The Journey to "Normal," Part 2: Early Childhood Intervention

11 months. The news hit me in the heart much in the same way a fist to the stomach leaves you breathless and spinning. It wasn't possible. There was some sort of mathematical error, these people were crazy, I didn't understand what they were saying and just needed a little clarification. But when it was explained to me again, the answer was still the same. 11 months.

Imma at 2 1/2. We had finally gotten the evaluation done. In Texas, when you think your child may have a speech or developmental delay, may need some sort of therapy, you contact Early Childhood Intervention. In Collin County, the organization is called Lifepath Systems. You make a quick phone call, in my case, an extremely polite and understanding professional takes some information, reassures you that everything will be just fine, sets an appointment, and the some nice therapists and diagnosticians show up at your house to see if your kid's alright. Simple enough. The evaluation itself was conducted by a speech pathologist and a diagnostician. They gave a few weeks before Christmas and stayed for about two hours. They asked Imma to play with certain toys, look at certain books, manipulate certain objects. They asked her questions she could not answer, they asked her to sing songs she could not sing, and they asked her what sounds animals made. That, she could do. They had lots of questions for me, too. What she could do, what she couldn't do, what she like to do, what she didn't like to do, what she knew, what she didn't know, etc. Was there anything unusual about my pregnancy? Was there anything unusual about the birth? Was there a family history of learning disabilities, mental retardation, birth defects, etc.? Had she suffered any traumatic brain injuries or blows to the head? No, no, no. None of those things. She just couldn't talk. That's all that was wrong or different, I kept repeating, she just didn't talk! In fact, I even explained that we thought she was choosing not to speak, that she could if she wanted to. They were polite, they made notes that began with stems like, "The mother reports. . . ." I know those reports. I've taken those reports. They asked if we had had her hearing checked. Yes, we had. She can hear. She just doesn't respond. They understood. They would go back to the office and do some math. They would look at some charts and spreadsheets, use some equations and tables to figure some things out and they would be back in a week. One week and I would finally know what was wrong with my baby! Except for they didn't know. They came back in 1 week, this time with an Occupational Therapist as well. They talked about how sweet and beautiful Imma was and how lovely our home was, and how we were all going to have a Merry Christmas. Then they pulled out their charts and reports. Again, I am familiar with standardized screening and diagnostic tests. Part of my job is to help identify students who may need special education services. They talked to me like I had no idea what a "chart" was, and that's fine because at the time it didn't matter. I was waiting for them to say they were sorry but Imma just didn't qualify for their services. But of course, Imma did qualified for their services. In fact, of the four areas they tested in, Imma qualifed in two of them and almost a third. She did extremely well in the category that judges physical capabilities. She did extremely poorly in the language and communication category as I expected and she was borderline in another category that had to do with potty training, napping, that sort of thing. She was behind in her social skills, as far as interacting with other children and adults. And then they threw the number at me that made me stop breathing. According to their screener, she was significantly behind in her cognitive development. Again, I had to ask for clarification. My child was very bright. She could sort objects by color, she could problem solve like no other two year old I'd ever known, she could manipulate objects, find ways to make things work and had spatial reasoning skills that I couldn't believe but these people were telling me she was extremely behind cognitively. How far behind? 11 months. She's 30 months old. Do you mean she has the cognitive abilities of a 19 month old? Yes, she is 11 months behind. That's almost a year. Yes, cognitively, she is 11 months behind. At this point I asked a lot of questions about how they came to this determination. They showed me the charts, pulled out the tables, explained the questions and how they figured out what that implied. They said that most of the scores were based on her ability to answer questions and sing songs, recite nursery rhymes, etc. I said, "But she can't talk." They knew that. "So, how do we know that's not just an indicator that she can't talk and not an indicator that she is cognitively behind." They admitted that the test was heavy on the oral language skills and it is possible that she could be just fine cognitively but the test indicated that she wasn't. She was cognitively behind because she couldn't sing "Twinkle, twinkle, little star" tell then her name, tell them which picture was a cookie. I assured them that she knew those things, she just couldn't say them. They were very understanding and assured me that everything was going to be just fine. She would qualify for speech and OT services and they would find ways to help her develop. I still don't know if they believed my child was really that far behind or if they understood that you cannot judge a non-verbal child's intelligence based upon a verbal exam but we set up a schedule for the speech therapist to visit us once a week at home and the OT to visit once every two weeks at pre-school so that she could do play therapy with Imma while there were other children around. We had a plan in place now, and even though I was still reeling from their numbers, I was able to accept that she needed some help and I was hopeful that this would be exactly what she needed to be "normal" like everyone else's child. My final question was one I had been asking, and have been continuing to ask for quite some time. What caused this? The answer I got is a variable of the same answer I've been getting for years and may always continue to get. "She hasn't developed her ability to communicate verbally." Yes, but why? "Well, when she hears speech, she doesn't understand how to process it." I understand that. But what causes that? "It's some sort of developmental delay." And so the circle continues. At the time, it was very important for me to answer three questions. 1) What is wrong with my child? 2) What caused this? 3)How do we fix it? The last one, of course, was the most important one and I was content for the time that we were finally on our way to answering it. We would have 6 months of therapy through Lifepath Systems until Imma was 3. At that time, she would fall under the jurisdiction of the local school district, which I happened to work for. Of course, I was confident that we wouldn't need 6 months of therapy, but if we did get to the point where she would need to be evaluated by the school district, she wouldn't need any services, except for maybe speech. But like everything else on this journey, that mountain was around the corner and I could not yet see how extremely steep and sharply designed that path would be. If you live in Collin County Texas and you suspect your child may benefit from Early Childhood Intervention, please contact your pediatrician or Lifepath Systems at 972-562-0331, www.lifepathservices.org. There are lots of websites available if you have questions about what services you qualify. You can look at your state's official website. Early Childhood Intervention is the name for these services in Texas but it may be called something different if you live in another state, such as Ready Start.