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HomeHealthKidsDon't Worry When Kids Miss Milestones

Don’t Worry When Kids Miss Milestones

Baby Feet Walking
Marybeth Morgan of Dunkirk didn’t worry when her daughter Liv wasn’t walking at 12 months. The youngest of three girls, Liv was content to be carried. At 18 months, the little girl still wasn’t walking but she would scoot across the floor. “She had incredibly good locomotion with scooting,” Morgan says. “She was very fast. She seemed normal in every other way.”

Even though her pediatrician was “very laid-back and saw no reason for concern,” Morgan says she was beginning to wonder.
“I went back and forth” about getting help, she says. “You’ve always got that doubt in the back of your mind.”

When Liv was 20 months and still not walking, she decided to seek help from the county health department. “I had a good friend who is a physical therapist. She thought everything was fine, but she said ‘if you don’t call and get it checked out, you’d regret it if something really is wrong.’”
Liv took her first tentative steps the night before her assessment with the county physical therapist.

That’s not to say that Morgan didn’t find the sessions with the physical therapist helpful. “She gave me lots of suggestions on how to help Liv be a more confident walker,” the mom says.

Julie Ennis of Lothian had more cause for concern. When she was seven months pregnant with her daughter McKenzie, she got devastating news during a sonogram: The little girl had an intestinal deformity that would require surgery shortly after birth. Until this point, Ennis’ pregnancy had been normal and uneventful in every way. Unfortunately, the problems were even more severe than the sonogram reveled.

At birth, McKenzie weighed eight pounds, 13 ounces. She was the largest baby in the neonatal intensive care unit (NICU). In addition to the twisted intestines, the little girl had problems with her heart and kidneys, dimorphic facial features, and an extra digit on each foot that could impede normal walking. Tests could not determine the cause of the deformities. “Unknown syndrome” was the official diagnosis.
McKenzie spent three months in the NICU and had multiple surgeries. The doctors warned her parents not to have high hopes; the little girl would surely have developmental delays because of all the deformities.

“The only syndrome I had ever heard about was Downs. I didn’t know there could be an ‘unknown syndrome,’” Ennis says. “The doctors scared us to death.”

Based on the doctors’ admonitions, Ennis was constantly worried for her daughter.

It can seem like a mother’s main job is to worry. Is my child all right? Is he doing okay? Is that normal? My child isn’t rolling over, walking, speaking in five-word sentences, skipping, writing her letters yet—what should I do? Am I overreacting? Who can I turn to for help? These are the things that keep us awake at night.

Better Safe Than Sorry?

The first step is to talk to your child’s doctor about any concerns. Many pediatricians will have parents complete a questionnaire about their child’s developmental progress at each checkup.

Often though, it’s the childcare provider—not a doctor—who first notices a developmental problem.

Barbara S. Garrett, an associate professor of teacher education at Anne Arundel Community College says “Even though the first step is to talk to the doctor, pediatricians don’t always catch developmental delays because they don’t see the child in a play situation. Doctors see the child for such a short amount of time,” during checkups.

Garrett, who teaches the growth and development course, tells the future teachers to always err on the side of caution and refer a child for testing if they notice anything unusual. She recommends parents familiarize themselves with development milestones for their child’s age and seek help if their child is six months to a year behind. “If the red flag goes up,” she says, “always pursue it.”

If a parent is overreacting, no harm is done, she says, but the sad cases occur when a child’s delays are not caught soon enough. “It’s important for parents to know what the norms are,” Garrett says. “Always follow-up; don’t let it slide. There are lots of websites on childhood development and wonderful books in the library.”

Jeff Franklin, the co-chair of the Early Childhood Coalition Task Force and former owner of Be Beep toyshop in Annapolis, says it can be difficult to pinpoint when a parent should be concerned because it varies from child to child. “You don’t want parents to be overly concerned if their child doesn’t exactly match the [parenting] books,” he says, but you don’t want children to fall through the cracks either.

Sue Powell, a diagnostic technician with the Anne Arundel County Child Find, echoes this sentiment. “I would rather tell a mom that things look okay than have to tell a mom there’s a problem that could have been caught earlier,“ she says. Child Find is a federally mandated program that offers free screening and services for all preschool children. Anyone, including parents, grandparents, caregivers and doctors, can refer a child for diagnostic screening if they suspect a problem.

Powell says the main reason children are referred to Child Find is for speech or other communication problems. Typically, the Infants and Toddler program, which screens children from birth to 2 years 10 months, sees cases involving medical or physical developmental problems.
After a child enters elementary school, the public school system is responsible for screening and testing children for developmental delays, regardless of whether the child is enrolled in public school or not.

All screening and services through the state are free. Parents can also seek out screening and services through private practitioners; fees vary and may not be covered by health insurance.

After a Child Find screening, if everything looks on track, Powell will give the parents activities, strategies and games to further help the child’s development. If there seems to be a problem, a more formal assessment will occur. If Child Find is going to make recommendations for further treatments or services, the office will develop an Individualized Education Plan that recommends services either through the school system or in the local community depending on the child’s need. All recommended services are free of charge.

Milestones Matter for Older Kids
For older children, noticing a problem may be harder for parents, Garrett says. Adolescent developmental milestones are social and emotional, rather than physical or cognitive. “Parents should be aware of how their kids are doing in school all the time, not just when the report card arrives,” she says.
Garrett’s own son would come home from high school and say his homework was done and everything was fine. Later his mom would find out the homework wasn’t done and he hadn’t studied for his test.

It’s normal for kids to tell their parents everything is fine with school, because they want to solve their academic problems on their own.
Garrett says parents should also pay attention to the child’s peer group—who she hangs out with and what their activities involve: these are all clues to how the teen’s character is developing.

It’s a part of normal development for adolescents to pull away, according to Ava Siegler, author of the Essential Guide to the New Adolescence (Dutton, 1997). It’s also a time that children create new attachments, formulate their ideals by challenging their parents’ authority, establish a mature sexual identity (yikes!), and create their own character, all of which prepares them to function as a capable and mature adult, according to Siegler.

But knowing that child’s behavior falls within the normal range still doesn’t stop a mom from worrying or feeling guilty. “The one thing I’d like to tell moms is that their children’s delays are not a result of something the mom did or didn’t do,” says Powell.
Thankfully, both Liv and McKenzie are doing great now.

Liv is an energetic and talkative 5-year-old. With her love of ice skating, you’d never guess she was a late walker.
McKenzie surprised everyone by surpassing most of the developmental milestones. She began looking around and responding to familiar faces at 2 months. She began walking at 8 months, partly motivated by the desire to catch up to her older brother Justin.
“She’s my miracle child,” Ennis says. “Sometimes you [and the doctors] just don’t know.” McKenzie, who is now 4, still sees specialists at Johns Hopkins, and despite the doctors’ early predictions, she is right on track developmentally and enjoys her preschool class.

Suggested reading:

Is It a Big Problem of a Little Problem? When to Worry, When Not to Worry and What to Do, by Amy Egan, M.A., Amy Freedman, M.A., CCC-SLP, Judi Greenberg, M.S., OTR/L, Sharon Anderson, OTR/L, St. Marten’s Griffin (2007).

A Parent’s Guide to Developmental Delays, by Laurie LeComer, M.Ed., Perigee Books (2006).

Essential Guide to the New Adolescence, by Ava Siegler, Ph.D., (Dutton, 1997).

Side Bar:
Where to Turn For Help:
Note: All children with suspected developmental disabilities are entitled to free screening and services through the public school system or county health department regardless of whether they attend public school or not.

www.marylandpublicschools.org

Maryland State Department of Education
200 West Baltimore Street
Baltimore, MD 21201
410-767-0261 or 800-535-0182

Your local Child Find office within the public school system (for preschool children)

Anne Arundel County
Age 5 through 5th grade
Preschool/Elementary/Speech and Language
Anne Arundel County Public Schools
2644 Riva Rd.
Annapolis MD 21401
410-222-5470

Margie Kerman (Non-Public)
2644 Riva Rd.
Annapolis MD 21401
410-222-5479

Calvert County
Donna Young
Calvert County Public Schools
4105 Old Town Rd.
Huntingtown MD 20639
410-535-7380

Howard County
Linda Flanagan
County Diagnostic Center
5451 Beaverkill Rd.
Columbia MD 21044
410-313-7046
Email – lflanagan@mail.howard.k12,md.us

Prince Georges County
Carol Reed (School Age)
14201 School Lane
Upper Marlboro MD 20772
301-952-6346

Queen Anne’s County
202 Chesterfield Avenue
Centreville, MD 21617
(410)758-2403
1-800-336-7775

 

By Rose Talbot

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