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Old 07-07-2016, 09:38 AM
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Default Gross Motor Delay/Low Muscle Tone

New dcf. They started in mid-June. Upon my recommendation the parent had the child evaluated. They didn't go the EI route due to the waiting list but went with a private developmental specialist that I referred them to. They had a complete medical/developmental eval done.

Gross motor concerns- Dcg is 19m, just started walking within days after turning 18m. Her walking has not improved at all. She has very low muscle tone in her legs. They even look underdeveloped, mostly they are limp. When I change her, she doesn't lift her legs up like most toddlers can do. When I hold them, there is literally no resistance, it's like changing a newborn. (If I am explaining it correctly and you can understand what I mean.)

Fine motor skills/texture issues- she can't use any silverware, If you place it in her hand she drops it/can't grip it. She has a hard time holding a full sippy cup even with two hands. She can't use a straw cup/can't suck from a straw. Still prefers purees over actual food. She does manage to feed herself (although it is more like a 9-12mo) her pincer grasp isn't great, she misses/drops small foods like cheerios. Still rakes to pick up mostly.

The eval scored her motor skills in the 2-5% range.

EI waiting list for services is 6 months. The parents have made calls to insurance, pediatrician and private physical and occupational therapists to try to get her SOME services in the meantime.

Any advice here on what I can do on my end (and what the parents can do at home?) We are constantly outside and get a lot of gross motor activity, but dcg is content to 'sit and watch' she manages to pull up into a child size chair and plops there, or she will sit and run her hands through the grass.

Also- zero speech, although her comprehension seems ok. Still drools.

I don't have concerns about autism. She makes great eye contact, she mimics/pretends in play, attempts to socialize, is affectionate to me and peers, understands basic directions (eg. time for outside, she will start clapping, scooting towards the door).

On a side/related note- this is another child I have from a local montessori school. The mother noted to the teacher almost MONTHLY since dcg was an infant (she forwarded me their emails) about her concerns, and the teacher completely blew her off, even going so far as to call her a 'worry wart' and saying how 'it's normal for first time parents to be concerned about their child's development'. She even aged her up to the toddler room, although dcg has NONE of the listed skills needed to be in that room other than down to one nap. In addition, based on conversations and observations this mother made and the observations other parents from her program have made, I am guessing she has contributed to this delay. Regardless of time parents arrived, the kids were seated in a kidney shaped infant table (in both infant and toddler rooms) and strapped in. The kids were 'engaged' with an adult, but were being showed flash cards, read to, doing small table 'centers'. There were never toys out and there was little movement of the children around the room.

I also have two older preschool children from her program. Both children (and parents) related to me that the children were doing 'centers' these centers required no free movement within their classroom, instead the children were put on carpets and the items were moved from child to child by an adult. Both preschoolers upon starting with me were nervous to take out toys, leave one area to go to the next, ask to go to the bathroom, and they couldn't believe we had outside time and art.

I am strongly suggesting that the parent take this up with licensing. I know that both of my preschoolers parents have made calls complaining about this- it is in direct violation of our regulations to strap in children and require them to remain on a carpet/mat all day, etc.

One of the clients I got from her was KICKED OUT of her program for coming unannounced to pick up dck.

She is licensed for 16, and the parents also noted that there were always more children than allowed eg. 4-5 infants to one teacher in the 'infant' room, 6 toddlers to one teacher in the toddler room, and 6 preschoolers-kindergarteners in the classroom (she also teaches kindergarten at her program and keeps children until 1st grade- these CANNOT count as school age because they are not enrolled in school.)
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Old 07-07-2016, 10:04 AM
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I think your hands are tied in regards to the provider and the mom may have grounds for neglect or abuse charges.

To help child I would do as you have been. Keep engaging her. Keep encouraging her and keep offering her a stimulant rich, texture filled environment. Fill it w smells and sounds and colorful things. Get her whole body involved in exploring "stuff"
Messy stuff. Sticky stuff. Smelly stuff. Slippery and prickly stuff.
Try to squeeze as many first year experiences into the next month.
Allow her to flail and scoot and flop and struggle. And praise the entire amount of happiness in your soul when she does something new.
Create opportunities for her to strengthen her body.
And once mom gets her in to who she needs to see they will have more ideas.
Also....
If she's been basically sat and talked at, look into her eyes when you smile at her. Make silly faces. Be amazing. Be loving. Be kind. But most importantly.. Be THERE for her. Show her how important she is.

For the record. I'm so incredibly angry at the old place.
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Old 07-07-2016, 10:07 AM
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It is illegal for there to be a wait list for early intervention services. I don't know what state you are in but all states have agencies that oversee early intervention services. If you post your state, I can give you more specific information.

I have filed a complaint regarding services in my state before and it was resolved very quickly. They don't like to look bad.

Regarding the center, if there are concerns, the parents should address them with licensing.
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Old 07-07-2016, 10:24 AM
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Quote:
Originally Posted by laundrymom View Post
I think your hands are tied in regards to the provider and the mom may have grounds for neglect or abuse charges.

To help child I would do as you have been. Keep engaging her. Keep encouraging her and keep offering her a stimulant rich, texture filled environment. Fill it w smells and sounds and colorful things. Get her whole body involved in exploring "stuff"
Messy stuff. Sticky stuff. Smelly stuff. Slippery and prickly stuff.
Try to squeeze as many first year experiences into the next month.
Allow her to flail and scoot and flop and struggle. And praise the entire amount of happiness in your soul when she does something new.
Create opportunities for her to strengthen her body.
And once mom gets her in to who she needs to see they will have more ideas.
Also....
If she's been basically sat and talked at, look into her eyes when you smile at her. Make silly faces. Be amazing. Be loving. Be kind. But most importantly.. Be THERE for her. Show her how important she is.

For the record. I'm so incredibly angry at the old place.
This is EXACTLY what I have been doing. We are active, and play based. She is obsessed with the water table at the moment. I added different texture/weight items to it (float and sink for my older kids) lots of different size cups to dump and pour, things to squeeze, pump, etc. She won't touch anything slimy, but she loves soft, squishy, course. We do a ton of finger plays, we read, sing, and interact all day long. She has not wanted to leave since she started. The Mom is 100% on board. They have stopped doing things for her and carrying her unless absolutely necessary. They hold her hand and she walks everywhere now. I haven't made any accommodations for her. I let her tiny self struggle. She was DETERMINED to get on the picnic table today, finally managed to get up there side saddle and was so pleased with herself! I removed the baby stroller from outside as she was using it as a walker.

Quote:
Originally Posted by spedmommy4 View Post
It is illegal for there to be a wait list for early intervention services. I don't know what state you are in but all states have agencies that oversee early intervention services. If you post your state, I can give you more specific information.

I have filed a complaint regarding services in my state before and it was resolved very quickly. They don't like to look bad.

Regarding the center, if there are concerns, the parents should address them with licensing.
I am in NY.

illegal? seriously? Because I have ALWAYS had parents on waiting lists for evals and services. I have a special needs child and we waited well over 90 days for an eval and then an additional 30 days for an appointment to review his case for services and then another 60+days to get services. Every child I have ever referred goes through the same thing. They literally wait until the last possible day to do anything. They also pull things like offering 30 minutes of group speech 1x/week and when you say no, they have another 30 days to make another 'treatment plan'. You have to either pay out of pocket, be a VERY good advocate (or both) OR get what they give you, which is nothing.
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Old 07-07-2016, 10:36 AM
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Angry doesn't cut it with how I currently feel about this provider. Montessori program? not even close. She has numerous licensing violations, and since she advertises herself as a 'school' parents buy it hook, line and sinker. (she's a group family childcare, she lives upstairs, her program is run downstairs) She is the ONLY 'private' school in the area that isn't religious based. As soon as I explain to parents that her licensing status and credentials are NO different than Suzie Q down the street doing home daycare in her family room with an assistant, the parents have been ticked to say the least. She has NO college degree and I seriously question her montessori education. I see her at licensing classes and she has nothing but disdain for parents, and even towards children, imho.

She charges an INSANE amount, here the highest center rate is around 50/day for an infant. She is charging 55/day for ALL ages. Her 'tuition' payments are due monthly- and are regardless of days used. Part time, full time, same rates. She provides no food- all kids must come with all meals and snacks in lunchboxes, prefilled cups of milk for meals, etc.

Her website and what she CLAIMS to offer is incredible.

I am hearing so much from these parents about what she CLAIMS licensing says as well- If it's over 80 it's too hot to go outside. Young children get heat stroke quickly. If it's under 32 it's too cold to go outside. Children MUST remain on mats for 3 hours. The state doesn't allow me to accept a cloth diapered child. The state doesn't allow me to warm up breast milk. The state doesn't allow parents to drop in as needed throughout the day. The state doesn't allow me to offer a morning snack, even if the parent provides it. The state doesn't allow me to show you all of the areas used for childcare. The state doesn't allow me to post my credentials, only the state license.

This is just SOME of what I have heard from 5 parents, I have two more of her (former) families on my waiting list. Her parents are onto her.

She's full of it.

Ok, rant over!
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  #6  
Old 07-07-2016, 10:45 AM
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That's all incredibly sad.

I think y'all are heading in the right direction with everything y'all are doing. I pray she is able to get assistance ASAP.
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Old 07-07-2016, 11:32 AM
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I know some of you work in great, super awesome centers but I have dealt with children that come from them and their legs are always floppy and seem underdeveloped with no muscle tone. It is my personal belief that these centers are not allowing gross motor activities and just strapping infants into chairs all day long. Within 3 months and working everyday with one of my dcgs from a center she is growing leaps and bounds, started to walk and is almost running, napping great and is happier and healthier than when she started. I've interviewed other children over a year that can't walk and have skinny floppy legs and they have a hard time crawling, all of them from centers.

I honestly believe this child could be fine, just hasn't been taught and given the opportunity to learn these skills. Again, my opinion.
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Old 07-07-2016, 11:41 AM
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Quote:
Originally Posted by spedmommy4 View Post
It is illegal for there to be a wait list for early intervention services. I don't know what state you are in but all states have agencies that oversee early intervention services. If you post your state, I can give you more specific information.

I have filed a complaint regarding services in my state before and it was resolved very quickly. They don't like to look bad.

Regarding the center, if there are concerns, the parents should address them with licensing.
I thought there were waitlists for public intervention services due to them being free but that a parent can seek paid services anywhere they want.

I am not aware of the legality of it all so do you have a link you can share? I'd love to read it.

Quote:
Originally Posted by daycarediva View Post
I am in NY.

illegal? seriously? Because I have ALWAYS had parents on waiting lists for evals and services. I have a special needs child and we waited well over 90 days for an eval and then an additional 30 days for an appointment to review his case for services and then another 60+days to get services. Every child I have ever referred goes through the same thing. They literally wait until the last possible day to do anything. They also pull things like offering 30 minutes of group speech 1x/week and when you say no, they have another 30 days to make another 'treatment plan'. You have to either pay out of pocket, be a VERY good advocate (or both) OR get what they give you, which is nothing.
This is from NY and might be super useful/helpful to you

http://www.advocatesforchildren.org/...guide.pdf?pt=1
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Old 07-07-2016, 11:43 AM
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Quote:
Originally Posted by daycarediva View Post
Angry doesn't cut it with how I currently feel about this provider. Montessori program? not even close. She has numerous licensing violations, and since she advertises herself as a 'school' parents buy it hook, line and sinker. (she's a group family childcare, she lives upstairs, her program is run downstairs) She is the ONLY 'private' school in the area that isn't religious based. As soon as I explain to parents that her licensing status and credentials are NO different than Suzie Q down the street doing home daycare in her family room with an assistant, the parents have been ticked to say the least. She has NO college degree and I seriously question her montessori education. I see her at licensing classes and she has nothing but disdain for parents, and even towards children, imho.

She charges an INSANE amount, here the highest center rate is around 50/day for an infant. She is charging 55/day for ALL ages. Her 'tuition' payments are due monthly- and are regardless of days used. Part time, full time, same rates. She provides no food- all kids must come with all meals and snacks in lunchboxes, prefilled cups of milk for meals, etc.

Her website and what she CLAIMS to offer is incredible.

I am hearing so much from these parents about what she CLAIMS licensing says as well- If it's over 80 it's too hot to go outside. Young children get heat stroke quickly. If it's under 32 it's too cold to go outside. Children MUST remain on mats for 3 hours. The state doesn't allow me to accept a cloth diapered child. The state doesn't allow me to warm up breast milk. The state doesn't allow parents to drop in as needed throughout the day. The state doesn't allow me to offer a morning snack, even if the parent provides it. The state doesn't allow me to show you all of the areas used for childcare. The state doesn't allow me to post my credentials, only the state license.

This is just SOME of what I have heard from 5 parents, I have two more of her (former) families on my waiting list. Her parents are onto her.

She's full of it.

Ok, rant over!
Yeah she definitely sounds full of it. I've known providers like this. I mean we're all in it for the money but you seriously have to have a love for children too. Sounds like she's running a baby factory I.e. taking all profit and not putting one cent into running the business. Everything looks good on the outside and in but she's getting away with not properly caring for children.
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Old 07-07-2016, 12:18 PM
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Quote:
Originally Posted by Blackcat31 View Post
I thought there were waitlists for public intervention services due to them being free but that a parent can seek paid services anywhere they want.

I am not aware of the legality of it all so do you have a link you can share? I'd love to read it.



This is from NY and might be super useful/helpful to you

http://www.advocatesforchildren.org/...guide.pdf?pt=1
There are really specific timelines related to early intervention services. The services are "free", but are funded (in part) by the federally government.

The day that the agency receives the call about a child a 45 calendar day clock starts ticking. They have 45 days to evaluate, make an eligibility decision, and develop an IFSP.

They have to start services "as soon as possible." (per IDEA Part C) It has crossed the line into "not legal" in this case because it is going on for such a long time.

Once the IFSP has been developed, the providing agency has to review the goals at 6 months. (and show progress or justify lack of progress) The time frame the state would have to serve the child and write any type of meaningful 6 month progress review.

Post-Referral Procedures—Screenings, Evaluations, and Assessments
§ 303.310 Post-referral timeline (45 days).
(a) Except as provided in paragraph (b) of this section, any screening under § 303.320 (if the State has adopted a policy and elects, and the parent consents, to conduct a screening of a child); the initial evaluation and the initial assessments of the child and family under § 303.321; and the initial IFSP meeting under § 303.342 must be completed within 45 days from the date the lead agency or EIS provider receives the referral of the child.
(b) Subject to paragraph (c) of this section, the 45-day timeline described in paragraph (a) of this section does not apply for any period when—
(1) The child or parent is unavailable to complete the screening (if applicable), the initial evaluation, the initial assessments of the child and family, or the initial IFSP meeting due to exceptional family circumstances that are documented in the child’s early intervention records; or
(2) The parent has not provided consent for the screening (if applicable), the initial evaluation, or the initial assessment of the child, despite documented, repeated attempts by the lead agency or EIS provider to obtain parental consent.
(c) The lead agency must develop procedures to ensure that in the event the circumstances described in (b)(1) or (b)(2) of this section exist, the lead agency or EIS provider must—
(1) Document in the child’s early intervention records the exceptional family circumstances or repeated attempts by the lead agency or EIS provider to obtain parental consent;
(2) Complete the screening (if applicable), the initial evaluation, the initial assessments (of the child and family), and the initial IFSP meeting as soon as possible after the documented exceptional family circumstances described in paragraph (b)(1) of this section no longer exist or parental consent is obtained for the screening (if applicable), the initial evaluation, and the initial assessment of the child; and
(3) Develop and implement an interim IFSP, to the extent appropriate and consistent with § 303.345.
(d) The initial family assessment must be conducted within the 45-day timeline in paragraph (a) of this section if the parent concurs and even if other family members are unavailable.
(Authority: 20 U.S.C. 1433, 1435(a), 1436(c))

Initiation of Services

Parents must give informed written consent before services may begin. If there is not agreement on all services, only agreed upon services will be provided. 20 U.S.C. § 1436(e); 34 C.F.R. § 303.342(e). Services must be initiated "as soon as possible" after the IFSP meeting. Id. § 303.344(f). The IFSP must be reviewed at least every six months and evaluated at least annually at an IFSP meeting. 20 U.S.C. § 1436(b); 34 C.F.R. § 303.342(b) and (c). Additionally, the parents may request a review of the IFSP at any time. Id. § 303.342(b)(1).

Here are some resources in New York. In my experience, parents that make noise get services quickly.

Complaints in New York

http://www.advocatesforchildren.org/...ntion.pdf?pt=1

https://www.health.ny.gov/publications/0532.pdf
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Old 07-08-2016, 09:43 AM
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I am passing along all of this info to my dcm. I book marked them to read myself later as well. Some of what spedmommy just posted is in DIRECT contradiction to the 'rights of a special needs child' packet the parents were just given.

The parents have the money for services, and dcm has arranged for private PT lessons. She just needed a referral (the evaluating physician was more than happy to fax it over) and her insurance is covering 20% of it, which is better than nothing.

Dcg starts services Monday afternoon.

I also told Dcm that she should rely on her own instinct. She could have called for an eval herself, regardless of what the teacher said. But this teacher left her second guessing herself. First time mom, relying on her provider for advice and THIS is what she got.

Unfortunately there is only one decent center in our area- and the kids I get/see from other centers are seriously lacking. Our school district does kindergarten entrance exams in the spring before K. They even ask where the child attended DC if they haven't gone to UPK because THEY are noticing a pattern.

*MY* kids have all done great on evals and in K, even though I do NO formal worksheets, academic instruction, or desk work whatsoever. They're exposed to a great deal of play, free art/projects of their choosing, they get a great deal of socio-emotional skill and self help practice, a variety of literature and open ended discussion. One of my dcg's just got accepted for early K entry. She JUST turned 4.

I have two friends who are K teachers in our district, and both have told me that center kids in our area are almost always flagged for services or on the 'watch for services' list upon eval. Even the academic pushing prestigious montessori program kids. It has nothing to do with income, as one center doesn't even accept subsidy and the other only takes 20% subsidized kids. We don't have a huge low income population here, we only have ONE head start class. This is just poor programming, or DAP, or both. So frustrating!
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Old 07-08-2016, 05:24 PM
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Quote:
Originally Posted by daycarediva View Post
I am passing along all of this info to my dcm. I book marked them to read myself later as well. Some of what spedmommy just posted is in DIRECT contradiction to the 'rights of a special needs child' packet the parents were just given.

The parents have the money for services, and dcm has arranged for private PT lessons. She just needed a referral (the evaluating physician was more than happy to fax it over) and her insurance is covering 20% of it, which is better than nothing.

Dcg starts services Monday afternoon.

I also told Dcm that she should rely on her own instinct. She could have called for an eval herself, regardless of what the teacher said. But this teacher left her second guessing herself. First time mom, relying on her provider for advice and THIS is what she got.

Unfortunately there is only one decent center in our area- and the kids I get/see from other centers are seriously lacking. Our school district does kindergarten entrance exams in the spring before K. They even ask where the child attended DC if they haven't gone to UPK because THEY are noticing a pattern.

*MY* kids have all done great on evals and in K, even though I do NO formal worksheets, academic instruction, or desk work whatsoever. They're exposed to a great deal of play, free art/projects of their choosing, they get a great deal of socio-emotional skill and self help practice, a variety of literature and open ended discussion. One of my dcg's just got accepted for early K entry. She JUST turned 4.

I have two friends who are K teachers in our district, and both have told me that center kids in our area are almost always flagged for services or on the 'watch for services' list upon eval. Even the academic pushing prestigious montessori program kids. It has nothing to do with income, as one center doesn't even accept subsidy and the other only takes 20% subsidized kids. We don't have a huge low income population here, we only have ONE head start class. This is just poor programming, or DAP, or both. So frustrating!
That doesn't surprise me. Most parents would accept that what the early intervention agency says is truth. Those that can afford to will access services somewhere else. The ones that can't afford to, usually just wait patiently.

Unfortunately, both of these situations perpetuate the continued lack of services. Because some parents walked away and others waited the state didn't HAVE to fund additional therapists, which are clearly needed.
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Old 07-09-2016, 12:51 AM
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The symptoms you are saying the child has sound a lot like RETTS syndrome. I'm not trying to diagnose I just want to put it out there so you can be on the look out because it can be something that takes a long time for a formal diagnoses. I had a little lady with it until she moved away.
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