Mo' Movement Monday

This morning Joshua woke up at the crack of dawn, ready to eat and play the day away. I sleepily got him a bottle and then started getting ready for the day myself. We saw Daddy off to work, and then the woman from Early Intervention and the Physical Therapist "Evaluator" came around 9:15 a.m. The lady giving the evaluation played with Joshua, and he actually liked her right off the bat (which has been rare these days, so I was quite thankful for that!) and started playing.

Afterward, he was ready for a brief nap, and they gave me the results. He does qualify for Early Intervention in three areas. All three, though, basically relate to mobility. The first area is "self-care" and the only reason that he didn't score well in that area is because he isn't eating from a spoon yet. She said as soon as he starts eating solid foods, he will be fine in that category. The second area is "cognitive" something-or-other, which she said he scored low in only because he didn't have the physical strength to fully reach out and lunge for a toy and examine it thoroughly. The third area was mobility, which was the greatest concern. She showed me some charts of where he should be for his birth date. We then talked about him being premature, and she said he's within the range of normal for a 4-month old, which is where he would have been if he would have been born on his due date. He's slightly behind even for a 4-month old, but she said the lung surgery probably should also be taken into consideration, knowing that he has to work on breathing, spent time in the N.I.C.U., and has had more things to deal with than most other 4-month olds. If she was doing the evaluation based on his due date, he would not qualify for services. Since they don't back date for prematurity, he does qualify based on the evaluation for a 6-month old.

They then created a Family Plan with an outline of goals. Within the next six months, they want him to be able to support his body on his arms, roll both ways, pull himself up and hopefully start walking. Basically, they want him to be strong enough to move his body against gravity. She did show me a couple of ways to do that, but then he was starting to get fussy to eat again since his breakfast had been so early this morning. So, I got to see them but not practice them with the women there. (I tried them later in the afternoon, but they felt awkward compared to how easy she made it look.) The physical therapist thought that we could be monitored for the next six months to make sure that his physical capabilities improved, but the Early Intervention lady suggested that someone come every other week for a little while to show us some suggestions (based on my request to learn how to do more things to encourage him) and then we could scale back to once a month or even follow-up via mail once we believe that he is continuing to make positive progress toward our goals.

The best part is - besides the fact that I will learn some new ways to play with Joshua that I am THRILLED about - that the baby should now qualify for a medical Access card. The card is not based on how much we make (I had looked into medical benefits help after quitting my job but we made just over the limit) but on Joshua being considered to have a form of disability. CHOP takes this insurance, and it would also cover Joshua's RSV vaccines that we had discontinued when my insurance ended. So, while they don't think that Joshua's mobility is anything to be too concerned with (they do think we should work with him, but they don't think that he's too abnormal based on his due date), we still will get the medical benefits we needed for him.

I have to say that today was a little tougher than I expected it to be. I was so glad to hear that they thought Joshua was right on track with his 6-month age of talking, laughing, and social interaction. He can see well, responded well to them, and can hear great! At the same time, it was a little heartbreaking to see when they would try to see if he could do something physically and he couldn't. I already knew it to be the case, but you still want your son to outshine all areas of the examination. On the other hand, I would have been disappointed had we not qualified for the medical benefits. Truly, today was a win-win. But, I so want Joshua to be the best he can be and not have any difficulties in life. I guess that's my momma instinct coming out.

One thing that was interesting is that they said I should leave his toes out more so that he can discover them. I always have socks on to keep him warm, but once he pulls his feet towards his chest, it will be more mentally easy for him to learn how to roll. One other thing that I thought was interesting is that they said his scootching or back-crawling is NOT good and should not be encouraged. (The picture below is where he ended up one day to get his little heart-shaped toy when he had been on his mat.) We don't want him to learn to get things the wrong way and then not do normal things like crawling or walking - this behavior is his lazy "work- around," and when we see it, we need to roll him on his belly to encourage him to move that way instead. I wouldn't have thought about it being bad (I was just happy to see him moving) but it does play havoc on his hair. So, now I know. I'm glad that they are coming to show me different things since this is my first kiddo, and I'm learning as much as he is.