Experience with baby EI?

[scm1011]

DD (8.5 months) had a well check up this morning and the doctor was concerned that she was a) still not sitting and b) hadn't gained weight since her last well visit. 

The latter I'm not too concerned with (she had pneumonia and possibly the flu and vomited daily for almost a month). I've definitely noticed DD is behind her peers with motor skills (she can sit briefly unassisted but is not reliable and falls over after <minute, she does nothing close to crawling), but I seemed to remember DS being similarly lumpy. I just went back through photos/videos on my phone and I was mistaken, he was definitely sitting reliably at this point. 

Any experience? Curious if her long bout of illness slowed her progress, or if we should be more concerned. She's also very long (~80 per height, ~5 per weight) so I wonder if that's a factor. DH brought her to the visit and did not ask any follow up questions 

[sparkythelawyer]

My mother in law is an EI physical therapist (kids aged 0-3). They can do amazing things to help get kiddos caught up for a variety of reasons. An EI eval will help you know if she is behind enough to warrant some assistance. An EI eval can also let you know if she could benefit from other services like OT (to help her eat better/more effectively etc). EI Evals in our state (IL) can be done in the home, as a lot of providers like to see baby interacting in their "natural habitat" so to speak. A good EI PT can also give you some tips and tricks to work on with her on your own time to help her make those milestones. I'd at least go for the evals and see where things stand after that.

[icedcoffee]

Call for the eval. It can take a bit to get in, but it should be free. We did EI for DS1's speech at 2 years. They were so nice and helpful and reassuring. We ended up not qualifying for services, but if we had I know we would have been in good hands.

Definitely don't worry yet. A month of illness can definitely cause delays I am sure and those therapists will be able to get her back on track.

ETA:  We had our 6 month visit yesterday and need to go back in a month for a weigh check as he's less than 5% too so hugs there.  

[ohgillian]

I would go ahead for the eval. The services can be so helpful in catching kids up, or in helping them meet their own milestones on their own time. FWIW, I had one in EI but both kids did PT. The EI baby walked at 18 months but I feel pretty certain she wouldn't have made it even by 2 without the intensive services.

[Susie]

We never actually did the EI eval for DS this fall, but had tentatively planned to schedule it at 6m, when we expected he was going to have "officially" missed a motor milestone(s) and would therefore stand a chance at qualifying for services.  We ended up not going through with the eval because he made great gains in private PT between 4-6m.  While he still had some core weakness, he wasn't going to qualify for services because he (just barely) hit the 6m milestones by the time frame.  He's been out of PT for about a month now, and I've been watching like a hawk to see if he continues to progress without therapy, and I think he is.  He'll never be on the leading edge of motor milestones, but he's progressing and gaining skills on his own.  His brand new one now (like within last 24 hrs) is getting himself into a sitting position rather than just sitting after someone puts him there.  We still put a pillow behind him though because he occasionally still loses his balance and falls backward from a sit.

I hated doing private PT.  It was annoying spending a $20 copay every week, taking time off work to take him, and all that, and that's even with insurance that covered it pretty generously.  EI would've been so much easier because they could come to daycare.  But at least in DS's case, there was a meaningful value in not having to wait to get services started.  His pedi felt he had an issue at 8w, and 5 days later he was in a PT's office getting help.  I think that had a lot to do with catching up before he would've even qualified for EI.

I have the CDC milestone tracker app on my phone to keep a close eye for DS.  For both he and D, the next time frame is 9m.  It might be worth calling the pedi and asking their thoughts on a PT referral now, which might give you better feedback for whether an EI eval is appropriate right at 9m, if/when she has officially missed a motor milestone.  I felt like our PT was a lot more knowledgable and specific than our pedis about what would qualify for EI, what would indicate a need, etc.  I would worry about what you're describing too, although I have no idea how much of it might be explained by her illness in January, and the "worry" is not like omg something major is wrong, just your average vanilla mom concern.

In any event, I will say -- it was pretty great what a therapist could help DS gain in motor skills, and I'm glad in retrospect that we put so much effort into it.

[shauni27]

I would call and ask to speak to the nurse or pediatrician just to ask follow up questions.

My experience is that EI is always a good choice if offered, but that it is overwhelming and scary and sad to think your kiddo is not meeting milestones or not developing normally (physically or emotionally). I only dealt with this once and my initial reaction was to cry and be overwhelmed and scared, but then I thought about it more and thought of EI as a resource and help with my parenting. We did not end up needing it, but others who have rave about it and see leaps and bounds in development skills in their kiddos.

I am sorry you are dealing with this, friend.

[scm1011]

Thanks, all. I appreciate the info and experience. We're definitely going to get her evaluated, but I think I will follow up with the pedi for more info and potentially a referral to PT. The one time DH brings her for an appt, gah!

Susie, thanks for mentioning that app - I'm downloading now.

[sparkythelawyer]

Feb 19, 2020 11:36:36 GMT -5 Susie said:

We never actually did the EI eval for DS this fall, but had tentatively planned to schedule it at 6m, when we expected he was going to have "officially" missed a motor milestone(s) and would therefore stand a chance at qualifying for services.  We ended up not going through with the eval because he made great gains in private PT between 4-6m.  While he still had some core weakness, he wasn't going to qualify for services because he (just barely) hit the 6m milestones by the time frame.  He's been out of PT for about a month now, and I've been watching like a hawk to see if he continues to progress without therapy, and I think he is.  He'll never be on the leading edge of motor milestones, but he's progressing and gaining skills on his own.  His brand new one now (like within last 24 hrs) is getting himself into a sitting position rather than just sitting after someone puts him there.  We still put a pillow behind him though because he occasionally still loses his balance and falls backward from a sit.

I hated doing private PT.  It was annoying spending a $20 copay every week, taking time off work to take him, and all that, and that's even with insurance that covered it pretty generously.  EI would've been so much easier because they could come to daycare.  But at least in DS's case, there was a meaningful value in not having to wait to get services started.  His pedi felt he had an issue at 8w, and 5 days later he was in a PT's office getting help.  I think that had a lot to do with catching up before he would've even qualified for EI.

I have the CDC milestone tracker app on my phone to keep a close eye for DS.  For both he and D, the next time frame is 9m.  It might be worth calling the pedi and asking their thoughts on a PT referral now, which might give you better feedback for whether an EI eval is appropriate right at 9m, if/when she has officially missed a motor milestone.  I felt like our PT was a lot more knowledgable and specific than our pedis about what would qualify for EI, what would indicate a need, etc.  I would worry about what you're describing too, although I have no idea how much of it might be explained by her illness in January, and the "worry" is not like omg something major is wrong, just your average vanilla mom concern.

In any event, I will say -- it was pretty great what a therapist could help DS gain in motor skills, and I'm glad in retrospect that we put so much effort into it.

Just taking a note to respond to this.

Yes, a lot of EI (and most EI providers in my state also do kids on insurance) will go to daycare.  But a lot of them hate it.  I get the appeal, I'm a working parent.  But it's a provider appointment.  They want to talk to the parents, let the parents know what they're seeing, show the parents what they are doing with the kiddo so that the parents can work on it outside of the session, ask the parents about any changes since previous sessions, etc.

Also?  Lots of daycares don't necessarily have set, private space where a provider can meet with a kid that is still also then supervised by daycare staff.  In my MIL's case, that means she tries to treat a kid only to end up having twelve different two years olds trying to use all of her toys, equipment, climb on her, etc.  She generally will not see kids at daycare anymore because it is just not the best way for meaningful therapy to happen in this age bracket. 

[CloudBee]

Just an FYI that many people say EI is free. In most states it is not. It is processed through your insurance and / or paid for using a sliding income scale. We had to pay around $300 out of pocket each month.

That said, my son was evaluated and received speech services. We had a great experience. The initial eval can (in some cases or regions) take a while to get setup. I urge you to reach out to initiate the process in the event that you need to utilize services. You can always opt out, but you don't want to drag your feet on scheduling an eval if you do in fact need one.

[greenmonkey1]

DS3 is in EI right now and being evaluated for an IEP through the public school district this his 3rd birthday is in April. I highly recommend getting an EI evaluation if you are concerned and especially if your child's pediatrician shares the concerns. If anything to ease your worries and/or get therapy started as soon as available. The evaluation should be free; whether the service is or is not will depend on your location. In my state, the services are free up to a certain number of visits per therapy need (i.e. 54 visits for speech, 54 visits for OT, etc.). After that it goes to insurance. The care coordinator should be very transparent about any costs associated with services. I had to sign a document indicating I understood the cost schedule (which was free in our case).

I didn't have DS2 evaluated until after he turned 3 (for speech) because I convinced myself I was being ridiculous. But I wasn't and he's been in speech therapy almost 3-years now. I wish I had him evaluated earlier because maybe I could have avoided some of the private speech he ended up needing ($300 a session; twice monthly for two years). DH and I will do what we need for our kids, but that cost really put a huge dent in our budget.

So I'd absolutely put in a call to EI and good luck. I'm glad your LO is healthy after what sounds like a horrible month of illness.

[Susie]

Feb 19, 2020 11:59:04 GMT -5 sparkythelawyer said:

Feb 19, 2020 11:36:36 GMT -5 Susie said:

We never actually did the EI eval for DS this fall, but had tentatively planned to schedule it at 6m, when we expected he was going to have "officially" missed a motor milestone(s) and would therefore stand a chance at qualifying for services.  We ended up not going through with the eval because he made great gains in private PT between 4-6m.  While he still had some core weakness, he wasn't going to qualify for services because he (just barely) hit the 6m milestones by the time frame.  He's been out of PT for about a month now, and I've been watching like a hawk to see if he continues to progress without therapy, and I think he is.  He'll never be on the leading edge of motor milestones, but he's progressing and gaining skills on his own.  His brand new one now (like within last 24 hrs) is getting himself into a sitting position rather than just sitting after someone puts him there.  We still put a pillow behind him though because he occasionally still loses his balance and falls backward from a sit.

I hated doing private PT.  It was annoying spending a $20 copay every week, taking time off work to take him, and all that, and that's even with insurance that covered it pretty generously.  EI would've been so much easier because they could come to daycare.  But at least in DS's case, there was a meaningful value in not having to wait to get services started.  His pedi felt he had an issue at 8w, and 5 days later he was in a PT's office getting help.  I think that had a lot to do with catching up before he would've even qualified for EI.

I have the CDC milestone tracker app on my phone to keep a close eye for DS.  For both he and D, the next time frame is 9m.  It might be worth calling the pedi and asking their thoughts on a PT referral now, which might give you better feedback for whether an EI eval is appropriate right at 9m, if/when she has officially missed a motor milestone.  I felt like our PT was a lot more knowledgable and specific than our pedis about what would qualify for EI, what would indicate a need, etc.  I would worry about what you're describing too, although I have no idea how much of it might be explained by her illness in January, and the "worry" is not like omg something major is wrong, just your average vanilla mom concern.

In any event, I will say -- it was pretty great what a therapist could help DS gain in motor skills, and I'm glad in retrospect that we put so much effort into it.

Just taking a note to respond to this.

Yes, a lot of EI (and most EI providers in my state also do kids on insurance) will go to daycare.  But a lot of them hate it.  I get the appeal, I'm a working parent.  But it's a provider appointment.  They want to talk to the parents, let the parents know what they're seeing, show the parents what they are doing with the kiddo so that the parents can work on it outside of the session, ask the parents about any changes since previous sessions, etc.

Also?  Lots of daycares don't necessarily have set, private space where a provider can meet with a kid that is still also then supervised by daycare staff.  In my MIL's case, that means she tries to treat a kid only to end up having twelve different two years olds trying to use all of her toys, equipment, climb on her, etc.  She generally will not see kids at daycare anymore because it is just not the best way for meaningful therapy to happen in this age bracket. 

What question are you responding to?  I didn't have one, so the quote feels like a call out.

My point in my pp was that we recently did private PT to get DS help with motor skills, it was helpful and ultimately worthwhile, but it's not the only option and it had some definite drawbacks.  Every week for my first 5 months back to work after mat leave, I lost 2 hours of work time per appointment.  On top of pumping breaks, two kids' worth of well visits, sick days, etc., it was hard time to free up.  If his therapy was at daycare through EI, I could've walked over, participated in his entire appointment, and been back at my desk in like 45 minutes.  That would've been so much more manageable!  

We might still end up doing that, it depends on his motor development going forward.  His PT warned us that it's possible he could be fine, or he could struggle later with crawling, walking, or other milestones.  It's quite an assumption to suggest that availing myself of the EI option so I could make therapy manageable over a long haul if needed, would mean DS may have a therapist who hates doing his appointments, and/or him having an unmet need for his therapist to "talk to the parents, let the parents know what they're seeing, show the parents what they are doing with the kiddo so that the parents can work on it outside of the session, ask the parents about any changes since previous sessions, etc."  Benefit for him and manageability for me isn't a zero sum game.

Anybody who is doing their best to navigate therapy for their kids has enough worries without adding judgment from other parents for not doing it in a particular way.

[thoseareradishes]

We got E into the EI system around 5 months old because of her extreme prematurity. At least in NJ, the initial screening is free. However, due to our income, services were not free and we ultimately decided to go to a private therapist. She did OT for about 6 weeks (she was around 7 months old), then speech once she was 17 months old. It was all pretty easy, we had a coordinator who did all the paperwork for us, and she worked with the therapists who evaluated E and coordinated with them.

[starburst]

We had DS1 evaluated after his 9 month appointment when he wasn't rolling or even close to crawling. He could sit, but you had to place him in the sitting position; he couldn't get there himself. It took almost two months from when I called to when he started receiving services. In the meantime, we started private PT. He's been receiving PT and OT through the county ever since, transitioning to the preschool age program when he turned 3. He still receives services at 4.5, and his IEP will follow him to kindergarten when he starts in the fall.

In my state, EI is completely free, regardless of income. In addition, you also automatically qualify for medical assistance, which was really great when we were also doing private PT because it paid for all the copays. It also pays for his orthotics.

We've had a really great experience with EI and DS has loved all his therapists.

[suzv]

We got an EI assessment for gross motor for my son at 9 months old. Mainly due to him not sitting unassisted for long periods, rarely rolling in either direction, and showing no signs of being able to crawl. He qualified for PT and we started once a week. He made huge progress in about a month of visits. He was crawling and rolling over within that first month and started walking on his first birthday. The PT alternated weeks at home and at daycare. She still sees him now at almost 13 months, but it’s every other week now. I think we will be finished with it in the next few weeks.

[waverly]

We never did EI, but I wished we had. DS needed OT and PT, and it did require me to take time off work and take him to appointments and was quite expensive. Also, since he was not in EI he was not grandfathered into the school system, so when I contacted the school system they made him wait until he started K for speech services. I did not hear that they went to daycares here. I believe they went to the home sometimes or you met them at the school in our area. Our state it looks like it would have been free for us.

Like anything there are pros and cons. The OT and PT that we did do was at an older age, so he was able to understand and participate more, so that did help. Also, they had a fully equipped gym unlike if they come to your home which makes more sense for older kids as well. DS was 6-7 when he did OT and PT through a private practice.

Many people also do a combination of services, for example sometimes I have heard that there is break in EI or school services in the summer and they do private services then. Part of me wants to take DS back for OT because he has floppy wrists (over extension), but otherwise he is doing OK in school with writing and sensory stuff, so the cost and time off work are definitely barriers here.

[blondemoment123]

EI has worked wonders for DS. I voiced concerns for months with his previous pedi, but was dismissed as “being a young, anxious first time mom”. That, among other reasons, is why I switched pedis.

At the first visit with the new pedi,she knew he was not where other kids his age were. She started the referral process. DS has had genetic testing, MRI, and other tests all covered by the EI program. Having someone tell you that your child is “severely developmentally delayed” is gut wrenching, but seeing his progress is truly amazing.

He sees his EI, SLP, PT and OT weekly and they are fantastic. My son went from not crawling to running. Not speaking more than 2 words to 4 word sentences in about a year of having services.

There were some hiccups of course finding the right therapists, but once there were firm goals made and a plan to reach them that was agreed upon by the EI, therapists, pedi, and the school things have been great.

This novel isn’t what you asked, but I just wanted to say that EI truly does make a difference.

[blondemoment123]

Oh and regarding them going to the daycare, DS’s school has been amazing at accommodating all of his therapies. A floater sits in on the sessions, but they don’t have to.

I get notes sent home and the therapists text me about the visits. Admittedly this took awhile to get them all to do, but as a working mom who can’t attend the weekly sessions it’s needed.

[luv2rn4fun]

DS2 did EI for speech for about 6 months before transitioning to the school district. He made amazing progress, it was super easy (she came to our home), and it was free! Wish we would have done it sooner!

I also wished I would have had DS1 evaluated earlier. He went through the school district and neurologist assessments at his 4 year old appointment when we were still having behavior concerns. This was a year ago and he has been in school district supports for behavior and speech along with private ABA (20 hours per week). He’s making great progress!! But I also kick myself because we could have started it sooner and had services covered more (we changed pediatricians right as things were starting to escalate more so it took time for our pediatrician to really see the concerns). As is, he needs OT but we can’t afford it right now ($25/session).

[jorja]

If the doctor is recommending an evaluation, do the evaluation. It’s not going to hurt and it is essential if there is something going on.

[awkwardpenguin]

We had the experience of doing an EI eval at a young age and not qualifying for services, despite delays. DD was 9 months and only two months behind where she should have been (22% delayed) so she didn't meet the threshold for services, which is 30% in our state. That said, the evaluation process was very helpful in terms of what to look for, giving us some ideas to help her with gross motor and sensory stuff, and knowing when we should call back. DD continued to be just on the edge of needing re-eval/intervention for a while (walked just shy of 16 months, they told us to call back if she wasn't walking by 16 months) but seems caught up now that she's almost 5. In addition, our initial eval helped reassure us that her gross motor stuff wasn't linked to a global developmental delay, so we could take her late milestones more in stride.

[cherryvalance]

Just wanted to chime in, in case you were on the fence. We just did an EI eval for my son, who is 2.5, and I so wish I had done it sooner!

I'm in NJ, so our eval was free and they assured me that if he hadn't qualified, they would have given us strategies to use to help him develop his skills. The evaluators were great (although I'm sure ymmv on that), and it was convenient to have them come to our house. They also assured me that there's no harm in having an evaluation done and it can only benefit the kid if they end up needing services.

I don't know if you wanted an idea of costor of that will even help, but we will be using a sliding scale and insurance for payment, and so far our cost will be $15/session with a max of $400/month. I'm not sure exactly how insurance covers it yet.

Our EI will go wherever you wish, so when we solidify our plan and see how many sessions he qualifies for, we're hoping to have at least 1 at school and 1 at home. A friend recommended the school session (which is appealing anyway because we work) because if your child spends a lot of time there, it's good for them to use that environment to build skills. In our case, DS is speech delayed so they'll work on social communication there. In your case, there might be exercises the caretakers could be learning that will help.

Good luck! I was overwhelmed, anxious, sad and just scared and they have been really fantastic so far.

[grover]

We just went through the EI assessment last month. I am a special education teacher and brought it up at the twins' 6 month appointments but doc said to give it to 9 months. (They were rolling at 6 months but not attempting to sit at all). Sure enough, at their 9 month appointment (3 weeks late), we received a definite referral for Twin B for low muscle tone, and a might as well referral while they are out here assessing his brother for Twin A. Initial eval was free. I did have to take off work for an intake meeting with the coordinator, and then again for the actual therapist assessments a few weeks later. At the end of the assessments, the coordinator showed up. Twin A was borderline and ultimately our choice, so we are holding setting up a plan for him (in the 2.5 weeks between the referral and assessment he mastered both sitting independently and army crawling). Twin B qualified for both Physical Therapy and Developmental Therapy with a 40% deficit (needed at least a 30% deficit to qualify). We're now waiting for insurance to get back to the coordinator about prechecking benefits, and trying to get a set therapy schedule set up with daycare during school year and home during summer. It's looking like regardless of insurance I'll have to pay up to $50 a month. While he hasn't started therapy yet, they just turned 11 months old last week and Twin B is sitting independently!