Tuesday, April 28, 2015

Developmental Delays

The funny thing about the term "developmental delays" is the connotation that it invokes in people's minds.  Admittedly, it does the same to me, too, even though I know it's not accurate.  But the image is that it's an across-the-board assessment of a person's position on a sort of timeline of expected development.  For instance, if a child who is 2 years old is developmentally delayed and assessed at about the 6-month mark, the assumption is that the 6-month development milestone applies broadly to all aspects of development.

But of course, that's not true.

Developmental milestones run the gamut of development.  Even in the broad term of "cognitive" or "intellectual," it only means that in general, the patient is approximately at whatever level that was determined.  It doesn't mean that it applies to all things across the board, while those of us who don't have developmental delays are expected to be at our age-appropriate stages.

Henry is, of course, behind on a lot of things.  The easiest way that I describe it to others is that he's a 2½-year-old in a 4-year-old's body with the mind of a 1-year-old.  It's far too simplistic, of course, but given that it's tough to get engagement in casual conversation with people who aren't invested in his well-being to actually give a damn, that's about the extent of the conversation before it treads into an area of discomfort.

It's the easy way to set the stage without forcing someone who isn't ready to deal with this to deal with it.

However, I know in my own head and with my own experience with Henry that such a blanket statement doesn't actually apply to him.  I know he's capable of more and he's shown it.  He's shown a lot of advanced abilities to us, but not to those at MISD who are doing his assessments, so his paperwork says one thing, but we know he's beyond that in certain areas.

He doesn't speak in words, but he does speak....to us.   Even though we don't know all of his grunts and vocalizations, we do a reasonably decent job in deciphering what he wants to say, because Henry-speak is a combination of his babbles and body language.  We know he's capable of more, and that becomes evident in some of his play.

I don't remember exactly when we started doing this, but Henry has a plastic cereal bowl that he likes to play with in the kitchen.  He's never actually eaten cereal out of it.  It's not a utensil.  It's a toy.  He and I throw and slide things across the floor to each other, like a game of "catch."  This bowl was one of them.  What I don't remember is when I started rolling this bowl on its side to him, and he fell in love with that.

(normally, we're both better at this than what the video shows)

What's significant is that, barely two or three times after I rolled it on its side to him, he started trying to do the same.  And he's actually pretty good at it, despite his age, coordination, and difficult lot in life.  Maybe there is something to certain talents that kids who are on the autism spectrum have that belie their other difficulties (not saying that Henry is on the spectrum, but just using it as illustration).

But this is just one example of the things that Henry is actually very good at.  Things that therapists and teachers at school don't always see, and things that our pediatrician's office definitely doesn't see (because they are so unprepared and almost kind of unwilling to deal with special-needs kids, it seems -- the only doctors at that office who were prepared for this and even embraced it have left the practice, of course).  Also included in the differences between what they see and what we see is also a bit of shrewd calculation in Henry.

What may come across as inability or incomprehension to perform a task, we can actually sometimes see it as apathy or preference.  In other words, is there a chance that, when he doesn't perform a task, it's just that he doesn't want to versus unable to?  We can see it in his body language and in how he behaves at home.

So the term "developmental delay," while it's applicable in a general sense to categorize a person, it certainly doesn't tell the whole story.