Daniel finally evaluated!
Last Thursday (7/11), I took Daniel up to Eugene for an evaluation at the Childhood Developmental and Rehabilitation Center in Eugene, OR for his evaluation appointment due to his developmental delays. The following is from the report the doctor sent home with us. There will be more detail when his final report comes in about 4-6 weeks.
Diagnosis: Severe Global Developmental Delays, Borderline Metal Disability.
Assessment Summary: Pedicatrics
Referred for concerns/questions regarding Developmental Delay.
Findings and Recommendations:
1. Typical Growth, minor issues with choking with solids and coughing with liquids, on dairy free diet... refer for medically-based Occupational Therapy for feeding support and to address sensory issues.
2. Sleep problems, delayed sleep onset but now sleeping through the night... consider trial of melatonin.
3. Not toilet trained, BM consistency issues.... Keep symptom diary, address toilet training in conjuction with school staff.
4. Fine motor delay and sensory issues... Refer to OT as above. (#1)
5. Ligamentous laxity with flexible flat feet... Wear shoes with stiff soles, medical arch which are lace up.
6. Stereotypic movement, no intervention needed.
7. Cognitive skills, estimated skills in borderline range, compuslive behavior/rigidities.... Continue in classroom services, would benefit from 4 day per week program, use picture schedules, also see report of CDRC pyschologist, PCP to obtain blood for CGH microarray and Fragile X DNA study.
8. Mixed receptive and espressive language disorder by history... Refer to private Speech/Language services.
Clinic follow-up: CD Clinic re-evaluation in 1 year. Devel Pediatric chart review over phone in 3 months.
Assessment Summary: Physical Therapy
For Concerns/Questions regarding possible autism vs. developmental delay.
Daniel is a 4 y.o. male who does not meet criteria for a diagnosis of autism. He has appropriate social interactions and uses a variety of communication strategies to indicate wants and needs. That said, he does appear to have global delays, and functions as a child younger than his age. He also appears to have some possible sensory concern, poor registration of his internal environment (ie. Pain, needing to urinate, etc.) and some visual processing issues. He also has a strong need for consistency and routine. He may benifit from increased services to help him with school readiness.
1. Refer for outpatient occupational therapy to work on fine motor and sensory concerns.
2. Suggest the family discuss services levels with IFSP team, as it does seem that the consistency of attending a program may help Daniel with learning.
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Basically, Daniel is being reccomended (and the doc wrote a "prescription" out for it) for 1x weekly OT during summer and 1x weekly Speech Therapy during the summer. They are reccomending 4 days of classroom setting preschool per week during the school year to prepare him for Kindergarten in Fall 2014.
They have ordered blood work for Daniel to rule out a genteitc mutation being the cause of his delays. They are anticipating a normal blood result (no mutation) but are ordering it just in case.
I am going to call the Dr. we saw and ask him that if he was evaluated 2 years ago (when we first started services with ECI) if it would have been an Autstim diagnosis because we have worked REALLY hard with him to get him where he is today. Brad and I agree that it wouldn't change anything for him now, but I'm curious.