Wednesday, February 20, 2013

First Steps Evaluation

Ruth had her evaluation through First Steps last Thursday.  Several have asked about it, and it's really way too much to write on facebook, and it's a long conversation to have 45,000 times so I thought I would just blog about it, instead of Ruth posting today.  While we learned alot, we won't know her exact scores and what all she will or won't qualify for until March 1st.  At that time they are going to come back out and talk to us, and let us know what options we have, and possibly set up a game plan if she is considered delayed enough.
They tested 6 areas - fine motor skills, gross motor skills, adaptive, cognition, social-communication, and social skills.  They told us that she was far ahead of her age for fine motor skills.  Britt got to test a little with her, since he wanted to play too, and she far out ranked him on fine motor skills, some of what she's doing they told me was at a 4+ year level.  For example, she managed to almost completely cut out a shape, and I've never even let her attempt something with sissors.  I still think that was a fluke.  She is spot on with gross motor skills (this is what her funny gait falls under), she can jump, gallop, kick a ball, etc.  With her adaptive skills, they looked at things like how she eats, just generally works with her environment, once again that was at her age level.  With cognition they were looking for how quickly she processes and figures things out.  She was ahead in this area as well, though they didn't tell me what level she was at.  Ruth's problem areas are particularly in the social-communication area and as a result of communications issues also a few problems in the social skills area.
Sprawling out is ok, in fact, it's perfectly normal
for her to look a little knock kneed up to around 4.
Ruth had several red flags in her social-communication.  The first is that she uses almost no consonant sounds.  At this age they don't expect them to use the right consonants, but they do expect them to be using some consonants.  For example, I know that "uh-ey" means monkey, "ah-ul" means apple, and "uh ou" means love you, but none of those "words" have consonant sounds in them.  Secondary concern is that while she has a large vocabulary it is primarily nouns, she uses almost no adjectives, and very few action words.  Additionally when she uses action words, she doesn't attempt tenses.  For example, she would say "I run" not "I running," "I ran," or "I runned" all of which would be normal at this age.  She also never says things like I eat, but rather things like I hungry.  Which of course sounds more like "I uh-ey", and we only know the difference between monkey and hungry because we figure out from how she acts, or from asking several different things.  She had one additional flag in the social skills area.  In everything else, she rated above her age level, but since she is a social butterfly who has never met a stranger we aren't surprised.  Her one flag is her frustration level at trying to communicate.  She attempts to carry on a conversation, and she understands everything that is said to her, BUT when you don't understand her (which happens alot) she gets frustrated, and rather than showing you, or trying to rephrase what she wants, she just repeats the same thing over and over and over, until she's pitching a fit or you figure it out.
Ruth W-sitting.
As for her walk, best they can tell, short of doing xrays to confirm, there is nothing wrong with her walk.  Most kids walk a little pigeon toed before three, and the only reason that she's not growing out of it faster is that she does W-sit alot.  I didn't realize what that meant when someone asked me about it last week.  They were impressed with her ability to quickly get up from a squat, which is her favorite way to sit and play in the floor, and said that she had good strength and muscle tone.  W-sitting means that over time as her pelvis matures, that it might not line up quite like it should.  It's ok for them to do that, but she is doing it too much.  Additionally for Ruth she is not pointing her toes straight behind her when she sits but the foot that turns in, she points out perpendicular to her body.  They could verify that she sits this way too often, because they checked her flexibility.  When they laid her on her back and had her butterfly her legs (feet together, knees out) she couldn't put her legs flat to the floor, like kids under 3 should be able to do.  Additionally when they put her knees together and her feet out to the sides, she could not only lay them completely flat but she could actually pull her feet all the way up to her sides, making a V shape.  She was more flexible than she should be.  What that told them is that she keeps her hamstrings in the shortened position most of the time, and she's not working them enough (she has a little bit low muscle tone as a result, not much just a little low).
Ruth squatting.
While they couldn't tell us her actual score yet, I did overhear them discussing that she was borderline, and that they would recommend her for speech therapy.  Even if she doesn't qualify for the program, they gave us some stuff to do help her.  For the gait, we just encourage her to "sit like a big girl" and they gave us several ways to have her sit instead.  We won't completely eliminate W-sitting that's just her preference, and there's nothing wrong with that, just encourage her to not sit that way as often.  For the speech, play lots of singing-finger play songs (like itty-bitsy spider).  Most kids learn through singing to speak clearer, and since she loves to sing and dance, this one will be great for her.  Also, to pick a sound to work on so that when she drops it, we repeat it back to her, emphasizing the missing sound.  The key here is to do this often enough, that she begins to hear what she is dropping, and to encourage her to add it on her own.  She won't start doing it right way, it will take time.  The next milestone we are to be looking for is using more consonant sounds at the beginning and ending of words.  If she has had no improvement in 6 months, they recommend having a full hearing check at 3, just to be sure that's not an issue (initial test, showed that it's not though).  All in all, we got alot of information, and I'm glad we went ahead and had her tested.

1 comment:

Dianne said...

Danielle, sounds like she's above-average *except* in the lack of consonant usage. Singing a good tool for little ones. I had never heard of "W" sitting either. It would be a foreign word and action here in this household of seniors but I have seen the boyZ sit like that when on the floor playing. God bless you and Gary to continue being active and aware parents.