When and why did A mother in Cairo start to feel concerned about Y.'s health and development?My son was two and a half years old when the nursery staff called us - me and his father - for a meeting. They said he has severe tantrums and he doesn't want to play with anyone. He wants to do what he wants to do, not to follow the class rules. He sticks to a certain toy or a certain activity and doesn't want to leave it. His school referred us to the Learning Resource Center, which is a beautiful and professional center in Egypt. We had a multidisciplinary assessment at first. We answered questions with: “No, No, No… He doesn't have tantrums. He plays with his friends,” and so on. After the parent intake at the Learning Resource Center, they scheduled the child assessment. During this time, we realized that we answered, “No,” but actually, we could have said, “Yes.” He puts blocks into a tower. He follows the lines in the floor. He doesn't answer his name. We called the doctor to correct our answers. Then, at the first examination, my son completed a cognitive screening and later did an autism spectrum disorder test. We were told he is on the autism spectrum with a moderate degree. I had a panic attack. We decided to see many - too many - doctors. Some of them said that he is borderline because of his age or we cannot diagnose him accurately at this moment, we have to wait three years. Another doctor said, “No. He is not autistic at all.”
When and why did DK start to feel concerned about T.'s health and development?My younger daughter, T. , would go to a birthday party - which she hated to do, because she was so anxious - and come back and tell you in detail the colors of every girl’s dress. For 10 girls, she would tell you what they wore, what the pattern was, what the color scheme was. Then, you would sit down with her and say, “This is the letter ‘A’” in a book and, on the next page, “This is the letter ‘A’”. You would then turn the page again, and point to an “A,” and say, “What is this?” And she would say, “I don’t know.” We benefited from birth order. Having an older daughter served as a point of reference, developmentally. My older daughter did things very early, but even accounting for that, I noticed disparities. The other reason T. hated going to the birthday party was because she didn’t like the social dynamics. She said, “Well, if I go, then this girl feels left out.” She had lots of emotional intelligence. I first started noticing T.’s learning differences at about three-and-a-half or four, and she didn't learn to read till she was about eight or nine. I learned more in hindsight. If you look, you also see this anxiety in children like T. Some of that may be her personality, but in my experience observing T. and other kids with learning differences, they felt like they weren’t meeting some sense of expectations. And that feeling created anxiety. In preschool, it was fine. But then, in PS6, it was hard for T. because there was constantly this sense of external benchmarks. Carmen Fariña, who became the Chancellor of New York City Schools, was the principal of PS6 at the time. I am eternally loyal to her. She put a cluster of kids together with teachers who were veterans and really knew what they're doing. They provided T. with a resource room teacher who was on the board of the National Dyslexia Foundation and taught at Hunter. In New York City, it's not like you're out at play all the time, and have other ways of expressing your capabilities. In spite of their efforts, school is pretty constrained. Certain places like PS6 were academically focused. I think this leads to an emotional toll. But I will tell you: when I go and read the assessment they did of T. at the age of five, everything is still true in her adult life. It was brilliant. They identified her issues with pattern recognition and sequencing. Now, T.’s a web developer, and she lives in Austin. One of her biggest struggles is: “Oh my, there's 10 projects to handle. What do I do first?” That problem of prioritizing tasks. At the age of 28, every once in a while, she still calls me up and goes, “Okay, I just need a little help. What should I do first?” I expect (and hope) she'll do that as long as I'm alive.
When and why did Donia start to feel concerned about J.'s health and development?When my son was born, I said, “His breathing sounds super-congested.” The doctor said, “Yeah, he probably swallowed a little amniotic fluid. Don't worry about it.” I saw his chest pulling in a little bit when he breathed, and I kept on questioning. (Now, I know those were called “retractions.”) They said, “Don't worry about it. That's normal.” He was born at 35 weeks. We knew that potentially at 35 weeks there could be some minor respiratory issues. But he was six pounds eight ounces. He looked great. His Apgar scores were really good. All the things that we use to measure the typical stuff were good. Then, my husband pointed out that he was not really responding the way our other son had responded 24 hours into being in the world. Bright lights weren't really making him squint. A bunch of things just weren't happening that we thought were normal. (My first son is a healthy, typically developing six year old now.) He also has what I call his “cute” ear, a malformed ear. That was something I also pointed out, and the doctor said, again, “Listen, your kid is healthy. Don't worry about it. He's okay.” My son was born in Jamaica because both my Husband and I had successful careers there. It was a private hospital with a reputation for great doctors. So we thought, “We got this. This is okay. We didn't need to come back to the U.S. to have a baby.” They transferred him to an ICU unit because of his breathing. He had a little jaundice. We were in the ICU unit for about a week. While we were there, I kept on asking questions: “You know, when he cries, I noticed his mouth is a little lopsided.” (“Don't worry about it, Mom. It's not a big deal”.) “His breathing is still a concern to me.” (“Don't worry about it. He doesn't need oxygen. His O2 is fine.”) He wasn't feeding well, and they said, “Well, sometimes with babies it just takes a little time for them to figure out feeding.” They discharged us from the ICU because they had more critical kids. They handed me a syringe and said, “Just keep squirting some milk in his mouth until he gets sucking under control, and head home.” I thought something doesn’t feel right. We went to our pediatrician, and he said, “Listen, I hear your concerns. I can refer you to any doctors you want. Yeah, his breathing looks a little off. Maybe he has something like a PDA (patent ductus arteriosus), which is very common in a lot of kids.” He sent us to a cardiologist who seemed to be rushing. She said, “He has a minor PDA. It's nothing to worry about.” My husband said, “Listen, this is actually good news. It's not like he has a major heart condition.” But again, something felt off. We went to an ENT (ear, nose, and throat doctor). They said, “Everything looks great. His airway is perfectly normal.” I thought, okay! But again, he still wasn't feeding. We just kept on pushing and pushing. It was constant: “Mom, you're freaking out too much. There's nothing to worry about. It just takes time.” But while this was going on, he was losing weight. I could see it. I mean, I could see it. He was the most miserable baby as well. My other son was such a happy little baby. I know kids are different, but there was just something about it that didn't feel right.
When and why did A mom in the Bay Area start to feel concerned about R.'s health and development?My son is almost two years old now. Last summer (when he was about 1 year old), he was sick for two or three weeks in a row. We weren't too concerned at the time, and then suddenly – well, it wasn’t sudden, but it seemed sudden – he lost 10% of his body weight within a month. He got to the point where he was so backed up, he wasn't eating anymore. I'm sure there were signs earlier that we didn't catch. For instance, he was not going to the bathroom regularly. And between me and my husband and our childcare, we never put that together. By the time we saw all the symptoms, he wasn't eating very much. And when he did, he’d throw up. Lots of throwing up. And he was in massive pain all the time. He was in such pain a few times that we had to go to Urgent Care. It was the worst. The scary thing was also that he just stopped all of the progression that he had been making. He had been cruising and starting to walk, and he just stopped everything. He wasn't talking yet, and he just became listless. It was terrifying. We never diagnosed why he lost all the weight. We found that there were a bunch of different issues, gastrointestinal issues. The weight came back first, but the bigger problem was that it took longer for him to get back to any physical and speech milestones. He started walking only once he had started on a new formula for a few months and gained weight. Now, we're actually seeing progression in his speech, which we haven't seen in the past. Up until he was well over 18 months old, he had no words that were consistent. I'm sure they’re supposed to have at least five to 10 words (or so) at that stage. That's when we went to a speech pathologist, and they acknowledged that he should have some consistent words. Recently, he's developed around 20 consistent words, and he's imitating, and you can just see him gaining confidence and gaining consistency. I'm feeling cautiously optimistic.
When and why did GF start to feel concerned about C.'s health and development?My son (nicknamed C.) is a sensory seeker. He's very active. At 18 months, he was constantly moving and doing a lot of physical activities that I didn't see other kids his age do. He also had an enormous amount of trouble self-soothing at night to go to sleep. He was having trouble going from a highly aroused state to a calm, relaxed state where he could fall asleep. We tried sleep training. We tried to do all the typical things that people tell you to do at that age. None of it worked. I just felt like something was off. Like there was something else going on. And when he would wake up in the middle of the night, which a lot of kids that age still do, he just couldn't go back to sleep. He was in a highly vigilant state, wide awake. It was at 18 months that I first mentioned this to his pediatrician. She said, “Well, his nervous system is still maturing. Let's see what happens”. As the months went on, and he started to walk, we noticed that it was like he had no sense of where he was. And then feeding challenges started: he was a really good eater until he wasn't. It was very dramatic. We felt like there might have been some sensory-related stuff going on with either what we were putting in his mouth or what he was seeing. We still struggle with feeding. I mean, it's gotten better. But picky eating was a big indicator of his condition. Then there was the activity level and the lack of focus. C. had a hard time staying focused on one activity. My son was born extremely premature at 24 weeks. Not everybody knows that 24 weeks is the line of viability. He was literally four days after the line. It was a very traumatic birth for him and also a traumatic labor for me. He was born weighing 705 grams. I'll tell you why I say it in “grams.” Because when they are born that early, every gram matters. They consider your probability of surviving partly based on the number of grams you weigh at birth. After he was born, all the nurses kept coming into the recovery room saying, “Oh my! He's 705 grams! Isn't that amazing?” There was like this celebration. He was a little bigger than normal for 24 weeks, but 705 grams is actually one pound and nine ounces. He was tiny. He fit in the palm of my hand. He was very, very small. He spent about five months in the NICU, and it was a very complicated NICU journey for him. Every child in the NICU has their own story. He was challenged with a host of medical issues that almost claimed his life, and also were potentially going to impact his development. When we came out of the NICU we were linked with Strong Start, which is Washington D.C.’s version of early intervention. We started Strong Start at about four months of age, if we correct his age for his premature birth, or eight months old from birth. We were working on some very basic things around gross motor skills, making sure he was moving his head right, that he was making eye contact, some of those typical infant developmental milestones. From the beginning, I had a sense of vigilance around potential delays in his development. In that respect, I think my story might be a little bit different than most families. I already had a heightened awareness that things were probably not going to be typical. The challenges that I had were really the struggles with the system. We knew C. was going to need a lot of therapy. We knew that he was potentially going to be diagnosed with a host of medical conditions that we couldn't predict in his early infant years. I was very proactive about it. But it was still very, very challenging to get the right services, to know who the right people were to talk to, to get coverage from insurance. I always tell people who have questions about what it is like to have a child who was born early or has special needs: this is all really hard. You have the typical challenges of raising an infant. And then you also are a medical coordinator, you’re an insurance advocate, and you're an expert at X, Y and Z diagnosis. You have a host of different hats that you have to put on every single day. The system is not always cut out to support you, right? It's almost the opposite. There are some days where I wake up feeling, “Okay, I'm in fight mode. Let's go!” I have to fight to get through the day, to be able to accomplish the things that my son needs in order to continue to develop and to thrive. That’s our overarching experience. He is now three years and seven months old. When you're born early, they use “corrected age” (based on the date you should have been born, so to speak, if you came to full term at 40 weeks) versus actual age for the first two years of life, because there is a developmental lag. The medical and school systems assume that by the time you are two years old, the child should have caught up, unless there's a major medical issue. Then after two years, you use only on the actual birthday so to speak. So he's actually three years and seven months from his day of birth.
When and why did Jeff start to feel concerned about S.'s health and development?Our son (nicknamed S.) is an interesting case. If you were to ever see him, you might think he was two years old, not his actual age of three-and-a-half. Not only does he model some immature behaviors, though he's well-behaved, but he's very small for his age. He wears size-two clothes still. He is getting a little taller, and he eats like a horse. But he just stays very thin. He’s not even 30 pounds. He has a little sister who is 10 months old who is catching up to him in weight. She's close to 20 pounds. She’s right around the 50th percentile for everything. He's still around 4%. On his growth chart, he has been less than the 5th percentile his whole life. And then speech-wise, he's actually more like a nine month old (not a three-and-a-half year old). For whatever reason, again, we can't figure it out. His expressive delay is huge and he does not talk. I would say that what he understands is a lot closer to a match for his physical size (of 2 years old). If we say “Hey, slow down,” if we're outside walking around, and he gets a little too far ahead, he'll slow down. If we say, “Okay, we're about to cross the street. We’ve got to hold hands,” he puts his hands up. He knows we're going to cross. If I say, “Alright, you’ve got to sit down in your chair.” Then, instead of standing up, he sits down. But he can’t talk. He's so small physically, and that has got to be holding him back in some way. I'm probably wrong, but I feel like that in my heart. Our son was born with a couple of strikes against him. His mother had a two-vessel cord during the pregnancy . He was basically always very, very tiny, through the entire process. To the point where we even got geneticists involved. And they were telling us it could be some kind of skeletal dysplasia. It could be this. It could be that. They were telling us a number of things that it could possibly be. When S. was born, he was supposed to go naturally. We ended up trying to induce early. I think it was three-and-a-half weeks early. That didn't work, so they did a caesarean. When we went home from the hospital, he was actually below five pounds. Then, right away, he had an inguinal hernia, so he went through surgery. As well as that, he had digestive issues. He was allergic to milk. It took us a little while to figure out what was going on. As he grew, we noticed that he wasn't hitting a lot of his milestones, whether it was movement, or speech, or others. He finally started crawling around a year old but he was not very good at it. And he didn't walk independently until he was just about two. We started to notice when he wasn't developing language. He also has a little bit of a lazy eye, which I think is genetic. I had the same thing when I was a child. These were all little things that we knew were somehow contributing to what was happening. Those were our first indications when we started to put together these puzzle pieces.
When and why did J start to feel concerned about baby boy's health and development?I am a first-time mom. My son is 23 months old now. My son prefers to sleep on one side of his head, and when he was eight months old, he developed a lopsided head. We took him to a neurosurgeon - I believe that is the type of doctor that assessed him - and he was diagnosed with plagiocephaly. To reshape his head, he got a helmet that he had to wear 23 hours a day. He was wearing this thing, and it was hard for him to sit up. Every time he would sit up, he would fall backwards. He would bang it and I would hear him in the helmet when he was sleeping at night. Well, I don't know if it's because of a helmet, but he didn’t start walking until he was about 17 months old. Everything he did, he did really late. Initially, he qualified for Early Intervention because of his medical condition, and because he wasn't sitting up yet by himself or crawling. I thought the helmet was going to come off and he would be a typical, developing child. Unfortunately, it just took him a really long time. He did crawl, but he did it really late. He did sit up finally, but he was almost one. Then, I was concerned he wasn't walking. I had thought “Oh, well, it's okay. At 13 months, we'll do it.” Nope. 14 months. Nope. He was almost 17 months old when he started - that’s late! He’s still struggling with how he walks. He trips and falls a lot. He still has physical therapy. He walks like he doesn't have the muscles in his legs - like a penguin, that would be my interpretation. And he doesn't pay attention to where he walks. He doesn't look straight ahead. He's walking and he's looking over here, and I keep telling him “Look ahead! Look where you're going!” He bumps into the wall, and he'll trip and fall. It's like this catch 22. I am nervous about taking him out walking, because I feel like he's going to fall. But if I don't take him out walking, he doesn't get to practice the skill. And he's not talking. He's now at 23 months, and he has no words. He has a speech therapist that we do Skype with once a week. She gives us suggestions and advice on how to repeat (and repeat, and repeat) certain things. He says, “Mama”. He was saying “Papa,” but he stopped and that's where we are today. People tell me, “I wouldn't worry. My son didn't talk until he was three years old.” Or, “My son didn't talk until two and a half.” Things like that. I have a lot of friends with kids his age, and I’m on certain Facebook groups. We do video [chats], and I see how communicative their kids are. How they say, “Hi!” This one little girl said, “Happy birthday!” I have this hope that it's going to happen. But the reality is, nobody really knows if he's going to communicate or not. That's the biggest stressor for me. Not knowing.
When and why did KE start to feel concerned about F.'s health and development?My son started talking and walking at 10 months old. For all we could tell - and for all the doctors could tell - he was typical. You could ask him, “What does a cat say?” and he would answer. He would play peekaboo. He was engaged, and he had probably 30 words by the time he was 18 months old. I noticed at around that 15-month mark that he was not saying “Mama.” My husband said, “He's saying it. Do you hear him? He says, ‘Mom.’” I said, “I don’t think so.” That was the first thing that I questioned. He would say words, and then he would stop using them. Then, on top of that, he wouldn't eat very much variety. The doctors told me, “Oh, he's fine. Lots of kids are like that. As long as he's eating yogurt and those fruit pouches, he's fine. Don't worry about it.” So I didn't give it much thought. Then, at around 18 months, some of his words started changing. He went from saying “bite” to saying “bing,” and then he lost that word completely. I was pregnant with my second child at the time. F. was going to be 22 months old when I had my second one. At around the 20-month mark, he quit eating even more, dropped even more safe foods and then dropped even more words. By the time he was 22 months, right around the birth of my second child, he lost basically all of his words, and his level of social engagement dropped to very little. A friend of mine was getting married, so we traveled out of state from Georgia to Oklahoma to go to her wedding. That's when it was the worst. We realized just how far into himself he had gone. My family was there with us, and we all thought, “He's just not engaging at all.” He went through a regression, basically. In December, at the age of two, he wasn’t responding to us and there were no words at all.
When and why did LH start to feel concerned about M.'s health and development?In utero, we already had a few challenges that came up. We found out about clubfoot at one of the early scans. It was a non-issue really, in the scheme of things. When M. was born, he had left clubfoot and torticollis. Those were the only issues of note. We started seeing a physical therapist right away for torticollis at the Hospital for Special Surgery in New York City. My dad, who is a retired physician, noticed that M.’s eyes were non-reactive to light at about three months old. (It wasn't the pediatrician who noticed. It was my dad.) That is where I would say our journey really began. Then, one by one, other issues started to crop up over the years. For his vision, we saw an ophthalmologist. We went to one ophthalmologist when he was still three months old. This is one of those stories: The doctor was like, “Well, he could be blind.” We thought, “What? What are you saying to us?” So that guy was out. We switched to another doctor. And actually, M.’s eyes just kind of caught up to other kids. He was diagnosed with cortical visual impairment years later, and he wears glasses, but his eyes did catch up to a degree. Some of my friends have a similar story, too. You end up seeing a lot of different physicians to get all the information you need. But after this, M. wasn't really meeting the expected milestones. We had gotten into Early Intervention early. He must have been six months old. He needed physical therapy because he wasn’t rolling over and the torticollis was unresolved. Then, at 12 months, M. wasn't really verbalizing at all. I think one of the main reasons M. was given an autism diagnosis early on was because of his visual impairments. It's the way he used vision: when he's thinking, he looks someplace else. When he's walking, he doesn't look and instead he uses his feet to feel. He wasn't he wasn't making eye contact when you were talking to him, and then he also wasn't speaking. The autism diagnosis is definitely not correct. It helped us get therapy early on, but it also was not accurate. Later on, that diagnosis also didn’t help get other kinds of support. I always knew it wasn't autism because of his social engagement. M. was always so sweet and engaging. He was also given a diagnosis of PDD-NOS (Pervasive Development Disorder - Not Otherwise Specified). I don't think they give it anymore. It was a catch all: “We don't know what's happening here, so we’ve got to give you something.”
When and why did MG start to feel concerned about M.'s health and development?I had a little heads up that things might be different. At the amnio, they found a marker on Chromosome 17. This was back in 2008. My daughter is 11 years old now. I went to everybody I could find: my doctor, other doctors, other specialists. I said, “What would this look like?” because the genetic counselor at the obstetrician’s office was trying her best to persuade me to abort. She went as far as to propose a date. They didn't know what a marker on 17 meant, or what it would look like when my daughter got older. My daughter looked okay in the sonogram. Finally, I found a genetic specialist who said it would look like learning disabilities and wouldn't show up until she was in elementary school. I'm a teacher, so I thought, “How could I possibly abort a child who has learning disabilities?” Anyway, the birth proceeded, and everything looked okay. This was my first and only child. I had no idea what to look for, or what the milestones were. Then, as she got older, it was clear there were issues with her development. She didn’t roll over. She didn’t sit up. She had hypotonia: she was like a rag doll with no muscle tone. She did make good eye contact, though. She talked early, before two years old, and has never stopped talking! She crawled late - two weeks before she turned two, and then she started walking at two or thereabouts. She couldn’t climb the steps, initially. She couldn’t run well. She has always had a problem with the right leg not quite keeping up with the left. She definitely has signs of ADHD. She has a very poor attention span and very poor frustration tolerance. She’s a brat, if there’s not a better term. She’s very oppositional. She wants what she wants, when she wants it. And she’s also needy. She always wants attention. She loves negative attention the best. It’s like she’s an addict, and her drug is being yelled at or being scared. She should eventually be a skydiver because she loves that high. She likes this more than positive attention. More than: “Hooray!” She’s really good with language, and has a really good memory. But she behaves like a two-year old. Except that a two year old goes and destroys something because they don't know better; she will destroy something because she wants to get a reaction. She’ll rip her book. She’ll grab a plant. We have to baby-proof the house. Knives can’t be out. She’ll grab one… She did it twice yesterday, because my brother made the mistake of leaving one on the island in the kitchen.
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