Daycare suspects developmental problems-help!

[westcoastmummy]

My son is almost 3 and has had health problems since he was born -- all relating to reflux, asthma, allergies. In the last year he seems to have grown much stronger and we were very pleased with his progress. But recently his daycare told me they suspect a developmental delay or disorder, so we went to see his pediatrician who thinks he might have mild delays caused by his illness in the past (he was very ill and weak for a long time, more or less the first 2 years of his life). But the doctor is also watching him for NF 1 (he has freckling under armpits and groin and several cafe au lait spots). One of the markers for NF1 is developmental delay.

I asked a developmental delay specialist from the local children's hospital to assess my son, and the first thing they have done is send an "ages and stages" questionnaire to me and the daycare to fill in separately. We have come up with almost diametrically opposing picture of my son. Almost all my responses to his sensory profile and motor development were in the normal range, but the daycare see significant problems in most areas, especially the sensory. They see things I have never noticed in him -- such as reacting emotionally or aggressively to touch, enjoying unusual noises, difficulty standing close to other people, dislike of certain food textures...To me, this points to ASD and maybe ADHD.

I have been worried that the daycare have been heavy handed with my son, and that they have already labelled him as special needs. They insist that he must stay in the toddler centre for another 6 months, and not progress to the preschool with all the other children of his age. At the end of the month, the developmental specialist will visit us at home to observe him, and sometime afterwards visit the daycare too. But I would like advice about what to do just now. Should I confront the daycare about the difference of our views of him and ask them to explain more to me? Should I try to find a private developmental consultant to see my son more urgently? And is it possible that my son has a developmental disorder that I'm simply missing? I'm prepared to see that he might have some subtle delays with his development. I know from a friend that an autistic toddler can behave differently at home with parents that with other caregivers...they missed his autistic symptoms for a long time. Any suggestions would be very welcome! I'm feeling frustrated and concerned.

[joensally]

Hi, I'm sorry you're in this uncomfortable spot with waiting.

Those things sound like they could be sensory processing disorder.  It would be worse in group environments, and when you have a sensory kid it's very easy to not realize just how much you're accomodating him.  So, it would be noticable at daycare and not so much at home where you just don't give him the food he dislikes and he can exercise more control over his environment etc.

[Linda on the move]

Originally Posted by westcoastmummy 

Should I confront the daycare about the difference of our views of him and ask them to explain more to me? Should I try to find a private developmental consultant to see my son more urgently? And is it possible that my son has a developmental disorder that I'm simply missing?

I wouldn't confront. They see him in a different context, and kids can be very different in different environments. If you want to ask for more details about what they see, go ahead. But there's nothing to "confront."

I don't understand enough about who your son is waiting to see now to say much, but in many areas, there are just waits for these things. I don't know any parent who just made a call and had their child in the next week. If you want to check around and see what your other options are, that's always a good idea. Check carefully about what your insurance will pay for, get the name of the person you speak to at your insurance, and get estimated costs from your chosen provider (I know people who've paid hundreds, our last eval was $50 out of pocket).

Kids can have delays for lots of reasons, and often they are just delays. Many (most?) kids with delays catch up. Sensory issue can occur without being part of ASD. Therapy is helpful for many kids with sensory issues, and some kids seem to find they lessen as they get older.

I think the key for a child is to figure out what sort of therapies might be helpful for him now. He may just be a little quirky and on his own time table. None the less, some therapy could help him reach his potential.

[KCMichigan]

Originally Posted by Linda on the move 

I wouldn't confront. They see him in a different context, and kids can be very different in different environments. If you want to ask for more details about what they see, go ahead. But there's nothing to "confront."

I don't understand enough about who your son is waiting to see now to say much, but in many areas, there are just waits for these things. I don't know any parent who just made a call and had their child in the next week. If you want to check around and see what your other options are, that's always a good idea. Check carefully about what your insurance will pay for, get the name of the person you speak to at your insurance, and get estimated costs from your chosen provider (I know people who've paid hundreds, our last eval was $50 out of pocket).

Kids can have delays for lots of reasons, and often they are just delays. Many (most?) kids with delays catch up. Sensory issue can occur without being part of ASD. Therapy is helpful for many kids with sensory issues, and some kids seem to find they lessen as they get older.

I think the key for a child is to figure out what sort of therapies might be helpful for him now. He may just be a little quirky and on his own time table. None the less, some therapy could help him reach his potential.

I agree 100% with Linda.

Sometimes kiddos act/behave differently in a group environment than at home. Plus, as parents- we are able to avoid triggers, situations, routines, etc and just overall be more accommodating (quiet environment, more sleep, specific toys, etc) than a group setting. Especially sensory related things.

If it is a daycare that has been working with kiddos for awhile and/or is trustworthy- I would trust what they see that occurs *at daycare*. They work with that age group day in/out and should be familiar with developmental milestone and be quick to refer kiddos that may benefit from further assistance.

Delays can be temporary and/or improve with time. Both my DDs had developmental delays from prematurity from 0-3.5. One DD shows no  delays (though she does have medical issues), my other DD still has some delays-- but they are greatly improved with therapy and intervention. I am very very happy with the therapy and results we have seen with all the early childhood specialists we have worked with, for my kiddos-- it was only a benefit.

I would wait and see what the specialist says at the end of the month. Really, that is not a bad wait time and they can give you a great idea of where your DC is and where the majority of kiddos his are developmentally and take it from there. Even if they do not see any delays, they may be able to give you some suggestions for daycare to help him there. Obviously, he seems to function differently in the two locations (home - daycare).

*HUGS*

[OTMomma]

I would follow through with the specialist and it does sound to me like sensory issues may be involved. However, I would also consider that this daycare might not be an ideal fit for your son. My oldest had a horrible experience in a preschool setting because of her atypical development-fine motor delays, sensory issues and gifted in such a way she just seemed weird, not smart. She was much happier when I removed her from the group setting and had another mom with a child her age become her regular sitter.

[naturemomma13]

Not sure exactly how it works in other states, but for children under 3 in NJ, you can call Early Intervention Services for a complete developmental evaluation, and they are out to see your child within 22 days-- and then if eligible for services, a plan is made within 45 days of your first phone call.  If your son is 3, you can call your local school district for the child study team to assess him.  Of course you will want to get your own evaluations done with neurodevelopmental pediatricians, such as what you already have scheduled, but this a great start, a way to know what is going on with your son, and an even better way to address things in the meantime.  It's not uncommon for a child to act differently at home and at daycare, but it seems there is such a discrepancy in the picture that the evaluation by a professional will give you some clarity or at least some direction of where to go from there.

[Kokolove]

I am sorry you are going through this. This is exactly what happened to me one year ago.  I thought my DS was fine, but daycare complained that something was wrong.  Just to prove them wrong, I scheduled a speech evaluation right before his 3rd birthday.  They dx'd a significant delay, and we were referred to OT, pediatric neurologist, and developmental pediatrician.  He was diagnosed with autism about 5 months after the daycare first reported to me there was a problem.  Turns out they were right all along. 

I was pretty upset with the daycare during that time - a "shoot the messenger" thing, I think.  My DS is now in developmental preschool, but my DD still goes to the same daycare and in retrospect I am so glad they were proactive about telling me their suspicions. 

As for you and the daycare having wildly different results of the questionnaire, I think that is normal.  Kids act way different at home than at school or daycare.  I truly didn't think there was anything wrong with my son, because at home he acted so "normal".  But since then I have observed him at school, and he acts differently there. 

[FarmerBeth]

While you're waiting for an assessment on your son (the above posters would know more about what I do about services, I'm Canadian), what can you do with the daycare to help things run more smoothly.  Can they get a TA or special needs early childhood educator in for some of his daycare day so that it will be easier for him to eventually stay with same age peers?  Do the daycare teachers have any ideas of some things you can do at home that would help his development or do they know of good services for assessment?  It's my experience that many daycare teachers are knowledgeable in these things, and everyone could have an easier time working together on this.