10/14/2013

Developmental Delays in Type 1 Toddlers?

Correlation Between Developmental Delays and Type 1 Diabetes in Toddlers?


     Although I can find no research either way, and our Endocrinologist says not, I would like to state that I unequivocally think that diabetes caused a speech delay in my daughter. She was diagnosed at 22 months, but started sliding downhill in the 20th month. She was always a little behind on the clarity of speech and number of words but was very active. She mastered the motor skills at early intervals. But at 20 months, she should have been making rapid gains in language skills. And she lagged. And lagged. Then I notice she started not wanting to come down the steps from our second floor to the first. I had to carry her every time. Not normal. This continued for months. I thought maybe she had developed a fear of the stairs due to some unknown reason.  

 
     After her diagnosis (on a Saturday), she was treated for DKA and her blood glucose levels were brought down. That following Monday, she gained more words in one day than she had managed to learn in the past three months. Suspicious, that’s what I call it. When you go from one word per month to three in one day? Immediately following receiving the insulin that your body needs? For a quick refresher, glucose is what the body breaks down for energy. Energy allows you to perform both physically AND mentally. IMO, if you have high energy needs physically, there is going to be less available for mental. She is a high energy kid. So the insulin wasn’t there to break down the glucose, meaning less glucose was available to support her activities. The body goes on survival mode and will keep supplying the glucose to the physical energy needs, leaving the learning (ie: mental) needs lacking. She simply didn’t have enough energy to supply her little brain the tools it needed to grow and thrive. Thus, she wasn’t learning new words. Then even her activity levels started dropping. Then the downward slope into real diabetes symptoms and finally DKA. Therefore, she got the insulin in the hospital, which broke down the glucose needed for her brain to learn new things, and poof, within no time at all she was learning new stuff.
 
     I am not a medical doctor or researcher, but I have enough analytical experience to recognize patterns and put two and two together. I also have an undergrad degree in clinical psychology, which includes lots of statistical/research courses. It is a tough area to have science backing me up on, because of the age of onset being so young that there are not a lot of kids to study but I would bet (HEAR ME OUT RESEARCHERS), that if they were to aim a focused study at developmental learning in this age range it would show a correlation between the two (type 1 diabetes onset and delay in speech/learning). I currently have her being assessed by a Developmental Assessor for a state program (through IDEA) and she agreed that there was a high likelihood of the two being related. If your brain is foggy from a high or low, how much harder would it be to take in new things and retain them?


A FEW UPDATES (JULY 2014):
1. Researchers have now shown a link between DKA and brain changes in children. They followed them for 6 months and found that DKA correlates to instances of brain change in children. Diabetes Care vol. 37 no. 6 1554-1562. 
Again, I say that it is possible that delays are occurring before DKA.

2. After completing 6 months of home-based speech therapy, DD was evaluated by our local school district for an ESSS program designed for delayed 3 year olds where they are integrated with "normal" 4-5 year olds in the VPK program. She showed significant delay in expressive language and some delays in cognitive behaviors. They recommended classroom therapy for up to VPK's full-time schedule (pending parent concerns), as well as 90 minutes of speech and language therapy per week. We were terrified at this prospect, but at her IEP meeting, it was determined that she would have a 1:1 nurse assigned to her. Since registering for school, we also set-up Nightscout, where we are able to remotely view her Dexcom! (More on this in another post.)

3. As of 3 years, 3 months, she is doing better but still far behind her peers (as my 4 year old cousin stated, "Why doesn't she know how to talk yet?"). She mainly has a go-to cache of words and spontaneous sentences are still rare, so although she is very vocal, it's a lot of the same words or pre-learned sentences. If someone asks her any question, she always answers with "I'm Kayla". So it is still a work in progress....

3 comments:

  1. Wow, this is so similar to my situation! My daughter was diagnosed one month ago at 19 months. Since she was about 16 months, I felt she was possibly a bit behind in language. In the last month since diagnosis she has gained SO many new words and it started happening days after diagnosis. What kind of speech therapy at home did you do and what age did you start? I'm LOVING your blog and reading every. single. post. Thank you.

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    1. We had her evaluated through our state's Early Intervention program, and after qualifying, they sent a speech therapist to the home. From what I can remember, she seemed to do well on with receptive language, meaning she understood what we were saying but couldn't communicate it back to us. She also had some minor developmental delays. The speech therapist did "floor play" with her. At 3 they age out of home based therapy (the free one through Early Intervention at least) and she was assessed through the school district. She was approved and ultimately went into the ESSS program, basically the special needs portion of the school. Our school allowed her to basically go into a VPK class part-time even though she was 3. So she got to interact daily with slightly older kids, plus 3x/week speech therapy. Once she turned 4 and was "supposed" to be in VPK, we did FT and upped her to 4x/week therapy. Now going into Kindergarten, she will go back down to 3x/week and have a specialist come into the class at least 1x/week to make sure she isn't falling behind due to missing class for diabetes related items. They've also dropped her developmental delay designation. I'm so pleased you like the blog!!

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    2. I forgot to add, she started speech around 30 months but could have been evaluated earlier, however the intervention program had a huge wait to be evaluated. I'd absolutely say I'm glad I ignored the pediatricians advice to wait it out for a bit (I went after the evaluation directly). The earlier they start speech, the easier they can catch up.

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