Tuesday, 10 November 2009

The Early Intervention Saga

After being home for almost two months, we finally got our early intervention evaluations. Finally. You may be wondering why we sought them out, and that is simple: all children who grow up in orphanages, no matter how loving, have delays and are considered "special needs" for a time. Orphanages simply cannot provide the kind of attention required for optimal development. Tommy was, we believe, physically delayed due to parasites and poor nutrition and as a result is small for his age (25th percentile), despite being a large baby when he arrived as a newborn at the orphanage.

Because of his background Tommy's pediatrician gave us the referral we needed for an early intervention evaluation.

Now, at the time we were aware that we would be moving from Cook county to DuPage county. My referral was for Cook county, and when I called they said they couldn't evaluate Tommy because we were moving to DuPage and I should call them. So I did. DuPage said they couldn't evaluate Tommy because we still lived in Cook. I love bureaucracy. DuPage said I could call once we physically resided in the county. On Sunday, September 2, the day we moved into the Argonne Guest House, I called and left a message for the intake coordinator. It took a few days for her to get in touch and set up an intake appointment for the end of the next week. At the intake appointment we discussed my concerns and she explained the program and told me therapists would be calling me the following week to set up appointments. We had five therapists come out over the course of two weeks to evaluate speech, development, attachment and psychological state, and gross and fine motor skills. The evaluations all happened within a month of my calling.

The evaluations went well. My very favorite was the psychologist who told us that Tommy is attached! All of his body language and responses indicated a bond to us. We are still, of course, being careful of this bond, because we don't want to damage the progress we have made, but it was very encouraging news. She added that she was very impressed with Tommy's overall attitude and that many of the skills he demonstrated for her were above average for his age. She felt that he was more advanced at some things than many children born in the US. We thought he was pretty clever and fast at picking up on things, but believed ourselves to be biased...apparently not!

The Occupational therapist felt he was also at or above age level in his fine motor skills, and the physical therapist said he was doing well for an early walker (he learned to walk late, but they don't consider it delayed as long as it is before 17 months) and that his muscle tone was great and that she doesn't anticipate future delays.

The developmental therapist noted some delays, as did the speech therapist, but neither were severe enough to require services, although we can request reevaluation in those two areas in three months to make sure that he is moving forward at the appropriate rate.

But here is the kicker: the physical therapist said, in an offhand way, after saying that we wouldn't qualify under her, "If only you would have had him evaluated sooner, he would have qualified when you first brought him home"!!!

Not qualifying is a mixed blessing. Now we don't have to deal with scheduling a therapist and making appointments, but instead we are responsible for catching Tommy up with no guidance and no help. I'm not complaining about having to teach Tommy things. That is my job as his parent, and we knew when we adopted that he would have delays and had prepared ourselves for those delays to be much worse. That said, at the end of the evaluations I felt a little like I did the day when Sister handed Tommy over to me with the words "He should be walking and potty trained by now. You should work on that."

He has some delays. You should catch him up.

Thanks. He still isn't potty trained.


Heather said...

Potty trained before 2? I know people do it. We did not push it with either of the boys and it worked out great. They potty trained in a day and I didn't have to deal with accidents. Evan was newly 3 and Micah was about 30 months.

lauragifford said...

I second that -- I'm impressed he's been interested in going on the potty at all for you; that in itself is great. By American standards I'd say he's ahead of the game.

Gretchen said...

Just wanted to let you know that Anders is STILL working on potty training and its NORMAL. (just wears a diaper when he sleeps). =0) It sounds like Tommy is doing extremely well for his age and from all of the pictures and stories he seems to be quite healthy.
I can tell that you guys are doing an amazing job as parents.

Noelle said...

Hi guys! As you know this used to be my job in Cook Co. I totally understand about the mixed blessing of not qualifying. If you want you could contact Roberta Hansen who is the parent Liason for CFC #11 where I used to work. Let her know I suggested you call her for some guidence and she should be able to point you in the direction of some support and consultative services and info to be sure you stay on the great track you are on now! Her number at CFC is 942-7863. I would be happy to help with any other suggestions...I know most about Cook co, but could make some calls or send some emails if you wanted! Keep up the good work. I'm hoping to visit chicago in January and would love to figure out a way to meet Tommy!

Cuppa Jo said...

Potty training. You sooo need to go back and read every post I've written on the subject with regards to Zane.

Zane was 4 when he was finally trained.

And surprisingly he's also dry through the night now - even gets up on his own to go.

However, we had major difficulty.

I'd lay off it unles Tommy initiates.

thecurryseven said...

I could write exactly what Joline did in regards to one of my boys. I'm still buying diapers/pull-ups for 5 children. Please cross it off you list of things to worry about!

About EI...it sounds as though he had a great evaluation. Here is my humble opinion (which I realize that not many people will agree with -- and in which I sound as though I am bashing therapists, but I'm not): K. was very, very delayed when we brought him home and qualified for every type of therapy EI had to offer. While I really liked some of the therapists who came to our house, and I believe they helped to speed up his progress, I think that much of his catching up was a result of living in an enriched invironment and being encouraged to try and do things that he never had to opportunity to do. We didn't have 'homework' that we spent a lot of time on between therapy appointments, but just lived our usual lives. He is now nearly caught up in everything, and even speech is quickly catching up. It sounds as though any delays Tommy might have are purely a result of environent and not something organic that truly needs outside help. I've watched you parent and, really, just keep doing what you are and enjoy your boy. You are doing the best things you can for him already!

Kate Glenn said...

You don't know me but I follow your blog religiously. My little boy I almost 4 he is in the 98th percentile on everything and he is not potty trained. They will do it in there own time. So don't let anyone tell you he should be. It will happen. When it happens.