How to approach the mother of the twin toddlers I babysit about their seeming developmental delay?

Question

I'm a mother of three grown sons and have been a nanny to dozens of children. Last year I started babysitting 3 week old twins. They were only 2 weeks early, but their development is significantly delayed. They are now 15 months old. They neither talk nor walk. Only one (the boy) pulls himself up to stand - using the table or sofa for help.

The parents don't seem concerned and are still feeding them formula and applesauce! I'm getting very uncomfortable about the twins' developmental delay and wish the mother would discuss it with me. She is an older, first time mother (44) and doesn't want to hear anything negative. Am I concerned for nothing? I have raised dozens of children, but this is the first set of twins I've worked with since they were 3 weeks old.

If there was a problem, wouldn't the pediatrician say something to the mother?

Answer 1

My daughter has developmental delays (well, more like outright stopping now) due to her cerebral palsy.

Pediatricians tend to be much more relaxed than parents on the issue of developmental delays. They field several questions from overly worried mothers every day, that almost always turn out to be nothing. The kind of delays you're talking about are relatively rare, but not devastating. Chances are, in a year or two they will be mostly caught up.

To be frank, if they're not ready to hear it, trying to convince someone their children have developmental delays is not very helpful. I don't fully understand why, but for mothers especially it usually involves feeling like you've failed somehow at your most primitive biological duty, and that can be hard to accept.

Alternately, if they have accepted it as their own version of "normal," it tends to come across like telling someone, "Did you know if you were taller you could reach that more easily?"

What is helpful is providing strategies for what to do about the specific issues. For example, "I taught him sign language for 'eat' to help me know better what he wanted." Or, "I put their favorite toy on the couch and it helped them practice pulling themselves up." Or, "I read about an interesting way to help babies learn to chew solid food without choking. Do you mind if I try it today?" Or, "I found out our state has a free early intervention program to help kids who aren't walking by 18 months. Might be worth checking out."

Answer 2

Unasked-for advice is tricky. No one can see what you see and know the parents like you do.

If you really believe the twins are delayed developmentally, I personally feel it's not only ok but ethically responsible to approach the parents, but not with just your dis-ease about the situation.

I would suggest that you start by doing some solid research. Find out everything you can (it's pretty easy) about developmental milestones, such as speech and walking. If you're going to mention their diets, research that as well. It's completely possible that the parents just don't know much about how babies are supposed to progress, and aren't concerned enough about it to compare their kids to others. It's also possible that you'll learn they aren't that far off the charts.

Armed with facts gleaned from multiple reliable sources (if you're still concerned after your research), ask the mom if you can discuss some concerns you have with her (or, alternately, both of them). Just tell the truth, but make it about yourself, not them.

This is just my fallible opinion, but I'd approach it something like this:

• I'm sorry to be so dramatic, but I'm feeling a bit uncomfortable about (baby x) and (baby y). In my limited experience, most babies (cruise, say their first words, dance the cha-cha) by now. I didn't want to overreact, so I looked at a few pediatric websites. I hope you don't mind. I did find (this) on (these websites). I would be so relieved if maybe you could run this by their pediatrician on their next visit? (They should have a 15 or an 18 month check coming up.) I wouldn't feel right about myself if I didn't bring it up.

What I would not say:

• I'm concerned that (baby x) and (baby y) aren't (cruising, saying their first words, dancing the cha-cha) yet. I've taken care of a lot of kids, and I think they're significantly behind on their milestones. I don't know (Dr. Doofus) but I can't understand why s/he hasn't said anything about it to you.

The first is putting a bug in their ear, showing empathy for the concern you might be causing them, and is in keeping with your respective roles. And you can occasionally feed the bug if at first you don't succeed.

The latter, while it's straightforward and true, is a lot to give people suddenly. When people are anxious (which they will be as soon as you get it out), they have a natural tendency not to hear what you're saying and sometimes to react emotionally, not reasonably.*

Whatever you decide, I hope it works out for the best. I think it's great that you care enough to bring it here.

*_{I've learned this the hard way early and repeatedly.}

Answer 3

Just for completeness - you also need to see if it's just the speech, or many other developmental markers.

The reason is that - as I was told by many pediatricians - twins tend to exibit major developmental delays specifically in their speech because of the existence of the twin - the communicate non-verbally and thus experience less need to learn to talk. I don't have research to back that up but heard it about many twin pairs, both from parents and pediatricians.