Oh, I feel so special using abbreviations that only those who have most likely been through it would know.
CDC = Child Development Center
EI = Early Intervention
Now that we have that out of the way, here is how it went down and the outcome recommendations of the CDC team. First off they started the formal evaluation first. They took G into a room with a younger woman who is a speech person and an older woman who I think is like the senior evaluator. They were testing all the normal developmental stuff like his ability for interactive play, pretend play, engaging in play, problem solving, speech, fine and gross motor skills, etc. G fell in love with their shape sorter and basically he did everything he could just to play with that. Anytime they wanted him to do something he didn't want to do (like they put a few cheerios in a little plastic bottle with a screw on cap and wanted him to get the cheerios out) he would just walk away from them. When they tried to contain him in his chair he just got out of it. The kid does not like to be contained.
Anyway, the team recommendations are:
1. G would benefit from CDC's Part C Infant & Toddler Program
2. G would benefit from direct speech therapy.
3. A consult with an occupational therapist to address possible sensory integration issues is recommended.
4. Encourage opportunities for g to interact witih same age peers.
They "diagnosed" him as having "Multi-System Developmental Disorder" (MSDD) which I don't necessarily agree with. The characteristics of MSDD are:
1. Significant impairment in, but not complete lack of, the ability to engage in an emotional and social relationship with a primary caregiver, (e.g. may appear avoidant or aimless but may evidence subtle emergent forms of relating or relate quite warmly intermittently).
2. Significant impairment in forming, maintaining, and/or developing communication. This includes pre-verbal gestural communication, as well as verbal and non-verbal (e.g. figurative) symbolic communication.
3. Significant dysfunction in auditory processing (i.e., perception and comprehension)
4. Significant dysfunction in the processing of other sensations including hyper- and hypo- reactivity (e.g., to visual-spatial, tactile, proprioceptive, and vestibular input), and motor planning (e.g., sequencing movements).
I don't agree with #3 and #4, but #1 and #2 are right on.
They basically came to the same conclusions I did in that G's inability to focus his attention for any length of time (at age 2 it's not like I'm expecting him to sit for an hour or anything) is what is holding up his communication. They think he knows a lot more than he's letting on to knowing. He gets distratcted easily so he's just wired and he needs to be able to be calm at times as well. He doesn't interact socially (i.e. he wouldn't engage in play with them) in the respect that he doesn't really "play" with his toys - like driving his cars or trains everywhere. Yes, he does that for a minute or two but he doesn't make any pretend noises or drive them up things or use things as a road or tracks. If I try to play something with him he sits and watches me or he decides to do something else.
I think once we get to the point where he's got the ability to focus his attention (don't get this confused with ADD or ADHD because it's not) then things will really start to come together for him. Our first "goal" is to get him to communicate to us that he's done eating or full instead of throwing his food/utensil/plate on the floor.
Communication Summary: (Strengths, Test Results, Behavior, Needs):
G is an energetic and well-coordinated little boy who enjoys trains, cars, books and active outdoor play. He is very independent and good at getting things he needs without adult assistance. He presently communicates using mainly one or two word utterances, several of which are his unique invention (e.g., "go-go" for water). He has had very limited opportunities to socialize with other kids thus far and does not demonstrate expected skills in the area of social/reciprocal interaction (e.g., initiating play or imitating play routines, showing objects of interest, responding to questions, seeking attention, etc).
Communication Diagnostic Impression:
Receptive and expressive language delays, and delays in social interaction.
Psychological Summary: (Strengths, Test Results, Behavior, Needs):
G is a very active two year old with a definite mind of his own. At today's evaluation he displayed below age level attention, persistence, concentration and problem solving. On the Bayley III Cognitive Scale he was able to complete tasks up to the 19m level. He had significan scatter in his social emotional development which gave him a scaled score of 3. Sensory processing score showed possible sensory processing difficulties. The short sensory profile showed overall probable differences with definite differences in tactile sensitivity, seeks sensation, and auditory filtering with probable differences in visual/auditory sensitivity.
Cognitive/Psychological Diagnostic Impression:
Multiple System Development Delays (cognition, speech, social/emotional) with sensory processing difficulties. Garrett's area of strength was the fine motor manipulatives.
So, what does all this mean? It means he'll see a language pathologist for language therapy. He "knows" plenty of stuff (names of objects, colors, numbers, letters, etc) but he just doesn't communicate them. The occupational therapist, I believe, will work with him on his play skills. Sounds strange I know, but it's not. Things like, "It's my turn," when he is playing, or asking for things he needs instead of just getting them himself, etc. I am not worried about the sensory integration issue because I think it's environmental mostly and related to his frustration at not being to express himself verbally.
Playgroups. You betcha. A little difficult considering where we live, but if I can find one that I like for him then I'll gladly bring him into town for interaction with other kids. I should also become more friendly with Nicola, the Fish & Game officer's wife - as they have a little girl who is 4 months older than G and a second little girl who is just over a year younger than G. It'd benefit their girls and G and probably us momma's. I've just gotten used to being somewhat isolated by choice. I love our little house and our dynamic and I'm not opening myself up to relationships with those outside my family. I need to change that.
I'm a little doubtful of some of what they said in their evaluation (i.e. they said his problem solving skills were awesome - way above par - yet in the summary she says his problem solving is below his age level) but they did "see" the things that have been concerning me. So, I'm open to their assistance in his language and giving him the tools to improve his attention.