Is this normal toddler Development, hypotonia or Sensory Issues?

3under3

Pls. HELP. We appreciate you taking time to read and answer! We have a beautifully bright 3 year old soon to be 4 in Oct. I recently scheduled an apt. w/ her pediatrician as a few odd things her father and I have noticed in her development. Also our other daughterâ speech therapist made a comment a month ago as to which daughter she needs to be seeing as it seems that our daughter in question has many oral motor issues. Another event that transpired this trip to the pediatricians is: we were at the store and as usual, she fussed about sitting on the bench seat-shopping cart. She did however and when I went to move the cart (not jerking just as I had the entire time) she fell off the bench not once but twice She fussed about getting back on and I asked her to sit back in the seat like her sister. She lost it and started to cry and say that âI just canât sit like that!!!!!!!!!!!!! I canâtâ I immediately had a light bulb momentâ¦all this time I thought she was being courageous (another positive form of defiant) in other areas as well see list below. She went on to tell me âI know I will hold the safety bar the hole time.â You what she did. I do not like to let her walk because she holds on to the cart so tightly that I am fighting against her pull and yet I still have to push the other two kids and the load of groceries. As we all know it is only a matter of time before things get ugly so I must get in and get out.
We have been working with her to ride her trike a challenge and she tantrums every time we even bring the idea up. At the beginning of summer, we placed elastic bands on the pedals for her feet as she could not pedal the bike per advisement of my other daughterâs Occupational Therapist. This helped although she cannot get her feet inside the bands by herself and it is almost as if you are fighting her legs and her feet to get them in there. She wears a helmet, elbow and kneepads. Any sort of slightly uneven surface and she falls. Also, the other day I was walking behind her on flat and level surface (not uphill) and I blinked and the trike was flipped handlebars and seat on the ground. She was laying 5 or 6 feet away on her stomach and earth shattering screaming. I immediately went over; consoled her, got her calmed down, and treated her scraps. The next day the same exact thing happened. I am completely bewildered by this and wonder why she does not try to brace her fall? Just today she was out with a sitter, tripped over her own two feet, and completely scraped up the side of her stomach, arms, legs, and cheek. The babysitter said it was as if she tripped on air she still does not understand how this happened. The babysitter commented that she landed face down and thought that it was odd as she falls a lot.
Yes I know toddlers have grey areas of development and perhaps odd behaviors but my husband and I are concerned as we made this list together and are overwhelmed with the things that bother her. Pls. read the list and determine in your opinion is this normal toddler development? We DO NOT want to turn a molehill into a mountain but would rather be proactive than do nothing. Thanks!!!
Note: Her brother has hypotonia does that run in the family? The events or concerns listed have happened more than a few times so much so that we are concerned and we feel do not have to do w/ lack of sleep or discipline. We strongly believe in setting our kids up for success and will go the extra mile to do so and believe that we must be as positive as possible in our words and our actions. We do not discuss their weaknesses in front of them as they are all under 6 hence we are concerned about this peds. apt. and how she will feel while we discuss these issues in front of her. Any thoughts on that?
Gross Motor
-W sitting
-much encouragement to learn to and continue to ride trike
-flipping herself and trike several times
-any sort of slightly uneven concrete she falls off bike
-elastic bands to place feet in
-no one can get near her when riding bike except (mommy, daddy or nana)especially not other kidsâ¦I think for fear they may make her fall
-fighting legs when putting on shoes, socks or pants
-fighting her legs to put pants
-she cannot take off a shirt by herself
-struggles to get on underwear or pants and pull them up. Difficulty w/ thumb grasp to pull-up pants.
-falling off bench seat on shopping cart (does not like to ride on it) told me one day that she cannot sit well on the bench and has to always hold the safety bar in front).
-Peculiar way of holding hands/wrist when engaging in conversation or telling a story so much so that many people make a comment about her hands.
-peculiar way of holding hands down from wrist at times they seem to dangle
-peculiar way of holding right arm out for balance her arm makes the letter L shape while the left arm is held in real tight w/ hands bent down at wristâ¦we are noticing this more and more frequently
-cannot and will no
-cannot and will not learn to ride scooter
-does not enjoy to play soccer at the field will say mom âIâll watch you playâ
-pants are always falling down her bottom is always hanging out and she says she does not feel it and struggles to use her thumbs to pull up her pants. She always says she cannot. I always tell her there is no such thing as I cannot itâs Iâll try.
-buttoning or unzipping her pants she cannot do.
-I have never seen her pump her legs on the swing
-Would prefer to talk her way through anything as opposed to actually doing it.
-extreme force when picking up a glass with little in it almost as if her motor planning is off.
- seems to tire easily after riding her bike 6 houses or walking 6 houses she has to take a bike regardless of time of day.
-does not enjoy hugs, kisses or close contact and runs when family members near her to do so especially guests.
-prefers to kiss peoples arms if she must engage in affection
-difficulty sitting still when dressing wash
-runs into things a lot uncoordinated
-does not brace her falls or try to protect herself when she falls.
Expressive Speech/Oral Motor Development
-Large vocabulary
-50% or less others can understand her
-Since Sept. we have been working on drinking from a cup and every meal she spills from her mouth insists on wearing bib because she knows she will dribble.
-refers to herself in 3rd person and we constantly encourage her to use I
-when place room temperature cool whip on her upper lip she cannot lick it away or anywhere in close proximity to her tongue she cannot lick it away.
-it took since Sept to get her to form her lips to kiss
-blowing bubbles/kazoo/flute is difficult as she struggles w/ blowing
-will not eat cold things ice cream, popsicles, etc.
-recently started smacking her cheeks and saying just give me my favorite things I cannot say what I want.

Other
-Does not like wind in face in the car
-does not like water from spray bottle or bath or shower on her hea
-does not like water from spray bottle or bath or shower on her head or body/sprinkler too. We reward allot for good behavior if she does not tantrum which does not always happen.
-difficulty unwinding to get to sleep
-does not like loud noises
-tantrums when hair starts to touch her shoulders said she just does not like it. So we keep it short and cut it every three months and she sits perfectly to get it cut but nearly looses it when the spray bottle comes out.
-unexpected events or routine broken she encounters much difficultyâ¦she has to talk out all situations prior to engaging the night before we found this the best solution to the problem however as life is not always planned it does not always work that way.
-tantrums during most transitions
-worries about which classroom she will be in for her tot class and discusses it the night before and practically the entire way to class
-worries about what craft we will complete or what color shirt her teacher will wear.
-litera
-literally goes into a knock down tantrum when she has to have her nails cutâ¦we have never cut her. We reward if she does not tantrum, which has never happened. Our other children are not bothered by getting their nails clipped.
-Will only drink water or soy vanilla milk (one brand)
-is a thumb sucker so much so that last month she had an infection growing underneath her nail and she sucks it so hard that there is a permanent indentation in the nail.
-must have blanket at home and we only allow it in the car. It never leaves the car. To aide in comfort during outings as we noticed this slightly eases the times spent out of the house.
Forgot to add we let her walk now in stores regardless of the tight pull on the cart as this is what is best for her.

Answer
You are right....this IS NOT normal toddler development. I have a son just a tiny bit older ( 4 the first week in November) and he has none of these issues and he DOES have verbal apraxia and a little bit of sensory dysfunction too. Some of it DOES sound like my older son who is on the autism spectrum. I believe your child has some sort of apraxia. Kids with apraxia can drool, have articulation problems, have oral aversions, crave oral stimulation and be unable to move thier tongue around effectively. My younger son has very limited vertical and lateral tongue movement, likes strong tastes, and has articulation issues.

What I want you to do is go buy a copy of a book called "the out of sync child" by Carol Stock Kranowitz and literally read it with a highlighter. Highlight anything that sounds like your daughter. I suspect that you will have an "ah ha" moment before you are half way through it. I also want you to get a speech evaluation done for her. AT her age she should be about 75%+ intelligable to strangers. Tell the SLP that you suspect that your daughter has some form of apraxia. Also tell her about the feeding issues and lack of tongue movement you have noticed.

If you are in the US, contact your local elementary school and ask to speak to whoever is in charge of the special needs preschool program. Under the federal law called IDEA ( individuals with disabilities education act) the school must evaluate her for free to rule out a disability. IMO she would qualify for an IEP ( individual education plan) definately based on speech, and probably for OT/PT too. In my district if a child qualifies for an IEP, they also qualify for a grant through the board of developmental disabilities. My younger son uses his for addtional private speech therapy and for speech therapy tools.

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