03 June 2008

Early Start - The Assessment

Yesterday Aaron and I went in for his assessment. His appointment was at 8:30 at a location 30 minutes from here. It was a bit of a challenge getting out of the house with Aaron that early in the morning (I'm not a morning person), but by packing up the diaper bag the night before and with Thom's help in the morning, we made it on time.

It started off with a small orientation with another mom and her baby who appeared to be about 5 months old. We met in a small conference room with the woman in charge of Early Start and 3 service coordinators and a couple other people. Apparently that is not how the usually do things, but they had so many referrals recently they are trying to streamline the intake process by orienting multiple families at once (another mom and her baby were supposed to be there too).

After the 10 minute orientation, the other mom was taken to another room and we got to stay in the initial room. There were some toys there that Aaron had fun playing with, although he also just enjoyed exploring the room and crawling under and around the chairs. There were two outlets in the room - one that had a babyproof faceplate and one that didn't. Guess which outlet he was determined to put his fingers in?

Our service coordinator stayed with us and we filled out paperwork - releases for his medical and birth records, etc. Then a developmental specialist came in and the assessment began. They had a booklet with different age ranges and for each age range, there were about 8 categories - gross motor skills, fine motor skills, communication, self-help to name a few. There were check boxes of skills associated with each age range and category. Through a combination of questions and hands on activities with Aaron, they scored how he did in each of the categories.

To qualify for the Early Start program, he needed to be delayed in at least 2 categories. In gross motor skills, he was delayed 25-50%, meaning that he was about as developed as you'd expect for a 7-10 month old. They also said he was 25% delayed in fine motor skills which surprised me. She went through the checkboxes, and apparently he was deficient because he hadn't stacked the blocks she gave him to play with. She hadn't asked him to stack them - only to put them in a cup and bang them together (which he did). When I told her he stacked blocks at home, she got the blocks back out and tried again, this time stacking them and then asking him to stack them. He stacked them 4 blocks high. This was enough to adjust his fine motor skills score up, putting him on par with a 15.5 month old's development.

But he was still considered delayed in speech (for not using words) and self-help (for not using a spoon to feed himself) and I think another area because he doesn't have a transitional object (a blankey or a lovey to cuddle with). I'm only concerned about gross motor skills at this point, but I'm glad he was delayed enough for us to qualify for the program.

The whole process took 2 hours and all of this was during naptime. Despite being tired, he did so well. He was social and charming and everyone who saw him commented on his happiness and personality. He had been flirting with everyone in the initial orientation meeting, looking around and smiling at them. And during the assessment, the two women were so impressed with out well he responded to everything. But after 2 hours, he was getting fussy and wanted Mommy. So we decided to schedule a follow up visit to create our "individual family plan", which normally would have been done once eligibility was determined. So I go back Monday for that. It should only take an hour, but since it is during morning nap time again and Aaron's participation is not required, Thom volunteered to go into work late so I can leave Aaron at home.

Although I won't know for sure until we do the family plan, it did sound like we will be referred for physical therapy. And although they don't know if there is a PT who does home visits in our city, they said there is a good place they can send us that is much closer to us than the office we went to yesterday. If they suggest speech therapy or anything else, I will probably turn it down at this point. That is the nice thing about the program - all these services are available to us, but it is up to me to ultimately decide what I want to do. If he is still not talking once he is walking, we can consider doing something about that.

And the reason Aaron isn't feeding himself with a spoon? I didn't tell them, but it's probably because I don't give him a spoon! I still think it is more mess than it is worth at this point. I'm a mess-aphobe and prefer to spoon feed him myself. But he does self-feed finger foods, so I'm not worried about it.

Oh, and the good news is that Aaron is starting to successfully pull himself onto his knees - which I understand is a precursor to pulling to a stand. He's done it in his crib, in his playpen and yesterday with a child's chair. The developmental specialist recommended we get him a bench or a stool that is lower than the coffee table to give him a chance to pull to his knees. That will help him work on balancing with his hips and later to stand.

No comments: