Evaluation

When I was a kid, I mean really young, my younger sister got to have occupational therapy. I say “got to have” because her therapy seemed so cool to me as it helped her work through the tactile defensiveness that would later prove to be a symptom of autism. She’d do things like play with shaving cream and eat popsicles and all the stuff that, to a five-year-old like tiny me, seems like the best thing ever. Now, of course, because she was tactile defensive, she hated all of that, but I was so jealous that she got to do these things and it was called “school.”

funny-cat-gif-cat-licking-delicious-popsicle-but-brain-freeze-coming-soon
(I think I did this once? in school? It must’ve been third grade because my third grade teacher was amazing)

And it all came through Early Intervention, a program for infants and toddlers who either have developmental delays or are at risk for having developmental delays, with the aim to reduce or remove those delays. And I’m thinking about it quite a lot because Isaac has officially qualified for Early Intervention, as of today.

He is developmentally delayed, meaning that he’s failing to hit a handful of milestones, all thanks to his torticollis. Apparently the doctor we saw about a month ago, who seemed entirely useless, actually referred us to Early Intervention, and after some telephone tag, I scheduled an evaluation for Isaac for this afternoon. The idea was to see if he qualified to receive their services and, if so, what services he should receive. And, as it turns out, he does.

His delays aren’t cognitive or social, which is a huge relief to me–not that motor delays are fantastic, but at least we know that whatever caused his torticollis hasn’t negatively impacted his cognitive and social development much. The ladies who came to evaluate him–all some version of a Platonic Form of “mom”–all fell in love with him the second he smiled (and I can’t really blame them; he’s got the best gummy little grin. They both do, really).

The evaluation was mostly playing with him to see how much he could turn his head, if he would move and interact with stimuli, if he’d interact with people, things like that. Like Sam before him, he’s infinitely more interested in people’s faces than in objects, no matter the object in question. One of the evaluators and I had to hide our faces during some of the testing because he kept ignoring the toy he was supposed to focus on to smile at us.

His trouble comes entirely in his movement, and that’s what we expected to hear. His torticollis isn’t absolutely impossible to fix–he’s able to get his head to turn to face forward briefly, at least, which is good–but it’s bad enough that we definitely qualify for assistance in that regard. In the meantime, we have exercises we’re supposed to do with him to stretch out his neck. With any luck, between those and the helmet, he’ll be doing well enough in a few months that this–like the NICU–will all be backstory.

The helmets are pretty much a given for both twins, even though Carrie doesn’t have the torticollis as obviously or as badly as Isaac (the EI people said that they’d do a free evaluation of her if we wanted, which I may take them up on, but not until we’re in a more settled pattern with them–probably next month). I’m trying to keep reminding myself not to feel guilty about the things they’re delayed on and the flatness because those delays and the flatness are both byproducts of their prematurity and their twin gestation. Still, it’s hard when you read “your four-month-old should be able to roll over” and your four-month-old is mostly just doing mini-pushups when you give them tummy time.

Still, their social development helps me to focus on the good, even when the physical development lags behind. They’re both absolutely delightful. Isaac has developed a fantastic giggle that comes out whenever we change his shirt for the day for some reason, and I may have changed his shirt multiple times a day just to catch that giggle in action. Carrie is still just a sunshiney girl overall, and they’re progressing well. Both on the curve, both hopefully ready to graduate to real people formula and save us some dollars in the process.

money_jetssons
(how to buy formula when you have twins, illustrated)

The dollars are a stressful thing because our budget right now leaves us basically no wiggle room, even with as many things cut out as we can (i.e., in the year of our Lord 2018, it is not practical to cut out internet or wireless, and while I’d love to downgrade our cable, we’re in the middle of a contract, and doing so would cost more immediately than it’s really worth). This particular pay period is tight because we had a surprise antivirus autorenewal (Kyle had been talking to me about when we could renew that subscription, only to find out that it had renewed itself! Surprise!), the cat needed a trip to the vet that cost more than the $75 I usually expect (because she’d inexplicably grown troll claws that embedded themselves in her paw pads and so we needed to have her claws clipped while we were there, which seems simple enough, until you factor in the antibiotics she got afterwards), and our water bill was due. Without these unexpected expenses, we can do our budget really well and get along with slightly tightened belts. With the surprises, things get… tense.

I remind myself constantly that we’ll be in a much better place by this time next year. We’ll have paid off the car with the larger payments, and the twins will be off formula and onto cows’ milk. Our tax return should look really good: we’ve added two dependents, and I quit my job, which is a significant decrease in income since last year. In September (or August, school years are weird now), Sam will be starting kindergarten, which means no more preschool tuition (I love his preschool, but I’ll be glad to stop paying that every week). When all is said and done, we’ll have an extra $800/month by next summer and an extra $1100/month by next December.

Which is very comforting, but it doesn’t help right now, when I’m more than a little on edge because the twins went through a growth spurt, and now the 3 month clothes I expected to last them the summer are all too small.

Sigh. Money is dumb. But we’ll make it, I’m sure. We’ll be stressed out and poor and exhausted, but we’ll make it.

And in the meantime, early intervention is free, no copays even, so that’s pretty nice.

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