In September Juliet will have been enrolled in early intervention for 6 months (so fast!).  She has been progressing nicely in the program so far seeing both a developmental therapist once a week and a physical therapist once a month. In September her review will be up to see if she can remain in the program or what services need to be added or dropped depending on her progress. Both her therapists recently did an evaluation to submit paperwork ahead of the evaluation. Currently Juliet is still delayed in every area practically (in varying degrees), and most likely will be staying in the program, though we don’t know if any services will be added or taken until September.

The therapists evaluated Juliet on 6 different categories. Juliet will be 15 months of age in September, but for the paperwork she was assessed for her abilities at a 12/13 month range as that is how old she is currently.


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Communication

Speech has always been Juliet’s weak spot and this evaluation really showed me really how much. At 13 months Juliet still can only say ba ba ba consistently as her only verbal sounds. She has added in a few ya yas and ga gas and we have heard her say dada, mama, and hi a few times but never consistently, and she won’t do it when we ask or try making the sounds to her.

I have only heard her say mama twice. I had placed her down on the kitchen floor at the home of the girl I babysit while I went to clean a dish. There was an island so Juliet lost sight of me. She was upset when I put her down as she had wanted to be held so when I disappeared behind the island, I heard a desperate cry of mama as she started to search for me. I was so thrilled that I tried to reenact the scene and disappeared again, but by then she had learned where I was and crawled around to me. That moment gave me hope as it showed me that she could say the sound and attach the word to me, both things that are key to speech development at this age. But she doesn’t say it on a regular basis when I’m holding her and saying mama and pointing to myself, but I still hold onto that memory for now as hope for things to come.

Juliet was evaluated at a 6 month level in her expressive speech, so she’s well behind where she ought to be at her age. Her receptive speech was scored at a 12 month level, so she’s right on target for her age. She does understand a lot of things I say to her including her name, no, and come here. Because of the low score in her expressive speech, Juliet will qualify to stay in early intervention. Currently she has a developmental therapist and will most likely will continue on with her, and maybe even see her more than once a week. I was told speech therapists are usually not assigned until kids are closer to 18 months – 2 years of age, but it is possible if her therapists make a push for it.

Cognitive

Juliet scored 8 months on the cognitive portion of her evaluation. She understands to wave hello and goodbye, reaching for others when they reach their hands to her and looks when she drops a toy.  The evaluation wanted her to be able to shake no when she didn’t want anything (right now she just pushes things away and squirms as a no) as well as make more verbal sounds. Some of the benchmarks required a verbal sound to be made to show she understood, and she doesn’t verbalize well.

Gross Motor

Juliet is cruising, climbing, pulling up, crawling with gusto, and transitioning from furniture to furniture well on her own. She can stand and even let go of what she is holding on for a little bit before sitting down again. She isn’t taking steps yet though, even with my support. I can’t get her to hold my hand and try to walk, though she will hold my hand and then let go to stand. Because of this she scored 11 months for the evaluation. Her therapist said that she will see her 2 more times before the actual evaluation in September, so she might catch up very quickly and possibly even be walking by then. Most likely if Juliet begins to walk by September, she will be dropped from the program for physical therapy. If she isn’t walking by September, they might let her stay in until she can walk and dismiss her then. Though physical therapy is what got Juliet into the program to start with (she wasn’t sitting up well enough), I think she has made huge leaps and bounds in this area and honestly I am not concerned much at all these days. Drake didn’t walk until 15 months, Mr. Chocolate until 16 months, and Mr. Chocolate’s mother until 18 months, so late walking doesn’t scare me much. I think she is close and with her therapy work for the next 2 months, I’m sure she will be walking soon enough.

Fine Motor 

Juliet scored at 10 months in this category. In the evaluation system they run down a list and mark whether the child can do something and move down the list until they hit a series of negatives (I think 3 or 4), and then stop to see the corresponding age. Juliet couldn’t do many of the 10 month skills for her therapist, such as place something back into a cup, mimic banging spoons, etc. But her therapist tried some of the 11 month and 12 month skills just to see unofficially, and she was able to do almost all of those. The therapist said sometimes babies don’t like to cooperate but she couldn’t give her a higher score. Since I saw she was able to do some of the older skills, I’m less concerned. I am working with Juliet on placing items back in after she removes them, pointing at objects with her finger,  as well as copying me when I do things, but overall I know she is capable of a lot more than what the paper says.

Social Emotional

Juliet scored at 10 months here as well, but I was told this is within normal for her age. The therapist said she was clearly attached to me and she knew Drake. She could respond to her name and knew the difference between family members and strangers she never met before. She scored a little lower because while she understands when we speak to her, she won’t always do what is asked, especially more complex things like handing things to us. She knows if we say no to drop what she has, but she won’t bring it to us. Walking is also part of this category for some reason and since she isn’t walking yet, it lowered her score too. Overall the therapist said she was on track here and she seemed like a happy, healthy, child, and that’s all that really matters to me.

Self Help

This was Juliet’s best category scoring her in the 14 month range! Most of this category had to do with Juliet’s ability to feed herself (something she can do in spades!), as well was climbing stairs, helping me by putting her arms up when getting dressed or wanting to be picked up. Also if given a spoon she understands its purpose and tries to put it in her mouth. Anything to do with food my child is aces in, which is probably why she scored so high here. They wanted to work on her using more words and pointing to get what she wants, so I am working with her on those now. She is fine in the self help category so I am just working with her to keep up her skills and continue progress.

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Overall it’s clear Juliet’s biggest obstacle is speech. I love her current developmental therapist who is basically working on speech as well as other parts with her, but I think I would love to have another therapist in for speech sooner than later.  It might just be that Juliet is working so hard in every other area she isn’t focusing on talking yet. I am trying to get her to speak more and speak to her more. Drake also talks over everyone so I’m not sure if that’s whats hurting her a little too since he is so overpowering with his speech.

In September when Drake starts school again, I am going to try to start a class or take Juliet to story time, somewhere else to expose her to other kids her own age to see if their influence will help her start to babble more. I think Juliet is being taken care of quite well in early intervention though, and I’m so happy and pleased with their work and her progress. I hope September brings us more good news and in the meantime, I will savor that memory of mama until another time I hear it.