Developmental Pediatrician.

As some of you know, Ella saw a developmental pediatrician from UMMC on Friday (hence forth "the doctor"). She was extrordiarily patient, observant, and made every effort to be helpful. However, in her own words "Well, I'm at a place where I can pretty much only tell you what you already know".

She spent some time discussing with us, as well as observing for her self, Ella's current abilities and behaviors.

On the plus side, she was able to confirm many of our observations, and be a bit more specific than we could be. In general the highlights of discussion where:

Autism - Ella's not showing any signs of Autism at present. Her sociability is too high for that, and we already knew this much. The doctor was also able to point out that her chances of developing autism are quite low. According to her, normally children that are sociable, but develop into autism start off with some signs of abnormal social behavior. During her observation, Ella started off being cautious toward the doctor because she was a stranger. Over a period of a half hour, Ella warmed up a bit to her and started playing near her, letting her hold her hand for walking, etc. According to the doctor, that's very normal, and children "at risk" will tend to have either really short or really long warm-up periods. The doctor still can't be 100% positive that Ella won't develop into Autism, but it's unlikely enough that she admits her gut reaction is "no, not a concern".

Cerebral Palsy - This much we already knew quite solidly, but the doctor did point out that she has no signs of Palsy. Her reflexes and muscle tone are both normal. ( Muscle tone is a reaction thing, not a strength thing, thus related to neurological health. If you suddenly straighten a child's arm, leg, whatever they'll automatically engage their muscles to protect the joint from being jolted. A child without low muscle tone will react slowly or weakly. A high tone child will react much too strongly, or may stiffen immediately.)

Metabolic Disorders - Ella's not really showing any signs of metabolic disorders, no enlarged organs, etc. However, the doctor did say she would have Ella's pediatrician review the metabolic screen she had at birth (ie: the PKU, etc they run on the heel stick), and possibly run some additional screens if some of the ones of interest weren't in her test. This is largely a precautionary measure, and the tests are simple enough to run with a small finger-prick sample of blood.

Assessment - In the process, the doctor also performed a developmental assesment, which was a different assesment tool than the E-LAP that the county used, but I forget which one. In general she came up with Ella's gross motor skills now being around 12-13 months, and her communication is much further behind. That's a bit further along than we thought in gross motor (we've been thinking around 10-11 months), but otherwise no surprise to us. As mentioned above, her social development was age appropriate, as was her cognitive and fine-motor.

Dyspraxia (aka Developmental Coordination Disorder) - This is the "working assumption" of Ella's Physical Therapist, and the doctor agreed this is a reasonable assumption. At this stage she couldn't really rule out any other problems, but that is what is evident at present.

My motor disorder - For those that don't know (which most of you do) I have some form of mild motor disorder. Unfortunately, not a whole lot is known about my disorder, largely because it was detected but deemed to mild to worry about by the neurologist I saw as a child. I can tell you that my disorder primarily affects my fine-motor skills (as anyone who's seen me write or free-hand draw will know), but it does have some lesser impacts on my gross motor and hand-eye co-ordination (as anyone who's seen me try to catch a ball will know). Obviously, since I have some kind of motor disorder, this was a significant topic of discussion since Ella is showing signs of one.

Ella is affected a bit differently than me, as mine is primarily fine motor and Ella's is primarily gross motor. However, my fine motor wasn't really noticeable until I entered school and was doing more complicated things like writing, crafts, etc. Also, I had no obvious gross motor issues at her age, as I was walking at 10 months.

Follow-up - The doctor wants to see her again in 6 months to see how she's progressing.

So, at this point, we only have some confirmation of things we knew, and possibly some additional metabolic screening. But a little confirmation is better than nothing at all.