March 18 - Meet the Team

Today the Early Intervention team comes for Mikaela's evaluation. They ask a series of questions about what Mikaela is presently doing, her eating, sleeping habits. What she is able to do physically and her responses to people and the way she interacts. They also do a physical "exam" of sorts and determine what her needs may be.

She obviously qualifies for a TOD (Teacher of the Deaf). The TOD teachs us how best to help her. Yvonne is proficient in ASL and will teach us. She will answer any questions about Mikaela's learning and even keep us informed about deaf events in the area. She shares books/resources. Others I have spoken to say Yvonne is very good at what she does.

Mikaela needs physical therapy too as she is delayed in head and core muscle control. They said often once she gets caught up with PT, she may need OT (Occupational Therapy) for fine motor skills.

Early Intervention also offers a social worker to come out and share information with us...we'll take advantage of that as well. Why not?

One of the women believe that Mikaela may be in a bit of a sensory shut down due to all the trauma she has endured thus far. She is having trouble self-regulating. For example, she doesn't always wake up for feedings. I have to set the alarm to get up an feed her over night. At this age, she shouldn't be going 9 hours without eating! :-)

Her cognitive area is good. She is very attentive, can hold a toy, did a lovely job mouthing, holding and watching the rattle. She reached for a toy, dropped one to reach for a second. Social-Emotional was strong. She is very sociable and happy baby. She vocalizes to respond to the family. She often mimics facial expressions and is very aware when you change your expression.

Some areas of the evaluation she scored under her current age. Like I stated above, her gross motor and fine motor abilities are that of a newborn. Admittedly, I coddled her quite a bit with all that she's been through. Specifically, due to the acid reflux and surgery, I have not worked with her on tummy time and I cradle her most often. With the other children, I would bounce them, let the push to a stand on my lap, do raspberries on their tummy, etc. With Mikaela's fragile state, I held her like an infant. Truthfully, she doesn't push back with her legs like my other two did when I put her on my lap. She just lets her legs fold up. She is still working on early neck control. She hold her head latterally bent to the left. Two weeks ago it was to the right. She has a hard time relaxing to bend at the waist. She stiffens up - another reason I just held her often in that "infant cradle" hold. She isn't showing a morrow reflex (extension when suspended) most likely due to lack of overal tone and muscle control.

Regarding her fine motor development, she has discovered her hands and will open her right hand to reach for an object. She can grasp an object placed close to her right hand and holds it, manipulates it and brings it to her mouth for about 45 seconds. She will still hold her hands in fists and tightens all across her shoulders. She bends at the elbows to compensate when working on any postural demand (supported sitting, tummy time or even over the shoulder for a burp.) While working on tummy time, she will only prop up on her elbows when given help. She briefly pushed up on extended arms with hands in fists when she wanted off her tummy. She will lift her head briefly to look at/follow a motivating person or toy. She is not yet reaching toward an object while on tummy, but does a beautiful job of being interested and actively engaged when she is fully supported posturally (semi-reclined on her back).

So, our next step is an IFSP meeting to set this evaluation to a plan and begin receiving services.