Evaluation

Clare had her one year evaluation with Early Intervention today. Her occupational therapist, Jessica, came over along with a speech therapist and physical therapist. I was very nervous leading up to this evaluation because Clare has not been officially evaluated by a team of therapists since she was three months old. We would find out today if Clare needed additional services and how delayed she is.

The therapists spent about an hour and a half playing with Clare and testing her skills. Shawn and I answered lots of questions about Clare's daily activity and what she does and does not do. You could tell that the two new therapists were instantly charmed by Clare. (She has that effect on people!) She played shy and coy with them at times and favored them with huge grins. Clare is such an expressive baby that when she is proud or happy over something she's done, it spills over and makes you so proud and happy as well. Clare showed some skills that we didn't even know she had. She did fairly well handling the amount of work the therapists wanted her to do. Clare still does not have the longest stamina and tires easily, so she got lots of little breaks.

After the playing was done, it was the moment of truth. I know I had butterflies in my stomach waiting to hear how Clare was doing. OT evaluated her fine motor skills and self-help skills. Jessica said Clare was doing great, has shown considerable progress, and is right on target for an almost 15-month old. Clare can do all the fancy tricks like transferring objects, bringing her hands to midline, claps, waves, using the pincer grasp to self-feed, and "helping" us to dress her (takes her arm out of the sleeve, that kind of thing). The only "negative" comment Jessica had was that Clare is not releasing objects. Clare will not stack toys, nest cups, or even hand you a toy. Now, personally, I think a lot of this has to do with having an older brother. Once Clare has her pudgy little hands on something, there is no way she is going to let go! So she is facing lots of container play in the future and working on releasing toys voluntarily. (Rather than us prying her iron grip off something!)

PT evaluated Clare's gross motor skills and strength. As expected, Clare is delayed in this area. She has good lower body strength, but her upper body is weak. Much of this is due to Clare's lack of tolerance for tummy time. That has always been a battle with us, especially after Clare's open heart surgery when she had restrictions on tummy time for a couple months. As expected, Clare is delayed in the area of crawling and pulling up. She has mastered sitting and is doing a nice job with rotating her body while sitting. So tummy time will continue to have a starring role in Clare's therapy!

The final evaluator was speech. Also, as expected, Clare is delayed in speech. She is at an 11-12 month level. We have heard Clare's repertoire of noises explode over the last month, so I know she is on her way to talking. Her list of words include "hi," "yeah," "da da," "jay jay" (for Jamie), an occasional "ma ma" (okay, I only heard it once!) and her newest addition - "yup." Her understanding of words is a little more progressed - she will give hugs and kisses when you ask her. She will wave when you tell her to "say bye-bye."

The most startling observation for us (and I think for the therapists) was that Clare's learning skills were on the level of a 16-18 month old (she is actually advanced in something!). The therapist played some games with Clare involving object permanence, and Clare excelled at them all. She found that darn mouse every time! Once Clare sees how to do something or figures something out, she can do it again immediately. After I brush her hair, I let Clare have the brush, and she tries to brush her hair as well. This was such an amazing piece of news to Shawn and I because we do not know how cognitively-impaired Clare will be. This is a glimmer of hope that Clare may not be as impaired as we feared she would.

At the end of the session, the therapists all agreed that Clare did not need additional services at this time. Yippee! Clare is not delayed enough in any area to warrant more time spent in therapy. Her OT, Jessica, will continue one hour of OT a week and focus on progressing Clare's skills in all areas.

So all that worry and uneasiness over two of the big things happening in Clare's life lately turned out to be for nothing. Thank you, God, for that! With the good news from her cardiology appointment and now today's good news, I feel that we are finally hitting a real good stretch of road here. And I am going to savor every last mile of it while it lasts.