Arrested Development

I admit that there are times when I can't turn off the clinician inside my brain. Although I don't have much experience with babies and paediatrics once they leave the womb, I do remember studying the Denver Developmental milestones. Whenever I see my friends' kids, I can't help running through that checklist. While spending Christmas Day with my aunt and cousin in 2011, I carefully observed her fifteen month old son. He was able to speak random words such as "turtle" or "bubble" which seemed to be on target.

Despite our close proximity, we don't get together with my aunt or cousins that often. Our interactions are pretty much limited to major holidays and when my parents are visiting. In particular, I don't think I saw my cousin at all during 2012 until the Thanksgiving and Christmas holidays. While I was dodging my cousin's questions about when we were going to have kids, and watching everyone fuss over her second baby, I took note that her two and a third year old son didn't seem to speak much and when he did, it was only one or two words. I spent some time reading with him and saw that the could count and connected that he had four books. This seemed really basic and I would have expected to see much more progress in his sentence structure.

I had a few private conversations with my aunt, who is a paediatric nurse. She has shared my observations, but felt a bit of relief when he finally uttered a complete sentence by the time we was two and a half. Just before his third birthday, we attended a gathering with my cousins and their friends with kids. As I was watching all the tots play, his delayed speech was really apparent. He seemed to be just making random sounds, and there didn't seem to be much purpose to the one or two words he employed.

A few months later I spoke again with my aunt as we were cleaning up Thanksgiving dinner. She had observed that while her grandson could speak short sentences, he would mostly repeat what others were saying ("Is the moon bright?" - "yes the moon is bright"). He didn't seem to express much original thought. The teachers at his day care/pre-school had a conference with my cousin and recommended a specialist evaluation. However, my cousin was resistant to this idea as she was in special education classes during her elementary school years and she didn't want her kids to go through that experience. I wondered why my cousin couldn't appreciate that she need to address this developmental issue now to prevent her son from attending the special-ed classes when he gets older.

We got together with my aunt and cousins for brunch on Easter Sunday. Although we're atheists, Husband and I felt it was important to attend so that another six months wouldn't go by before we visited with my relatives who live ten miles away from us. Additionally, we learned that my uncle was recovering from his second hip replacement and my aunt was just diagnosed with stage I breast cancer. The tumour was detected at an early stage and the surgeon feels she has a very encouraging prognosis. If her lymph nodes are negative and the pathology reveals clean margins, she most likely won't need any adjunctive chemotherapy or radiation treatments. Her lumpectomy as actually planned to be an outpatient procedure, so I offered to check on her that night as well as to be available for dressing changes. My aunt commented that so far, 2014 has been a tough year on their family medically, as their oldest daughter just had surgery on her neck and my other cousin is scheduled for a cystocopy to evaluate her chronic urinary tract infections. I added my grandmother's hip fracture to that list. "Plus, what we've been through" Husband offered privately, but it didn't seem to compare.

I'll admit that I'm not in a good position to evaluate my nephew and his speech development since I don't see him often and our interactions are quite limited. I also admit that one paediatrics rotation does not make me an expert and this is definitely outside my area or expertise. However, it's so glaring to me. What I see is a lack of progress in the past year and a half. I took note that his parents and grandparents (finally) dropped the baby talk and seemed to be making an effort to engage him in conversation. Yet even getting him to recall his Easter presents was difficult and was met with just one word answers. Husband, who has no experience with kids and no related training, not only picked up on how behind he is, but he noted that his younger brother (the spontaneously conceived 'surprise') seems more advanced.

My aunt later revealed that the director at his pre-school gave my cousins a two week notice to find another school for him. Holy shit! I never knew you could get dismissed from pre-school! Apparently, he failed to meet their potty training deadlines and he wasn't transitioning well when the class would move from one activity like colouring to story time. They enrolled him in a Montessori program, which my aunt isn't sure is going to be the best fit. She added, "I have heard from some of my patients that the three-year old instructor at his old school is not very good."

So we're moving to the tactic of blaming the teachers... I recalled that when he was two yeas old, my cousin's husband acknowledged that his speech was behind. "You just want to hear that everything with your kid is perfect" he admitted. Although I may not get to this place, I've been thinking about how infertility's effects still linger during pregnancy and while parenting. Can it induce a form of blindness? Or throw one into denial? Okay, selfishly it also concerns me that their IVF conceived child is delayed while that natural one is seemingly normal. I lament how hard conception and pregnancy are for us, but I'm reminded that it may only represent only the beginning of our challenges...