Check Ups for Mama and Calvin

Calvin's first birthday is coming up faster than I can believe, and I am now past the halfway mark of my pregnancy! Big times for both my babies!

Up until my 20th week of pregnancy, I had all my prenatal care done at home by my awesome midwife, Michelle Welborn, who was also my midwife when I was pregnant with Calvin. We are planning a home birth, which we also planned last time (though Calvin ended up being born at the hospital due to his early arrival at 36 weeks). At 20 weeks exactly I had my first appointment at my doctor's office - just a routine check up, a quick ultrasound to confirm my due date (7/11/13!) and then we scheduled my mid-pregnancy ultrasound for a few days later.

The mid-pregnancy ultrasound showed that all the baby's organs have developed well and are functioning well. We saw how active the baby is - although I could have told you that myself from all the movement I've been feeling! And we got the news that we are having another baby boy!

An heir and a spare! A baby brother for Calvin! 

Also during the past week, Calvin had his 10 month check up with his pediatrician. His growth progress is totally on track, though he is still teeny for his age (just to clarify: even though he is on the small side, he is growing at the same rate as other babies and therefore is healthy).

A few days later, Calvin was seen by a nurse and case worker from our local Regional Center, which is the organization through which Calvin can/will be set up with support if he turns out to need help with speech or motor delays due to his chromosome anomaly: 22Q deletion syndrome. This first visit was just an initial evaluation to see if, at this point, Calvin could benefit from any kind of therapy or classes. 

The case worker interviewed us about Calvin's development, and the nurse played with him and did some assessment of his motor, language, and cognitive skills based on his interaction with her. Most babies/kids don't qualify for services unless they are 3 or more months delayed in at least one of these areas. With Calvin's genetic diagnosis, he qualifies no matter what so it was just a question of what, if anything, would be helpful for him. They were evaluating him based on his gestational age which is a month younger than his actual age because he was born a month early. 

Both the case worker and the nurse concluded that Calvin is totally awesome and within the normal range of development for a 9 month old! Seriously, they loved him. He really is such a friendly baby that I just have to brag on him for how well he interacts with people. Plus he wins them over with his one dimple. 

Here are some main things they told us about how well Calvin is developing...

- It's fine that he's just starting to crawl, it's still within the normal range of when babies learn to crawl.

- Once he builds some more core strength he will be able to pick up his belly and crawl on hands and knees, instead of the "Army" crawling.

- His other motor skills are also on track... picking up toys, receiving things handed to him, manipulating moving parts of toys, clapping/banging toys together, pulling up to standing, taking steps while holding on to an adult.

- His receptive language is on track. He understands verbal directions combined with demonstration, he recognizes his name and knows who to look for if you say "Mama" or "Daddy." He responds differently to different tones of voice. 

- His expressive language may be delayed. He didn't really "talk" to the nurse at all (which is typical - he is much quieter around new people). She said that babies usually focus on one type of skill at a time, and that he seems to be focused on motor development right now so the verbal skills will come later. Nothing concerning enough to merit speech therapy. 

- His cognitive skills seem well-developed... she talked about his cognitive skills in terms of his receptive language, how he mimics and responds to verbal and visual cues, how well he interacts with others, how he figured out how to move small parts of toys, and that he seemed to recognize toys in pictures (when presented with a toy truck and a picture of a truck, he seemed to know it was the same thing). She even said that some of his cognitive skills seem to be advanced for his age! 

So all in all, very good news for us and for Calvin. Whew! After being told repeatedly all the things he is at risk for, it is ALWAYS nice to hear that actually, he's doing great.

They gave us some recommendations for him, most of which we already knew and have been doing. It was nice to hear that we are doing some things right, and also good to know things to change.

- Lots of tummy time/floor time... set toys away from him so he is motivated to crawl for them.

- One or two toys at a time... he is discovering that he can make things "work" (manipulate objects) so only give him one or two so that he can focus on really figuring them out and he won't be distracted or overwhelmed by lots of toys. 

- New high chair to help him build core strength... at that time we were using the Chicco hook-on high chair which I love because it doesn't take up space in our small kitchen and it allows Calvin to join us at the table. But the nurse said that one is better for older babies and that one with a firmer seat and back will encourage him to use his core muscles to hold himself upright. So we got the Evenflo modern high chair. 

- Use a tray for feeding so that he can use the raised edge to help pick up slippery food, whereas with the hook-on chair, it was too easy to push food off the table. Another reason for the new high chair.

- Hand him things at his midline... this is to allow him to develop both sides of his body because he can reach for the object with either side. This will help him develop balance which is important for crawling/walking. Yet another reason for the new high chair because now I can sit directly in front of him to feed him instead of feeding him from the side. 

- Keep talking to him and verbalizing our actions. 

- Give him time to mentally process by waiting longer for his response  to cues and commands (we teachers call it "wait time").

Without his 22Q diagnosis, he wouldn't have qualified for services because he isn't really delayed. But since he qualifies anyway they set us up with an occupational therapist (OT) to help with feeding since that is an area of concern for us. It took Calvin a few months to start accepting solid foods - even purees. He wasn't really eating solids until January (9 months old), and we are still concerned about him starting to eat whole foods (cereal, peas, beans, pieces of soft or cooked foods) and starting to self-feed. He still seems to be having trouble, and isn't willing to eat much. So we will have our first visit from the OT next week. 

So glad to hear that our little chicken is doing fine! He really has made lots of progress just this month... belly crawling, some self feeding, pulling up to standing from hands and knees, some "cruising" in his crib, and just today he figured out how to sit himself up from crawling! Like I said on Facebook this morning, it seems like he is trying to get in a bunch of new motor skills at the last minute before his first birthday!