd had no one yr check, but after a passing chat at a children's centre the hv popped by. Dd is 20 months and the hv wanted to refer her for a development review. She said she should be understanding/ saying words, be less wobbly and do simple jigsaw or point to body parts. At first I was borderline annoyed and disagreed, dd is smiley, happy and loving and I wasn't worried. I did though drop in to the salt drop in as recommended and the therapist agreed with the referral. Also I was playing with younger children today and their abilities surprised me, a 17 month old named a few fruit, fetched it on asking and put pieces in the jigsaw as well as listening to a book. He copied my actions mainly too in the story. It made me think her understanding is to be honest behind where her brothers was at 10/ 11months when he understood things such as "all gone".

I'm less blase now, and a bit defensive I guess that my perfect girl might not be just a little small/ immAture and is different. I'm stewing over it quietly whilst claiming to be ok.

I had worries when she was tiny, she met motor mile stones late but my worries were dismissed. I was told she had "very mild hemiplegia" but their exact words were "it will be of no consequence" as she compensates. She was discharged from physio with mild weaknesses, delay and reduced finger movement. I'd forgotten my worries as I was so whole- heartedly dismissed. A year on though it's been turned upside down and suddenly I've gone from a dismissive attitude to being rung, urgently, by multiple professionals.

I hadn't seen the hv since birth, I when through the gp for the (former) rigidity of her arm.

Am I worrying over very little? Are these referrals common? What e experiences do others have?

I think the HV has knocked your confidence and has a lot to answer for.

My DD could have done the things you mention the boy at the group doing, but my cousin's DD and some of her friends couldn't communicate so well, and are still somewhat unclear at 4.

However DD can't get to grips with a bike, either a balance bike or with stabilisers. Two of her friends are already on two wheels. I won't worry about it. I will come in time if we continue to give her the opportunities.

Likewise she is quite babyish in that she won't give up her bottle at bedtime. On the other hand she thinks she's too old for CBeebies and prefers the likes of Tracy Beaker

My point being that all children are different and won't reach the same milestones at the same time. They will all roughly catch up developmentally by the time they go to school and if they don't, that is the place for identification and intervention in any learning difficulty.

I think that if the referrals turn out to be not necessary, the only downside is that you will have worried for nothing.

On the other hand, if intervention is needed, the earlier the better imo.

I think there are a lot of referrals at the moment, certainly for speech & language services - I have heard it's very common to need this. My own DS2 has been receiving SALT, group & individual, since 23 months and is delayed in other areas too (I've recently been told he's hypermobile, which explains a lot), so I understand your concern.

Can you try to look at this as a positive thing rather than a negative? If there is anything 'wrong' it is good for it to be noticed & dealt with as early as possible. Perhaps you could ask HV what you can do to work on your DD's weaker areas. Once I realised my DS2 had a speech/language delay I arranged hearing tests for him, bought a DVD by a speech therapist , read some books (It Takes Two to Talk by Hanen is a good one) & made sure we went to a singing class as I'd heard singing helps develop speech, as well as other things. It made me feel much better about DS' delays to be proactive. He is still delayed, but not by as much & it is wonderful to see him progress each day.

I've got hearing tests arranged, however I am confident her hearing is ok as my sister is deaf an my mum teaches deaf pre-schoolers so we'd be likely to be aware. I also work with young children with sn. Maybe it's why we're relaxed, as the children we see have high needs.

I have been quite naturally doing singing, subconscious sign support (as I use bsl a lot for sister) an every other tip the therapist had. It made me feel worse she was still behind as she agreed I did a lot and the group she ran would be of no use.

I know salt is common, but I work with older children and I'd believed she was too young for referral. However she is apparently behind enough already to warrant it.

i think you should see it as a positive move after all the HV and another person has recommended the referal and if it turns out to be nothing then no harm done but if there are any issues then surely its a good thing that they are picked up on. A HV once told me she thought my daughter had a hip problem, worried me for days had to go for a scan in the snow and the ice, waited for over an hour to be told after a 30 second scan that there was no problem. I was just relieved that someone had checked it out early enough for any problem to have been caught.

My ds2 is 22 months and can't do simple puzzles and is only now starting to say a few more words other than "mummy" and "daddy". My dd1 could do wooden and jigsaw puzzles from about 18 months and dd2 was speaking in sentences at 18 months. However ds2 was walking confidently at 9 months while dd2 was 14 months when she took her first wobbly steps.

All children develop differently so try not to worry too much. As pp have said the referrals may turn out to not be needed but if they are then its best that they're done as soon as possible.

To be honest, your lack of concern up till now is a GOOD thing in my opinion.

Most Mothers I see on here and in real life who'se children do have some special needs have had niggling concerns for quite some time.

he fact that you work with children with special needs suggests that you would know what to be worried about but haven't been.
As you probably know, quite a lot of DC under 2 aren't talking lots.

But having said that, if she DOES need SALT then at least you're in quick.x

Thanks, I probably need talking down. I was so worried about her physically early on, it's probably simply brought all the anxiety back. I'd accepted she was a bit uncoordinated and weak on one side, now I feel like suddenly she delayed in multiple areas. It wouldn't worry me had it been my son, I just feel with her likes it adds up to a bigger picture. I feel like I notice more and more now. In tesco just now it was like seeing her walk through new eyes, it's like a stiff drunk.

My job makes it worse if anything! I sit here thinking oh gosh, x or y was like that his mum said... obviously I work exclusively with children where concerns heightened rather than the ones who caught up.

In the bigger picture I thing with long hours, her lack of sleep, money Nd childcare stress and the stress of her early days I'm simply getting generally anxious/ tired/ not coping. I've lost 3 stone recently.

I don't care about talking either, my son didn't, it's the fact she doesn't understand anything at all. Even mummy is a general word for speciAl person attention. I thought she understood but she reacts to any word in the same tone to call her.

i hate this too my son is not as advanced as his peers but neither was his brother at this age

but they expect so much more from them these days the checklist for 18 months even suggests potty training from 18 months! it always used to be 2 1/2 years now its 18 months?!

i personally think children with older sibs are disadvantaged by their siblings they "talk" for him get him things he is a lazy bugger really but he is so loved by them ive had to put my foot down and tell them he needs to speak for himself ! how cruel do i feel but its working he is saying more words sort of

his sister is the eldest she was slower than others physically but her speech and cognitive development was way ahead of others
middle child was better physically as we are a chatty family he would get what he wanted rather than asking for it

im sure it will work out ive had referrals off HV before only to be told the child is fine she is being fussy xx

Does she copy? How do you teach her things (e.g. drinking out of a cup, physical skills etc?)

Referrals can take ages (I waited a year for ds2 - who was at high risk of a communication disorder - to be seen by SALT after I referred him at 2) - so an early referral is good imo. You can always cancel if it becomes unnecessary.

Did they investigate the cause of her hemiplegia?

TBH the assessments can be a bit random at times. DD2 did not walk until she was over 2 years old. I did not see the HV (busy city area) for the period between her being 18 months for vaccinations and over 2, and when I did see her again, DD2 was walking, but HV said if she had seen her at 2 and not walking, she would have done a referral. As it is, there don't seem to be any other problems, and it seems as though Dd2 was just lazy (she was also slowish to gain weight and was referred for that, but is not skinny now at 4, though far from being overweight). The talking also can be very variable between children. Both of mine have been quite gobby pretty much from birth, but I saw friends' babies at this age and some were not talking much if at all. Obviously it's better to get it checked out than to let something slip though without help if they need it, but it doesn't have to be cause for panic because a lot of the time you will come from the referral having been told everything is fine (and if it isn't, there is a lot of good early intervention available now so the outcome in the end is often good even if a problem is diagnosed).

she has acquired physical skills through watching and hours of independent experimentation mainly. quite hard ti direct her but she's a trier.l

the original letter actually says "probable hemiplegia" but subsequent ones omit the probable. the speculation was it was either the infection that caused prom and a 36 week delivery or the very high level of jaundice at 5 days. i think the later as she fed after birth but then had some difficulty after. that's my speculation . if was a quick diagnosis and discharge. its very subtle now, though obvious early on.

Ok - it sounds like she has an understanding of copying then even if she finds it physically hard to recreate the movement. Ds1 had no ability to copy until he was 8 - before then we had to teach him everything hand over hand as he couldn't learn from observation.

That's good news! :)

If the hemiplegia is a result of CMV or simiar infection it could be possible that it has caused some cognitive issues too.

That doesn't mean they will be significant but its really worth getting a proper peadiatric review. If anything just to set your mind at rest.

I would expect a child with hemiplegia to be followed up/monitored as a matter of course anyway.

Your question about whether these referrals are common...yes they are. If a child has delays/difficulties in more than one area they should get referred for a review so they can be referred on to physio, OT, SALT, portage and any further investigations.

Please try not to be too anxious. It could be as simple as being assessed, getting a bit more physio and SALT and perhaps a ref to portage. It doesn't mean that there is something terribly wrong with your little girl.

It sounds as if she is doing some great things already. Copying (as Saintly says) is brilliant, a really important skill.

Signing is great but with a child who isn't Deaf its important to use the word rather than just the lip patterns.