As you can probably gather from my last post, Jamie has continued apace on his "Speech dyspraxia? Claim I have speech dyspraxia, will they? Bwahahahaha – I’ll show those fools at the Family Health Centre!" campaign. For a while I went on making approximate attempts to keep a list of the words he could say and a running total, but it was becoming more and more a gesture – it simply wasn’t possible to keep track of them all. As of last weekend, the grand total was over a hundred even with the inevitable underestimation that came from trying to remember them all at the times that I could actually make it to the computer to write them down. After that, I gave up adding more.
He’s stringing them together, coming out with phrases – Peel ‘nana. Daddy big car. More garden. Want go window. (And, of course, press button green man, now augmented by the additional commentary of green man come out.)
By the way, it is worth noting that he does now say ‘mummy’. This proved not to be quite the emotional heart-turn-to-mushy-puddle moment that I’d anticipated – instead of yelling the word out with an enormous smile as he rushed to greet me at the door one night, as I’d always pictured, he used it to comment on the existence of my elbows. "Mu’y elbow," he informed me gleefully, pointing.
All of this means that the proposed programme of tests now seemed like a bit of a moot point, but, well, we had them organised and I liked the idea of getting him checked out. (Besides, I find this sort of thing fascinating. I spent a misbegotten and geeky childhood reading books about child development and assessment testing and trying the tests out on the neighbours’ children. My sister still swears growing up with me warped her for life.) So, he has now had both his hearing test and something called a Schedule of Development, which was a general assessment. (We’re still waiting for the speech therapist to get back to us. It’s a good job he does now appear not to have a problem.)
The hearing test was on Thursday 22nd February, which was one of the days I’m out at work, so I couldn’t go along to that one. Apparently he did appear to have a slight hearing loss, but since he also had a rotten cold at the time this was not considered to be of huge significance – they’re going to call him back for retesting in another three months. The health visitor was kind enough to go out of her way to schedule the general assessment for the following Tuesday so that I could be there for that one, so, that morning, I arrived at the Family Health Centre and told the front desk that I had an appointment with the health visitor, whose name I apologised for not knowing.
"It’s Carol N__," the receptionist said, in a startlingly good stereo effect. I was quite impressed by this, until I realised that the second voice had in fact come from behind me. The health visitor had come out to meet us.
Carol had to start out by filling out the paperwork – the forms are specially designed, can’t be photocopied (from what I saw, one of them was a fold-out form and one was in multiplicate with carbon copies for every professional who might need a copy), and are expensive, so the health visitors are told not to fill them out until the child actually arrives to avoid no-shows wasting a lot of money. This was just fine by Jamie, who got to enjoy the playhouse again for a bit while we were waiting.
I can’t guarantee that I’ve remembered all of these in the right order, or even, for that matter, that I’ve remembered them all; but these, as far as I can remember, were the tests he had to do. In between these, I answered various questions from Carol about his development in areas not easily measured in a test setting, assuring her that he had indeed passed such crucial milestones as walking upstairs two feet at a time, using a spoon in a manner that can be charitably described as ‘skilful’ if we don’t get too close to the Trades Descriptions Act people, and rebelling against his parents.
The first test was block-building. Jamie was less interested in the blocks than in the rest of the room (a small room that doubles as the doctor’s room on other days, and hence contains various enticing items such as a trolley just the right size for toddlers to climb on and a screen that, towards the end of the proceedings, he managed to push over in one heart-stopping moment that certainly tested Mummy’s reflexes), but she managed to coax him into building a tower of whatever the requisite height is – I think it was six or seven blocks. He was unsuccessful at building a three-block bridge, but that’s not surprising since that’s normally of three-year-old standard. (This did, by the way, make me glad I did spend a misbegotten childhood reading about such things – at least I knew this. It made me wonder whether it ever gets nerve-racking for parents who don’t realise that these tests are put in to look for children advanced beyond their usual stage, and who only see that there’s something their child has been asked to do and can’t manage.)
Following the block-building, Carol moved onto formboards – those puzzles where a child has to fit shapes into holes of the corresponding shape in a board. Jamie made short work of the basic formboard (circle, square, triangle), and with more difficulty and a bit of coaxing, managed the advanced version, in which the pieces were three very similar fish with subtle differences in shape and size. (I think I’d have had difficulty with that one, but that’s probably more of a reflection on my skills than on his.)
For language comprehension testing, Carol put a spoon, a cup, a hairbrush and a doll on the table for Jamie to carry out particular requests. At this, he did very well. He successfully brushed the doll’s hair when asked to; demonstrated knowledge of prepositions by placing the spoon in the cup and chucking the brush almost off-handedly under the table; and followed a two-part request, putting the spoon in the cup and giving the doll to Mummy. He almost achieved the giddy heights of following a three-part request, but, having put the spoon in the cup and given the doll to Mummy, he got distracted just as he was about to put the brush under the table and brushed the doll’s hair with it instead.
To test his co-ordination, he was given some of the little pegs we used to use in the old ‘Mastermind’ games of the 70s, which he had to put first into a cup and then into the holes in a board. He managed both of those with no problems.
Carol asked me how he was with his colours, and I proudly assured her that he knew them well and sat back waiting in happy anticipation to see how impressed she’d be with his colour vocabulary – I knew that he could already name red, green, yellow, blue, black, orange, and purple, which strikes me as pretty good for a two-and-a-quarter-year-old. (He’s since added brown to that list, incidentally.) However, it turned out he didn’t even have to name them – all he had to do was to match each of ten coloured cards to their corresponding colours on a piece of paper. He had that one down cold – he matched each one within seconds. It seemed like quite an easy test to me, but apparently, as I found out in due course, it earned him a score equivalent to the 48 months level on the visual skills area.
He was less of a natural at the drawing test. Jamie likes scribbling when he’s in the mood for it – which he apparently wasn’t on this occasion – but he regards paper and writing implements as having the primary purpose of allowing other people to write and draw things at his request. What he wanted right then was for Carol to draw some numbers for him. Requests to copy straight lines or draw eyes on a picture of Mummy were dismissed as uninteresting substitutes. "Nye!" he demanded fiercely of a slightly bemused Carol. "Three!" She gave up on that one and moved on to seeing whether he could throw/kick a ball (I remember that this one came next, because she initially made a ball by crumpling the paper up, which interested him considerably, before bringing out a more conventional ball for him to try).
He wasn’t too stellar at ball skills either – although he loves balls, he tends not to do that much with them, carrying them around rather than playing with them. Or, on this occasion, standing on it, which wasn’t such a good idea as it was a rather fragile hollow plastic ball. Meanwhile, he’d noticed the giant mirror on one wall and was finding that much more interesting. However, Carol did manage to coax him into kicking it successfully, though she couldn’t elicit an overarm throw. She then asked him whether he could do ‘bunny hops’, which mystified Jamie completely and left me a bit puzzled as well. It turned out all she wanted to know there was whether he could do a proper both-feet-off-the-floor jump, which he certainly can and has been able to for some months. As soon as I just asked him to do a jump, he managed it with no problems. He couldn’t balance on one foot, but, again, that’s a three-year-old standard and not something he was expected to be able to manage.
Carol then brought out a book of pictures for further testing of language skills. Jamie successfully picked out, on request, people engaged in particular activities ("Who’s drinking?") and objects with particular uses ("Which do you use to eat with?") He didn’t, however, manage to name objects in a picture on request, which I think was just due to shyness – he certainly knew the words ‘cat’ and ‘mouse’, which were the ones he was being asked to say before Carol gave up on that one. He also couldn’t manage negatives ("Which of these children has not got shoes on?"), which was hardly a surprise – from doing the preschool assessments as part of my GP training, I remember that this one is usually a question that baffles even children who have reached the grand age of three-and-a-half. But he could successfully differentiate between the big spoon and the small spoon, which, again, was no surprise at all to me – since the days of the Big Snowball, the concepts of ‘big’ and ‘small’ have held utter fascination for him. He works them into the conversation at every chance he gets. ("Daddy bi’ car. Mu’y sma’ car.")
Having completed all the tests, Carol went through and added up the scores and then discussed them with me as best as possible while Jamie entertained himself with what little there was in the room for him to play with and I struggled to keep him to the subcategory of things in the room that he was actually meant to be playing with. It was at this point that we had the aforementioned Screen Toppling Incident, when I was briefly distracted by trying to actually listen to what Carol was telling me about my son and he managed to push over the screen that, in the room’s other incarnation as a doctor’s room, folds out to go around the bed and provide patients with a sketchy modicum of privacy. Fortunately, my co-ordination skills are better than those displayed by Julie at her son’s assessment by an infinitesimal but crucial margin and, with a finesse that astonished even me when I had a chance to think about it, I pivoted round at Carol’s yell of alarm and caught the screen smoothly on its way down without even spraining anything (and then looked nonchalant and modest about it. Catch screens with my bare hands? P’shaw, ma’am, ‘twaren’t nuttin’.)
The test results are obtained by adding up the different scores allocated for the different items to give a total score in each developmental area tested (gross motor, manipulative, language comprehension, spoken language, etc.), and then checking the number obtained for each area on the results form, where it is possible to see what developmental age that particular number corresponds to. It’s an inevitably imprecise method of working out a child’s strengths and weaknesses, but it does give a good general idea of how they’re doing in each area and, most importantly, of whether they have any problems that need addressing.
Jamie did not have any problems that need addressing. In visual skills, as I said, he scored at the 48-month level; in language comprehension, at the 36-month level, thanks to his mastery of pronouns, the two-part command, and concept of different sizes. In all other areas, he was scoring within the normal range for his age (30 months for manipulative skills, 24 months for all others – the test is not precise enough to give a 27-month reading.)
Carol says that, in spite of his spectacular progress, we should still keep our appointment with the speech therapist when we get it, just in case she does have any further advice. Oh, yes – and we’re also supposed to feed him French bread, because it’s chewy and will help build up some of the necessary mouth muscles. (Substitutes of equivalent chewiness are perfectly acceptable; she used French bread only as an example.) I told her proudly that I’d nursed him for sixteen months, which would hopefully have laid a good foundation as far as building up oral musculature was concerned, and she agreed that this was all to the good. But, apart from the French bread and the distant prospect of an eventual appointment with the speech therapist, no further intervention is needed at this point – Jamie is right on track, except for the areas in which he’s nicely ahead.
Since I knew this anyway, I suppose getting official approval of it shouldn’t really be such a satisfying moment – what, I’m waiting for some stranger with her forms and tests to tell me what I already know about my own child? But it was. The frustrating thing about raising a child is that it takes so long for any results to show up – on one level you may know that all that reading to them, talking to them, and otherwise stimulating their tiny minds is bound to be having some sort of beneficial effect in the long term, but that sometimes seems very distant on a day-to-day level. The copy of the form I was given to take away, with the cross-hatching in the boxes corresponding to his developmental levels, is immediately available hard evidence that all that effort really is doing something.
Besides, I got to see a real-life developmental assessment. And Jamie got to play with a real pretend playhouse. So we both counted it a satisfying and worthwhile day.