Tuesday, April 21, 2009

IFSP Review

On April 1st, Landon had his annual IFSP review. For those not familiar with the terminology, it stands for Individualized Family Service Plan. Any child that receives services through the Infant and Toddler program (for ages birth to three) will have an IFSP. The purpose is to determine which services are needed for the child and then to evaluate the effectiveness of those services.

So, how did Landon fare? His skill level was evaluated in 7 areas of development: cognitive, expressive communication, receptive communication, gross motor, fine motor, social/emotional and adaptive. Generally, Landon fell into the 8-9 month range, with some noted exceptions. His fine motor skills were in the 10-11 month range and his receptive communication was in the 5-6 month range. It was explained that it is not common for children to have a lower receptive language skill than expressive.

Receptive language is what you understand when someone communicates something to you. If I waive to you, receptively, you know that I’m saying hello. If I shout, “No!” you know that I don’t want you to do something.

Expressive language is, in turn, what I listed in my example as my way of communicating. As we get older, we learn more sophisticated ways of communicating, and receptively, understanding.

In order to be able to express language, you have to understand it. That is why it is unusual to find that Landon’s receptive language skills are lower than his expressive. The infant educator gave us the specific example that Landon is not consistently responding to key words such as "Daddy" or "ball" or following simple directions. One reason, she thought, could be a hearing problem.

I took Landon in for a follow-up hearing test. He hasn’t had one since he was about 4 or 5 months old. The result? Landon can hear. The audiologist did say that the tube in Landon’s left ear was not working for him and she’ll discuss with the ENT on how to address that.

My theory on why Landon’s receptive language is lower than is expressive, is that we haven’t really worked with him on following directions, or really expressed to him who “Daddy” is or what a “ball” is. Actually, we haven’t worked on many developmental activities consistently up to this point, shamed as I am to admit it.

When I look back and think, "why haven't we done these things?" I have to admit that my focus with Landon has been completely different then it was with McKayla. When she was a baby, I followed What to Expect the First Year to a T. I kept up with each month of development and followed suggestions on how to help McKayla accomplish "milestones." I read parenting magazines and scoured babycenter.com for ideas. And many things, we didn't have to work on. McKayla just picked it up, as most children tend to do.

With Landon, I find myself researching and learning about Down syndrome. Instead of my focus being on just reading to your child, when to wean your child from a bottle, to what foods are safe for this age, instead, I'm reading about Transient Myeloproliferative Disorder and leukemia, hypotonia, hypothyroidism, cataracts and eye health, oral motor development. I also have to remind myself that it is going to take more work, determination and time for Landon to reach "milestones". That they don't come as easy for him as they did McKayla.

Actually, I often feel overwhelmed with all that I need to keep "in mind" for him. Remembering to schedule the appointments for the well baby checks, the hematologist, the ophthamologist, the pulmonologist, the ENT, the cardiologist, the infant educator and the speech therapist (I feel like I'm forgetting an ...ologist in this list). And when I schedule, making sure that Dustin or I can take him without missing too much time from work. And trying to remember the information and instructions from each appointment. And following through with the recommendations.

Though I constantly feel tired and overwhelmed, one thing remains true. I love the source of my worry with all my heart has to give. I don't question why I was given this beautiful gift. I also don't feel that I'm different from any other parent that strives to pave a full and rewarding road for their child. We may have to work harder, but it will pay off in the end. For I see us as not just weekend gardeners, but landscapers, laying out a foundation that will eventually blossom into a beautiful garden. And I have no doubts that Landon will blossom.

To be continued…

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