A child's development is so hard to evaluate when you are the parent. There's this broad range of what's "normal", often spanning several months. Beginning to crawl for example is expected anywhere between 6-9 months, supported standing 8-12 months, walking 9-18 months, etc. It's so easy to start comparing your child to every other child in the world and when you add the preemie factor in, with adjusted ages versus actual age, it can become overwhelming. We have been really blessed with Gabriella's physical therapist; she is so down to earth, so patient, and has taught us so much. She was great with teaching us all about normal ranges and kept us focused this year on areas that Gabriella really needed to be pushed (a good example is when we brought her home she would lay completely straight, not curled up like full term infants do. Her PT helped us position swaddle blankets under her shoulders, arms, and bum to help bring her into what we know as "fetal position". This position is really critical in infant development; it helps strengthen their core muscles which leads to rolling, sitting, etc.). That being said, I was really curious how she would score in her speech. She makes a lot of different noises, says dada all day long, as well as a few other words. I was also really interested in how a speech evaluation on a 1 year old would work.
The SLP that came was so kind and we laughed that Gabriella must have known she was there to evaluate her because as soon as I let her in, Gabriella crawled over to her, waved, and said hi. She then pointed to a cartoon drawing of a boy on her bag and said dada. Two checks in the box, greeting someone and recognizing an image of a person (girl knows how to work the crowd :)).
The evaluation consisted of so much more than simply speech. She looked at how Gabriella reacted to new toys, how she would react when frustrated with a difficult toy or object, and whether or not she would recognize familiar toys, people, and objects. When frustrated, she would try the toy and then hand it to me, point at me, and babble a bit. The SLP told me this is exactly what she wanted to see, Gabriella trying, and then reasoning that she couldn't do it but mom would know how. She was also happy to see that while Gabriella doesn't say the words yet, when prompted to "get the baby", "get the piggy", "get your cup", she was able to go get those items out of a line up of other things. At the end of the evaluation, they told me she scored in the 12-14 month old range which is wonderful! Her real age is 15 months, adjusted age 12, so she is scoring even better than they would have expected.
The areas that she is delayed in a bit are the behaviors that a 15 month old will typically show. A 15 month old will start to choose between items ( banana or cheerios, milk or juice, etc) as well as have a lot of "expressive communication". This is when toddlers really use their facial expressions and hands to get across a message. Typical examples are rubbing their eyes and making a fake crying noise when they are sad, stomping feet when they are angry,and hands on their cheeks when they are surprised. I had no idea, but this expressive communication is the bridge between a 12 month old saying simple words and a 2-3 year old telling simple stories with voice fluctuations for emphasis. She told me that because Gabriella is developing normally, this step will happen on it's own, but we can start adding hands and more expressions to phrases when speaking to her and she will catch on quickly.
Gabriella's final evaluation with Birth to Three is being written up and I will sign in next week. I am so grateful for the services we received; we learned so much and Gabriella has thrived. I will really miss seeing her PT twice a month, but "graduating" from this program is another reminder of just how blessed we are.
Mary
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