Friday, August 16, 2013

The Coming Changes

J's state-funded intervention has been phenomenal and aggressive. Physical therapy twice a week for a year and once a week for an additional 18 months. Speech therapy twice a week for a year. Placement in a school that specializes in developmental delays for nearly two years. His intervention has been impressive. In fact, I'd put it up against any other state. I really don't think J could have had more help in catching up with his peers.

Studies show that the earlier a child can get intervention, the better the child will do longterm. But, here's the problem: All this intervention doesn't come cheap. Insurance companies and state governments pay a pretty penny for it. I am conscious of the fact that J's therapy came at a great cost when there isn't much extra money lying around in state budgets.

I have just learned that M's experience may be totally different from J's. She's already receiving physical therapy, so hopefully she's guaranteed that service until she begins to catch up with her peers. She's seven months old, and she doesn't roll over from back to front, much less sit up or crawl. She needs help that I am unable to give her. But, the state is encouraging a less expensive approach: send a teacher into the home to talk to the parent. My response: about what? I have had this service with both J and M, and I can vouch for its limitations. Someone can look at her and give me suggestions, but what about when she's on the verge of walking and clings to every piece of furniture in the room for months without letting go, like J did? Or what about when she struggles to say any words at all at age two, not even calling me "Mama," just like J did? She was less premature, she's a girl, and she seems like a natural extrovert, so maybe she won't need all the services J had. But, I can promise you, I am no substitute for trained teachers and therapists, no matter how much you talk to me. I can try, but I am her mother, not her coach. And J needed lots of coaches.

It doesn't matter? One day all kids will catch up? Not necessarily. And at what cost? My friend with quads has all of her kids in a public preschool. They didn't get the therapy J got because the philosophy in her state is different; less therapy up front in the hopes most kids won't need services later. Wrong! Now, the state is paying teachers full-time to teach her children. J didn't qualify for state preschool, but he would have qualified had he not had all of the intervention. Of that I am sure.

There is the argument that when we were kids, such services didn't exist, and we turned out just fine. My response: there are more preemies now who survive. J wouldn't have lived a few decades ago, so how can we even make that comparison? And delays are being diagnosed earlier. Does that mean we should ignore diagnoses until children are school-aged? And I'm not just talking about my preemies. I'm talking about kids with autism, Down's syndrome, and cerebral palsy. I believe in being proactive, because I see the happy, healthy child that J is. Without all the enrichment he's received from his skilled team, what would he be?

My philosophy is you can pay now, or you can pay later. I'd rather, as a society, that we put the effort into our tiny babies. We don't have the money for that? Then, our priorities are all wrong.

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