Early Intervention services typically cover kids from birth to age three. L turns three in a few days and will officially be aging out of Early Intervention the day before. When we started services a year and a half ago, three seemed so far away. We started discussing what services might be needed six months ago. Even then, three seemed far away. Now we’re here and I’ve had mixed feelings.
To think of where L was a year ago and see him today, I am blown away by his progress. He’s started taking an interest in books (finally!). He’s gotten a bit braver about heights and now jumps off of the couch and onto the hardwood floor. Though, some days he insists on holding my hand to go down the slide. His vocabulary blossomed – especially over the summer. He’s learning to take bites of food versus shoving it all in at once.
His speech still concerns us at bit. His low down is especially noticeable (at least to those trained to see it) in his face. This means he works harder to talk. There are days he still insists on grunting and pointing to get what he wants and needs. There are still moments I fully believe his brain is working faster than his mouth can (apraxia).
L’s exit review was basically a chance for me to air any final concerns I had and review his goals from his previous review, which had been at the end of the summer. I think L easily could have graduated from the program at that point, but I wasn’t ready and his therapist was willing to work with me on setting goals that could keep him in the program until he aged out in a few months. L had met the goals and his therapist said the only therapy she’d recommend is speech. The subject of private speech therapy had come up several times since L was 2.5, so I wasn’t surprised by this recommendation. She also said we could have him re-assessed for the county’s public preschool program if we felt there was a need to.
We also had a developmental pediatric appointment this week. This was the soonest I could get L in after initially making the call in June. L progressed so much I did wonder if it was necessary to keep it, but to be honest I liked the idea of another set of eyes on him. Eyes that aren’t emotionally attached to him. That’s been the biggest blessing being in the Early Intervention program – the therapists L has seen have been able to tell me when there’s been cause for concern and when there hasn’t. I have struggled with some of their advice, but overall, I liked having someone coming around who at least validated my concerns even if there wasn’t anything to really worry about. L’s therapist warned me that the doctor would probably recommend All The Therapies (PT, ST, and OT), but she didn’t think PT or OT were necessary.
I went into this appointment intending to smile and nod my way though a bunch of recommendations, but it turned out the doctor felt the same way as L’s therapists. She determined his speech is at about a 30 month old level (maybe a bit higher since he was being shy) but he was spot on 3 years old for motor skills. She said physical therapy for kids his age is nothing different than playing, and since he’s following his older brother around he shouldn’t need anything more as long as we’ keep him active. The doctor did agree with speech therapy and was able to give us a referral since Early Intervention couldn’t. She also agreed with the types of doctors L is seeing (neurologist, geneticist, and orthopedist) and the course of action we’re taking in finding a “why.”
I asked about possible apraxia, but she said in kids this young, it’s really hard to officially diagnose it and to wait until his in elementary school before getting to concerned with it. This aligned with what L’s therapist has told me as well.
But the best part of the appointment was being told we didn’t need to see the doctor again for a year. And that’s if we still want some peace of mind he’s on track. I’ve been so used to getting told “Come back in 3-6 months” that being told “I don’t really need to see you unless there’s a problem” is a nice surprise.