Developmental Evaluation

We are blessed to live in a county that takes extraordinary steps to make sure that all children within it's boundaries have the opportunity to be accessed and evaluated for any potential delays or problems.  They like to catch things as early as possible so that they can work with parents to provide the necessary treatment or therapies needed for the child.  While I knew some things about their work, I was still a bit surprised by how helpful and proactive they are at the MISD (Macomb Intermediary School District).

On May 9th I took Q in to have a developmental evaluation performed since she was not yet doing many of the things that a 9 month old would typically do.  When a child is referred to the MISD they evaluate that child for any and all types of delays so I was not just asked questions regarding her physical abilities but also concerning her speaking skills, how she reacted in certain situations, if she would respond to her name, how she responds to strangers, etc.  They want to know about the TOTAL well being and progression of the child.  We met with two ladies, one was a physical therapist there to evaluate her developmentally and the other was more there to evaluate her to make sure there were no learning delays that may need to be addressed.

As far as there being any learning disabilities or hiccups, they feel that she is right on schedule for a 9 month old.  As far as her motor skills were concerned she was at the level of a 6 month old, so it's not terribly far behind but we have a lot of work to do.  One test that they preformed was taking her foot and seeing how far they could bend it forward - she was able to bend Q's foot all the way up to her shin.  She should not be that limber!  The physical therapist said that if she stays that limber then we need to get her in gymnastics as soon as she is old enough!  But what this showed them was that she has very little muscle tone and that is a huge reason why she's not doing many of the things she should be doing at this age.

Since the MISD operates under the school system they do not operate during the summer months.  The therapist recommended that if we do not see improvement by the middle of June then we should seek treatment through private means just until school would open again in September when she would be able to work with the MISD.  Either way, they will give me a call in September to schedule another evaluation with her just to see how she has progressed and if she needs any further assistance.  For now we are just supposed to do exercises with Q several times each day to help build the muscle tone and encourage her to crawl and pull herself up.

**UPDATE**
Q is already making lots of progress!! She can almost sit herself up from laying without any assistance and she has no issues getting where she wants to be.  She is starting to show so much more interest in everything around her and if she sees it and wants it she will find a way to get to it!  She's much more steady now while sitting and rarely, if ever, tumbles over.  She's also beginning to use one hand to stabilize herself while using the other hand to reach across and grab something (this is great for strengthening her upper body).

Not Out of the Woods Yet & Q's 9 Month Stats

You may remember a few months ago our pediatrician heard a "clicking" in Q's hips when he was giving her an exam and sent us to the children's hospital to have an ultrasound done of the hip.  A few weeks later we received a call and were notified that the ultrasound had come back negative, showing no signs of hip dysplasia.  As you can probably imagine we were very happy to hear that.  Even though it can be corrected through the wearing of a brace, every parent's biggest desire is to have their child completely healthy and strong 100% of the time.

Today was Q's 9 month well-baby visit and when Dr. B was rotating her hips he was hearing a very noticeable "clunk" (which we know is much worse than a "click").  After coming home B mentioned that he could hear the sound that the doctor was referring to as Q was on his lap during that part of the exam.  If I'm honest I must admit that while I watched Dr. B take so much time and focus so much attention on rotating her hips my heart began to sink.  To make a long story short, he heard a clunk and even though the ultrasound came back negative he wants to have her evaluated by an orthopedic surgeon to find out once and for all if there is something going on with her hips.

This evening before putting the girls to bed I called a friend of ours who attends our ward and is an orthopedic resident here at one of the locals hospitals.  I asked him if he would mind rotating Q's hips himself to see if he heard or felt anything.  He said he'd be glad to do it but did give a warning that he hasn't had a lot of experience with that sort of thing so he may not be the best source but if it was a definite "clunk" he would know, it's the slight "clicking" that he may not be the best at identifying.  That was more than acceptable to me, I'd just like to have another opinion on the matter if possible and preferably without shelling out several hundred dollars if not necessary. 

As for other stats from the appointment she weighs 17 lbs. 14 oz. (approx 38th percentile) and is 29¾ inches long (95th percentile).  For comparison's sake Y was 19 lbs. 5 oz. (approx. 55th percentile) and was 28¾ inches long (75th percentile).  Y has always been tall for her age but it's looking like Q might be even taller, but at this age things change quite often so you never know.  As far as all the health stuff is concerned she's doing great and honestly that's what matters the most.

But, with that said, we have been referred to the MISD (Macomb Intermediary School District) to have a developmental evaluation performed on her.  For a 9 month old Dr. B did not feel as if her gross motor skills were nearly where they should be.  She is sitting on her own but only the tripod seating, she's not pulling herself up or even acting interested in doing so.  I'm not completely surprised that he's sending us to have her evaluated, last week Y spent much of the week watching videos of herself when she was Q's age and even though Q was "late" doing many things she was still farther along than Q is.  So taking her in to make sure that all is well will actually be a relief.  What I later realized that I should have asked the doctor (and I may call tomorrow to ask) is if the "clicking or clunking" in her hip may have any affect on the delay of her gross motor skills?  It may be a shot in the dark or it may not be, but it seems like a good question to me!