TIPS

Preemie developmental follow-up was today.  I'm awaiting in the mail a more detailed "score" of how they did, but in chatting after we left, Jeff & I are pretty darn proud of our trio.  They (of course) still test & evaluate them based on their corrected gestational age (15.5 months).  And Jeff & I felt like every task they would present to the kids, they would say or act like... this is an emerging skill at this age so don't be surprised if they can't do it.... and our kids would do it & we'd think to ourselves, yep they mastered this 2 months ago.  Therefore, putting them right on par for being caught up for their age.  Again, just our assessment as TIPS does not tell us "Yes your kid is caught up developmentally" which is what I'd like to hear.  Instead they evaluate to watch for delays even for corrected age, which preemies are at risk for. 

Except for being scared of people (seriously tired of the stranger danger thing) it went well.  Scared as in I would guess Logan cried 65% of the time we were there.  Kind of hard to get an accurate display of abilities like that wouldn't you say?  I know we don't get out much having 3 & all, but come on kids, you are not THAT sheltered.  Actually, to be more fair, on top of strangers, they are more terrified of small closed rooms that resemble a Dr. office.  So take that & throw in a room full of strangers. I can see how that would be scary I guess.

The kiddos got weighed & measured.  Let me start by saying I am VERY interested to see what they get for weights at our 18 month pediatrician visit on Weds.  (Yep more Dr. on Wednesday... more crying I assume)  Because according to this Livi & Logan have actually LOST a few oz over the past 2 months?!  Which I guess wouldn't be totally weird.  Lots more mobile.  Playing outside.  Up & down stairs.  PICKY eating.  Plus Liv had a bout of about 5 days of a fever about a week ago during which she ate NOTHING, literally nothing for 4-5 days.  (And yes we took her to the DR & found nothing wrong.)  Logan had the same fever & same refusal to eat, only for about 36 hours though.  Who knows what bug that was?  But that could account for some weight loss?  Oh & I just realized, both of these times they were weighed in clothes... now its warm, then it was cold, so that could account for some variation too.  But for the 1st time, I think I'd have to agree with the heights.  Still shorties.  And even if they are not completely accurate, I'd have to at least agree with the height differences they got between the kids.  Yes they kick & scream & buck & try to get away, so weighing & measuring is NOT fun & there is plenty of room for error.  Guess we'll see what Wednesday brings.

Hayden:  27lbs 8oz, 31.8 inches
Olivia:  23lbs 5oz, 31.4 inches
Logan:  23lbs 6.5oz, 30.9 inches

They seperated the kids into 2 rooms (which I also think added to the "we are scared" problem).  Hayden & Livi were together with Jeff & overall I think did better than Logan, who was in the other room with me.  For the evaluation, they play with different toys & objects.  Test the kids in figuring out different things.  Cognitive skills & gross & motor skills.  And I can see how it would be way too overwhelming to have all 3 in one room.  They tested them on looking for hidden objects.  Problem solving to get an object out of a clear box with just 1 open side.  Picking up the correct object when asked to.  Stacking blocks (which they all shocked me & did!  Something we have not worked on, so they learned that one on the spot.).  Putting pegs in a peg board.  (They were impressed with this one.  This is apparently an emerging skill at this age & they didn't think the kids would do it... but they dazzled & did the whole thing!  Just like their favorite nails on our tool bench.)  A puzzle with circle & squares.  Hayden & Livi put in a few & Logan of course did the whole thing, and then did it again.  Putting things in & out of a cup.  Putting cheerios in a little small mouth bottle (which they did great at, explaination of why I'll explain later).  Colored.  Hayden & Livi even replicated a vertical stroke on the paper that the lady told them to do.  Wow!  Pointed to named objects in a book.  We were discussing the kids following simple instructions.  And they were glad to hear we could tell them, "Go get your sippy cup."  Meaning they were almost floored when we said we could say (to any of them, just substitute name) "Go in the living room & get Olivia's pink sippy cup & give it to her."  And they will go get sippy cup (not always the correct color but I always try to incorporate that in to try to teach something on a daily basis) & procede to give it to the correct sibling.  They differentiate eachother better almost better than they differentiate mom vs dad.  And while playing, they stopped to respond to familiar names (ie.  Hayden, Olivia, Logan, mommy) and did not stop playing to acknowledge other names (ie. George, Betty, Lucy.)  One thing that they did not do was pretend play.  As in, take a cup or spoon & feed a baby doll.  But they do like to give us drinks of their milk & they said that sitting & driving toy cars saying "vroom" is the start of the pretend play, so we should be ont he brink.  Like I said, I'm awating a more official "score" of the kids' "performance" but I do know that for cognitive skills & fine & gross motor skills they all tested as competent.  They score them as Competent, Emerging (meaning they are still on track, just still working on it), or Delayed.

For language (which is what I was really interested in) Hayden & Olivia tested as competent.  Logan tested as emerging (which I think is partially just due to the situation he was in being seperated from Hayd & Liv).  But even so, I would have to agree that Logan is a little less competent in communicating that the other 2.    Since the kids were scared, they didn't say much for them so it was mostly based on parent report.  And mostly I just discussed with Dr. Needleman what we need to watch for & at what point (if ever) we should talk about early intervention (EI) IF there comes up a problem (I REALLY wanted his opinion since my pediatrician is a little bit of an EI pusher).  He verfied what I thought about things, so it was nice to hear that I'm thinking on the right track.  I asked specifically what the range is in terms of language development at this age.  He said "It is just that, a range.  A HUGE range."  And that as long as they have a few words (meaning even 2 or 3) & as long as they are showing you that they understand the link that is communication, at this age they are fine.  So yes, even that annoying, continual, pointing & grunting is a communication milestone.  He said he doesn't usually recommend EI for speech before age 2 anyways, because the range you find in kids is so large.  They only time he would recommend it at this age is if they are not communicating at all, they do not understand a simple command, or their behavior is getting too out of control because they are frustrated with their inability to communicate.  (Which struck a nerve with me because sometimes I think this is part of Hayden's tantrums, part of, definately not all of it.  So we'll have to keep that in the back of our minds.)  But he reiterated that he would be surprised if we had 3 30 week preemies, none of which at some point required EI of some sort.  And that most of the time, yes it is speech.  Because following a family history of speech delays, prematurity, multiple birth & being a boy are the next 3 risk factors for a speech delay.  So just to continue to be vigilant in monitoring their develoment, talk to them as adults (ie. no baby talk), and don't hesitate to call EI or them if we have concerns over the next few months.  But for now... there are no concerns from me or the experts. 

They don't "recommend" a 3rd TIPS follow up unless a baby was born at less than 1200 grams.  (We weighed approximately 1280-1390grams)  But said we were welcome to come back again if we so choose.  To which I of course replied, yes.  I'm not about missing the opportunity to have some experts evaluate my preemies development!  So we will go again at 2 years corrected age, so that should be next January. 

But for now... we are in tip, top shape!