Thursday, June 18, 2015

Early Intervention

When the girls were born at 33 weeks, we knew to expect developmental delays. We knew they wouldn't hit all the big milestones right when they would be expected to. Overall, they did better than I thought they would. They hit milestones slower than other kids their same (actual) age, but they didn't have any severe delays. They were both walking by 13 months. My cousin's full term singleton didn't walk until he was 18 months. I wasn't worried.

Recently, we did start to worry about their language development. They do say words and know several signs, but it still seemed like they should be doing more. As they approach their 2nd birthday, I look at other 2 year olds and they seem so much more advanced than Paige and Riley. I know kids change fast at this age, but there just seems to be such a huge gap. At their 18 month appointment, the pediatrician said on average they should have about 20 words. We were nowhere near that. The doctor wasn't worried because of them being preemies, but she still wanted to check in with us in a couple months to see if there was any improvement. We decided not to wait and looked into getting them evaluated. California has something called the Reg.ional Center. It provides services for individuals with developmental disabilities, including providing early intervention for babies and toddlers.

Several weeks ago we went through 3 separate evaluations.  The first was a speech therapist who basically just came over for less than an hour and interacted with the girls and gave them different toys to play with all while taking notes on their behavior and communication. The 2nd person came over and asked SH and me a million questions about the girls but didn't specifically do anything to evaluate the girls. The last person was an Occupational Therapist. She did a standardized test to evaluate their overall development. It's all play based, but it's a weird thing to test such young kids. They obviously have no idea they are being tested so have no incentive to show all their abilities. While they were friendly and social to everyone who came over, they didn't say anything out of their admittedly limited vocabulary. The final testing was long and they got tired and restless by the end. It was close to lunch. So they didn't succeed at all the tasks even though they were things I knew they could do. I think you have to take the results of this kind of stuff with a grain of salt. I think they paint a good general picture, but might not be exactly accurate.

We finally got the results and recommendations a couple of days ago. In social/emotional development they score above their age (yay!). In cognitive development they test a couple months behind (not too terrible). However, in language they have a severe delay. Riley was put at a 9-12 month level in expressive language. Paige was at 12-15 months. They were 20 months old at the time of the test. Obviously, I know they are delayed which is why I asked for the evaluation, but it's much more severe than I thought. They did better at receptive language. They understand a whole lot more than they are able to communicate. They are recommending speech therapy twice a week and cognitive therapy once a week to help with their fine motor skills. That's a lot.

The complicated part of this is that SH, who has been the stay-at-home dad all this time, was set to go back to work in July. The girls were going to start daycare full time. But now, that might not happen. He may need to postpone going back to work for the next 6 months and manage all these appointments. They go to a very small, in-home daycare. Even though the speech therapist will go to wherever the kids are, I just don't think there is any space for something like this. Another option is getting a nanny. Then the girls would be at home and the therapists could go there. But, nannies for twins are expensive and the cost would eat up all of SH's take home pay. Then there isn't much point in him working, right?

The logistics of the appointments and working and daycare is worrying me more than the speech delay, to be honest. I know that Paige and Riley will be fine. I know there will come a day when they are asking millions of inane questions and I will wonder why I was in such a rush for them to talk. In the meantime, I have to figure out their suddenly very busy schedule.