Archive for the ‘milestones’ Category

The triplets are all getting therapy through our county’s early intervention program. They have both a general special education/developmental therapist and a speech therapist working with them. The great news is that the triplets are doing great and have reached the vast majority of their developmental milestones. The therapists were kind of curious about some of the idiosyncracies in their development, though… they don’t really imitate, for example… we’ve been doing sign language with them since they were 6 months old and now, at 23 months old, they don’t imitate a single sign, nor do they respond to a single sign. They used to play peek-a-boo, but only in their high chairs – not elsewhere (the girls just recently started doing it elsewhere, too).

They are also pretty far behind in their speech/language milestones, enough that at their 15 month appointment, their general pediatrician noted that we should get them evaluated and get them speech therapy services ASAP.

Since we happen to have an “in” with an excellent developmental pediatrician (for the J-man), I ran the therapists’ questions by Dr. S. His first recommendation was to continue with the speech therapy, but also to get the triplets’ speech/language development formally assessed on either the Mullen Scales of Early Learning, or similar after a solid 6-8 months of speech therapy (that would be… now). He had a few other suggestions, and did say he’d be happy to see the triplets if we thought that would be beneficial (this is a great gift from him – he’s not currently accepting new patients). He said we should definitely talk more after we get the assessment. This all seemed perfectly reasonable.

So… we started the assessments on Friday and finished all except Ellie’s receptive language assessment, which I’m not in the least bit concerned about. The girls, unsurprsingly, came out just about where we expected them to – about 6 months behind expressively (which means they’ve made huge progress since they started speech therapy in January) and only a few months behind receptively (assuming Ellie comes out where we expect her to once we finish her receptive assessment next week).

Sam’s assessment was more significant, however. He tested out as 4 months for expressive language and 11 months for receptive language. Wow.

I talked with Ye Olde Developmental Pediatrician and did tell him that Sam’s 2 year check up with our regular pediatrician is next month, reminded him that we’re still doing weekly speech therapy with all the triplets, and asked him what he suggests we do from here. He said that he thinks it’s important that we remain vigilant with the intensive speech therapy and he suggested we meet and talk more after their 2 year check up. That certainly seemed reasonable. I trust YODP, and I trust our general pediatrician. So I believe we won’t be led astray by either of them (and it happens that they are former practice partners and good buddies of each other, so they trust each other, too).

I’m quite certain this will resolve over time and that we’ve got the right professionals on our team. It’s just… more stuff to do.

Well, it’s always gotta be something, right? I wasn’t having nearly enough fun these days anyway.

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Conjunction Junction

Conjunction junction Well, we may not be up to conjunctions and grammar yet, but I would be remiss as a mother if I didn't mention the huge strides that my kids have been making in the speech/language development department.  Especially the girls, as has been the trend, of course. 

On March 2nd, Ellie was in the hospital (as many of you may recall) and I was talking to a nurse or doctor and Ellie (who had been refusing food most of the time she was in the hospital) was standing in her crib reaching out toward the bedside table where there was a sleeve of Ritz Crackers (one of her favorite snacks) saying "Cacka! Cacka!"  She said it in such a soft, sweet little voice that it took a couple minutes for me to realize what was going on.

"Oh my goodness!  You want a Cracker!  You can have all the crackers you want, little girl!" 

And she did gobble down those crackers, like a ravenous little fiend.   She knew what she wanted, and she clearly communicated it.  And thus, a first word was born. 

Well, that's not really fair.  I'd posted before that she had said "mama" before.  And it's true, she had.  But just as quickly as she started saying Mama, she stopped (a few days later).  And she hasn't said it since.  It took Ellie a long time to say anything other than cracker, in fact.

But Ellie does now have a nice little array of words – "Cracker", "Cup", "Up", "Abba" (meaning "father" in Hebrew – though I'm not sure she really knows what that one means, she does seem to use that one rather randomly), "Ball", and um, that might be it.  I'm sure Seth will let me know if I'm missing any.

In April, Abby started to follow suit.  The difference between Abby and Ellie, though, is that Ellie speaks extemporaneously – if there's something she wants she says the word (assuming she knows the word).  But she never imitates sounds just for the sake of imitating sounds.  She's not a mynah bird the way a lot of children are when they first start talking.  Abby's first clear words, however, were obviously imitation, though, as you'll see…

Each day, when I walk in the door, the triplets are usually playing in the sunroom with SuperNanny.  When I walk in, I am generally accosted by three loving babies who are eager for a hug, a kiss, or (most importantly) my cell phone or car keys.  I always exclaim "Hi Babies!"  One day in April, Abby whispered (with a devilish little grin on her face), "Hi Babies" after I greeted them. 

Wait, what?  Did she just say what I think she just said?

"Hi Babies!" I said again.
"Hi Babies!" she whispered with a grin.

Whoa.  Seriously?  That's your first word(s)?  Neat!

So Abby imitates, but for a long time would not say anything extemporaneously.

Ellie started doing this thing where every time she had a ball she would throw it up in the air while saying "Up!" (something her speech therapist taught her) and Abby started imitating that.  But now Abby will casually say "Up" whenever she sees a ball.  Once Abby said Piglet (but that was, again, imitating us calling Piglet by his name). 

The girls are definitely improving on receptive language skills as well.  They will point to their noses (or mine) if I ask where their nose is.  Abby will point out Piglet's nose as well.  They will follow very, very simple instructions ("bring that to mommy!").  And Abby (and to a certain extent Ellie as well) is very receptive to the emotional needs of her siblings – if they are upset, she will bring them their loveys. 

Sam?  Well, Sam's not talking.  But he lets us know what he needs.  He's taken to SHRIEKING (make that SCREAMING) in the middle of the night if he wakes up and discovers that his pacifier is missing.  This is a new and definitely undesirable behaviour, as far as I'm concerned.  Gah.  If he wants to be picked up, he'll stand there with his arms raised grunting.  No question what he wants.  But if you want him to follow a simple instruction, you must use far more visual cues with him than the girls need.  The girls still need more visual cues than other kids their age, but Sam needs visual cues for virtually all instructions.  Still, he has definitely made progress – it used to be that he couldn't follow an instruction even with a visual cue.  And he is now responding to his name (he turns his head) and will stop what he's doing if you say, "No, Sam!" in a stern voice.  Whether it's the words or the inflection he is understanding, I'm not sure, but either way, it is progress.

We are still getting their hearing checked on May 20th, because they are still behind on receptive and expressive language, and while no one believes there's anything wrong with their hearing, it's a good rule-it-out step and it is non-invasive.  So we'll have all kinds of fun with that.  Umm.  Yeah.  Something like that.

Some day, I'm sure I'm going to wonder why I ever wanted them to talk.  :) 

I do remember that at their 18 month appointment, the pediatrician remarked that it was probably a testament to their underlying personalities that they aren't having far more temper tantrums and fits, because with the language delays that they're having and the fact that they are otherwise developmentally on target, this can be very frustrating for them to not be able to communicate their needs.  While they DO throw fits, they aren't constant and they are very predictable and generally happen not as a result of communication failures, but as a sign that bedtime/naptime is looming.

Yep, I just have really, really good kids.  I'm one lucky mom.

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In Happier News…

Ellie-bean seems to be trying to say her first word!  She now waves "bye-bye" (FINALLY) and while she's waving she says "aye-aye" in exactly the right intonation to sound like when I say "bye-bye".  She is definitely copying us saying "bye-bye."  She's using it in context, and consistently, so it is for SURE her first word!  Neat, huh?

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Sam and Ellie can clap now! Abby can't clap yet, but she's willing to try the one-handed-clap! 🙂

(note if you're getting this via email subscription, you probably need to go to the blog to see the embedded video)

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Ellie Bellie Ballerina

My beautiful, graceful girl hasn’t had a whole lot of firsts… she’s had a lot of lasts, actually. She was the last to get the okay to be discharged from the NICU (though they were all discharged on the same night). She was the last to come off a heart monitor. She was the last to stand. The last to crawl.

She was, however, the first to take a STEP! The very first to make that first move toward walking.

Oh my!

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How did that happen? Ellie has six toofuses. Poof! She was so funny, because she had this snaggle tooth – this one tooth on top that was way longer than the others since it had come in first, and I was looking today bemonaning the fact that it was less snaggly than it used to be since the others were catching up and *poof* I realized there were *four* teeth on top, not three!

When did that happen? How did I miss it? Was I seriously not paying attention to my baby? She’s so quiet about teething compared to the other two that it’s hard to notice when she has teeth popping out, but this isn’t just a tooth barely cutting through, it’s way out there – I completely missed it! Whoops! Now each of my babies has six whole teeth! That’s 18 toofuses. That’s a whole lot of chompers. Here’s a very blurry picture of Ellie’s new found chompers:

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We had an experiment today. It wasn’t a total disaster or anything, but I thought Abby might deck me a coupla times:

Yeah, I said I wasn’t going to have anything to do with solid food until after Passover…and I meant it. But see, I had these avocados and bananas that were not going to last if they hung around too much longer, and well…

Actually what really happened was that I was concerned about Ellie because she’s back to not gaining weight particularly well, and I thought the fat from the avocado would be good for her if I could get it into her. She didn’t mind the food, but I can’t say we got much into her. I also tried some banana, thinking she might like something sweet, but honestly, I think she liked the avocado better. Either way, I gotta say, it was a whole lot of effort for not a lot of success, and the truth is, Ellie was positively STARVING later, so I’m not sure that’s really the answer. Ounce for ounce, breastmilk has more concentrated calories than any solid food, and since we fortify her milk to 28 calories per ounce, all the more so. My guess is that solid food is not the magical answer to Ellie’s weight gain.

Well, Sam woke up while I was feeding Ellie, so we tried it with him too. He didn’t take well to it immediately and at first he just pushed everything right out of his mouth. He didn’t seem to mind the taste, but he definitely still had the reflext that causes babies to push things right back out of their mouths when it gets put in there. So I put some bananas on my finger and let him suck on it and then tried the same with avocado. He was all for that, and he also didn’t mind sucking down milk served on a spoon, so once he figured all that out, he did a reasonably good job with food on a spoon, though he made a MUCH bigger mess than Ellie did (but all things considered, he also probably consumed a lot more than she did, so I’m not surprised by the difference in mess).

Though my original plan had been only to try Ellie with some avocado and banana today, since I’d ended up with 2 out of 3, it seemed only fair to try Abby with some food also once she woke up from HER nap. After all, she’s the only one of the three that’s shown ANY signs that she might be getting close to being remotely developmentally ready for solid food (and even then, I still think they’re not entirely ready, so there!). Well, Abby wasn’t sure just WHAT to think about the experiment, and I have to say, I’m not sure what to think either.

So it wasn’t a total disaster, but I have to admit, I’m not eager to repeat the experiment any time soon. It took freaking FOREVER to feed them, and they were all positively STARVING later, especially Ellie (and she’s the one I’m worried about). It didn’t make as huge a mess as I’d been worried about (but then again, I didn’t use the dreaded rice cereal…ick). I contained them in the bumbo seat (with tray, though the tray wasn’t strictly necessary)…though Seth just held Ellie in his lap when we fed her, which was easy enough. I think it would have been harder if we’d been trying to deal with high chairs, so I’m not sorry I don’t have high chairs yet. For now, I’m okay with it being a one-time experiment that we can play around with some other time in the future, but I don’t feel some compelling need to do this again tomorrow. I did freeze a bunch of mushed banana and avocado in an ice cube tray, though, just in case.

And yes, I know I TOTALLY broke that rule about introducing only one food at a time, so don’t even worry about telling me that one. Neither banana nor avocado is considered a high-allergy food which is why they’re both considered excellent first foods. Plus, we Americans get far too ridiculous about our approach to solid foods. I refuse to make myself any more neurotic about this than I already am. I have no concerns that any of the three is going to have an allergic reaction to either banana or avocado, so I feel absolutely no regret about serving them both on the same day.

And hey, if you have nothing but free time on your hands, here’s the whole pile of pictures from the grand experiment, because, well, WHY NOT? Enjoy!

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