M has taken a few steps. If we encourage her, she'll take two or three before she gleefully collapses on the floor and crawls away at lightning speed.
I wrote about her first steps in "Waiting to Walk" and more recently in "The Timing That Is Not Our Own," but the truth is that we've seen no progress on any of her physical goals since she stopped getting physical therapy a month ago.
I've heard from a number of people specializing in developmental delays that a toddler's brain, especially a preemie's brain that is working overtime to catch up, will often focus on either walking or talking, either on physical goals or language goals. And I have seen that scenario play out in both of my children. The most recent example is with M, who is now picking up at least one or two new words each day, but she's not walking, though she's nearly 19 months old.
We had M assessed by the state this week to determine her eligibility for early intervention services, and, as I expected, she has significant delays in her gross and fine motor skills, while she's completely on par with her peers in language development. Until age 2, our state corrects for prematurity, so M is being evaluated based on when she should have been born and not her actual age. Before we moved, we lived in a state that was more aggressive in the first years and did not adjust for prematurity. There she would still be evaluated as an almost 19-month-old, instead of a barely 16-month-old.
The advantage in M still not walking is that she qualified this week for therapy, and once a child has services and is in the early intervention system, it's so much easier to increase or alter services. I am so relieved to know that M is now in the system, so she'll be followed more carefully until she's 3. Had she not qualified now based on the referral generated by our out-of-state move, we might have had to wait until her delays were even more significant before she received any services.
I am such an advocate for early intervention, because I have seen the difference it has made in my children. I don't believe in waiting to see what happens. Children's brains, particularly in their earliest years, are fantastically malleable and incredibly resilient, so the philosophy behind early intervention is to help children bounce back from all the setbacks of being a preemie during the window when a child's brain is the most forgiving.
So, I'm thrilled that M will receive early intervention, but I'm also surprised that she qualified for occupational therapy instead of physical therapy. Occupational therapy is generally more focused on skills necessary to everyday life. Our former pt texted me, "What did she not do?" and I texted back, "Walk?" with a smiley face. I think the belief behind the recommendation of occupational therapy over physical therapy was that if we push M too hard physically just when her language skills are blossoming, her talking may suffer as well. And the therapists assessing her all agreed that she is so very close to walking.
But, as her mother, it was my job to say, "Yes, but she's nearly 19 months old, and she's not walking. I see that as her biggest issue right now." And it's my prerogative to be concerned that maybe we really should be pushing her physically, because she is capable and she is falling so far behind. However, I will reserve my judgment until we meet our occupational therapist and set M's new goals. Occupational therapy will be a new experience for me, and as long as we can give M the confidence she needs to begin taking steps on her own, I'll be grateful for the help, regardless of which kind of therapist provides it.