Tag Archive | development

Pre-k starts soon…

Little Miss Minion will be starting pre-k this year at school, which means that next year, she will be starting kindergarten! In an effort to make sure that she is ready next year, I took some time to go through the CDC checklist of things most children do by the time they turn 4. Since LMM is 4 right now, I figure this will give us plenty of time to get official assessments if we need them. Our school district requires an assessment before kindergarten anyway, but since LMM has had some delays before, we want to make sure we catch any issues before they get too big.

According to the CDC, this is the list of things most children are doing at LMM’s age. I’ve added my own notes after each one.

  1. Enjoys doing new things. LMM loves new things! She is always excited to go somewhere new or try a new food.
  2. Plays Mom and Dad. She has started carrying around one of her baby dolls and shushing it or giving it a bottle and a nap.
  3. Is creative with make-believe play. The other day, she told me she was playing with her friends at school and then there was a dragon and everything was on fire. I think this qualifies 🙂
  4. Would rather play with others than alone. She spent 45 minutes over the weekend playing doctor/vet with Mr Minion, myself, and a collection of stuffed animals. We are all healthy.
  5. Cooperates with other children. I think she shares as much as one would expect from a small child. She has several close friends at daycare and a Best Friend.
  6. Often can’t tell what is real or make-believe. See dragon story above.
  7. Talks about likes and interests. She likes to announce her preferences for things like food, colors, drinks, and activities. She also remembers which of those things are liked or disliked by myself or Mr Minion.
  8. Knows some basic grammar. She occasionally messes up past tense verbs, but is getting better. We never baby talked her (its against my DNA, as an English major), and I think it shows.
  9. Knows songs or poems. She is always singing to herself in the car on the way home. She also likes the Daniel Tiger songs about everyday activities and will sing when appropriate.
  10. Tells stories. Its sometimes a little hard to get her going, but then she will just talk and talk. She likes to tell stories about what happened at school that day or something that happened in a movie we recently saw.
  11. Can say first and last name. Yes, and working on middle.
  12. Can name some colors and some numbers-Yes, she is very good at this.
  13. Understands the idea of counting-Yes, can count reliably to 15, knows some higher numbers, but not able to put in order.
  14. Starts to understand time. She understands “yesterday” means the past, “tomorrow” means sometime in the future, and is starting to know morning, afternoon, night (in terms of progression of time).
  15. Remembers parts of a story-yes. We read stories before bed and then she gets a turn to tell it back to us.
  16. Understands the concepts of same and different-yes. Every day, she will compare and contrast our shirts or outfits.
  17. Draws a person with 2-4 body parts. Yes. She draws about as well as I do 🙂
  18. Uses scissors-yes.
  19. Starts to copy some capital letters-Yes
  20. Plays board or card games-She likes Chutes and Ladders, Pretty Princess, and memory games
  21. Guesses the next event in a book-Yep.
  22. Hops/stands on one foot-Yes
  23. Catches a bounced ball most of the time-No
  24. Pours, cuts with supervision, eats own food-Yes

The only thing from this list that we really need to work on is the catching a ball. Not too shabby for a former 28 weeker.

End of an Era

A few weeks ago, Little Miss Minion had a special education evaluation through our school district. They did a series of tests to see how she performed in several areas, like speech and gross motor skills. This morning, we got our answer. Little Miss Minion has been disqualified for further services. This means that, according to the school district, she is caught up with her peers on gross motor skills, speech, language, and cognition.

It’s a strange feeling to know that we don’t have to schedule weekly speech therapy and physical therapy anymore. We’ve had someone come to our home to work with LMM ever since she came home from the NICU. So many appointments, tests, clinics, screenings. Part of me is a little in denial. How can my one pound fourteen ounce 28 weeker NOT qualify for additional services? She’s had five brain surgeries! She has actual brain damage (called periventricular leukomalacia). She spent the first 3 months of her life under 24 hour care in the best NICU in our area.

She caught up. That’s how she doesn’t qualify. Not only did she have to consciously learn to breathe on her own, how to suck, swallow, and breathe while taking a bottle, how to regulate her own temperature, how to regulate her heartbeat, how to live in the world three months too soon, but she did all that and more. 36 months after her dramatic entrance, she’s caught up to where she should be. At this rate, who knows how far she can go?

Our next steps are to come back for another evaluation (if we feel like she needs it) in about 7 months and to continue to be utterly impressed by our little rockstar.

NICU Developmental Clinic

Every six months since she graduated from the NICU, Little Miss Minion has gone to the NICU Developmental Clinic for follow ups. Our first visit was nerve wracking. Only a week after graduating from the nicu, I had to transport my three month old to a medical center full of little kids (aka germ cesspools) and see how she was measuring up to her chronological age (spoiler alert:not very well, as was expected). We talked about her NICU stay…how she had come early due to my preeclampsia and HELLP syndrome…how she had stayed 84 days and developed sepsis, meningitis, and hydrocephalus…how she had endured brain surgery at 6 weeks old. They had me feed her, so they could see how she was handling the bottle and the Super Preemie sized bottle nipples. I left feeling like this was going to be our lives forever–shuffling her to and from various doctors and specialists. The weeks and months after that were as I’d expected. We saw pediatric neurologists, opthalmogists, hearing specialists, physical therapists, speech therapists, neurosurgeons, and our regular pediatrician. But as the months went on, the number of specialists began to dwindle as she “graduated” from their services. 

Today, LMM graduated from the NICU Developmental Clinic. I won’t have the official results for a couple of weeks yet, but here are some quotes from today’s appointment. 

“She’s absolutely perfect.”

“I can’t believe she has two shunts and presents like this.”

“I ran out of tests for this category. She blew it out of the water.”

“Didn’t she have some PVL (essentially, brain damage)? I am amazed at her development.”

The only thing we need to keep working with her on is expressive speech. The current theory is that she knows the words if they are given to her, but she has trouble “finding” them when she wants to use them. For example, if you give her a series of pictures and ask where is X, she will find it every time. But take those same pictures and ask “what’s that” and she has trouble. 

I’m happy to cross out another specialist from our list. If I’m not mistaken, this takes her down to just a pediatrician and a neurosurgeon, plus our early intervention team. She graduates from them this spring…and might even test out of the school district program that the early intervention shifts into at age three. 

All in all, it’s been a good day in the Minion household. 

Two Years Adjusted

LMM turned two years old (adjusted) yesterday. Her birthday is in May, but since she was due in August, we adjust for her prematurity when assessing her development. 

She’s up to 23 pounds and is pretty much on track for all of her developmental milestones. Her therapists are working on her speech one a week right now, with physical therapy being moved to twice a month. They want her to say more individual words and then we will move to two word phrases.  Physical therapy is focusing on getting her to clear the ground when she jumps, plus balance on going down steps. 
Not much else going on right now, so I’ll keep this short and sweet, just like Little Miss Minion. 🙂

And the results are in….

We got the official report back from the NICU follow up developmental clinic. I was pretty optimistic about it when all I had were the preliminary numbers. I read it as soon as it came in the mail and it was even better than I thought. 

Here’s the deal: they do bunch of skills tests with Little Miss Minion and they score her on how well she does. It’s pretty much three hours of playing with her with various toys and equipment. Luckily, she’s a pretty easy going kid, so it usually goes pretty smoothly. 

The stats:

At the time of the evaluation, she was 22 months chronological, 19 months adjusted for prematurity. Since she was born three months early, we subtract those three months from her chronological age to give her time to catch up. So for these tests, we are “expecting” her to score closer to 19 months than to 22 months. 
The scores: 

Receptive communication: this is how well she understands things that other people say. Ex: we ask her to bring us something or to point to a particular object. She scored at 18 months, which falls into the “average” range. 

Expressive communication: this is how well she communicates with others. Ex: pointing to things that she wants, asking for food, toys, etc. she scored at 18 months (average) again. 

Gross motor: how well she moves the large muscles in her body. Ex: running, jumping, etc. She scored 18 months here as well, so average again. 

Fine motor: how well she moves the small muscles in her body. Ex: coloring, picking things up with fingers. She scored at 20 months here, which is still considered average.  

Cognitive: how well she interacts with her environment. Ex: figuring out how to find hidden objects, placing puzzle pieces correctly, etc. She scored at 21 months here, which is considered high. 

All in all, she scored at the Average category. That means that she is performing at the same level as other kids born on her due date. This is huge. The last part of the visit is a meeting with one of the neonatologists from the NICU where they discuss the general results. The doctor had to double check his papers because of her nicu chart. Little Miss Minion has hydrocephalus, which usually impacts some aspect of development, and she also has brain damage from the infection. So he was shocked that she was doing so well. His notes include this surprise as he states that her progresss has been very reassuring, given her history of sepsis, hydro, meningitis, periventricular leukomalacia, and four brain surgeries. 
The upshot of all of this is that she is well on her way to catching up!

NICU Development Clinic

Yesterday was Little Miss Minion’s third NICU clinic. This is the big appointment where she is evaluated by physical therapists, occupational therapists, speech therapists, a neonatologist, and a NICU nurse. We don’t have her official write up yet, but I have the rough numbers. She did really well!

For those who are unfamiliar, her age is measured by two numbers. One is her chronological age-this is how old she is based on her birthday. The other is her adjusted age-this is how old she is based on her due date. So, by her birthday, she is 22 months old. By her adjusted age, she is only 19 months old. This doesn’t really seem like much, but in terms of early development, it is a big deal. 

Her speech was scored at eighteen months, which is a HUGE improvement. This score technically means that she is no longer considered delayed in speech, which is amazing since she’s only had about a month of speech therapy. They gave us some tips on how to encourage her to talk, but said that she is so close to really talking.

Her cognition was scored right at her chronological age, which is also fantastic. This means that she is scoring three months ahead of her adjusted age, which means that she is pretty much caught up for now in that area. With her early birth, the hydrocephalus, and the brain damage she incurred as a result of either the meningitis or the initial pressures of the hydro, this is really a best case scenario. The doctor told me he had to double check her chart to make sure she was the right kid. 

She’s pretty much on track with her adjusted ago with regard to her fine and gross motor skills. They looked at how she walks, how she holds things, whether she can stack blocks, how she picks things up. 

All in all, I think her average score was twenty or twenty one months, which is great, great news. I’ll post more details once we get the official results in a few weeks. But for now, yay for LMM!

Chunky Monkey

I took Little Miss Minion to the doctor yesterday to check on her shunt sutures. They looked a little red and bumpy, and shunt infections are a BIG DEAL so I wanted to rule that out. They gave her an extra strength neosporin type cream and some sensitive skin soap, and it already looks better today. It isn’t an infection, but they want it to heal faster. 

We got a weight on her while we were there. Little Miss 1 Pound 14 Ounces now weighs 9 pounds 7 ounces. Almost exactly five times her birth weight. She’s almost too big for some of her Newborn onesies (I find that the onesies run small).

I set up her play gym with some new additions today. I added a chain of connecting plastic rings for her to grab and suspended her zebra from the middle. She was trying to grab at it this afternoon and actually laughed for the first time. She does this evil genius cackle thing, but this was a genuine laugh. And lots of smiles. 

It’s amazing how much progress she makes every day and how quickly she picks up new skills.