We have completed our program of appointments at UCLA and have an "answer" and a direction for the future for Luke.

The short "answer" is that Luke has global developmental delay and that the treatment for this is to get speech therapy, occupational therapy and go to a special preschool.

The doctors did not find any physiological cause for Luke's growth problems in their testing. Because he grew two inches last year and tested over the passing level for growth hormone, the endocrinologist wants to wait another year to evaluate his progress. We didn't revisit the gastroenterology side because extensive workups had been done previously without showing anything abnormal. The neurologist said that he couldn't see anything special from Luke's CT, MRI and EEG scans and referred him to a child psychiatrist.

This doctor said that Luke is clearly not autistic (an autistic child shows delay in one or two areas, esp. social, whereas Luke is delayed in all areas including physical growth). She recommends Luke go to a special preschool where trained workers can give him individual attention and help him to develop. This doctor is from Israel and says that the special preschools in Israel are better than those in CA, however they are usually in Hebrew which is not ideal for a child like Luke.

She referred us to a child development doctor who confirmed the earlier analysis and gave us the term "global developmental delay" to describe Luke's condition. She says she has seen lots of children similar to Luke and with no apparent physical cause. Luke's delay is "global" which means in all areas - speech, fine and gross motor movement, social and problem solving. The doctor evaluated Luke as being at the level of an average 2 to 2 and a half year old (he is almost 3 and a half now). She also recommends therapists and special preschool for Luke. She says it's impossible to tell what this could mean for Luke long-term.

We have reason to be encouraged. We've watched Luke continue to develop a good deal this summer. He is talking more and expressing more advanced ideas ("Daddy...go...hike...mountain...Luke...go). He is still small (20.5 lbs buck naked this morning), but his appetite has been better the last month. In the area of listening and learning, we think we see progress as well.

Our plans are to return to Israel after the birth of our third child (ultrasound this morning shows a 7 lb. happy kid correctly positioned), due Aug 26. Then we'll seek out some specialists to help Luke - specifically a language therapist (native American English speaker, possibly we can find one in the next town over from us), an occupational therapist (this is someone who works with his motor movement, helps him to learn to dress himself, etc.), and a special preschool. I expect the last to be the most difficult. They have good ones but they're in Hebrew and they're also probably distant from where we live and driving into Jerusalem on a regular basis to drop off and pick up is an unhappy prospect. We'll also continue to monitor Luke's physical growth for possible future growth hormone testing.

A few specific ways you can pray for us and Luke:

1. That Luke's physical and developmental growth would increase (ultimately to being "caught up")

2. That we can find the best therapists and program for Luke - best in terms of what's helpful to him, and affordable and logistically feasible for us

3. That if there are other medical tests that we should be doing that these would be brought to our attention (UCLA tells us now we've done all we can). I'll be searching out resources on the Internet to see if we can learn more about similar children and things we can do.