Martie Wynne knew something wasn’t right. Her 13-month-old daughter, Meredith, was not making any word-like sounds. She knew that Meredith, adopted at three months old, could hear very well — she made eye contact when she was spoken to, and she reacted to the phone or doorbell ringing.
Her pediatrician, however, was “spectacularly unhelpful” when Wynne shared her concerns. “He said I was a pushy ‘yuppie,’” the Winnetka, Illinois, mom recalls.
“Language underwrites all academic performance,” Wynne says, “so I was not about to waste any more time.” When Meredith still showed no improvement four months later, Wynne took matters into her own hands and had her daughter assessed at the Northwestern University Speech and Language Clinic.
The evaluation showed that the 17-month-old had a receptive-language age of 33 months — and an expressive-language age of seven months.
Wynne immediately placed her daughter in speech therapy. “I wish I had a nickel for everyone who said, ‘Einstein didn’t speak until he was four,’ or ‘She’ll outgrow it,’” she says.
Wynne is an educational psychologist, so she knew what to watch for. That’s not usually the case for first-time parents, which many adoptive parents are.
As a result, problems with language, learning, motor skills, and attention often go undiagnosed until children reach school age and begin to struggle academically. The trick is to pick up on them much earlier. Here’s what to look for and where to turn for help to ensure your child’s success.
Why Does This Happen?
Up to 20 percent of all children are affected by language- or learning-related problems. Half of all cases of language difficulties, learning disabilities (LD), motor skill problems, and attention-deficit/hyperactivity disorder (ADHD) are inherited — the biological parents’ genes wired the child’s brain in a certain way.
If a biological parent were to raise the child, she may recognize her same symptoms. Parents who haven’t experienced such difficulties won’t necessarily know what patterns to watch for. In other words, adopted children aren’t at a higher risk for these problems, but they may have a higher risk of going undiagnosed.
No one’s quite sure what causes LD or ADHD in the other half of all the cases. Both have been linked to poor prenatal care (including drug and alcohol use during pregnancy) or early life deprivations, which means that children adopted from so-called “high risk” backgrounds may have a higher incidence.
As Wynne says, “I do not believe my daughter’s difficulties were ‘adoption-related.’ She would have had the same problem had she stayed in Korea — it simply would have been handled differently.”
What to Look For
At birth, the brain has almost all of the nerve cells it will ever have, although most are dormant. Cell groups are activated at set intervals according to a beautifully orchestrated genetic plan.
Each maturational “burst” results in new abilities. For example, a newborn has little or no muscle control, but can usually raise his head by about one month of age, can roll over by four or five months, and can sit by six.
Since each area of the brain is wired differently, some children may display new problems with each phase of maturational growth. It’s possible that some skills will lag and then suddenly “catch up,” indicating that certain developmental tasks were delayed, but not impaired.
For example, your one-year-old daughter might not be saying words or phrases, but she seems to understand what you say and communicates with you through gestures. By age two, she begins to use words, but the words are difficult to understand.
By age three, you notice that she has difficulty remembering what you say, and also has trouble getting her thoughts organized in time to answer you and engage in conversation. Perhaps, by age five, all of these problems go away. On the other hand, by five, it may become clear that her speech problem is a language disability.
Not sure what’s “normal” and what’s problematic? That’s where a solid education in developmental stages becomes critical, says Stephanie Mullins, a mother of 10 children. “Read books or online articles about child development — or simply talk to lots of other parents.”
“Yes, we all love our kids and think we should accept them ‘as is,’ but comparison is the best way of detecting possible differences,” she explains. “A child doing anything too much — spinning, pushing, giggling for no apparent reason, crying — is a sign that something needs to be assessed.”
The sooner you can spot these difficulties, the better. Finding help early on can minimize more complex problems (thus lessening future difficulties) and ensure that the child who’s simply delayed will “catch up” as quickly and completely as possible.
For some, this help will be needed for a short period of time. For others, it will be necessary for many years.
Until children turn three, parents may use a wonderful program known as Early Intervention (EI). This federal program is administered on a state level, so available services may vary. (The Center for Parent Information and Resources is a great place to start looking for information on your state.)
Adoption-medicine specialist Deborah Borchers, M.D., advises parents whose children are “at risk” for developmental delays to look into EI. In particular, any parent who adopted his or her child from an institutional setting will want to do so.
“Research has shown that a routine office visit to a physician will identify less than 30 percent of the children who have developmental problems,” she adds.
Good news: EI services are free. When Vince Stelluto noticed that his one-and-a-half-year-old son “just wasn’t saying as many words as other kids his age,” he had him evaluated through the New York State EI Program.
For a year now, Stelluto’s son has been receiving in-home speech therapy twice a week. The boy has made great strides, yet Stelluto has “never paid one penny for this service.”
Other Ways to Seek Help
Infancy and early childhood: Whenever you suspect a problem, first discuss your concerns with your child’s doctor. If he wants to “give it time,” be persistent.
Request a referral to a developmental pediatrician or the appropriate specialist, such as a psychologist, educational diagnostician, speech-language therapist, occupational therapist, or a pediatric neurologist.
Preschool and elementary school: Again, start by discussing your concerns with your child’s doctor. If you feel you need a more detailed opinion, ask for a referral to the proper specialist.
For both a preschool- or school-aged child, you have another option. All public school systems in the United States have “Child Find” programs that screen for possible problems with language, learning, motor skills, attention, or social situations.
Even if your child hasn’t started school yet or attends a private program, you are entitled to this service as a taxpayer. Speak with the principal of your neighborhood elementary school about the screening. If the school can’t provide the proper screenings, they may be required to pay for a private evaluation.
If any problems are found through Child Find, professionals will follow your child through preschool into kindergarten, and guide you through each step of therapy or special-education.
Often an observant teacher will be the first one to mention a problem to a child’s parent. If this is the case, try to keep an open mind and not go on the defensive.
“A very wise pediatrician I’ve worked with says she ‘relies heavily on therapists, family members, and teachers to be her eyes and ears,’” says Amy Woolridge, a pediatric occupational therapist and adoptive mom.
Trust Your Instincts
Parental intuition is a powerful indicator. If you share your concerns, well meaning relatives may try to reassure you, or your child’s doctor might even trivialize what you’re saying.
Years of language therapy resulted in a tremendously positive outcome for Wynne’s daughter — she’s currently an English major in college. Still, she’s told often that the girl would have “developed” in her own good time.
“That is pure bunk,” Wynne says. Children do develop at different rates, but you, as a parent, may sense or observe that your child’s development is off-track.
“Remember, you are looking out for your child’s best interests by being vigilant,” Woolridge says. “Always trust that quiet, nagging voice in the back of your head.”
Hopefully, your child will grow up with no delays or disabilities, but be on the alert. If you see any signs of difficulties, seek help. If problems are found, get whatever help is needed to set your child up for success.