Help me help my sister....(long - sorry!)

[GoofyPrincess]

Good morning. I am coming to all of you for advice and help. I apologize in advance if I inadvertently use incorrect terms or context - there is no offense meant and I really, truly appreciate any feedback or ideas.

My darling nephew is 11 months old. Recently I have started noticing some development issues that I feel are important enough to at least bring to the pediatrician's attention. Examples include things like:

- He refuses to eat any solid foods and gags/throws up on even small (Cherrios) things. He prefers babyfood and bottles.

- He is not trying to walk. He will attempt to walk if you hold both of his hands and insist that he try, but you are supporting almost all of his weight and he has no interest in trying to stand or walk on his own.

- Not much talking at all. Some babbling, but nothing like I am used to with my/other kids.

- It is very, very difficult to get him to smile. At all.

- If you walk in the room or make a loud noise, he doesn't care. Doesn't turn his head or acknowledge your presence. (Not a hearing issue - that's been checked)

- He gets really focused on spinning things. He will sit and spin coasters or baby toys (steering wheels, tops, etc.) for a very long time. Over and over. It is difficult to distract him.

Now my other sister used to teach special needs kids. She has raised similar concerns, but she uses bigger words like "gross motor skills", etc. She says that she feels it could just be delayed devlopment, but that she would be concerned enough to have him 'checked out'.

I want to offer support and help with anything she needs, but I worry that any mention of our concerns will cause her to shut down or explode. I think she already suspects that there is something 'different' about my nephew and her solution has been to withdraw and pretend like everything is fine. If anyone starts to talk about any of these 'quirks' of his, she picks him up and leaves the room/house.

Even more concerning is that she seems to have closed in. She doesn't have any friends. Her husband and her work off shifts so that they don't have to use child-care, but they never see each other. She rarely, if ever, takes him out beyond the local park or grocery store. The poor kid hardly ever sees other kids and my sister only sees my parents and the folks she works with. (My other sister and I live about 1200 miles away.)

So my question is - how to I start this conversation? What can I do to help my nephew and my sister? How do I convey my concern and support without causing my sister to shut down and withdraw from us? Or should I truly just mind my own business and let it be until she asks for opinions or help?

Thanks for any help!

 

[lanejudy]

Wow, you are really a caring sister and aunt! How wonderful! Keep in mind there is a very broad range of "normal development" for most things like walking and talking.

An 11-mo-old who isn't walking yet is NOT going to raise any red flags, assuming he's otherwise making himself mobile -- crawling, hitching, scooting, etc. If he still can't sit up unassisted, that would be a concern. (BTW, these are "gross motor skills" your other sister mentions.)

Talking is not expected at this age, just some babbles and sounds. Non-verbal "communication" is important -- does he look at you, make eye contact, cry when appropriate, follow a toy if you move it?

Eating solids may be a texture issue, that he may or may not overcome on his own. He doesn't seem to care about loud noises, but does he have any type of a startle reflex?

It honestly sounds like either 1) she's somewhat in denial or simply doesn't want to discuss the concerns even though they are likely on her mind, or 2) she's feeling judged -- either that you (or whomever is questioning her) is making a judgement on her parenting and/or comparing her child to others. At this age, it's really not appropriate to one child to another; all are different and all make their milestones on their own timeframe, which can vary greatly.

Really, the best way you can "help" your sister without potentially alienating her is to simply ask "have you spoken with his pediatrician about developmental milestones?" And leave it at that. Simply let her know you love her child (and reinforce something positive -- his smile, the color of his eyes, the cute dimple), and that you are there for her if she ever wishes to discuss anything. Then stop all the talk about delays or quirks or child development. She'll feel less threatened and more likely to open up when she's ready if she's not feeling defensive. It can be very challenging to hear suspicion that your child isn't "perfect" because for 9 months she dreamed of the perfect baby and a perfect life for that child. Even when we (parents of children with disabilities) recognize there is a difference, it can still take a while to be willing and able to talk about it.

You are very caring!

 

[bookwormde]

One good thing to keep in mind is that differences are not necessarily negative in unto themselves, if is often societies expectations that create issues.

Also do an inventory of both sides of the child's family to see if there are any differences, even if the person has self adapted to the point where the impacts are not significant or even beneficial. This can often help parents who are defensive, by showing differences do not preclude a successful and fulfilling life

There are some more formal developmental millstones that is it worth looking at, as well as the importance of early supports.

http://www.cdc.gov/ncbddd/actearly/milestones/index.html

Many parent's confuse developmental delays with intellectual limitations, and while they can occur together, more often they are completely independent.

If a child is at risk, then it is every adults responsibility to speak up. Children do not come with an owners manual, so just be honest with your observations and share information in a non judgmental fashion (avoid having her feel that there is something "wrong" with her child0, use positive words about the differences you observe. For example say the child has an amazing ability to focus, not that he can not be distracted.

The set of characteristics you describe, do fit into a known pattern, but there is much more information needed. Of course there are amazing gifts and significant challenges if the pattern if verified.

 

[GoofyPrincess]

Thank you both so much - this is exactly what I needed.

I am going to be down there with them in a few weeks. I'll just enjoy the time I get to spend spoiling my nephew and see if the opportunity for discussion comes up. It seems like there are a lot of changes in a child around one year, so I'll just keep my eyes and heart open and see how things progress.

The good thing about my sister is that she is an awesome (even if a little overprotective...) mom and no matter what happens, my nephew will certainly have the love and support he needs.

Thank you for the information and the perspective. I knew I had come to the right place to ask!