Pediatric Services Pediatric Services: An intervention team serving children with developmental delays.

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Case in Progress

Danny - year 1

Danny was born on January 1, 1997, the first child born that year in our city. His mom’s health at conception was good and prenatal care started at three months. Mother took prenatal vitamins and attempted to eat well. She had significant nausea between the third and sixth month. Mother was offered alphafeta protein studies, but declined. She had two ultrasounds that were apparently normal. At between the 37th and 38th weeks mother developed some toxemia and a third ultrasound showed significant oligohydramnios. Labor was induced at 39 weeks using Pitocin with overall labor lasting approximately 18 - 19 hours.

Danny was delivered vaginally in the vertex position. His apgar score was five at one minute. There was evidence of intrauterine growth retardation, due to his low birth weight of 5 pounds, 3 ounces. Danny was 19.75 inches long at birth. Initially Danny had poor spontaneous respirations and required some assistance, then had supplemental oxygen. He became somewhat jaundiced and was placed in sunlight, which helped. Circumcision took place without incident. He was allowed to go home with his family the day after he was born.

Danny’s first few months passed without incident, although his parents noticed he seemed somewhat floppy. He is their first child and they were young and inexperienced at that time. No one was unduly concerned at this point.

Danny had a good suck and swallow and ate well. He gained almost 20 pounds in the first 7 months. However, after that point he ceased to gain weight easily, although he continued to eat well. Danny was bottle fed, and he began to eat baby foods at the age of 3 months. At this time it became apparent that it was difficult for him to sit for eating. It was also noted that he did not roll over with ease.

In August of 1997, at the age of almost eight months, Danny was referred to the regional center by his pediatrician for early start services. It was arranged at this time to have chromosomal studies done. These studies proved to be unremarkable. But, it was discovered that Danny had asthma.

At the age of nine months (36 weeks), Danny was assessed to have had the following developmental levels:

Perceptual/Fine Motor: Danny was at 28 weeks, scattered to 32 weeks.
Cognitive: Danny was at 28 weeks.
Communication (Receptive): 28 - 32 weeks, (Expressive) 28 - 32 weeks.
Social/Emotional: 30 - 32 weeks
Adaptive - Self Help: 24 - 28 weeks
Gross Motor: 24 - 28 weeks.

To address Danny’s global developmental delays parent and child education were begun twice weekly. Not only do these disciplines address the child’s cognitive needs, but also gross and fine motor needs. And maybe more significantly, teaching his parents and grandparents what they could do daily to help Danny reach his potential.

He began to make excellent progress, particularly in the area of gross motor skills. Danny was quickly able to learn how to sit and to begin to crawl. Prior to intervention, Danny had spent little to no time on his tummy at all. Danny was beginning to pay more attention to his surroundings, people that were around him, and to toys.

The first few months up to his first birthday passed quickly and successfully. His family and therapist were all pleased with his gains.

Next month we will address his second year of life. Watching Danny grow continues to be very rewarding.

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Last modified: January 26, 2013