Thursday, September 20, 2012

I'm walking too far ahead

I've been meaning to write about our experience with BabyT's gross motor delays. Even writing that sentence gave me pause, because the word "delays" imply to me that there's something wrong. I'm still not convinced that's true, but when you compare her to the average she has definitely picked up some skills much slower than her peers. And of course, everyone thinks their child is a genius and above average, right? We're no exception.

She was a super huge, healthy baby who LOVED her milk. So much that she was nearly always off the charts for weight. She got head control and reached for things right on schedule. She rolled over once "on schedule" but we didn't really see her do it again. She definitely was not interested in rolling to get anywhere.

She sat with assistance from a Boppy around 6-7 months, and got better and more stable at it over the next couple of months. Maybe a tiny bit later than her baby friends, but not much.

In general she was just not that interested to go after things out of her reach. We actually thought that was a feature, not a bug, since it was easier on us and she was content and happy to hang out with books and toys for LONG periods of time. I could even take a shower!

But at her 9 month checkup, her doctor expressed some concern that she was not even attempting to crawl. She recommended we get her an evaluation for all skills (language, small motor, and gross motor) with a local early childhood center if she wasn't crawling by 10 months or so.

I hated hearing this. I didn't want anything to be "wrong with" my perfect baby girl. But I made the appointment for the eval a few months out since they're hard to come by, and figured she'd work out the crawling thing, and we could cancel the appointment.

But she didn't and summer break for the center was coming up, so we went in for the eval around 10 months. T thought it was great - 3 people to play with her *and* new toys. She dutifully stacked cups, answered to her name and looked at things they pointed to, while we answered a battery of questions about what skills she had (did she "help" by putting her arms in sleeves when we dressed her, was she trying to pull up, would she "walk" if we supported her upper body, etc.).

They told us that she was doing well on language and small motor skills, but was 2 standard deviations behind the average in gross motor skills, which meant she qualified for Early Intervention physical therapy through our state's program.   They thought she would just need sessions twice a month, and we agreed to set those up.

I was disappointed about the results, and all of the official paperwork that showed up referencing developmental disabilities.  Granted, it's all boilerplate government documentation but still hard to read when it's MY kid they're talking about.

T started physical therapy in September 2010 when she was about a year old, and a few months later, at 15 months, started crawling.  She got really good at it.  We're not sure if it was the physical therapy or the fact that she started daycare in the toddler room at the same time, and wanted to keep up with the other kids.

We worked on building her strength and getting her to be more active at the park and playground. 

At 18 months with no sign of walking, I was officially freaking out so we increased her physical therapy sessions to once a week.  She was the only kid in our toddler group who was not walking.

She finally took her first steps when she was 19.5 months old and since she's super cautious, she apparently waited until *she* was good and ready, skipped the wobbly-falling down stage, and got good at it in just a few weeks.   We stopped using the stroller almost immediately and had her walk everywhere we went, to get her more practice.  Our toddler group friends cheered for her when she walked by herself to the park at our first summer playdate - she was so proud of herself!

But here's the thing - she was acquiring all those skills in the expected order, just about 6 months behind most of her peers.  And by the time she walked, she was already speaking in complete, clear sentences so I wonder if her brain was just working on other things.

It's hard to know if the PT actually helped but I know it didn't hurt.  She loved visits from "Miss Carrie" and I didn't want to take the chance that her skills would be even more delayed without it.  Upon recommendation from other folks at work with kids in the same situation, we signed her up for Little Gym around 16 months, to give her some more structured active play time and continued that through this summer.  She just started taking a combo dance and gym class there this week as per her special request to learn to "do ballet".

In March 2012 we decided to discontinue PT even though she was eligible for it through her 3rd birthday.  She was still a little behind her peers (still super cautious, not jumping yet) but I felt confident that she'd catch up over time.  She's become a lot more active in the past few months, though I think she's always going to be cautious - it's just part of her personality.  (I can relate!)

I wanted to write about this because Dr. Google alarmed me with a lot of worst-case scenarios around motor development. I couldn't find any info on kids who just happened to walk late for no discernible medical reason, but were on track (or ahead!) on development in other areas.

We did all the "right" things when she was tiny - tummy time, limited time in the Exersaucer, used an Ergo carrier instead of the infant carseat all the time, etc. But she developed her skills at her own pace and continues to do that.  Frustrating when you compare it to the standard timelines, but humans are all different, right?

So for anyone doing late night Googling about "why my baby isn't walking yet" or "not walking at 18 months", hopefully this is somewhat comforting.   It is worth getting the evaluation and the PT helped us feel as if we were taking action and doing what we could to help her without stressing out or trying to force her to acquire skills before she was ready.

It was also a good exercise in patience for me - just because we *wanted* her to learn how to walk, and practiced with her, didn't mean she was going to do it.  This is a familiar refrain around here (see also: Potty training)  Sometimes, you just gotta wait it out.


  1. I really think we should give our kids time. I have four children and have had 4 different experiences. With the first two twins who were born early they said that we shouldn't follow charts. Well, they both started walking at 11 months. Our third just needed more time. As parents we should stay vigilant. I try not to compare them to charts and tables and statistics. Love your post!

    1. Thanks for your comment! It's so hard NOT to compare with the stats since they're ever-present. I'm expecting Baby #2 any day now and am really curious to see how she develops. It's amazing how babies from the same family can be on completely different timelines.

  2. I really like your post, and even though it's impossible to judge for me, it feels like it's more a personality trait to be careful than any sort of inability. My son is the opposite; he climbs on things, falls all the time and would get off the couch head first if we hadn't taught him to go feet first. He started walking around his first birthday, but is bruised all over from falling down all the time. The amount of times he has pierced his lip with his teeth is more than I can count... Oh and he doesn't sleep through the night ;-)
    Sometimes it would be nice if we were by ourselves with no one around us, because then things would be so much less problematic! For us it's the "is he still not sleeping through the night?" whereas for you it might be the "is she still not walking?" I usually try to imagine if I would be worried if I no one ever said anything about it, and the answer is usually no.

    1. Yeah, I think the Mama Instinct is pretty powerful and it never kicked in for me (well, maybe at 18 months when she still didn't seem interested in walking). I never felt like anything was really wrong, but had so many worried people around me that it was hard to stay positive.

      And yes, we got that question *all the time*. Re: your son's sleeping - I remember reading one of Dr Sears books about babies who had a hard time being soothed, or had a hard time sleeping were usually the ones who wanted to walk/get moving early and experience the world. Sort of like they were impatient to "just get on with it, already". I thought it was an interesting theory :D

    2. Thanks for your suggestion! I actually just bought and read 'Nighttime Parenting' from Sears. I didn't read anything new (we're already co-sleeping and breastfeeding), but it's nice to hear that that's the way to go according to Sears.

  3. What an inspiring post! I had to stop googling medical issues as I was always having panic attacks and sure we were dying of some weird disease! I really think we should trust our instincts about our kids. My first born did everything early - she walked at 8 months, talked clearly by the age of one, just everything fast. My second born did everything so very slowly, he didn't start walking until he was past a year old and it was hard to understand him until he was 3! But we had an awesome pediatrician and he just told me to let my son do things at his own pace as there was nothing physically wrong with him. He's now 25, and just left for grad school to get his phd in chemistry! You know your child best! Trust your instincts!

    1. Hah, I love that your "baby" is getting his PhD now! :) So much of this stuff just works itself out in time, and doesn't impact Their Future Lives even though it seems all-encompassing at the time.

      We have a friend with a super-early walker, and I will say I did not envy how vigilant she needed to be with such a young baby walking. So in some ways, T waiting so long was actually easier on US :)

  4. I've always subscribed to what I was told once. When you look at a kindergarten class can you tell which kid walked, talked, or was potty trained first? No. I figure I'll worry if any of those don't happen by then. :) Otherwise, let them explore and learn in the order and the pace they want.

    1. I know, and even just in preschool it already doesn't matter that she started walking or jumping later than her classmates did. I like this filter ;)

  5. It's pretty much impossible to force another human being to do something on our timetables. Parenting is, perhaps, a long process of accepting this. Btw, my second kid walked much earlier than the first. I think he saw his older brother doing it and wanted to be like him.

    1. Yeah, I'm very curious about what Baby #2 will do! In some ways we had it easy with T not being mobile for so long - we didn't need to babyproof every.last.thing.

    2. Everyone told me this would happen and it didn't with us...L was weeks/months behind B in all milestones, including getting teeth 4 months later. and so I was worried that our second had delays, when in fact, he was just a tad behind his brother who was way ahead of the group...our pediatrician basically told me he suffered from "acute comparison"-itis. Oops.

    3. I know @ana! It's going to be so hard NOT to compare!! T didn't get her first tooth until 11 months, and the second didn't come in for at least another 6 weeks after that :)

  6. Henry didn't talk on schedule, and at around 2 or so the doctor wanted to get him evaluated. They checked his hearing first, then receptive vs. expressive speech. He was at the 95% or so for receptive (he understood what we said) but down around 5% for expressive (he said only a handful of words). I can't tell this story without mentioning that the speech therapist averaged these two numbers (!?!). They recommended speech therapy, but before we got to the top of the waiting list (4-6 weeks later) he was talking up a storm, so we didn't go.

    The thing with development is that there are lots of delays that are part of the natural landscape of human development, but *some* delays are because of an underlying problem and early intervention provides the most benefits. So some kids will get treated who don't need it because that's the only way to catch the ones who *do* need it.

    For the record, Emmett talked really early, and so did Luke (but a little less), so Henry was a *big* change!

    1. I love hearing from mamas with multiple data points ;) I've also read that subsequent kids tend to speak later because their older sibs tend to speak for them, or just get them what they need, etc. I wonder if you've noticed that?

      And yeah, i understand the need to over-identify potential delays so you don't miss kids who will really need it. It's just so weird to get official letters from the state's Dept of Developmental Disabilities and stuff :(

  7. Heh. Opposite data point here - early walkers (10-ish months), late talkers. Boys 1 & 2 were on the late side of the "normal" range (16 months, maybe? they're 7.5 and 4.5 now so it's hard to remember); Boy 3 was more delayed. Since he was the 3rd child and i was (am) the frazzled, tired, distracted old mom, i barely noticed. He was in a study at UW, though, and they mentioned a possible speech delay when he was about six months old. My reaction was an eye roll with the thought that HE'S SIX MONTHS OLD, PEOPLE! But that nagging feeling is there - i know my kid and figured he'd probably be fine...but what if he wasn't? I have good instincts but am not trained in these specialized areas, so, perhaps these nice people know something i don't.

    So, we had his ears tested, which, if you've ever tried to have a nine-month-old's hearing checked, you won't be surprised to know that we had to keep going back again and again and again. As he approached 18 months, i did recognize that he had hardly any words or signs when, at that same point, his older brothers *did* have a nice long list, so it was time to get evaluated.

    And, of course, because he's the poor neglected third child, that didn't happen until he was 23 months old. He qualified, just barely, and we began some in-home speech therapy and - an interesting development to me - some occupational therapy, too. (Behaviors i had chalked up to him "just being two, if a little more 'two' than his brothers had been", e.g. not being able to sit still for more than five minutes even with favorite distractions like food or TV, were explained as his way of needing/seeking more stimuli than his brothers required.)

    Naturally, this is when his language and coping skills exploded. It happened right when the home visits began and the therapist recommended ending them after only three sessions. (Same with the OT.) However, because we didn't want him to slip through the cracks, she referred us to the therapy center's playgroups where they can keep an eye on him till his third birthday (in May), making sure he's moving forward and not regressing. We started at the end of August - so far, so good.

    All this rambling to add to what you and everyone else has already said: Our kiddos will probably be fine without any intervention but, on the off chance that there's a fixable problem, better to get at it sooner rather than later. Most of the anecdotal evidence in my circle of parents has happy endings. However, i do know a few kids whose delays, for a variety of reasons, weren't discussed and probably would have benefited from early intervention. Better safe than sorry and all that, especially since we live in an area where these programs are still being funded and/or covered by insurance. Say what you will about the People's Republic of Seattle but this is one area they do really, really well. :)

    Random: We're also late teeth-getters. Boy 1 got a tooth at nine months, walked at 10.5 months. Boy 2 got a tooth at eight months, walked at 10.5 months. Boy 3 took his first steps (10 months, 4 days) a few weeks before he got his first tooth!

    1. Yes, I am constantly amazed by the services offered by the PRS or maybe it's WA state in general ;). Like all those mailings about developmental milestones, the fact that my mom got her TDAP shot for almost free, and the Early Intervention programs in general. We are definitely lucky to live here.

      T has failed a couple of hearing tests (or at least, they were inconclusive) because she just got bored with it, or had fluid in her ears. Because she went to daycare, she *always* had fluid in her ears, even if she wasn't sick. Sigh.

      So we do eventually need to go back and get another one, but given her verbal skills and her sharp way of repeating things she hears when adults are conversing, I am pretty confident her hearing is just fine!

      I've been curious about whether late teething is correlated with anything else. I guess we'll have another data point in a year or so :D


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