Developmental Evaluation Clinic

Patient Story

Ryan is a cheerful young girl who does well in school and gets along delightfully with her two brothers and new baby sister. Her positive outcome would have been difficult to predict given her early history.

She was born full-term but did not have prenatal care and had been exposed to cocaine during her biological mother's pregnancy. Ryan had significant drug withdrawal during her first weeks of life. She was removed from parental custody, and at 3 weeks of age, was placed in foster care with her foster mother, Willie. Willie fell in love with Ryan immediately and knew she wanted to be her mom. She hoped that she could adopt Ryan or become her legal guardian.

Willie knew that Ryan was a baby at high-risk and wanted to be certain that Ryan would be closely observed for any signs of developmental or behavioral problems. Dr. James Wilkes saw Ryan at 8 months of age for a developmental evaluation at the Developmental Evaluation Clinic and found some stiffness in her lower extremities. Fortunately, Ryan did not show significant developmental delays at that time, but there was clearly a need for continued monitoring of her progress.

By 17 months of age, as Ryan's development unfolded, there were signs of more significant problems. Dr. Wilkes found Ryan to be exhibiting some problems with attention and high activity level and found her to be progressing at a slower than normal pace for her age. He referred Ryan to the California Early Start Program for early intervention services addressing Ryan's developmental and behavioral delays.

At 24 months of age, a developmental follow-up evaluation by Dr. Wilkes revealed the emergence of more significant developmental problems with delays in many areas. Ryan was referred to a center based special education program and speech therapy.

Willie remained faithfully committed to Ryan's progress despite increasing challenges, and she continued to follow through with all referrals for services. By the time Ryan was 3, there were signs that the early intervention was beginning to make a difference. She returned to the Developmental Evaluation Clinic where Ryan's performance on the developmental assessment showed dramatic improvement, with her skills now approaching age level. Dr. Wilkes recommended a regular preschool program to help Ryan prepare for kindergarten with continued outside help focusing on behavior. Ryan was at times aggressive, particularly toward her younger brothers, and needed some short-term psychological treatment at Rady Children's Outpatient Psychiatry Department.

After Ryan reached 5 years of age, she again returned to Dr. Wilkes for a follow-up assessment. By then, Willie had legally adopted Ryan. She believed that Ryan was showing improvement but wanted thorough developmental testing to identify any weaknesses and to ensure Ryan was ready for kindergarten.

The evaluation revealed some exciting news. Ryan had continued over the previous 24 months to make dramatic gains in all developmental and behavioral areas and was now showing readiness for regular kindergarten!

Willie volunteered to share this information with others and now describes her daughter Ryan as a happy, affectionate child who is doing well in school.