Turning Three...

There's a saying out there that preemies "catch up" by the time they turn two years old. We know this is a ridiculous myth. Birth to 3 gives children an extra year to "get it together," but once they turn 3, they can no longer be in the program. Caleb has been in the Birth to 3 program since he was discharged from the hospital (3 months old). He began PT/OT when he was 5 months old (They would have started earlier, but I wanted to wait until the RSV season was over). They have been the source of all of his therapies. (Except for his original speech therapies and the feeding clinic) He had his "transition" testing done with the local school district a few weeks ago. I still cannot believe he's turning three this week....YIKES!!

Warning: This post will most likely be very boring to most of you. If you don't want the long-winded version, just skip to "The results" at the end of all of this :)

A social worker came to our house for the initial eval. He tested Caleb with the Vineland II Adaptive Behavior Scale. It took nearly 2 hours and Caleb was about ready to throw this guy out the window towards the end. He was 35.5 months old when he did the tests. Here's how he did:
He's at a 35 month level for receptive language (how well he understands and can follow directions)
29 month level for expressive language (how well he talks)
14-29 month level for daily living skills (dressing, eating, bathing, etc)
23 month level for gross motor
24 month level for fine motor (he did this one last and Caleb was throwing blocks by that point, so I don't think this was too accurate).
So after seeing and meeting Caleb, this guy said that Caleb would "certainly qualify for special education preschool." I was a bit bummed, since I thought (aside from his speech and eating) that he's doing really well and never imagined that he'd qualify, so it sort of hit me hard. But, after thinking about it, I realized that it's not as bad as I was making it out to be. All of the teachers and therapists would know his weaknesses and could help him build on his strengths. If I sent him to a "regular" preschool, would they be as attentive to these things? I am not sure.

After I was feeling "okay" with the whole idea, I had to take him to the school so he could get officially tested by each specialty. He did SO good. He was doing things for them that I had no idea he could do (or things I have tried to get him to do and he never could/would....like draw a perfect circle, copy a line, stack 10 blocks, and cut, almost correctly, with a scissors!) Here's how he did:

Physical therapy:
"He has low muscle tone, with slightly sluggish protective responses and equilibrium reactions. However, he has excellent ball skills."
38 month level for object manipulation (ball skills...Joel was proud!)
25 month level for locomotion (walking, running, jumping, etc.) She noted that he cannot skip or gallop, cannot go up or down stairs correctly, exhibits signs of gravitational insecurity, is reluctant to jump, and has a flat footed gait with little trunk rotation and decreased arm swing while running...nothing like picking him apart, huh?!
However, this is not enough of a delay to qualify for PT because they average the 2 scores. I find it very "funny" that throwing/kicking a ball gets the same amount of "points" as being able to run/jump correctly! Yes, it makes his daddy proud that he is "advanced" in the ball skills area, but in my opinion it's probably a bit more important to be able to go up and down steps!

Occupational therapy:
Pre-writing skills: 33-34 month level
Cutting skills: 25 month level
Visual Perceptual skills: 30 month level
Manual dexterity: 28 month level
Sensory functioning/concerns: Auditory (responds negatively to loud or unexpected noises), Oral Sensory Processing (puts everything (but food!) in his mouth), Endurance/tone (weak grasp), Modulation related to body position (hesitates going up and down stairs), and Emotional/social responses (cries easily, outbursts for unsuccessful tasks, stubborn)
So he also didn't qualify for OT either. They did recommend the book, "The Out of Sync Child." Which I checked out from the library and it's about Sensory Processing Disorder. They didn't tell me that's what it was about, but they were pretty insistent that I read it. So now I am confused...is this what they think he has?! I guess I have more questions for them now!

Special ed teacher:
She was very impressed with how smart Mr C is. She said his pre-academic skills are intact and he demonstrated at an appropriate level for his age. She's a bit concerned about his over-shyness and lack of social skills, but is confident that these things will come once he's more exposed to children his age and social groups (library group, preschool, etc.)

Speech therapy:
Since I feel this area is his biggest weakness, I was glad to finally have someone test him who doesn't know him. That way, I would have a better idea of how he's doing. Well, the woman who tested him was in a big rush because she was leaving on a field trip. She did the auditory comprehension(receptive speech) test first. I told her that he never has had a delay with this. He did really well, but it didn't require a lot of talking, mostly pointing. She then decided it was time for her to go and said she'd do the articulation part of the testing "later."
When I went to the meeting to discuss Caleb's results, she put on her report that she could understand him "80% of the time," so the articulation part of the test was not needed. WHAT??!! I cannot understand him most of the time unless I know what he's doing and even then I have a hard time. I cannot understand him when I talk to him on the phone.

THE RESULTS!!! (Finally, right?!)
So obviously he didn't qualify for any therapy or special ed preschool after all. He needed to have a 30% delay in an area, which apparently he doesn't. (Which is surprising since he's almost a year behind in many of the areas) I am still not convinced about the speech part, and was ready to put up a fight to keep him in speech therapy, especially since I don't feel that she really tested him completely. However, they told me that they'd like him to participate in their new "speech class" which sounds like it will be similar to the speech therapy class he's currently in. It will be 1.5 hours on Fridays starting in January. There will be 6 "speech impaired" kids and 4 "models," along with a teacher and speech therapist. They want Caleb to be a "model." I laughed out loud because I thought they were joking! How can a kid who barely talks, and when he does is pretty hard to understand be a model?! Of course I am thrilled that they want him to be in it, but I have a feeling they might recant their offer once he's there. If nothing else, a different ST (not the one who tested him) will be able to see/hear how he does and I will ask her if she feels he needs to be retested.

PT recommended that I sign him up for gymnastics to work on his balance and body awareness and swimming to work on building his muscles. She doesn't feel that private PT is necessary since those activities will be just as good for him at this point. (She explained that he will always have low muscle tone, there's nothing we can do about that. But, we can work on strengthening his muscles and his balance so that he's able to compensate.)

OT recommended to continue working with him on fine motor skills at home (correct positioning of a pencil, cutting straight lines, stringing beads, and simple block designs. And to also work on improving sensory functioning by having him preform movement activities such as swinging, jumping and crawling/hands and feet (animal) walking. They also recommended the book "The Out of Sync Child has fun." Okay, now they really have me worried about SPD!!

So, as you can see our Big-little man is doing excellent! I will admit that it's hard to see his delays on paper. But all I have to do is think back to the day in the NICU when his neonatologist mentioned the words "cerebral palsy" to me, and I thank God that these are the only "delays" he has!