How Old is Hallie?

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Thursday, June 19, 2008

NICU Follow-Up Program Graduation

I can't believe we've graduated from Pennsylvania Hospital's Follow Up Program already. Honestly, for us 23 weekers, it seems that 2 years is far too soon to age out of the program (you'd think they were interested in what happens next, and on a personal level I think they are; it's just that they only follow their kiddos for 2 years and then it's sayonara). That's too bad, because we actually have come to enjoy these visits and very much like the folks who run the program.

Anyway, Hallie did swimmingly well yesterday. She is really into puzzles, and this was the first thing that Katie asked her to do, and she placed the large shapes into the proper cut outs like a champ. She then proceeded to put all of the long thin pegs into the pegboard, the small shape pieces into the proper place, etc. She also sat still for Katie and did not complain much (note to Hallie: can you try to replicate this sort of behavior at home from time to time? We'd really appreciate it). There were a couple of tasks where Hallie was noncompliant (like matching the proper color duck to the colored pencils on a page), but this was more out of a sense of finding the task tedious than out of not understanding what was expected of her. She was perfectly happy to tell you what color the duck was in her verbal or signing approximations ('oooh' for a blue duck; 'eeeeeen' for a green one; and a very clear 'yellow' for a yellow one); it was just a matter of why would you want to put a duck on a pencil, for Pete's sake, anyway?

Hallie was very happy to walk for Katie---she walked forwards, backwards, and sideways, and ran down the hall until we closed the office door, and then tried to open the door by turning it. She placed pennies into a miniature piggy bank until there were no more pennies to place, and then she tried her best to unscrew the nose of the pig (which is how you open the pig to empty it). She didn't quite manage to open the door or the pig, which we find heartening since this makes it less likely for her to break out of her room after a nap or break into a bottle of prilosec or God forbid something even worse. But she clearly gets the principle of the thing, and that is a good thing. She shows great capacity to generalize, as evidenced by her mistaking of Katie's stainless steel, french door with bottom lateral filing cabinet for a refrigerator (ours is stainless steel, french door, and bottom freezer in nature), and kept asking for an 'icy' (because this is what she does at home). That seemed clever to us.

Anyway, Hallie did do some talking this time around (in addition to saying her colors, approximating the word 'ball' ('awwwllll') and saying 'ready' and 'mama' quite clearly, she also said some other stuff. Back in October, Hallie hardly talked at all, and this had the NICU follow up team kind of worried. Now they aren't so much: Hallie's receptive language and cognition are phenomenal, and she is clearly trying to communicate using words and sign. Her expressive language is obviously delayed for her we-don't-correct-anymore-actual-age of just over two (she doesn't really try to use two word phrases, she obviously doesn't have the 300 to 400 words expected of those who are two), but she has come a long way and their sense is that she will catch up. It's just not clear when, and it is certainly true that her articulation still needs a lot of work. But other than that (and her eating issues; when they asked if she was on table food, Sharon and I just kind of looked at one another), no real problems. This was good to hear.

In terms of weight, there is no doubt that Hallie is thinner than she had been. We're not sure by how much, but the scale put her at 12.02 kilos dressed and with a diaper (probably not totally dry). She has certainly gained no weight since last week, but she might have gained in height. Standing up, the neonatalogist measured her at 35 inches. Sharon and I both think this is a bit of an exaggeration, but we wouldn't be surprised if Hallie were over 34 inches. So she is long and lean and, on top of this, is the proud owner of a pinhead---they measured her head at 43 cm, which is a loss of 2 cm over last week, and 1 cm over a month ago. Now we don't really think her head is shrinking---it just seems that these measurements could afford to be a tad bit more exact than they are. Anyway, her head doesn't look disproportionately smaller than the rest of her, and we're not terribly concerned (especially since Sharon has a bit of a pinhead).

So that was our visit; we'll continue to pop in at Pennsy (we live eight blocks from the hospital) but next time it'll just be to see friends, and not for any formal testing.

EDITED TO ADD: Two more vomit-free days to report...that's four in a row now...and make 57 days for 2008--precisely 1/3 days this year, given that June 20th is the 171st day of the year. And, of course, I probably just jinxed our whole family on the eve of our weekend in NY. Gee, I hope my 'magical thinking' stuff is proved wrong in this case....


Emily said...

What a great achievement to have aged out of the follow-up program. It is unfortunate that they don't at least follow kids on a bi-yearly basis longer to see what the true LONG TERM issues of prematurity are. I'm sorry but at 2yrs you haven't even begun to see the true outcome of a kid's premature birth.

And holy crap! 300-400 words?!?! Our speech therapist said 30+ words and starting to put two words together was typical of a new 2yr old. If it's 300-400 we're WAY WAY WAY farther behind than I thought. Haha.

abby said...

What our ST says about words is that, as long as she's trying and making progress, then she's pleased. It's the progress that she is most concerned with and not the number per se at this point.

On the numbers, yeah, I'm confused, too. I've heard 18 by 18 months; 50 by 2 years and putting words together -- this from our ped; 300-400 by early 2s from our ST; and a bunch of other numbers. I think it's like everything else---it depends on who you ask.

And then it's hard to tell, though, what counts as a 'word.' "Aw" can be 'all' or 'ball' is my favorite example. So much is dependent on context for us in terms of Hallie's pronunciation/signing. I hope this clears up some. And can anyone really explain why she says 'all' when she can say the letter 'b' and how hard is it really to place it before the rest of the word? And finally, given her inability to say 'ball', why the heck does she not have trouble with words like 'pidgeon'? What is that all about, anyway?

Nancy said...

Happy graduation Hallie! It is a good feeling to age out of the program. But on the flip side, it's just as scary that it happens so darn soon. Luckily here we have a program that follows up to age 8, but it costs nothing less than promising your next child if insurance doesn't cover it!

I agree that 300-400 words seems like a bit much. Unless they are taking receptive language into consideration, but then it would seem to low? Like you said, it's who you ask I suppose.

Anyway, kudos to you moms on hitting a fantastic milestone!

23wktwinsmommy said...

She's doing so great! You both must be very proud. And I hope you guys have a terrific trip to NY!
p.s. Edwin and I are talking about a drive down to Sesame St Place!!! We'll keep you in the loop...we'll only make the drive if we can meet Hallie, Abby, and Sharon I told him! lol!