2 year old, significant GDD: what else could we do?

[Firsttimer7259]

Our daughter is two. She has significant GDD across all areas of development. We have had some genetic and metabolic tests done. An EEG and an MRI. All have come back normal but the MRI shows a variation which may be within normal limits. We see a pead every 3 months, we have physio, SaLT (completed a Hanen prog) and have a portage person. What else could you suggest that might be helpful for her development?

To give you a fuller picture: her behaviour and skills are delayed but not really disordered as far as we can make out. There are no signs of sensory processing issues (she has no aversions we can spot, eats fine, had no problems nursing as a baby). Her movement is 'normal' (shes not clumsy and clearly plans her movements) she is crawling now and standing and taking a few cruising steps. She shows a clear preference for people over objects and makes lots of eye contact and smiling- the speech therapist thinks communication will be a strong point, she falls into the 'sociable communicator' box in Hanen. But she has no language as yet - she doesn't follow any instructions, doesn't point or wave, often does not respond to her name. There is no/little indication she gets language at all - altho she is making more sounds now she is very quiet. She has no words that she seems to understand. She doesn't really play - altho she does knock down a stack and is starting to turn pages in books (she doesnt look at anything I point to). Its not clear that she gets shared attention. She likes to explore and will crawl about looking at things or pull up and try to peek out the window. She makes jokes, giggles, plays peek a boo, and is affectionate and sociable.

Given this picture does anyone have any suggestions for things to do with her?

yes to physio and thanks for the response. I have a plan emerging that includes swimming on weekends (maybe with a float suit?) functional learning time every day ideally 2-3 blocks of 20 mins). Sing and sign dvd or Mr Tumble everyday.
We keep doing what physio and salt recommend and hopefully will gte OT soon.

I am investigating an assessment for autism just in case and want to include early intervention type games and activities in her day to day play. (am getting some books and may also pay for a couple of ABA type sessions to get some advice for activities to do with her.) Basically I want to get seriously proactive.
She is lifting flaps in peek a boo books now and enjoying this. More progress I think!!! I am also really challenging her to walk as much as possible and to use her spoon properly. I make her walk to her pram from nursery. She wants to crawl or be carried at least 2 times during this but then shes all proud when we make it.
Nursery is meeting with her various therapists I hope this will give them enthusiasm to do as much as possible with her. I am seeing progress in her fine motor skills after just 2 weeks of functional learning. I am really going to do a lot with her over the next 3-6 months. Really push myself as much as I can and look for other ways to bring as much input into her life in the hope that this helps her. I think if we could just get to the level where he understands basic instructions, has a few words or signs, and enough hand control to spend time putting stuff into containers etc this would braoden out what she how she plays hugely.

Sorry long post, I keep swinging between grand plans and 'the fear' so writingthis all down gives me hope

Sounds like you have a great plan in place. One suggestion I would make is to read the vb book and try to teach the signs as mands, rather than just labels. Mands are requests, so if she wants something , you do the sign to show her, then prompt her to do it (hand over hand if you need to), then give her the thing immediately. Make sure you vocalise the word when you do the sign, when you prompt her and when you give her the item. This really worked for ds. Thing is she has to really want the item not just be labelling it. The book explains it better. This is how we got ds signing and eventually say words. It needs to be quite intensive though to get results, so pretty much everytime she wants something. It's hard work but it does seem to work.

Obviously focus on a few signa and items at a time, don't make her sign for everything, that wasn't clear in my last post. Let's say you are teaching her a sign for ball, raisin and book, you need to follow the approach every time she wants those items.

Don't worry, my fear faded to a manageable level once I started feeling like I was being proactive and seeing results.

hello, sorry, can I butt in. Did you start with just a few signs you used regularly? We are trying to use signing with ds, but don't want to overload him so just use about 10 signs around the house, we all use them (including the dds). I like the sound of what you have just described,though.

ha sorry, just crossposted with you!

Have you approache any ABA/vb consultants, they are expensive but if it's something you can do, they really are great at getting you started.

Am going to do a big book order in March and the VB book is on my list. Sounds good, I kind of understand what you mean I think - I studied basic linguistics once upon a time -knew that stuff had to gte useful one day!

We started with 5 and only items he really wanted/loved. Also need to ensure the sign is achievable with regards to their motor skills. Any effort at doing it is rewarded and then you can slowly shape the sign to improve it.

It has to be motivating and fun, getting the item has to be worth the effort to do the sign. Biscuits cut into small pieces or songs/ singing can be good ones. Best to give her a taste of what it is she wants first so that she's keen to have more of it, then stop and follow the approach and then give her what she wants again, if that makes sense. The book is much better at explaining it than I am.

First thing ds signed for was raisins and it took ages for him to sign for anythig else, but eventually he got it and picked up new signs very quickly, just needs repetition. One mistake we made was not vocalising the word enough. When we started to do that, he tried to vocalise too. Does take time but once it happens, it's amazing.

I'm not saying it works in all cases but it's got to be worth a try.

Sorry for harping on about communication so much but I personally think it builds foundations for other things :)

Hi again Firsttimer. I posted on your other thread and really glad to see you're feeling better and have what sounds like a great plan. What I didn't say on the other thread is that we're working on a home programme with our DD that is run by the lady behind this organisation. I'm linking to it because it's based on Scotland and whilst I have no idea whether it's near you, it might be a useful contact. Despite the name it's not just for children with ASD. Might be worth a look. Good luck.

Firsttimer-we use this in the pool:
www.ebay.co.uk/itm/SWIM-SAFE-BABY-FLOAT-AID-SWIMMING-SUPPORT-SEAT-1-2-YRS-/230600507402?pt=UK_Baby_Safety_Swimming_Aids_CV&hash=item35b0dc800a#ht_2603wt_952
My DD does the same kind of pretend play with a cup,she also does it with a toothbrush. Our Portage helper suggested pretend food first because my DD loves her food although you wouldn't tell from her size :). She holds a toy food and one of her teddies in one hand. This is how she 'feeds' them I guess. She enjoys it when we have a little tea party for all the teddies.

It so great to see your enthusiasm,it gives me ideas too. Thanks!

We're going to our first visit to The London Centre for Children with Cerebral Palsy tomorrow-although my DD hasn't got CP,they do conductive education and that is something we were advised to do. She had a few sessions a year ago in Hungary but didn't respond very well as we also started a very intense physio at the same time and it seemed too much for her at that time.She was severly hypotone. I am so excited,heard so many great things about it.

isw-how often do you have conductive education?How does it work in your area?

AprilSkies -Your experience with signing gives me hope and I'm so glad for that! I thought that my DD's lack of imitation skills would mean that she can't learn to sign. I just bought the book you recommended for my Kindle, will start reading tomorrow.

I haven't tried one of those seats, but will when ds is better (one of the worst thing about ds getting ill all the time is missing all the stuff we normally do), I'm not sure how he will be in it though, as he is still pretty clingy and still gets carried a lot. He does really love being in the water though, I have to kick his legs for him, but I think he is starting to get it.

I do think the music with mummies thing we do is one of the best things though, he really responds to the songs and the sensory stuff, I don't know if it is just the teacher we have, but she is very good with signing.

Thanks for the detail aprilskies we ahve been signing for a while but she hasnt picked up any signs. Your approach might help - we have been a bit haphazard. I like the hand over hand idea with the signs to actually make her do the signs.

messmonster thanks for the link I am going to contact them. Looks like the kind of flexible support we are looking for.
I like the idea of play food varga she likes her food and chances for imaginative play would be good.

I have come to this new realisation that I have to keep believing in her abilities. Everyone else is waiting, I am not unrealistic this may not get better but I think right now we need to really keep at her and make her learn things in the hope that once she gets the basic maybe the other stuff will gt easier....

I think as well it is really important to focus on the things they enjoy, as this will help them develop. So when they do the SOGS, I found it really frustrating that they kept noting that he wasn't interested in the bricks, doesn't stack them,knock them over, bang them - but if he has his stacking cups he loves to put them together, and bash them and with our help build a tower and laugh when we knock it down. At nursery he won't play with the shaving foam, so they note down 'dislikes messy play', but he loves sitting on my lap and splashing in the sink. It was the same with my (NT) dds, dd1 is not interested in imaginative play at all, she loves logic puzzles, mazes and games.

Sorry that all seems very obvious! I am stuck to the sofa with ds (ill again) and my brain is turning to mush!

IKWYM Hazey, when I had my first flush of trying new things with our girl (10 months ago) I decided we'd focus on animals and animal noises. Loads of books (library thank god), visit to the city farm, animal toys etc. She doesnt like animals, she likes cars it turns out. Makes sense really in our citified life.
Our pead also plonks bricks in front of our girl continually and waits expectantly as she ignores them. Sigh.
Having said that I think she switches off from engaging with things wholesale (maybe to manage her frustration) and that this needs challenging. So I am now making her pick up stuff, put it in bowls etc even tho she has defensive/resistant behaviour in relation to this. I think she needs to learn that with practice she can do this and switching off is not good for her. It doesnt feel entirely right tbh but I will keep at this for a few months and then think about it again. After I have done it she is often happy and alert for a bit if she has some success with grabbing something etc. We are seeing a practitioner of this method next week and I will see what she advises.

I hope your DS feels better hazeyjane.

Firsttimer-I admire your attitude and I am sure your DD will get better. She's made progress already. It's just a slow process but you're doing everything possible for her.
How long has your DD going to nursery?What do you think of it?Has it been helping her? I'm hesitating whether to send my DD for a few sessions a week,maybe 2-3 mornings.I'm afraid that she would be left out and just sit in a corner playing by herself. I know it sounds silly but I have this vision of her.

We had our assessment in the conductive education centre. It went really well. DD responded brilliantly to the conductors and showed everything she can. The place is amazing and they offered us a place for a one-to-one session once a week. I can't wait to start.
The only downside was the journey there. We live in Central London and the centre is in North London,it took 40 minutes to get there by car. My DD got sick in the car, got really upset and just screamed. It happened on the way back too and then she fell asleep, it was 5 pm. I don't really know what to do because,she's done it a few times before and the homeopathic remedy didn't help. I might take the bus but it would take more than an hour to get there.
Does anyone else experienced the same problem with car journeys?I welcome any ideas.

Hi Varga, thank you for the compliment - it actually means a lot that someone thinks I am doing something well in all this turmoil. Part of it is just hiding the weepy chicken within, but I am having a surge of activity just now and going with it.

I hvae no advice on cars but...

Nursery has been excellent. To put you in the full picture I was kind of against nurseries before D was born. Wanted a smaller setting etc and she started out with a child minder. But CM couldnt cope with her and I ended up at this nursery in tears when CM quit on us just as I had a major project come through (I am self employed).

But the biggest thing for me was that they were really encouraging about D being different. They have experience of children with additional needs (downs and autism) and they basically said this is interesting for them and they often have special bonds with the children who need more help so thye really wanted her. This was such a change for the CM where I was always feeling apologetic that D wasnt fitting in.
The nursery are now meeting with Ds various therapists to learn more about how to interact with her etc. They initiated this and they are willing to have therapists come in regularly whcih will give us the space/time to arrange more sessions. I think in part its been great because the nursery are really good about this, The other part is that our girl is very sociable, she loves it when there's other people about (esp children) and activity. Shyness isnt really something she seems to experience. So its a nice busy place for her. It woudl be different if that was something she struggled with.
I would recommend having a look round nurseries in your area and seeing what you think. I ended up putting my (rather silly) prejudices to one side - its a chain nursery frtom their website I didnt even consider visiting them. But I have found in practice being part of a chain is great as it leaves staff free to focus on children and parents not invoicing and legal matters. So this is totally totally different from my rather muesli-esque leanings. But I love them, and they really do seem to love our girl!!
While we waited for the nursery place we had a nanny who is lovely but nursery has all these activities lined up in a way thats hard to do at home.

Oh I left out the practicalities and she does 3 full days a week 9-4 (I think full days are actually easier than half) since mid Oct. We have had some tears on leaving but often she is excited and smiling. She loves all the lights, mirrors etc. Likes the group activities. Other children seem to like her. She learnt to sit in a wee chair there and stand up from sitting. They ahve this perfectly sized furniture that is hugely expensive to buy.
She joins in activities - often not appropriately as she eats the sand, playdoh - but I think its good shes exposed to all that. She is getting a bit too good at stealing other kiddies food