Jan. 13th, 2011

marydell: My hand holding a medusa head sculpture (by me) that's missing its snakes (Default)
So, Charlie is 2 and a half, and is already falling behind on tests! Well, not exactly. His day care/school does the ASQ, which nowadays stands for Ages & Stages questionnaire but I think used to stand for Autism Spectrum Questionnaire? Anyway, it's a thing that parents or teachers fill out every 3 to 6 months or so (less frequently as he gets older) that asks questions about developmental milestones--gross motor, fine motor, verbal, social, etc. I have collected it when it was given and have even filled it in, but have not given it back to the school generally. This is because 1. we have him evaluated by doctors regularly, including at times with that same questionnaire, and we do therapy accordingly 2. It's not necessarily any of the school's goddamn business what his total medical profile is, particularly since we are not (yet) in the land of IEPs and special services, and if we ever are, it will be through our actual school district and not the day care, (which thus far has been very slightly faily about his disability, although great about his medical needs) and 3. (and most important) the ASQ is designed for children with normal morphology.

So this time his teacher did the evaluation--not just for him but for all the students in the class--and came up with "needs follow-up" (i.e. see your doctor about...) on gross motor, fine motor, and verbal. Now, we know he's delayed on verbal; we're in the "wait and see" stage, where he's catching up but might need a little therapy, or might not. So I think it's valid to flag that. For gross motor he mainly shows as "delayed" in things relating to balance; ok, fair enough, but I note there is not an "asymmetrical" option...anyway, ok, yeah, he's only been walking since May so I'd consider him delayed on gross motor, but the doc and the PT think he'll catch up on his own as his confidence grows.

For fine motor, I've always filled in "n/a" for most of the answers and not bothered to tally, because the questions MASSIVELY assume normal morphology. Stuff like "child can pass a small object from hand to hand, yes or no." Well NO of course. And "picks up a cup with both hands." NO. But he picks up a cup with his hand and the end of his short arm, and he tucks things under his short arm to carry them. He does not do really well putting lego bricks together, or scribbling on a piece of paper unless someone holds it for him. These are standard markers of fine motor skills but the question is not "can build a lego tower using only one hand," which is actually the required skill in his case. Some of the questions are less two-handy, like eating with a fork or spoon, but most of them are not.

His teacher went ahead and answered the questions exactly as asked--which is what she's required to do, and she was apologetic about it--so he now is rated with 15 out of 50 on fine motor. I would be happy to have a reliable way to tell if his fine motor skills are good for his age or if he actually is delayed, since he was significantly delayed with hand skills in his first year, and probably continues to be delayed now. But these questions are not the way to figure that out. I don't think the test should be redesigned, mind you, because it's a perfectly fine eval for the majority of kids. But the school should have alternative ways of assessing other kids - or just say, you know, "we skipped the fine motor skills section of this test because it's obviously stupid to ask these questions about Charlie; do you have an OT who could do an eval?"

Which, come to think of it, we do, although he hasn't seen her since he finally learned to walk. Maybe we'll get our doc to refer us for a little milestone testing. In the meantime: rargh! Stupid unhelpful test.

ETA: Since you've kindly read all this rantyness, you deserve a picture:

IMG_8546
Charlie playing with his Xmas choo-choo. Mike put velcro sticky pads on the bottom of the remote and on the table, so Charlie can work the lever without having to hold the remote.

April 2013

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