I haven’t written a blog for a number of weeks now for a few reasons. It is getting increasingly difficult to find the time when James doesn’t nap and I have lots to sort out with buying a house and moving in a few months. In addition to that we have had a bit of a stressful time with James and his development recently. I wasn’t sure if I wanted to blog about it, but after thinking about it if my experiences can help other people in any way then I want to share them.
Playgroup keep a learning journal for James which is essentially a book where they stick in pictures of him doing activities and write down observations they have made. Everything that gets stuck into his learning journal is then marked against the Early Years curriculum giving him an age in months to what he is achieving. The first time I saw his learning journal was not long after he started playgroup and I was shocked at how far behind he was. However, playgroup has really helped his development and he is now not far from where he should be in most areas. In maths he is actually smashing it and is well above where he should be for his age. Despite this, we decided that the right thing to do would be for them to refer him to speech and language for an initial assessment to see if they could offer him some support and accelerate his development further. We also decided to contact the Health Visitor to arrange a home visit so she could complete an Ages and Stages Questionnaire (ASQ) for James.
The home visit with the Health Visitor didn’t kick off to the best start with James crying and trying to push her out of the door. It then took a while for him to calm down, all whilst I am wondering what the Health Visitor is making of this and judging my parenting skills for calming down my child. Crying and pushing people out of the door has become a regular thing for James and it is quite embarrassing because it can make people feel like he doesn’t want them there. I think this behaviour actually stems from when my sister would come over and cut his hair and him feeling scared. The crying and pushing has recently got better and instead he says “bye bye” and will even bring people their shoes. Once he realises they aren’t a threat to him he calms down and even interacts with them.
So after our rocky start James was content with watching Peppa Pig and playing with his toys. I was very proud of him when he started interacting with the Health Visitor and picked up a hexagon and told her it was hexagon. I thought if nothing else he has shown her he can identify a shape. Unfortunately there was nothing about shapes on the ASQ. James could not do some of the specific activities on the questionnaire. I think part of this was because he wouldn’t cooperate and wasn’t in the mood to do the activities or answer questions. I didn’t have my husband with me who had already seen James complete some of these activities when he had spent time with James alone. I basically guessed the ones I wasn’t sure about and if in doubt said he couldn’t do them.
The Health Visitor was at our house for nearly two hours and we had a thorough discussion about my concerns with James and how his development was coming along. Although James didn’t perform well on the ASQ which looks at communication, gross motor, fine motor and problem solving. However, he did perform strongly on the social and emotional questionnaire. It was decided that after his speech and language appointment we would have a meeting with playgroup and the Health Visitor to discuss what support could be offered to James. The problem with the ASQ is that it focuses on a very narrow area of each skill and it felt like we almost needed to teach James to be able to do the tasks that are very specific to the questionnaire. The Health Visitor dropped the questionnaire back into us after photocopying so we could see if James could do any more in his own time. After spending some time doing some of the specific tasks we found he could, which would then improve his score making him not as behind as the questionnaire first indicated.
The speech and language appointment went surprisingly well. There were toys on the floor which James immediately started playing with and naming them. He played while I discussed my concerns with the speech and language therapist. I took a list of phrases that James uses because I have found that I can never remember the phrases he says when I am asked on the spot. She scanned down the list and concluded that they are what she would expect for his age, but did point out that they look like they are learned phrases from us or the TV. My other main concern with James’ speech was that he doesn’t always use words to ask for things, even though I know he knows the words for what he wants. I was advised to offer him a choice when he signals he wants something non verbally. That way he has to use words to tell me what he wants rather than assuming I am a mind reader from his groan or pointing. Offering James choices has worked really well for getting him to say what he wants and he has definitely improved in this area since the initial meeting. I think he is also beginning to say some phrases he has put together himself. This guidance has really helped.
After talking to me, the speech and language therapist wanted to play with James to try and gauge how much he understands. James likes playing on his own so I was interested to see how this would unfold. She put an animal on the roof of a barn and asked James to rescue the animal. He needed asking a couple of times but he did rescue it and then interestingly he turned his back to her and continued to play his own game. She said he is very rigid in his play and that was his cue that he didn’t want to play her game any more.
We agreed there was nothing to be majorly worried about but there were areas for improvement in terms of asking for things and creating his own phrases. It was agreed that we would be offered a block of sessions in January. As we are moving in February we were told that we could cancel these sessions if we feel he no longer needs them or if they are too close to the move. I left the session feeling quite positive about things because I had been given some direction and some strategies to help him.
This week we have had the meeting with playgroup and the Health Visitor. Playgroup and the Health Visitor assess James in very different ways. Unlike the ASQ, playgroup assess James through observation and then revert back to the Early Stages curriculum to see where he fits in. I think this is a much more reliable form of evidence to show progress because playgroup get to see him for longer performing a wide variety of tasks so have a better idea of his abilities. They can also see progress rather than just a snapshot.
What particularly struck me from the meeting was how well playgroup knew James and his little quirks. They totally get his personality, his likes and dislikes and they support him in being himself. They give him boundaries but at the same time don’t force him into doing anything he is uncomfortable with. We got to observe James a bit without him seeing us and it was fascinating to watch. He loves giving all the activities a go, he plays alongside other children but isn’t quite there yet at communicating with them to play. We were told James is very considerate to other children which I am very proud of because what I really want is for my child to be kind.
After discussing the playgroup observations and the ASQ it was decided that James should be given a My Plan. I had never heard of a My Plan before so I either don’t know anyone else whose child has one, or they just don’t talk about it. A My Plan is an official document used to set James targets that can be shared between education and health professionals. Children can come on and off My Plan as they develop or need extra support, so they may come off it but then need to go on it later on in their development.
We agreed My Plan sounded like a great idea. The main areas for James’ development are communicating with others so he can begin to communicate with other children to play with them, and secondly his fine motor skills. We weren’t so worried about his fine motor skills because we think it’s more of him not being interested in doing things that require fine motor skills than that he can’t actually do it.
The targets have to be achievable and realistic so James has been set targets to roll a ball or a car forward and backwards with an adult for 2 – 3 minutes every day at home and every session at playgroup. You may think that’s really simple for a 3 year old to do and yes it is; James has no problem rolling a ball but the idea behind this is that he gets used to playing with others by beginning with an adult. James is a child that likes making up his own games and playing by himself, so the challenge is to get him to allow an adult to play with him in the hope it will progress to playing with other children. We have also been given a target with some activities to try with him to improve his fine motor skills.
What I like about My Plan is that it gives us direction on how we can help James. Being first time parents we are by no means experts so being given ideas and a focus as to what we can do to improve things for James will hopefully be a big help. If further down the line James is showing signs of a social and communication disorder then it is important that evidence has been logged to back this up. Hopefully with a bit of extra support and direction he can catch up with his peers but if not we are starting early in supporting him.
The hardest part of James needing extra support is wondering if it’s something we have or haven’t done. Have I spent too much time outside with him rather than playing at home? Did we not talk to him enough when he was a baby? With anything like this I am always the first to blame myself because I see it as a personal failure. I have known for a long time that James isn’t as advanced with his speech as other children and has his own quirks. I find a lot of things most parents find easy with their children, difficult with James. We are hoping by putting the My Plan into practice and working with James on his communication skills that he will soon catch up. One thing’s for sure is that most of the time he’s a happy child, we have great fun with him and he’s very loved.