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"Developmental Delays" in 5 year old boy

Submitted by an LD OnLine user on

My son is 5, on an IEP in preschool. I’ve taken him to a behavioral and developmental pediatrician who has labeled him developmentally delayed, which seems pretty generic.

I am new to this site today and have learned more about my son here than in the past two years. Thank you.

My question is what to do next. He is having great problems learning ABCs and numbers. Things don’t seem to register for him. He also has quite a deficit in his fine motor skills. He can’t even begin to write his name. Even with the help he’s getting per the IEP in preschool, no real progress.

I don’t know what kind of doctor I should take him to next, a neurologist, a psychologist, psychiatrist, another pediatrician. Who can help me?

The idea of him starting kindergarten next year with 25 other kids is causing me to lose sleep. He’s so behind. I don’t know what to do to help him learn.

Any advice would be appreciated.

Thanks

Submitted by Anonymous on Sat, 10/16/2004 - 2:35 AM

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You might want to look at NeuroNet (http://www.neuronetonline.com ). It’s not widely available, but it’s possible to do it long-distance with periodic visits.

An alternative would be to do Balametrics at home (http://www.balametrics.com ). NeuroNet incorporates some Balametrics exercises but is much more comprehensive.

Is your son in occupational therapy now? It seems to me your developmental pediatrician should have ordered an occupational therapy eval. (NeuroNet is an in-depth version of occupational therapy.) Most medical insurances will cover an OT eval with a referral from your doctor. Private evals are usually more comprehensive than school evals. Look for a really good clinic in your community.

With what you describe, I would be focusing on lots of bodywork and therapies that stimulate neurological development and sensory integration. Occupational therapy is one. Sound therapy is another. TLP (http://www.advancedbrain.com ) is the one I am most familiar with. There is research evidence indicating it stimulates neurological organization in addition to conditioning the auditory system.

Your best bet is not to look to the school or even to most professionals for help, but rather to research everything yourself — the internet makes that possible — in order to decide which therapies and approaches are most likely to help your son.

Nancy

Submitted by marycas on Sat, 10/16/2004 - 3:29 AM

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Are the teachers worried about his rate of progress?

Entering kindergarten without knowing ones letters or writing ones name is not unique(and you still have an entire year to go)

I dont want to downplay your concerns;anything you choose to do can most likely only help, but I was a little surprised by the specifics of the concerns

Should he be in kindergarten this year by age? Is that why he is expected to do kindergarten work

Submitted by victoria on Sat, 10/16/2004 - 3:53 AM

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Several points

(a) Definitely, five years old is the time to be learning these school things, not to have them all mastered. Try to avoid pressuring him, which won’t help.
In some areas you can delay kindergarten entrance by a year — there are pros and cons which you would have to work out for yourself, but it is an option to consider, to give him another year to catch up. This is much less of a strain than repeating a school year later.

(b) Yes, the idea of things like neuronet and balametrics and OT, and also sports etc., to develop coordination and timing, all very good ideas. This basic work is even more fundamental than teaching the alphabet.

(c) I have typed up and posted a very long detailed outline on a method of teaching the alphabet with multisensory approaches and a planned, step-by-step progression. It was posted some time in the last two weeks. Use the search option at the top of the Teaching Reading page with my name in it. This method is very appropriate to work with someone like your son, focusing on one small skill at a time.
If you can’t get it by searching, email me and ask for a copy (and I’ll send the whole packet of teaching reading notes if you want them).
[email protected]

Submitted by Anonymous on Sat, 10/16/2004 - 2:58 PM

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Can you give us more history about your son. Was he premature? I would need to know what qualified him for the early intervention preschool program in your area? It sounds like he needs to be in a special day class that is geared toward helping kids with developmental delays.

I need to know the numbers on the assessments that qualified him so I can guide you better. On any of the paperwork do you see LIF as a diagnosis?

Submitted by Leslie-G on Sat, 10/16/2004 - 5:43 PM

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Thank you all for your responses.

The evaluation that qualified him for the special preschool through our school system was done in Feb ‘02, so I don’t know if that would be accurate as of today. It talks about delays in communication and adaptive behavior, delayed motor skills, social-emotional-behavioral functioning in groups. I think the speech aspect now is resolved, and the social concern never really seemed that great to me. Remaining is the fine motor skills, motor planning, distractability, needing to be redirected, and just shutting down when teachers try to work on areas of concern. I do seem to have more luck at home working with him, but it is frustrating, as he just does not seem to “get” what I’m trying to teach him, such as A, B, Cs, but he is making slow progress.

I’m curious though. The school has never mentioned the words learning disability or ADD. I’m just now figuring out on my own that he probably has a learning disability. Are they not permitted to use those words because before age 6 they have to simply say he has delayed development?

He has had an OT eval, but the therapist he had did not seem to be doing what I though she should be, and when he saw the developmental pediatrician, he verified that, so now I’m searching for a new OT person, which in my area is not that easy to find for a small child.

I would like to have him tested for specific learning disabilities, but I don’t know where to go for such testing. Is it true the school will not do that until he reaches the age of 6?

I also would like to find him a private tutor, but no one at the school has any suggestions or is willing to do it, and I’m wondering what would be a good source to find a person who has experience with a child like mine.

Thank you so much for your suggestions. It has already helped so much.

Submitted by Anonymous on Sat, 10/16/2004 - 7:26 PM

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That means the district still has to provide him intervention services. What are those services that they are providing, is he involved in a special day class preschool or kindergarten? If he has developmental delays those are diffierent from just run of the mill learning disablities.

So in your mind your son’s developmental delays are caused by ADD and not Limited Intellectual Functioning/LIF? Some children do not qualify for speech when they have developmental delays because they have LIF, or reduced general intellectual functioning which means their cognitive (IQ)abilities are commensurate with their developmental/functioning/speech skills.

If is he ADD then perhaps if the ADD is treated then he will make faster strides and catch up, but if he has developmental delays/LIF you will be in this for the long haul, he may reach a plateau and have functional trainable skills but he may not be able to do things like peers his age that are developing normally.

I work with kids who have LIF on a daily basis as speech pathologist. I want to make sure that you find out and understand what is causing his developmental delays. You may need to use your health insurance to get to the bottom of this if the school district is dragging their feet.

Submitted by Leslie-G on Sat, 10/16/2004 - 8:23 PM

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When my son was tested by the developmental and behavioral pediatrician in August, his IQ score was in the average range and I was told he had good cognitive potential.

What is the difference between a developmental delay and a learning disability?

I have never before heard the time LIF, and I do not believe that is an issue for us.

My understanding from what I’ve read is that LD and ADD are two completely different entities, and treatment for one will not necessarily affect the other. I realize if he’s able to focus more, he may be able to learn better, but that still will not change the fact that he has a learning disability. Any thoughts on that?

I’m just a little skeptical of what the school is offering. I’d like to independently have him evaluated for learning disabilities, but I understand the school won’t do that until he’s older. Where do I obtain that kind of testing privately?

By the way, in response to an earlier question, my son was not premature at birth, but I’ve always suspected that there may have been something arising out of the fact he was breech, was delivered C-section, had bilateral hip dysplasia which required his legs to be in what I would call a frog-like position continually for the first three months of his life.

Thank you.

Submitted by Anonymous on Sat, 10/16/2004 - 9:17 PM

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If is IQ is in the “normal” range and he has good cognitive potential then he is probably does not have LIF. :lol: Many kids that have LIF have global developmental delays. LIF is now the politically correct term for mental retardation. Kids with Down syndrome, and other genetic abnormalities may or may not have LIF.

I learned the hard way from attorney’s and advocates that if a child has been diagnosed as developmentally delayed/LIF they don’t have the cognitive potential that a child is was diagnosed as just “LD” would have. A child with LD’s can usually “catch up” to normal peers but a child with LIF won’t ever be totally “Normal” or “catch up” :( they will be a little behind or slow compared to the normal side of the population.

When a child is qualified for an IEP for a Leraning Disability the discrepancy model is used between Verbal IQ and Non verbal IQ based on their performance.

For a child with developmental delays with verbal and non verbal IQ’s in the less than 70 range they would be considered LIF. If there is no difference found between their IQ and performance when they are tested they would qualify for an IEP for a special day class but giving them more speech would not change their abilities that much if they do not have the cognitive abilities to work with.

For instance I know children who have a Verbal IQ of 70 (borderline LIF) but a non verbal IQ of 115 (high average) that is a 45 point split if the discrepancy model is used. This child would more than likely qualify for speech to improve the 70 verbal IQ up to the average range. Through therapy this child has improved in speech and language the Verbal IQ is now in the normal range and the non verbal IQ is still in the high average. There is still a split but not as severe as it was before having an IEP and speech treatment.

ADD can cause Learning disabilities if it is not properly treated. If a child is unable to attend and focus they can’t be remediated. When ADD is an issue the child is tuned into their own mind or distracted by other things in their environment. As the child ages this behavior impedes their ability to learn. So ADD can have a HUGE impact on remediation.

Your son’s birth history probably had an impact on his delay in motor skills. I hope this helps you understand the difference between developmental delays/LIF and learning disabilities.

If you have more questions just let me know. :)

Submitted by Anonymous on Sat, 10/16/2004 - 11:56 PM

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[My understanding from what I’ve read is that LD and ADD are two completely different entities, and treatment for one will not necessarily affect the other. I realize if he’s able to focus more, he may be able to learn better, but that still will not change the fact that he has a learning disability. Any thoughts on that?

quote]

LD and ADHD are often comorbid and failing to properly address ADHD can seriously inhibit remediation of a learning disability. Your child is young enough to truly benefit from interventions on both LD and ADHD, assuming he has either. If the school is reluctant to test, talk to your pediatrician about where to obtain an evaluation by someone expert in diagnosing and distinguishing LD and ADHD. In fact, if you can swing the expense, get your own evaluation even if the school will offer. A private evaluation by a true expert is often much more thorough and useful than the basic eval offered by the school. Once you know the cause of your child’s difficulties you will be in a better position to know how to remediate them. After the LD/ADHD work-up, you might consider an eval by an occupational therapist (esp. if the initial eval shows motor skills issues) and by a developmental optometrist if there are visual spatial issues. Be aware that occupational therapy for disorders of sensory integrations is controversial and lacks strong research supporting it. The same is true of vision therapy. Nonetheless, these are things you may wish to investigate, especially if traditional interventions don’t seem to be helping. Don’t wait, act now. The earlier you intervene, the better the outcome. A child who begins to receive help at 4 or 5 is infinitely better off than one who starts at 8 or 9.

Submitted by Beth from FL on Sun, 10/17/2004 - 12:09 AM

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My quite bright high school daughter did not know her ABC’s before K. It is quite normal not to know these things that you express concern about.
My LD son did not either—what I realize know is that the small differences in what they knew in terms of formal schooling did not capture the huge differences in readiness skills.

I just wouldn’t worry very much about the academics—I wouldn’t even try to teach him those things. He is clearly not ready to learn them. I would focus on underlying sensory systems.

I would put him in gymnastics and give him swimming lessons. Someone once said that gymnastics was the cheapest OT around.

We have done Neuronet and TLP, which Nancy recommended, with good results. My son has had motor delays too. He still has some kinks, like with handwriting, but he made the basketball team at his parochial school this year (fifth grade). All the therapy we have done has made him into an above average athlete, which has been good for a kid who may always work harder than most with academics.

Handwriting without tears is a wonderful way to teach a young child to write.

You might look at the posts under 6 year old with Asbergers for some other ideas. I wrote a long post there in response to the mother’s questions.

You are right that the label LD is not usually used for a child so young. My child was labeled LD in first grade and he entered the special education system at age 4 with speech delays. OT was soon added. And I think it was unusual for him to get the label LD in first grade. Still, I think it is reasonable to act as though that is what you are most likely dealing with.

Beth

Submitted by Anonymous on Sun, 10/17/2004 - 1:24 AM

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For my daughter hearing impaired daughter IQ testing was done in kindergarten at the age of 5, at that time she qualified for speech and DHH services, there was a huge split between IQ and performance. In first grade she still struggled so by the end of 1st grade she had another full round of Cognitive/speech/ testing by the schools and then qualified for both RSP and Speech. Underlying all of this was ADD and we didn’t get a handle on the ADD until 5th grade thinking it was just her hearing… Believe me if you suspect ADD I hope you jump on it before you end up playing catch up like we have been for 10 years…

I became an SLP because of my daughters learning differences, now she is 15 and doing well but I regret no doing early intervention when she was in elementary school.

Submitted by victoria on Sun, 10/17/2004 - 2:12 AM

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Finding a tutor:

start with iser.com
telephone the International Dyslexia Association

If those two don’t help, look around locally in weekly papers, libraries, bulletin boards, colleges, other parents in the special ed class, etc.

Submitted by Leslie-G on Mon, 10/18/2004 - 12:30 AM

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Interesting you mentioned swimming and gymnastics. My son is taking swimming lessons and a combination tap dance/tumbling/movement class. I thought the tap dance might help his motor planning.

Can you tell me what handwriting without tears is?

Thanks.

Submitted by Anonymous on Mon, 10/18/2004 - 3:57 AM

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http://www.hwtears.com/

Is the website where you can read up on it. When I was an SDC teacher the OT would come into my room twice a week and do Handwriting without tears with the kids to help them with their handwriting. It is a good program.

Your son is going to need lots of specialized therapies to help him with remediation or compensating for his delays. Sometimes kids with ADD also have poor penmanship and .with meds penmanship improves.

Submitted by Anonymous on Mon, 10/18/2004 - 2:26 PM

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From Beth’s post…..
“I would focus on underlying sensory systems. ”

Truer words were never spoken.

My son sounds a bit like your child. He had trouble learning his letters in kindergarten and had difficulty learning to write. He was found to have a visual motor deficit.

Once I had a handle on his specific issues I could address these issues through various therapies. Therapies such as some of the ones mentioned, balametrics, neuronet, vision therapy, etc. can address the specific areas of deficit. Addressing academic concerns before going after remediating the deficits can be like throwing water against a stone. Sure, you will wear it away over time but what you really need is a sledge hammer to break through. The right therapy, from the right provider can do that.

I really don’t like the diagnosis you got from this doctor because it sounds so much like the typical word soup some so called experts use. It is just words that describe the problem in very general terms but does not point you toward a treatment for the problem.

You are lucky to have found this board while your child is so young. I started much later.

My advice would be to start something like audiblox right away. This is a very good program for young children that addresses a variety of specific areas of deficit. Also, the advice of doing things that improve the global motor issues like balametrics, neuronet and even the gymnastics that you are doing is definitely a good idea.

I would also get a private occupational therapy and developmental optometrist evaluation.
Don’t wait, just get a handle on the deficits and then start chipping away piece by piece.

Submitted by LindaW on Mon, 10/18/2004 - 3:31 PM

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Where do you live? That may help some of us point you in the right direction. I like the suggestions others have given. I also recommend you check out the Handle Institute at www.handle.org. They have practitioners scattered around the U.S. who are qualified to assess your child and make recommendations for treatment.

You need a lot more information on how many of your son’s “systems” are working: sensory, vestibular, visual, auditory, proprioceptive … etc. Movement activities will be crucial for strengthening these systems. Your child can catch up and be a successful student. Your school system may or may not be of much help… Most of us have had to find and pay for our children’s treatment.

Submitted by Leslie-G on Mon, 10/18/2004 - 3:39 PM

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To Linda F:

What type of provider gave your son the diagnosis of a visual motor deficit? I’m not sure where to go to get the correct diagnosis. Is this a medical doctor or psychologist or through the school?

My son’s school has never mentioned to me the word learning disability or ADD, just that he has delays. I don’t know if it’s because he’s only 5, but I’d like to have a specific diagnosis sooner than later so that we can address this early.

Thanks.

Submitted by Anonymous on Mon, 10/18/2004 - 3:56 PM

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My son got this diagnosis in K by the school. He got the same diagnosis by an OT and by a develomental optometrist in first grade.

The school was the one who first sent me to an optometrist who told me it was just developmental. It did not take care of itself.

Beth

Submitted by Anonymous on Mon, 10/18/2004 - 5:59 PM

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I got the visual motor diagnosis through the school in first grade. I should have gone straight to a dev. optometrist but instead went to an opthamologist who also said it was developmental and that most kids grow out of such problems. This was probably the worst advice I have ever received.

We did occupational therapy through school and the ot was very good but once a week therapy was just not enough. We did vision therapy through a developmental optometrist starting in third.

The diagnosis of a visual motor deficit really was just a beginning. Even within that diagnosis the problems get more specific. My son has a specific occular motor problem. The vision therapist (this is a therapist that works in my dev. optometrists office,) said his occular motor functioning was the one of the worst she had ever seen. He could not follow a moving object with his eyes at all when we started. My son also had bilateral motor issues which made swimming very difficult. He could not coordinate both sides of his body to work in sync. Swimming helped but it was very difficult for him. Interestingly when I told people he had motor functioning issues I got strange looks because he really looks like a total jock to most people. He is very strong and fit looking. He has other deficits like sequencing. He just could not count numbers from a numbers chart or skip count. He now does pretty well in math.

Visual motor does point to a need for ot and vt just as auditory processing issues point to the need for an audiologist and most likely speech therapy. A good dev. optometrist and or pediatric ot should be able to give you further clues as to more specific deficits.

PS, my insurance paid for vision therapy. I had cigna ppo.

Submitted by Leslie-G on Tue, 10/19/2004 - 5:37 PM

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Could you tell me what symptoms your kids had that showed either the visual processing problem or the auditory processing problem?

Would you expect to have either one or the other, or is it possible to have both?

Thank you all for your replies.

Submitted by Anonymous on Tue, 10/19/2004 - 6:01 PM

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Auditory—possible signs—mishearing words—“Have you got a dime” instead of “have you got the time”, difficulties hearing in noise, asking for repetition, can’t rhyme, doesn’t follow conversations, can’t follow directions, says huh a lot, can’t hear differences in similar sounds, can’t repeat words,

Teri James Bellis’ book “When the Brain Can’t Hear” is a good reference.

Beth

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