Monday, February 24, 2014

Seven Posts in Seven Days 1: Ann Marie update

This is a post for me and for Ann Marie’s early intervention therapist, Miss Nancy. Ann Marie was enrolled in EI last January after I took her for her 12-month well visit in December and her doctor said, “What do you mean she can’t get herself into a seated position? And she has no words at all, you say? Hmmm.”

Honestly, I blame her motor skills delay on her parents’ forgetting how old she was. “She’s the BABY. Tiny babies cannot sit up! It’s perfectly normal! She’s only a few months old!” we thought, subconsciously. Also responsible: She is the THIRD baby. She does not get quite as much laser-focused attention as, I don’t know, her eldest brother did. Her brother and sister are sort of demanding, as it happens. This is real life. 

At any rate, she scored one point over the qualifying score for motor skills (she could not crawl or get into a seated position or roll over or pull to stand, but her fine motor skills brought her score up) and two points over qualifying for her communication skills. In other words, she did not qualify, but only by a hair. In such cases, children can be enrolled based on clinical recommendation, and that is what we did. Frankly, I was not concerned about her motor skills because she had improved substantially between her well visit and her EI qualifying interview, mostly because Andrew became aware that she was not, in fact, a four-month-old, and we made her try things. But I was a bit concerned about her learning to talk because she communicated non-verbally to great effect, so I was afraid that I would not know how to get her to use actual words.
Thus it was that Miss Nancy started coming to our house every Tuesday afternoon for an hour to play with Ann Marie. And Ann Marie was Miss Nancy’s favorite client, if you don’t mind my totally unbiased opinion. And, OK, I’m sure Miss Nancy worked with plenty of adorable kids, but seeing as how she worked primarily with children with severe developmental delays, I do think a pleasant hour playing with a cheerful baby who had a slight speech delay was a nice little break for her.

It probably helped that my other two children were always under some sort of magical spell when Miss Nancy came, and always acted like angel children from another dimension for that hour. Honest to goodness, Nora once spent the entire time playing with some dolls, singing a little song quietly to herself. If I hadn’t known better, I would have thought it was staged. The storybook magic always ended when Miss Nancy left at 4:00 and the children immediately began begging for a show, but it was always nice – if surreal – while it lasted.

Once Ann Marie started walking, we noticed a problem with her feet. They curved in. The orthopedist diagnosed her with metatarsus adductus, which is Latin for “curved in feet,” and prescribed special shoes for the day and boots and a brace to sleep in. I was told to expect that she would need to wear the brace for three years, and we scheduled a follow-up visit for that November, six months away. Well, her feet were noticeably better within two weeks. I know it was two weeks, because we got the brace right away but had to go back for the special shoes, and they were better by then. And by the time Ann Marie had her six-month evaluation for EI, her feet looked totally normal. The physical therapist who had come for a sort of foot consult before I took her to the orthopedist came back for the six-month eval, and she was astonished at the improvement.

But what is the six-month evaluation? In Massachusetts, if you qualify for EI, you get it for a year, with an evaluation midway through to check on the progress. But if you qualify for EI based on clinical recommendation, the six-month eval is a qualifying evaluation, and Ann Marie did not qualify. Not even close. In January, her almost-qualifying scores were 76 and 78. (You need 75 to qualify.) In June, her scores were 105 and 97. So the EI worked, apparently.

You know what else worked? Her shoes. I took her back to the orthopedist in October instead of waiting until November because she had outgrown her special shoes, and the orthopedist declared her cured. Cured! She didn’t have to wear special shoes or a nighttime brace anymore! I’m still pretty amazed by that. Six months is a lot less than three years. So, Miss Nancy, she hasn’t had orthopedic shoes since October!

She also talks a blue streak now, Miss Nancy. I’d list her words, but her vocabulary is too vast. This morning Nora was making her way to the car taking her to school, and Ann Marie called out, “Carefully, Nora!” correct syntax and all. Then while we came upstairs she said, “Can I watcha show? How ‘bout... Mickey Mouse! How ‘bout... Dora! How ‘bout… Phinny Ferb?” (That last one is Phineas and Ferb, and the answer is always no.) Yesterday Andrew asked Nora to get him a napkin and Ann Marie came running. “I do it! I DO IT!” and did it. When she wanted to stir my coffee for me I sent her over to stir Andrew’s instead. Jack said that he didn’t think Andrew wanted her to, and she said “I GOING to!”  She can count to twenty sort of, and she can count to eleven pretty consistently. She can identify “G” and “O” and knows what sound “H” makes. For the counting and letters I concede all credit to her Leapfrog Leaptop.

And she takes the stairs like a big kid. No more creeping. Sometimes she even alternates her feet while she climbs, although she has to be holding someone’s hand to do that. She can jump, too. Real jumps, both feet off the ground. She runs and climbs. She can get in and out of her crib and can even get out of her crib and make her way upstairs, all by herself. 

She is an utterly charming delight to be around. She has her moments of course, and we’re no strangers to tantrums about wanting or not wanting to wear her “cozy shirt” or some other nonsensical two-year-old problem, but she sure is fun.

And Miss Nancy, if you ever want to stop by for a visit, you are always welcome.


Joy said...

Glad she is doing so well. Liam had a year of speech therapy and at the re-eval also didn't even come close to qualifying again.

Kara said...

I didn't know my third child could read at all until her parent teacher conference in first grade. It never dawned on me to sit with her and have her read out loud (like I did with the other two kids). Because there was so much other stuff going on as well!

HereWeGoAJen said...

Ryan is a huge fan of this video. He says "yay!!!"