1 Yr Old Doesn't Crawl, Walk, Talk, Hold, Grab, Etc.

A neurologist is a second opinion. I would encourage your friend to go. A 14 month-old that doesn't even roll over is truly a concern. I would be supportive to your friend, she may be afraid of what they might hear.

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That is NOT normal. I know you don't want to offend them, but they need to see a specialist. Early intervention is the key in a lot of things. He's clearly not reaching any developmental milestones. It sounds like you babysit him? I would print out a chart of developmental milestones and the numbers for early intervention specialists in your area. There are normally government run programs to help identify and work with developmental delays. Just tell her that you noticed he wasn't reaching his milestones and that you're concerned. If it makes them mad, then at least you did the right thing for the baby. It sounds like maybe they know something is wrong and just don't want to face it. My niece has several developmental delays (she was born with part of her brain missing) and everyone says that the earlier you get them in therapy, the better the chance the baby has. IMO, this is NOT a situation where yous should be biting your tongue.

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At the risk of sounding politically correct, the term you want is "typical" not "normal." But, you do describe developmental issues that are not in the typical range.

He probably needs to be seen by a Developmental Pediatrican. This will take a commitment from his parents, as they will have to make the appointment many months ahead of time, and fill out tons of paperwork and ratings scales before hand. A Developmental Pediatrician will pull in every professional this child needs, and from what you describe, this will likely include a geneticist, neruolgist, psychologist, Speech-Language pathologist, ENT, Occupational therpaist, and a physical therapist.

These parents will get second, third, fourth, (and so on) opinions in one report with a master treatment plan for thier son. There is probably not much that you can do to make them see how serious this probably is.

What you describe about his hands is very alarming. If you open them, do they look odd? This is one of the first things a geneticist will look at.

I hope that they realize soon that waiting is the wrong thing to do. NEVER wait and see about developmental issues. Always find out from the best professional you can find, sooner rather than later, more therapy rather than less. This is one place where you should not care if you are over reacting.

M.

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This is NOT normal at all!
I am shocked that as parents they are too blind or afraid to admit there is something wrong.... They should WANT to help their child fix what is wrong.
I would have them follow their docs advice and have them see specialists! To me their doc should really be putting pressure on them to do something for this poor boy.
My 7 month old sounds like she can do more than him and I don't think she is advanced in any way. Just a normal stage for her age.
Good luck on talking with them, but be prepared for some resistance! If they aren't willing to listen to a doctor I am not sure they will take it well from you.

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Hi ~
First off I just want to say that you are a wonderful friend to be exploring answers and being concerned for your friend. I agree with Patty W and Sue W - I would definitely recommend that you encourage them to see a neurologist. Her doctor has concerns otherwise he/she would not have recommended going to a neurologist. Has the doctor ever mentioned concerns before this appointment??

I work with kids of different ages and diagnoses on development and I can promise that what you describe is not normal. Although it may be VERY hard to hear, unfortunately it sounds like this little guy has some significant issues (you are describing increased muscle tone in legs and arms which can be a sign of cerebral palsy). Here is a link to "red flags" in development http://www.pathwaysawareness.org/milestones

I would also recommend getting a physical therapy and occupational therapy evaluation to assess development (in a nutshell OT works on hand function, grasp, manipulation of toys, range of motion of arms, etc and PT works on range of motion of legs, transitions (rolling), walking, etc). It is not typical to have a child over the age of 2 months to have fisted hands –from 3 months on (laying on back) they should be reaching up to swat at toys over then next several months hold toys/manipulate (rolling toys in hands using fingers) and around 8 months the child should hold the bottle. By 14 months he should be stacking 3 one-inch blocks while sitting independently.

Most important thing you can do is be there and support your friend, which it sounds like you are doing :) Take care and please feel free to message me with any questions.

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I really do not know why anyone would wait, tell them nicely they need to see a specialist and have this baby evaluated.

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My son is very very mildlly delayed and our doctor suggested that he be evaluated by an occupational therapist. We had it done and it was basically play time for the baby. It was not a bad experience at all.

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I have read the other posts and agree that this is not normal/typical development. This child seems significantly behind.

However, it also sounds like these parents are in denial. If they did ANY reading or listening to their pediatrician they would already know that their child is behind developmentally. And if they wanted second opinions they would have already have gotten them. They are pushing this issue under the rug.

I think that if you want to express concern over their child's delay, then be prepared for the backlash. Clearly you have already learned from them that their ped referred them to a neurologist. I think the "easiest" path to take might be to ask, "So how did the appointment with the neurologist for JR go?" I think that is a non-offensive way to ask WHAT they are doing.

CLEARLY this child needs help. Unfortunately you cannot force them to seek a second opinion, referral to a specialist, etc. Also, unfortunately for the child, from what I understand, many delays like this that are caught early see the best results in treatment before age 3.

Obviously, you are a concerned friend. Obviously you see the delays in this child. However, CLEARLY the parents aren't moving forward to get their child help...for whatever reason. So if you pursue this issue with them, beware that they may lash out at you for calling their son "delayed" or "not normal"...even tho it's true.

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Hi there,

It is always difficult to offer advice when it isn't asked for, but in this case I would definitely recommend that this child be evaluated by Early Intervention. I had a child who was different from his peers and I always questioned why an acquaintance of mine, who was a speech pathologist, didn't recommend that I do something. Luckily after spilling my guts to another acquaintance whose son had similar issues, she told me to call Early Intervention. My son got services and was then soon diagnosed with Pervasive Developmental Disorder or PDD. Thanks to the early diagnosis and services that he received, my son is now doing very well. Your friend might be mad at you at first, but I think that she will thank you in the long run if something is wrong, and time if of the essence! I have talked to so many parents who regret not getting help sooner.

Good luck!

A. W.

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I would suggest that you be honest with them that he seems to be falling further behind what seems normal for his age. That you care about them and want to see them happy and healthy.

And then I would try to point out the fact that there may be worse consequences to not acting on this now. What if he isn't absorbing something through his intestines that he needs, and it means that he is slowly getting sicker? What if what is going on is something where he can catch up but only with the help of certain kinds of therapy which needs to already be under way? What if he can't express that he has a bad allergy to something in his diet, and he's missing critical windows for various physical and brain development because you just don't know it's going on? Wouldn't it be better to get on top of this as quickly as possible so that your son can have the best life available to him?

Understand that some parents are so far in denial that she may end up avoiding you until she breaks through her own emotional wall about this, if you say anything at all. But it's probably better for her and the child that you do. And some day she will probably come around, even if she doesn't deal well with it today.

Thank you for caring so much.

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Hi, you are a great friend for posting this. Your instincts are absolutely correct on this. In some kind of tactful and sensitive way, you should absolutely bring this up to your friends. As many of the responders have already written, he should be evaluated by a neurologist and possibly other specialists, asap.

There are state Early Intervention (EI) Programs (OT, PT, SLP) that this little one should be involved in. I don't know the details but I would suggest the first step would be to take him to his pediatrician for a neurology referral. If the pediatrician has completely missed this, you might suggest seeing someone else. Good luck and you are again a kind and wonderful friend for looking into this.

While many kids aren't walking til later, holding up your head and not having clenched fists are an earlier skill. Be sure to express how much you care about your friend and her son and just say you are concerned and want to be sure they get him checked out. Definitely sounds like something is going on and I'm surprised they haven't done anything about it yet. Could be just hypertension, or something more. Regardless, the sooner they know, the sooner they can start therapy, interventions, etc. Have them see another ped for another rec, and then encourage them to follow through with neurologist, PT, etc. Just be loving and supportive and understanding that this will all be very hard for them, but will be the best for the son and they will most likely want to do what's best.

It's clear that you realize that this child needs to see the neurologist as the ped already recommended - what you are asking is HOW to broach that with your friend. It is definitely a difficult place to be in, and you obviously care about your friend and your friendship as well as this child. You are a good friend.

You could say that you have been doing some reading about typical development and that you support her taking him to the neurologist for a second opinion. You could also offer the information on how to get in touch with Early Intervention (EI) to have him screened. Your friend is probably scared and may just need the moral support to take the next step.

I had a babysitter raise concerns about one of my children to me and suggest I see a doctor, and it is a moment I look back on with gratitude and respect. My child did end up having a pervasive developmental delay, and although the babysitter didn't know exactly what was wrong, her instincts gave me the courage to take the next step and get him evaluated.

I also think encouraging them to get involved with a play group of same aged children might help them see that they shouldn't wait. The earlier the interventions, the better for the child (and family!)

Good luck!

Wow. Do these parents not realize that the neurologist their pediatrician is recommending IS a second opinion? Maybe they are not telling you the whole story . . . or they are in MAJOR denial that their child has some MAJOR medical and developmental problems. I feel sorry for the child. Him not getting the medical attention he needs is neglectful, and you being his caretaker and not knowing the full story and exactly what is wrong with him, or how to take care of his special needs, is not helping the situation.

Maybe there is a family member you could speak with that could press them about getting that second opinion from the neurologist. Otherwise, I'm surprised the pediatrician isn't being more pro-active about getting this child's needs met. There may come a point when the doctor and authorities have to step in to make sure the child is properly taken care of.

I think, unfortunately, you simply need to let them find out on their own that their child may need some help. As he gets older it will be more and more apparent that he is in need of help. The fact that they are unwilling to take him to a neurologist speaks volumes - they are not ready to accept that their son may need help. They are not yet ready to put his needs above their own insecurities.

I do think that either Early Intervention would be a great option for them. They will come to her house and evaluate the baby by playing with him. They are honest, but kind. The sooner he gets help, the better.

It would be wise for your friend to call Early Intervention in your state. A team of therapists will come to the house and evaluate the child. It sounds like he has some developmental delays. If that's the case they will assign therapists like a speech pathologist, occupational therapist, etc. to come to the house once a week to help. I'm not sure but I think the services are free till the age of 3.

It sounds like that one year should see a neurologist. It also sounds like he could benefit from an Early Intervention program (their pediatrician can give them info on the closest EI program in their area.) EI programs have physical therapy, speech therapy and occupational therapy, counselors, etc. specifically trained to work with infants. This baby is already one...don't waste any more time getting him services!!! This is not normal.

If it were my baby I would be suspecting cerebral palsy

Did she take her son to his first year check up?
They will know immediately that this child is behind developmental schedules. Ask her who is her pediatrician and when was the last time her child had a check up. Figure out how to work it into the conversation. You could say you know somone who is looking for a doctor for her own child..

speaking as a parent of a child recently diagnosed on the autism spectrum (I don't think that's the case here) I know a lot about going through the medical system...your friends don't need a 2nd opinion. They need to follow the very conservative and non-invasive advice of their primary and see a neurologist. A 'second opinion' would only be relevant if the primary were making some sort of diagnosis and prescribing treatment...he's only doing the sensible thing and recommending they involve a specialist because all signs seem to point to a neurological problem (and whether or not there is a problem, a specialist would seem to be the one to make that determination). I would emphasize to your friends that there is no harm in taking him to a specialist, but not doing so may delay treatment of a condition that is more destructive if left alone. If they don't like what a specialist has to say, then they can seek a 2nd opinion, and at least they're one step closer to reaching a diagnosis they trust...getting another 2nd opinion from a generalist will only delay getting to a definitive answer that will almost certainly require a specialist.

I am an OT and I agree with the other posts that this child should be evaluated by a neurologist ASAP. Then after seeing the neurologist, that would be the time to seek a second opinion. I've never heard of anyone seeking a second opinion based on a recommendation for a specialist. Just go to the specialist for the opinion. Also, going straight to a PT isn't the answer in a situation as complex as this. A PT needs a diagnosis to work off of. Early intervention can help and should be started right away as well. I would encourage your friend to make 2 phone calls right away - neurologist and EI. Good luck.

I agree with Diane B's response from yesterday. Offer to go with them to the neurologist (which IS a second opinion) and to be there for them. They may be dealing with serious fears and denial; it certainly sounds like it. A warm nudge to be there with them, might be something they never thought of, which might help them take that step towards setting up an appointment. Sometimes having someone else being part of the process can prompt a family to not delay.

They may fear they have done something wrong. They may fear hearing a specific diagnosis. They may fear any number of things. But delaying will not help in the long-run. As many have said, more information is needed and Early Intervention can be key to their little one's progress.

Somehow encouraging them, without pushing them, is the trick. Trust your gut on this and I suspect you will be the help you need to be. It sounds like they have shared some details with you already. That could be a springboard for further communication.

Good luck!

I would follow up ASAP with the neurologist as the pedi recommends. I am glad to see that he is being proactive. Something is very off and they need to get to the bottom of it as time is of the essense to get him help because the earlier they do the better off he will be for the future.

Those certainly do sound like concerning symptoms. It seems like your friend is aware as you said she has discussed it with her pediatrician. I think her best bet would be to follow his advice and see a neurologist. Time is of the essence. Physical therapy, etc. could likely play a part, but a good diagnosis is essential. You could simply inquire of your friend if she has seen a neuroligist yet and what his/her opinion was.

J.

wow, I am shocked that the dr. really did not notice this and make a better move on it! I agree that this does not sound right, all kids to progress at diff. rates, but this does not sound right. It would be hard to bring it up bc you dont have a child of your own to 'compare' him too (yes comparing is not usually a good thing, but in this case it would help) do they not know anyone else w/ kids? they dont have playdates? daycare? CT has a wonderful program called birth to three and they come to the house and do free evaluations...you said they want a second opinion so that is where you can then bring this place up. tell them you saw a flyer at the library when you were getting a book (white lie) and tell them you wrote down the number for them bc it looked good. they come to your house and do activities w/ your child.....leave it at that and see how it goes. good luck, and you are a great friend for caring. xo

I'm confused, they want second opinions prior to the neurologist? Why won't they take him to a neurologist? A neurologist can help determine if he has a sensory disorder or is on the autism spectrum, either way if those are the case, the younger the diagnosis, the better since early therapy and intervention are key. Being around other children his age will not help him developmentally in those particular areas, those are not learned responses, they are developmental. I wish them the best of luck but do recommend they go with the pediatrician and see a neurologist sooner, rather than later. Also, they could check into Early Intervention (if CT has it, which I believe they do) and have him looked at to see if he qualifies for services.
Best of luck.

If the ped already recommended seeing a neurologist and they aren't doing it -it's difficult. They seem to just want the problem to go away but it won't. He is very far behind his peers and does need to be evaluated even if it's just by Early Intervention. He has a 15 month check up coming up. If the ped has spoken about this before I think he/she will bring it up again. Hopefully they will listen and start to do something. It is a touchy subject but the longer they wait to get an evaluation the farther behind their son will be.

Good luck,
L. M

I have a son who is now 2 years of age and is almost exaclty how you described the child you are talking about. My son doesn't hold a bottle or cup. He doesn't feed himself. He cannot walk on his own. He needs his walker. ECT.... He has seen a neurologist and they said that the left side of his brain is fireing slower than the right. He has not had an offical diagnosis. He has birth to three coming to the house 3 times a month. They work with him in all areas. I know they have helped him a lot. He wouldn't be where he is today without them. I do recommend that somehow some way you can meantion just seeing a neurologist or calling birth to three to come over and just evaluate him. It cannot harm him. It will only help him. Because there is something obviously going on. And letting it go is not helping the child. I would just maybe tell them how much you love there son and are genuinly concerned about him. You want to make sure that he is ok. Even if they think a neurologist might be too much at least call birth to three. They are awsome! And they come right to you. My son has just been told that he has motor delay. It sounds to me like the same with your friends son. It is all the exaclt things that happend with my son. We have been told that he could grow out of it or he could just be a little slow the rest of his life. I am a religious person and I am praying for him to grow out of it. I will be praying for you and your friend and her family. That whatever is best for the child will happen. If you need anything else let me know. I have really been thru it all with my son.
take care,
J.

I think that, if they have had a recommendation from a physician that they seek further evaluation, they are unlikely to listen to advice from a lay person who only has had babysitting experience. They may be resistant to your advice as they are to their doctor's advice. So I would offer to go with them to the neurologist's appointment. If they want a second opinion from another pediatrician, FINE. It's probably a wasted step, but if it gets them moving, then let it happen. And offer to go to that. When people are distressed, it can help to have a neutral party there just to listen objectively and to take notes. Promise them that you will not interfere, you will not speak at all, you will just have a note pad there and will write everything down. Another option, with everyone's permission, is a small tape recorder, so that they can replay what the doctor says when they are at home. It is normal to forget things in times of stress. It's always recommended that people take a friend with them when they are learning they have cancer or some other serious illness - and friends of mine just called me when the wife had a major medical episode, and they wanted me there in the hospital when the doctor came in. They said I was very helpful because I remembered things they forgot. So, I would offer my services that way if I were you, but do not push. They are already resisting what they have been told. If you say, "I'll be there for you" and even offer to drive so they can focus on what they're going thru rather than on the road, it might help.

I would not think that going directly to something like PT would help at all - they don't even have a diagnosis. And being in a group with other kids is only going to make their son stand out and it's not going to help him. If he has certain conditions, the stimulation will make him worse. These parents already know that there is something not right with their child. They just need the courage and support to go forward.

If you can gently suggest to your friends that going to a neurologist IS a second opinion, and that they don't have to do what the doctor suggests..........but it can't hurt to hear what he has to say and possibly run a few non-invasive tests. However, procrastinating could hurt. If this is something that needs early intervention, which could be as simple as some sort of therapy, then they may be missing a very important boat.

Tell them you are no doctor, but if their pediatrician had made this suggestion he must have some concern. Tell them the truth........you don't know anyone with a child this delayed. Ask them if they are afraid of labeling their child and help them around that obstacle if you can.

side note: My pediatrician wanted to put my son on medication for seizures when he was 6 months old. I asked to be referred to a neurologist. I'm glad I did. He gave us options, and one was to go off meds and try something else. I kept my son off meds for several years thanks to a bright and open minded pediatric neurologist.

It would be difficult to give advice only because I think it would be hard for the parents to take it. It sounds to me like they have a fair bit of denial. I agree with other responders that they really need to see a neurologist and not a specialized therapist at this point. You could do a little research on your own and present it in a friendly manner. Something like, hey did you ever make that appointment for the neurologist because the person I work with was talking about this great neurologist she sees named..... or something like that. We go to see Dr. Kleiman, a pediatric neurologist in Middletown, and I would recommend her. You are a great friend.