Layout Image
  • Home
  • About
  • Contact
  • Quilts

Archive for Early Intervention

Ending the lockout

By Goddess in Progress · Comments (10)·   December 15th, 2011

For the last six weeks, Ellie has been on strike during her weekly physical therapy appointments. Oh sure, she would seem agreeable enough with her big smiles and blowing raspberries.  But rolling over? Which she is perfectly capable of doing? No thanks. Grabbing toys? No interest. Nada.

It got to the point that going to the appointments was almost embarrassing. “I swear, she really does roll over at home. She does… you know… touch things from time to time instead of weirdly recoiling her hand when you try to give her something.”

We had really been spoiled. For the first four or five months of PT, there was noticeable improvement virtually every single week. Either she’d be doing something altogether new, or would be steadier and stronger at a previous skill.  Halloween came along, and Ellie decided it was time to take a little break.

Phyiscal Therapy

She wasn’t going backwards, exactly. In reality, it was clearly just a plateau. Normal. To be expected, even, after making so much progress. But with a baby who is already delayed, it’s frustrating when you stop seeing progress you’ve gotten used to. It’s hard not to get anxious over it.

Thankfully, in the last week, Ellie seems to be picking up the developmental pace once again.  Sitting up even steadier than before, and finally starting to use her hands to grab a toy or stuffed animal, instead of just using them to prop herself upright. In fact, not only will she pick up the rings from the floor in front of her, but she’ll transfer them to the other hand, AND put them in her mouth! Fine motor, cognition, and oral de-sensitizing, all in one easy toy!

Phyiscal Therapy

The fine motor stuff was starting to worry me, but I’m happy to say there’s been a noticeable improvement recently. Lots more grabbing and reaching, and suddenly in love with one of those four-key piano toys from my mother-in-law. She was even kind enough to show off for both the physical therapist AND the early intervention therapist this week. Everyone is thrilled to have her back with the program.

Phyiscal Therapy

Even the feeding therapy stuff has been going a little better. She likes to explore those teething biscuit cookies, and lets me poke around her mouth with this textured brush we use to try to tone down her gag reflex.  They’re small steps, but good ones for us.

Though I knew on a logical level that a plateau in her progress was totally normal and shouldn’t be worrisome, waiting for new skills to show up was really stressful and had me feeling quite discouraged. On an average day, I am only just holding the worry at bay, so it doesn’t take much to push me over the edge.  Seeing her master new tricks again? Suddenly all feels right in the world.

Comments (10)
Categories : Child Development, Infants
Tags : Early Intervention, feeding therapy, Fine motor, Gross motor, occupational therapy, physical therapy

Ellie, 9 months

By Goddess in Progress · Comments (10)·   November 28th, 2011

I have a particular gift for dates. I can remember the date I saw U2 when I was a freshman in high school, the date of my college graduation, and plenty of other random things. I remember a lot of birthdays. Well, sort of. I can tell you someone’s birthday, no problem. I remember the several days ahead of time that it’s coming.  And then the actual day arrives and I completely forget until two or three days later.  Such was Ellie’s nine-month birthday. Totally knew it was coming, totally forgot on the day of (last Friday, for the record).

Anyways, my sweet girl is now nine whole months old. Three-quarters of the way to her first birthday. We’ve just had her nine-month pediatrician visit and her semi-annual Early Intervention evaluation, so I’ve got a pretty good picture of where she stands.

Nine Months

As for the vitals, she’s about 17lb12oz, and 25.5″. That remains a perfectly average weight and a WAY BELOW AVERAGE length. Short and squishy, that’s my girl.  Lucky thing got four shots this morning. It was supposed to be three, but the ancient pediatrician accidentally gave her HepA instead of HepB, so she got them both. When is my regular pediatrician coming back from maternity leave, again?!

EI re-evaluates kids every six months to make sure they still qualify for services (the child has to show at least a 30% delay in one or more areas to qualify). Ellie qualifies automatically based on feeding alone.  They scored her at “0 months / newborn” in the area of “self care,” which is entirely feeding at this age.  Frankly, they’d probably give her a negative score if they could. She eats nothing. She wants to eat nothing. She gags on everything. The feeding specialist we see through the hospital is visibly disappointed by her total lack of progress, and has proclaimed Ellie a “tough nut to crack.”

Feeding therapy sucks. I literally dab my pinky finger in the smallest amount of baby food you could imagine, and try to get Ellie to let me put it near her mouth, on her lips, or even just barely inside her mouth. Sometimes it’s borderline acceptable. And then sometimes it touches her tongue the wrong way and we have a two-minute gagging fit. It is so, so demoralizing.  But we have to keep trying to walk the very fine tightrope of gently pushing her to try to get her used it it and to tame the gag reflex, while not going too far or too fast and creating/strengthening an aversion that will set us back several more months. It’s awful. I hate it. Period.

Nine Months

Gross motor skills scored at 5 months. On the one hand, Ellie’s sitting is getting very good. She’s rolling back and forth quite a bit, especially at naptime. She has even (after the evaluation, of course) started to get herself from sitting, down to her belly, then rolled over onto her back. It’s not terribly graceful and usually involves a slow faceplant, but it does seem to be quite intentional.  She still lacks a lot of strength in her arms, and puts very little weight on her legs. Much work yet to be done here.

Nine Months

Fine motor skills were even lower at 3 months. That might be a little low, in my opinion, but regardless, she still needs a lot of work. One problem we’re having is that she is not terribly motivated by toys, so trying to entice her to grab something is very hard. Her own toes? No problem. Your face? For sure. Bright shiny baby toy? Meh.  She is a lot more likely to grab things and play with them if she’s reclined or supported while sitting. When she’s sitting on her own, it seems like she’s using all of her energy to keep upright, nothing left for those little fingers.

Cognition was placed at 7 months, and the evaluator even wondered if it would have been higher if her fine motor skills were better. Some of the things they look for the baby to do to demonstrate understanding involves using their hands to manipulate objects. So it’s not necessarily that Ellie didn’t understand something, but potentially that she just didn’t have the fine motor skills to act on it. Regardless, I’m very happy that she falls with a fairly normal range on this one.

Receptive and expressive language were at 5 and 7 months.  She makes a lot of different sounds, consonants and pitch and range and all of that, which is excellent. She doesn’t consistently respond to her own name, though.

And finally, social and emotional development. Clearly, she is Daniel’s sister – they scored her at 10 months.  I couldn’t tell you exactly what it is she does that makes her a social overachiever, but she is most definitely an interactive baby. She loves to smile at people, loves to have company, loves to be entertained.

Nine Months

Feeding crap aside, I am really happy with all of this. I am especially thrilled that, at least for now, her cognition, language, and social skills are reasonably within the normal range. Every delay has its challenges, for sure. But the fact that she is so sociable, the fact that she seems to be making strides toward communication… well, that makes the rest of it downright bearable if you ask me.  Motor skills I can work with. We can practice, we can strengthen, we can adapt. That spark in the eyes? That seems harder to cultivate, harder to compensate for.

Maybe I’m way off base, I have no idea. All I know is what I’ve got, and I am so glad that my girl has plenty of spark.

Comments (10)
Categories : Birthdays, Child Development, Infants
Tags : cognitive development, developmental delays, Early Intervention, feeding therapy, Fine motor, Gross motor, NaBloPoMo, Social/emotional development

See, I knew he was a genius

By Goddess in Progress · Comments (11)·   March 3rd, 2009

This morning, we hosted three lovely folks from Early Intervention.  For anyone out there who is not familiar with EI, it’s a pretty awesome thing.  Basically, if you or your pediatrician have concerns about your infant or toddler’s developent from birth through age 3, you can request an evaluation.  They will send out a team (developmental specialists, occupational therapists, and the like) and do a complete evaluation on your child.  That means, if you call because you’re worried about speech, they’ll evaluate your child for fine and gross motor, too.  The eval is free, they billed my insurance.  And if you qualify for services (generally by showing a 30% delay in one or more areas), they’ll send someone to the house to work with your child.  A win-win situation, if you ask me!

Anyways, I called about Daniel.  I had a very odd, specific concern.  Basically, he still drools what seems like an awful lot (though, of course, it slowed down noticeably once I made the call a few weeks ago!).  And he has some difficulty chewing certain foods.  In particular, ones that you can’t just easily mash, but have to really break down with your teeth.  Crackers are no problem, nor are most kinds of fruit.  It’s not that he dislikes crunchy things or smooth things.  But with, say, a piece of tortellini… he’s most likely to mash it up in his mouth (getting out the yummy filling) and then spit out the actual pasta if it’s even the slightest bit al dente.  And it’s not a question of dislike.  He’ll ask for more tortellini (or clementine wedge, or grape, etc.).  And he eats a reasonable amount of food, is gaining weight, etc etc.  It’s not a huge problem, and I honestly suspected that we probably would not qualify for EI services.  But I just wanted it to get checked out and maybe get some suggestions for how to work on it.

So, three women came to my house this morning.  All very friendly, all fairly young.  Basically, two of them played with Daniel while the third asked me some health history-type questions.  It was fascinating to watch.  Each toy or object they’d bring out of the bag was designed to get at a particular behavior.  See if he’d do pretend play, model behavior, stack blocks, match shapes.  As far as he was concerned, of course, he was just playing with these nice new people.  He was his usual charming, sociable, talkative self.  There were a few things when they would ask him a question, and I had to stop myself from chiming in “c’mon, buddy, you know that one!”  Especially when it’s something he most definitely knows/understands/is capable of.  But he’s a toddler, and sometimes he’s just going to elect not to participate.  And you can tell those times, because he gives you the Daniel face.  It looks something like this, but with a bit more brow furrowing:

The D Face

Oh, and when it came time to check on his chewing? I gave him some clementine for a snack, which he always mashes and then spits out.  Except when the nice lady is there watching him.  Then he swallows segment after segment.  Show-off.  Way to make mommy feel silly.

At any rate, at the end of the eval, they will let you know how your child did, basically scoring them at a particular number of months for each developmental area.  So, if he were scoring right on target, that would be 19 months.  He would have to score at 14 months or below to qualify for services.  How did he do?

Gross and Fine Motor Skills: 19 months

Spoken language: 20 months

Receptive (understanding) language: 22 months

Cognition and problem-solving: 24 months

Social interaction: 26 months

Oh, and the feeding/chewing is under the umbrella of “self-care,” where he scored… 19 months.  She did notice the drooling, and said that he does show a little bit of low muscle tone in the lip area, which usually would lead to speech concerns. Not with my chatterbox.  She suggested having him use a straw (which he already does), and try sucking thicker things like yogurt or smoothies.  Also blowing raspberries, buzzing your lips, and trying to blow bubbles are all good for that kind of muscle tone.  For things specific to food, she suggested that we try to work on more foods with mixed textures, which is where he seems to have a hard time.  So try dipping things, like fruit in yogurt or cracker in hummus, or even try eating things like soup that have more than one texture in the same bite.

Yeah.  Basically, my kid rocks.  Obviously, as his mother, I have long suspected it.  But nice to have outside confirmation. :-)   He did particularly well on imitating unfamiliar sounds (zoop! zip!), finding a hidden toy in several different variations, and grouping similar objects together.  He showed good understanding of basic shape puzzles, even if he couldn’t quite get the triangle to fit properly, and did a great job labeling familiar objects with the correct word.  I’m so proud.

All of this is not entirely just to brag about my own kid (though, it’s my blog, so I can do that), but also to say that getting evaluated by Early Intervention was a really good experience.  The people were nice and great with the kids, and gave immediate and helpful feedback even though we didn’t qualify for any ongoing services or therapies.  Birth to age three, people.  If you have any worries, use it!

Comments (11)
Categories : Child Development, Feeding, Toddlers
Tags : cognitive development, Early Intervention, Fine motor, Gross motor, language development, Social/emotional development

Eighteen Months

By Goddess in Progress · Comments (8)·   February 3rd, 2009

A year and a half.  Six months until TWO!  As always seems the case, it’s incredible how time flies.  And for once, we actually had their well-child checkup on their actual “birthday,” so I have both stats and stories for updating.

Daniel, my big Baby A, is just shy of 25 pounds (24lb 14.5oz).  But the pediatrician was onto something when she commented that he looked leaner. Apparently much of Daniel’s growth has been vertical, as he grew nearly two inches in the last three months, up to around 32″ tall.  That puts him right at about the 40th percentile for weight, and 50th for height.

Daniel 18 months

Daniel has become quite outgoing and friendly, and showed that right from the get-go when he walked up to our doctor and asked her to pick him up.  He says “hi” to everyone he sees, and frequently will repeat it until that person says “hi” back.  He loved showing off the words he knows, the list of which is up past 30 now.  He proudly pointed to his nose, eyes, and ears, and to mommy, daddy, and Rebecca (or, in Daniel-speak, “Nee-nee”).  Everything else checked out well, and the doctor pronounced him healthy and an absolute genius.  OK, so maybe I’m paraphrasing.

Daniel 18 months

One of the very few concerns we have with Daniel is his drooling. He’s been a drool-monster forever, but I feel like he’s starting to approach an age where maybe he shouldn’t be going through 2-3 shirts every day, simply due to drool. (Mealtime messes not included.)  Our doctor said the drool itself isn’t inherently a very bad thing, except if it seems to interfere with language (which it does not, Daniel’s words are reasonably clear for a kid his age), or if there also seems to be an issue with chewing food.  Ding Ding! Aha!  That was the next question on my list. Daniel has a weird thing where he doesn’t seem to chew very well, despite having a full set of 16 teeth.  The doctor was not terribly concerned, but suggested we could always get an evaluation from Early Intervention to see if he qualifies for a little occupational therapy.  I think I’ll give them a call, just in case.  Either it’ll be nothing at all and I’ll be reassured, or he’ll qualify for and start receiving services. It’s a no-lose situation, I feel.

My little peanut Rebecca does not appear to have suffered for all the times she seems to skip meals entirely.  In fact, she put on a bit more than a pound and a half to reach 20lb 10oz.  Woo, 6th percentile! The measurements would suggest that she only grew about a quarter of an inch in height, but she had no interest whatsoever in sitting still, so about 30″ was just a best guess.  It only puts her at about the 10th percentile for height, which I think underestimates things just a little.

Rebecca 18 months

Rebecca has been extremely wary of strangers the last couple of months. If she knows you or is comfortable, she’s very independent and outgoing, and will happily get a book, shove it in my sister-in-law’s boyfriend’s hands, and climb up into his lap so he’ll read it to her.  But if she’s feeling uncertain or doesn’t remember who you are… she’ll give you the stink-eye, big time.  She had no interest in speaking to, or even looking at, the doctor.  She only wanted to cling to me or M, and screamed bloody murder when so much as approached with the stethoscope (not unlike the barrette fiasco).  It was hard to get accurate measurements as she was so busy screaming as though we were about to poke out her eyes with a sharp stick.  Oh my lord, does that girl have the capability for absolute rage.  Ever since she was a newborn.  Quiet, calm, and then red-faced in anger.

Rebecca 18 months

When she’s comfortable, though, Rebecca is all over the place.  She shrieks (often to wake Daniel up when she’s done napping… Daniel is not always as well-rested as she claims to be), she talks to herself and to us. She initiates chasing games with Daniel, yesterday it was each of them with one end of the dog’s leash, running circles around the first floor and giggling.  She loves to dance, she loves it when I sing the alphabet song.  “More, more, more” she signs, and I have to keep coming up with more songs to keep them awake when we’re driving home before naptime.  Her vocabulary is nearly as good as Daniel’s, give or take a few words, though Daniel is at a stage where he much more actively repeats everything I say.  Rebecca, you can tell, knows exactly what’s going on. Her receptive language and ability to follow simple directions is incredible (“go get Daniel’s other shoe, get mommy’s jacket, get Rebecca’s hat, etc.”  she has no problem distinguishing each item). But she plays her hand close to her chest a lot of the time.  She’s clever and calculating.  Trouble, I tell you. ;-)

I wrote an entry yesterday for HDYDI about whether or not things get “easier” as they get older.  And I maintain that there’s no real answer.  Some things get easier, some things get harder.  But despite the temper tantrum that Rebecca threw for about 30 minutes when we got home today, I really do like this age. Every new skill makes things more fun, even if it also makes things more challenging.  As I said yesterday: hard is always hard, bad is always bad. But good keeps getting better.

Comments (8)
Categories : Birthdays, Child Development, Pediatrician appointments, Toddlers
Tags : chair pictures, cognitive development, Early Intervention, language development, Social/emotional development
   

Got to pay the bills!

Archives

Search

Grab My Button



NaBloPoMo – November 2011

NaBloPoMo 2011

Superhero Photo E-Course

Alltop, confirmation that I kick ass

How Do You Do It?

Add to Technorati Favorites

Goddess in Progress
Copyright 2006-2011 All Rights Reserved
iThemes Builder by iThemes
Powered by WordPress