Hellobee

It’s hard to believe, but Juliet’s one year anniversary in Early Intervention is fast approaching. It’s amazing when I look at my little 19 month old baby and see how much of a difference one year can make. Juliet started Early Intervention at 9 months, barely being able to sit on her own properly, and now she is running, climbing, jumping, and being a busy little toddler. She recently had an evaluation prior to her one year review. As it always has been, she is on par if not ahead on all levels save for her speech.

Wonder who she would call if she could

Juliet certainly has made a lot of strides in her communication abilities, but sadly she is still only capable of saying a small handful of words, including mama, dada, byebye, uh oh, cat, baba, and lala. She makes an attempt at words like fish (shhhhh), jump (something that sounds like mp), hop (pa), up (pu), but as you can see most of those are more sounds than words. She can also make a small handful of animal sounds like ahah (for monkeys), meow, moo, and a few others. As each month has rolled past I have gotten increasingly worried about her speech, or lack thereof.

When she first enrolled into Early Intervention, Juliet was assigned a developmental therapist that she is still currently seeing, as our service coordinator said that speech therapists weren’t assigned to children younger than 18 months, if not 2 years. Juliet’s developmental therapist works a lot with her on speech, and is trying to get her to imitate play sounds like vroom, choo choo, etc. She also works with her overall communication abilities by teaching her some signs like open, all done, more, etc. I couldn’t be happier with the progress Juliet has made, and I doubt I would have been as successful in teaching her these skills without the help of Early Intervention.

Here is the breakdown of Juliet’s evaluation:

Communication – Juliet’s biggest hurdle has always been her lack of speech. I have a friend whose son is a little older than Juliet and will be coming up on one year as well in Early Intervention. He was admitted at 18 months for speech delay and when my friend and I both compared notes, we found it was quite similar. Both her son and Juliet are the younger child with an older sibling that spoke early and still does at a very advanced pace. Because of how much our older children talked and dominated the conversations, it didn’t occur to either of us that our younger child was not speaking. We both relished the silence in some ways since we were always chattering away with the older child, and so the image in our mind was always Older child talks so much not Younger child doesn’t talk enough. Looking back through our year I still remember at six months not hearing Juliet babbling, and only then first realizing that perhaps she ought to be. Juliet was just always so quiet it became part of the way I saw her rather than realizing something was wrong. In this category Juliet was scored at 21 months for her receptive communication which was well above her age at the time of analysis (18 months), but in the communicative score she scored at 12 months, putting her a good six months behind.

Cognitive – Juliet scored right on target for this area at 18 months. She was able to follow simple directions and imitate actions that were shown to her such as stacking blocks or pointing out pictures she recognized in a book. She can also understand the objective of certain objects like books for reading and crayons for coloring. Moving forward we hope she can start to understand more complex directions or ones that have two parts, as well as obviously being able to respond verbally to questions and commands.

Gross Motor – Juliet scored at 21 months so a little advanced here as well. It’s amazing that physical therapy is what actually qualified her into the program initially. She follows along with big brother with ease these days and was dismissed from the physical therapy portion of Early Intervention in Dec of last year because of all the progress she made. At two her therapist had said she should be able to kick a ball, jump with both feet off the ground, and walk up stairs assisted — all things she is working on and close to mastering, even when it comes to jumping. Overall she seems to be right on target in this area as well.

Fine Motor – Juliet was on target here scoring at the 18 month level. She can do simple puzzles and stack toys all with a pincer grasp. She isn’t as adept at feeding herself yet with a spoon and that’s something we are working on, as well as handing cups and working on more advanced puzzles. She is also working more on using crayons better, pushing down and actually having the colors show up darker on the paper. All in all we know what to work on in this area and it’s coming along fine.

Social Emotional – This is Juliet’s strongest category as she scored in the 24 month range. Her goals for this area are to start role playing more with dolls and kitchen toys etc. I thought the comments in this section were amusing as it said she has started to defend ownership of objects, and that’s certainly true when she and Drake play. Sometimes when I let Juliet play with my phone she thinks that only she is allowed to look at it, and will purposely turn her body to block Drake from seeing the screen. If he persists she often will run away from him and hide trying to shield him from seeing. It’s funny and frustrating at the same time, especially from Drake’s point of view. It’s something that is a work in progress as they learn how to play better with one another, but I thought it was cute that it was noted in her file.

Self Help – Juliet scored slightly lower for her age in this area at 16 months, but totally within the normal range for children this age. She isn’t as adapt at feeding herself quite yet, and she still places nontoys in her mouth. She does imitate household behavior such as sweeping and cleaning up, as well as carrying her dolls around and babying them slightly. I am working with her on the fork and spoon, and can’t wait for the summer time when we can eat outside and the messes don’t overrun our kitchen.

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After this evaluation was done and we could clearly see the great divide when it came to Juliet’s expressive speech, her therapist called in to have another evaluation based on speech. The evaluation took place just this past weekend and the scores were quite similar — in every area but expressive speech Juliet came up in the normal range. Normal range I was told was anything from -1 to +1. Her receptive speech was at -.33 but her expressive was at -2.33. Averaged together however that brought her overall speech to -1.47. Typically to qualify for services you need at least a -1.5 in two separate categories, or a -2 in one.

It’s hard to say what will happen since she would qualify with her -2.33, but averaged it brings her right into the range of normal and all her other categories are in the normal range. The meeting occurs at the end of the month so we have a few weeks to ponder. My gut says that she probably will qualify considering how behind she is in speech with the recommendations of her regular developmental therapist as this speech evaluator. Mr. Chocolate and I both have discussed that if she does not qualify to add speech to her therapies, we will most likely start searching for private therapies through our insurance. Still I remain optimistic things will go our way and I’m still waiting for all those lovely little words to come forth from my baby girl.