Checking in...

Yes, yes, we are still here.

Natalie and Abby are having a busy summer. We've traveled some, visited grandparents, had grandparents visit and started babysitting again with Walker and Bean. We've been to museums, beaches, and pools and are having a wonderful time.

We've also been busy going to evaluations for a variety of potential therapies. I'm not sure I mentioned it, but when the girls turned 3, they aged out of the CDSA program and the free therapies it provided. The next step was an eval to determine whether they would qualify for an IEP (Individual Education Plan) through the state public school system. If they were to need significant therapies and assistance, then they could attend public pre-school for free.

We weren't at all expecting to qualify for services to the extent of free pre-school. I was really only hoping they would qualify for speech. Qualifying for Occupational Therapy would also have been nice, but Speech was the most important.

In a strange twist of irony, Abby did qualify for Speech based on articulation. Natalie...did not. I was...perplexed. All our therapists, and I agreed that Natalie is the more difficult to understand. And so goes the subjective world of testing...

So, in response to the IEP exams and at the prompting of the OT's who evaluated them, I set them up for appointments in all areas. The OT's suggestive that there was a quality to their fine motor movements that might need attention. I wholeheartedly agreed. There's just something a little "off" about they way they use their hands and bodies. They can do almost everything any other 3 year old can do, they look a little different doing it.

All of these therapies will have to be done (and paid for) through our insurance and its providers, ie: Duke Hospital and its various clinics. We've already had our OT evals and they both qualified. Abby had her Speech eval and qualified. Natalie's is tomorrow. If you are wondering why I had Abby retested, it's because her therapy through the state would be 30 min twice a week at a nearby school. So, it would take me at least an hour out of the day twice a week to take her. That would be on top of taking Natalie to speech somewhere else and taking them both to OT and potentially Physical Therapy as well. If I can get all their therapies in the same place and co-current, then I may be able to do two in one day and one on another. Result: 3 sets of therapies (6 separate appts) done in 3 hours on only two days vs potentially running all over town 3 or 4 days a week. All we have left (after tomorrow) are the PT evals. Abby has been receiving PT but it will be new for Natalie. I'm not sure how those will go actually. They could go either way. They seems to have some low tone or strength issues but they may be able to be addressed through the OT therapies so we will just have to see.

You may be wondering why all of a sudden it seems that Natalie and Abby are having all these problems and are in need of so much help. Well. Such is the nature of micro-preemiehood. Without a doubt, Natalie and Abby escaped many of the issues that plague many micro-preemies: ROP, surgeries, brain bleeds, CP, major development issues, autistic-spectrum disorders, severe sensory issues, feeding tubes....the list can go on and on.

However, it's only as our children get older and the "norms" narrow in expectation, that problems show up. For instance, children are expected to learn to walk anywhere from 9 months to 18 months. That's quite a range. Even a child with delays might manage to do fall in the "normal" range. However, by age 3, kids are generally expected to be more on the same page in what they are able to do. As they are expected to be able to do more and more, areas of concern crop up.

For Natalie and Abby these concerns are primarily in the areas of fine motor, ie: how they use scissors, the ability to copy and draw a straight line horizontally, vertically, in a circle and as a cross, etc. That's where the OT comes in. That's the stuff they work on.

Could they continue to do ok without all these therapies? Maybe. But speech interferes in their social skills if none of their little friends can understand them. The fine motor skills will affect their pre-writing skills and make school that much more difficult for them. So, why risk it. If we can give them a better chance to be "normal", why not take it?

I promise (once again) to try to be better about posting. I get so busy and I have so much to say. If you haven't noticed, I'm not very good a being brief:-)