Children develop at different rates. Boys are often talk later girls, while reaching motor milestones sooner. Preemies are notorious for developing on their own schedule. Some delays are cause for further evaluation while others truly are not a big deal. All delays should be brought to the attention of your child's pediatrician.
Here is a list of "hallmark developmental milestones" to keep an eye on. Be sure to address any concerns with your child's physician. Listen to your gut. If your doctor dismisses your concerns you may want to find a different physician. If "wait and see" feels wrong, don't be afraid to ask for a referral to a developmental pediatrician or other specialist.
Don't forget to use your child's adjusted age when it come to reaching milestones. Some physician use adjusted age up to the third year. So don't forget to use their due date instead of their birth date. Save yourself from some worries and frustration: DO NOT COMPARE YOUR PREEMIE WITH TERM BABIES.
At 4 Months:
Follow and react to bright colors, movement, and objects?
Turn toward sounds?
Show interest in watching people’s faces?
Smile back when you smile?
At 6 Months:
Relate to you with real joy?
Smile often while playing with you?
Coo or babble when happy?
Cry when unhappy?
At 9 Months:
Smile and laugh while looking at you?
Exchange back-and-forth smiles, loving faces, and other expressions with you?
Exchange back-and-forth sounds with you?
Exchange back-and-forth gestures with you, such as giving, taking, and reaching?
At 12 Months:
Use a few gestures, one after another, to get needs met, like giving, showing, reaching, waving, and pointing?
Play peek-a-boo, patty cake, or other social games?
Make sounds, like “ma,” “ba,” “na,” “da,” and “ga?”
Turn to the person speaking when his/her name is called?
At 15 Months:
Exchange with you many back-and-forth smiles, sounds, and gestures in a row?
Use pointing or other “showing” gestures to draw attention to something of interest?
Use different sounds to get needs met and draw attention to something of interest?
Use and understand at least three words, such as “mama,” “dada,” “bottle,” or bye-bye?
At 18 Months:
Use lots of gestures with words to get needs met, like pointing or taking you by the hand and saying, “want juice”?
Use at least four different consonants in babbling or words, such as m, n, p, b, t, and d?
Use and understand at least 10 words?
Show that he or she knows the names of familiar people or body parts by pointing to or looking at them when they are named?
Do simple pretend play, like feeding a doll or stuffed animal, and attracting your attention by looking up at you?
At 24 Months:
Do pretend play with you with more than one action, like feeding the doll and then putting the doll to sleep?
Use and understand at least 50 words?
Use at least two words together (without imitating or repeating) and in a way that makes sense, like “want juice”?
Enjoy being next to children of the same age and show interest in playing with them, perhaps giving a toy to another child?
Look for familiar objects out of sight when asked?
At 36 Months:
Enjoy pretending to play different characters with you or talking for dolls or action figures?
Enjoy playing with children of the same age, perhaps showing and telling another child about a favorite toy?
Use thoughts and actions together in speech and in play in a way that makes sense, like “sleepy, go take nap” and “baby hungry, feed bottle”?
Answer “what,” “where,” and “who” questions easily?
Talk about interests and feelings about the past and the future?
Remember these are just guidelines. If you child is a month behind, it may not be cause for concern as long as they do meet them. They may just need a little more encourage and support than a term baby. It's better to be safe than sorry. We know how important early intervention is, so take advantage of it. You don't have to "wait and see."
For a list of early intervention (birth to three) contacts by state click here. If your child is three or older contact for your school district for an evaluation. You can find a more comprehensive checklist at http://www.cdc.gov/ncbddd/actearly/milestones/index.html
According to "Supporting You and Your Preemie: Milestone Guidelines for Premature Babies" put out by the National Association of Neonatal Nurses and March of Dimes,
"Ask your doctor about 'early intervention,' extra care some children receive to help develop. If your baby was in the NICU, the law says he or she should receive it."
Thought I'd put that out there for you if you don't already know it.
Assure the Best for your Baby's Physical Development
by Pathways Awareness
"Copy freely, do not change, must acknowledge Pathways Awareness." Copyright 2008.
*Note: There is more to the pamphlet, if you are interested in the additional information, PM me and I'll get a copy to you. Missie
thats good to know. but our EI said u had to be under 32 weeks to automatically recieve it. so she didnt get it based on being preemie..she was based on being delayed on 2 diff things. (which i have yet to understand how a 2 month old, newborn adjusted, can be delayed)
Quoting MissDipper:
According to "Supporting You and Your Preemie: Milestone Guidelines for Premature Babies" put out by the National Association of Neonatal Nurses and March of Dimes,
"Ask your doctor about 'early intervention,' extra care some children receive to help develop. If your baby was in the NICU, the law says he or she should receive it."
Thought I'd put that out there for you if you don't already know it.
I'm sure it varies from state to state somewhat. As for the delays, thankfully, EI looks at their birth age so they will obviously have a delay in comparison to their adjusted age so they can show delays large enough to warrant services.
Quoting oooomelissaoooo:
thats good to know. but our EI said u had to be under 32 weeks to automatically recieve it. so she didnt get it based on being preemie..she was based on being delayed on 2 diff things. (which i have yet to understand how a 2 month old, newborn adjusted, can be delayed)
Quoting MissDipper:
According to "Supporting You and Your Preemie: Milestone Guidelines for Premature Babies" put out by the National Association of Neonatal Nurses and March of Dimes,
"Ask your doctor about 'early intervention,' extra care some children receive to help develop. If your baby was in the NICU, the law says he or she should receive it."
Thought I'd put that out there for you if you don't already know it.
I have been told by a few therapists that it's easier to qualify them when they are very young. So, we should really have this done within the first few months of their homecoming. It's definitely better to be safe than sorry. I've met a few moms of 2 year old preemies with major sensory issues and minor speech issues, who wait to have their child evaluated and find their child is not eligible for any services. Theses kids need services, but their delay is not significant enough. Some have had to wait until their children are 3, when their speech delays got even worse. That was a year wasted. Don't wait for something to go wrong. Be proactive, not reactive! Even if you only qualify for OT in the beginning, it's easy to add speech or developmental therapy when and if it's needed.
I was wondering if anyone has information on developmental delays that occur later in life. My daughter seems to have problems with spelling and reading and is in the second grade. She wears glasses and can read will at home. The problem comes while she is at school and can't seem to stay focused. She was checked out by the Ped. and we were told she is fine. However, this is the second year with the problem, and now she is starting to fail her course work. Amanda was born 3 months premature but had no delays early in life. She spent 13 weeks in the hospital to await surgery on her bowels, but other than that, no problems.
You need to check with the student services program with the school district. There are programs in each state that look at students and their progress and try different strategies to help them out. They can also do testing that will tell you if she has a deficit large enough to warrant services with special education (which can run the gammut between learning support in the classroom to pull out support in a learning support classroom). If she doesn't qualify, there is a thing called Section 504 (in PA, but I can't remember if that is across the country or not) where she can get support for her areas of concern without special education. It is definitely worth checking with the district to see if they can help you out. Try speaking with her classroom teacher to see if she knows about the process (who to call, steps to take, etc.) about getting her evaluated. If she doesn't know, go to the Principal or ask the office for the district main office phone numbers and call them to find out.
BTW, I am a teacher who is certified in Special Education - among 3 other areas. It has been quite a few years since working in Special Education, but I know there are supports out there for your daughter. Good luck and let us know how you make out.
What happends if ECI evaulated your baby and says shes fine, but then she hits 5 months, almost 3 months corrected and appears to be behind. Can I ask my pedi for a referal to a PT? ECI isnt doing anything for us, and was actually quite rude when they came to my home, and implyed that i had lied about some of her medical conditions, even though i had them documented on paperwork from the nicu
Definitely talk to your pedi. He/she is the expert in your child's development and they can help advocate for you.
Quoting amb_josh:
What happends if ECI evaulated your baby and says shes fine, but then she hits 5 months, almost 3 months corrected and appears to be behind. Can I ask my pedi for a referal to a PT? ECI isnt doing anything for us, and was actually quite rude when they came to my home, and implyed that i had lied about some of her medical conditions, even though i had them documented on paperwork from the nicu
I feel as though being a mother of a preemie is a lot harder than necessary. I've read every article that I could find on preemie development, but nothing is every really spoken about it. My daughter is technically 7 months old, 6 months by her adjusted age and her pediatrician and our H.A.N.D.S. worker know this but both are always commenting about how she's not doing what she's suppose to be doing for a 7 month old. I was referred to First Steps (a group that works with children with special needs...but designed for "slow learners") and they are of no help at all. I understand that my child is going to be behind on a lot of milestones, but I want to know how to work with her and encourage her as a parent instead of going to people who (apparently) don't remember or care. Where can I go for information on preemies past the newborn phase because nothign is ever really spoken about them as long as they survive their first couple of months at home.
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on Aug. 8, 2009 at 12:59 PM