ped appointment/speech/weight

[Honey693]

DD had her 15 month appointment today and her ped is worried about her speech and weight. She's only gained 5oz in 3 months, but shot up 2.25 inches. She's still on the charts for weight, but has fallen off her curve. She has to go back for a weight check in a month and her ped gave me a few suggestions in the meantime, some which sound ok, some which sound not so great. She said start putting butter or sour cream on most of her foods. Fine, I'm ok with this. DD refuses to drink milk so she suggested Pediasure or toddler formula. I'm still boggled by this b/c she nurses ~12 times a day. I'm not sure how much of that is comfort nursing and how much is actual eating, but seriously? Formula or Pediasure? Am I just being stubborn about not wanting to give her either or does she not need them?

DH and I have been concerned about DD's speech for 4 or 5 months and her ped was at this visit too. She said she could still be on the normal curve, but just in case let's get her a speech evaluation b/c it's better to be too early and do something she might not need than be too late and end up with DD really far behind. I completely agree with this. The thing is, I have no idea what to expect. What do they do with a 15 month old during speech evaluations? I'm just worried they're going to tell me to do things I'm already doing with DD like narrating everything, not talking baby language, etc.

[Dov'sMom]

What's very far behind at 15 months?

DS1 at 15 months had one word -- baby -- and it meant me. No word for dad, nothing else at all. Was speaking in 2-word sentences by 18 months and full sentences by 2.

BTW, baby talk is actually good for babies.

[JBaxter]

... With her weight... did she just cut molars or a bunch of teeth? Mine ALWAYS slowed ( one even lost weight) at the 15mo check. Pedisure is GROSS and expensive. Will she drink smoothies? Organic whole milk yogurt, some milk, applesauce, banana, and I use some pumpkin ( vit A) ... sometimes some frozen mangos too( I vary my recipe to what I have available). Jack loves it. I also do french toast soak a slice of bread in a beaten egg w/ a dash of vanilla & cinnamon then butter well and add a little maple syurp or agave.


Speech. I have a wide rage of talkers early to late. 15 months I wouldnt worry unless you think she doesnt understand you. 20-24 months I'd start to worry.

[Honey693]

DD only has 2 words (mama/dada)and she uses them correctly only 50% of the time. She doesn't wave, doesn't sign and pretty much just freaks out when she wants something. She's getting evaluated Wednesday morning at the house and they said she needs to show a 25% delay to get services. Has anyone been through this and can tell me what they do?

[Kailey's mom]

They'll come to the house with a little suitcase full of educational activities, and they will play with your dd.. ask her to do "age appropiate" things. They will problably have some picture cards, and ask your dd " what's this a picture of?" At the end of the eval, they will go over their findings, and tell you if she would qualify for more therapy. It's an easy process

[kbond]

For weight, I can think of a lot of diet things you could do that aren't Pediasure or formula. My daughter is under-weight as well. (19 lbs at 16 months), and our ND has merely recommended that we give her more iron rich and fatty foods. So, we give her whole milk yogurt, avocado, beans and rice, quinoa, etc. FWIW, she also nurses a lot.

Anyway, she hasn't really gained any weight since we started this diet. But, she's happy, meeting all of her milestones, and my husband and I are both on the small side. So, I wouldn't necessarily worry too much just about the weight.

[EdnaMarie]

I totally disagree with your pediatrician.

SHe's on the charts, but she might be falling off her curve because she's about to gain weight. They go in spurts.

As for language, my child had all of zero words at that age and the ped said nothing. Even at 18 months, she was just starting. Is she not babbling?

I'm not a pediatrician, but your ped's advice sounds like a lot of CYA to me.

[ShyDaisi]

I wouldn't worry about either one. It won't hurt to do the eval if you want, but I wouldn't do Pediasure or toddler formula. I don't even think I would laden foods with hidden fats as it tricks the body and it stops learning how to regulate itself. If she is happy, meeting milestones (other than verbal), has healthy looking hair, her nails grow, she doesn't actually LOSE weight, I wouldn't change her diet a bit. I would offer plenty of healthy foods, let her choose what she wants, let her nurse on demand, and go about your day.

[JBaxter]

We had a speech eval at 24 months with DS3. They came to the house and did what I would say was interactive play eval. My DS3 did get speech for 3 yrs. They came to the house weekly for 30 minutes at a time. We had lots of fun in speech. Hang in there.

[pbjmama]

My ds only had 5 words at 22 months which was a 5% delay according to my state. I'm all for early evaluations but I wonder if there is some other concern than speech - are you getting a developmental screening? Hearing tested?

[Honey693]

Originally Posted by pbjmama

are you getting a developmental screening? Hearing tested?

The lady is coming twice and the first time is a developmental screening and the second is just speech. They're not doing a hearing test, but she seems to hear fine. The kid can hear the fridge open 4 rooms away.

I'm not terribly concerned about her weight b/c DH and I are both average (we'd be slim if we stopped eating so much junk food) and DH was a scrawny looking kid and so was most of my family. I will up her fat intake with more healthy food like avocados and the other suggestions, but I'm not doing Pediasure of formula. I'm glad I'm not the only one that seemed to think that was weird.

[JBaxter]

They pretty much always do the verbal & physical evals. It saves scheduling time.
http://www.drspock.com/article/0,1510,4839,00.html
12-14 months
Most toddlers say their first real word by or before 14 months of age. By "real word," I mean a sound that they use on their own (not imitating) to mean the same thing each time. Often, the first word is "mama" or "dada." A small number of toddlers do not start saying words until much later. Although these children usually do fine, many parents feel better if there has been a thorough developmental assessment to make sure that there aren't any other problems.

Most one-year-olds communicate well even without words: They let you know what they want with gestures, make speech-like sounds (even if you can't comprehend any of them), and understand some simple things (such as, "Give me the bottle," said while you are holding out your hand for it.)

15-18 Months - emerging words and understanding
By 17 to 18 months, 90 percent of children can say at least one word in addition to "mama" or "dada." Many already say 5 to 10 words, and some say many more than that. Understandably, parents of quieter toddlers are often concerned at this stage.

Because there is such a wide range of normal ages for beginning to talk, it's actually more useful to pay attention to how well your baby understands what you say to him. By 14-15 months, most toddlers will follow at least one verbal command, without any visual cues. So, for example, if you say, "Give me the ball," but don't hold out your hand, your toddlers will still hand over the ball -or clutch it even harder!

http://parenting.ivillage.com/tp/tpd...42cm-p,00.html


By the end of month 14 a child typically:

Takes two or three steps unassisted or may walk
If walking, may be learning to run
Stands alone well
Puts an object into a container
Stacks two blocks
Responds to one-step verbal commands without gestures
Speaks one to six words other than "ma-ma" and "da-da"
Uses jargoning (sounds like a foreign language)

By the end of month 16 a child typically:

Walks well
Drinks from a cup
Scribbles
Points to items wanted
Communicates affection, pleasure and excitement
Begins to understand limits
Imitates activities

By the end of month 18 a child typically:

Runs
Enjoys climbing
Understands some sentences
Points to nose, eyes and mouth
Walks while carrying toys
Says at least 15 words besides "ma-ma" and "da-da"
Feeds self with a spoon or fork
Begins to join words
Bends over easily to pick up toys
Gains some control over bowel and bladder
Enjoys small riding toys
Shows a preference for certain toys
Finds it difficult to share
Explores away from caregivers

[Honey693]

Originally Posted by JBaxter

They pretty much always do the verbal & physical evals. It saves scheduling time.
http://www.drspock.com/article/0,1510,4839,00.html
12-14 months
Most toddlers say their first real word by or before 14 months of age. By "real word," I mean a sound that they use on their own (not imitating) to mean the same thing each time. Often, the first word is "mama" or "dada." A small number of toddlers do not start saying words until much later. Although these children usually do fine, many parents feel better if there has been a thorough developmental assessment to make sure that there aren't any other problems.

Most one-year-olds communicate well even without words: They let you know what they want with gestures, make speech-like sounds (even if you can't comprehend any of them), and understand some simple things (such as, "Give me the bottle," said while you are holding out your hand for it.)

15-18 Months - emerging words and understanding
By 17 to 18 months, 90 percent of children can say at least one word in addition to "mama" or "dada." Many already say 5 to 10 words, and some say many more than that. Understandably, parents of quieter toddlers are often concerned at this stage.

Because there is such a wide range of normal ages for beginning to talk, it's actually more useful to pay attention to how well your baby understands what you say to him. By 14-15 months, most toddlers will follow at least one verbal command, without any visual cues. So, for example, if you say, "Give me the ball," but don't hold out your hand, your toddlers will still hand over the ball -or clutch it even harder!

http://parenting.ivillage.com/tp/tpd...42cm-p,00.html


By the end of month 14 a child typically:

Takes two or three steps unassisted or may walk
If walking, may be learning to run
Stands alone well
Puts an object into a container
Stacks two blocks
Responds to one-step verbal commands without gestures
Speaks one to six words other than "ma-ma" and "da-da"
Uses jargoning (sounds like a foreign language)

By the end of month 16 a child typically:

Walks well
Drinks from a cup
Scribbles
Points to items wanted
Communicates affection, pleasure and excitement
Begins to understand limits
Imitates activities

By the end of month 18 a child typically:

Runs
Enjoys climbing
Understands some sentences
Points to nose, eyes and mouth
Walks while carrying toys
Says at least 15 words besides "ma-ma" and "da-da"
Feeds self with a spoon or fork
Begins to join words
Bends over easily to pick up toys
Gains some control over bowel and bladder
Enjoys small riding toys
Shows a preference for certain toys
Finds it difficult to share
Explores away from caregivers

Thank you so much for this! It's weird to see how far ahead she is on physical things, but not so much on the verbal.

[mommy2maya]

Originally Posted by pbjmama

My ds only had 5 words at 22 months which was a 5% delay according to my state. I'm all for early evaluations but I wonder if there is some other concern than speech - are you getting a developmental screening? Hearing tested?

My dd is about the same, and her eval says she is at a 9m level for expressive language and >1% for her age.

[basmom]

Originally Posted by Crystal_R

Am I just being stubborn about not wanting to give her either or does she not need them?

No. Because Pediasure is gross and expensive. You can make your own calorie and nutrient-rich smoothies that tast soooo good! Just think whole milk yogurt, frozen fruits, etc.

Originally Posted by Dov'sMom

BTW, baby talk is actually good for babies.

Yes. If you mean changes in pitch and volume. But...please use real words. I beg you

Originally Posted by JBaxter

Will she drink smoothies? Organic whole milk yogurt, some milk, applesauce, banana, and I use some pumpkin ( vit A) ... sometimes some frozen mangos too( I vary my recipe to what I have available). Jack loves it. I also do french toast soak a slice of bread in a beaten egg w/ a dash of vanilla & cinnamon then butter well and add a little maple syurp or agave.

Speech. I have a wide rage of talkers early to late. 15 months I wouldnt worry unless you think she doesnt understand you. 20-24 months I'd start to worry.

Yes. On the smoothies and french toast!

As far a s waiting until 24 months if you feel unsure now....I'd do the eval now and get a baseline now. If your LO is not eligible, great. At least you will know what to look for next.

I am a an SLP with a birth-three program. I do these evals twice a week. We play. That's exactly what it is. We have a big bag of toys (specially chosen for the eval), that children get to explore. Our evals are very child directed and we get our info from obseration and parent report. In my state, a child needs to demonstrate a 33% delay in one or more areas of development in order to qualify. If your child qualifies, services will look like play and should be very chlild directed. Your service provider will be able to give you ideas to work "therapy" into everyday situations. It should always still feel like play...because that's what kids do. They play.

Originally Posted by Crystal_R

DD only has 2 words (mama/dada)and she uses them correctly only 50% of the time. She doesn't wave, doesn't sign and pretty much just freaks out when she wants something. She's getting evaluated Wednesday morning at the house and they said she needs to show a 25% delay to get services. Has anyone been through this and can tell me what they do?

see above pm if you have more questions. I know it's impossible, but don't be nervous. Write your questions down. I love it when parents grill me! It really gives me direction and let's me know where they're coming form and where they want to go!

By the way, I am also a parent of a child who went through Early Intervention. My son has been talking since he was in utero, but was delayed in his gross motor skills...I mean really delayed. He was just combat-crawling on his first birhtday. One of my colleagues, a PT, provided services and we loved it. It was a great learning experience for me and DS was totally in love with her, even though she made him work like he's never worked before!

Originally Posted by Kailey's mom

They'll come to the house with a little suitcase full of educational activities, and they will play with your dd.. ask her to do "age appropiate" things. They will problably have some picture cards, and ask your dd " what's this a picture of?" At the end of the eval, they will go over their findings, and tell you if she would qualify for more therapy. It's an easy process

I guess it depends on your state's process. That kind of sounds like a standardized test - ours is more play-based.

[JBaxter]

Originally Posted by Crystal_R

Thank you so much for this! It's weird to see how far ahead she is on physical things, but not so much on the verbal.

LOL Im on #4 so some things dont phase me. Evals are never a bad thing but it seems to me ... in my humble mom of 4 opinion that some kids develop physically ( running climbing etc) quicker then the verbal clicks ... some kids talk but dont stack cubes as quick it all usually evens out .. BUT if they want to come do some play therapy with my kiddo then it will only be a benefit.
Hope your eval goes well

[smeisnotapirate]

Originally Posted by EdnaMarie

I totally disagree with your pediatrician.

SHe's on the charts, but she might be falling off her curve because she's about to gain weight. They go in spurts.

As for language, my child had all of zero words at that age and the ped said nothing. Even at 18 months, she was just starting. Is she not babbling?

I'm not a pediatrician, but your ped's advice sounds like a lot of CYA to me.

:

My almost 20mo DS is 21lb and has MAYBE 4 words, though nobody but DH or I recognizes the sounds. So maybe. We just saw the FP this morning and he was totally unconcerned.

As for the milestones list, remember those are AVERAGES, so some kids will fall on the "later than 18mo" and some earlier. My DS was doing all of the 18mo motor skills stuff by 15mo or so, but has none of the verbal skills.

Sounds like your pediatrician needs to relax. Is (s)he young? I've found that young doctors tend to scare parents by trying to find problems where there aren't any.

[Honey693]

Originally Posted by smeisnotapirate

Sounds like your pediatrician needs to relax. Is (s)he young? I've found that young doctors tend to scare parents by trying to find problems where there aren't any.

She's youngish, maybe 35? 95% of the time I'm on board with her. The weight thing though I was ehhh. I'm very slightly concerned and our ped doesn't seem to worried, but more like a catch it in the bud if it is a problem thing. That's her take on the speech thing too. Although I'm wondering how much of her getting me a speech referral was me almost crying in her office today. I'm definitely a first time worrywart mom about some things.

I'm really glad to know the eval is basically just going to be a play session. Knowing what to expect really helps. I have no idea why I didn't ask when the lady called.

[EdnaMarie]

Originally Posted by Crystal_R

She's youngish, maybe 35? 95% of the time I'm on board with her. The weight thing though I was ehhh. I'm very slightly concerned and our ped doesn't seem to worried, but more like a catch it in the bud if it is a problem thing. That's her take on the speech thing too. Although I'm wondering how much of her getting me a speech referral was me almost crying in her office today. I'm definitely a first time worrywart mom about some things.

I'm really glad to know the eval is basically just going to be a play session. Knowing what to expect really helps. I have no idea why I didn't ask when the lady called.

If you were very concerned, or even appeared concerned, she may have been trying to respond to and validate your concerns, which is actually good. I didn't know that when I posted.

[JBaxter]

I think the new guide lines are saying to do speech /fine & gross motor delay evals because of the HUGE rise in autism. They want kids into early intervention asap. OP I am in NO WAY suggesting anything like that is wrong with your daughter but peds are watching children closer for any signs of developmental delays I would sooner error in the side of caution with mine and not qualify for speech or other therapy than to wait a full year to then discover my child could have been getting help sooner.