We have a toddler!

When Talia started cruising the furniture back in June, I had no idea it would take quite so long before she was really ready to walk by herself.

She took her first hesitant little steps two months ago, and could often be persuaded to walk while holding on to our hands. It was clear there was nothing physical holding her back, but she seemed to lack either the confidence or the incentive to get up and just go, preferring to either crawl (quite speedily, especially if trying to get away from someone who wanted to change her nappy or put her to bed) or wait for her “staff” to come and carry her to wherever she wanted to go.

When we saw the physiotherapist at the State Child Development Centre in mid September, she told us that she regarded a child to be walking properly when they were also able to stand up by themselves in the middle of the room. We passed that milestone on Wednesday last week. I was so excited I clapped and cheered. Talia gave me a big smile, took three steps forward and fell splat on her bottom.

However, the the big day has finally come - drumroll please - as of Sunday 16 November 2008, we have a toddler. Something clicked and she realised it was safe, easy, fun… whatever it was, she’s up and walking and it’s a wonderful achievement. Our only regret is that Talia’s Grandpa, who asked us so many times if she was walking yet, passed away just a few months too soon to see her in motion. He would have been so happy.

A wonder week

Ages ago I read an interesting article about “wonder weeks“. Apparently babies go through predictable stages where they spend a period of time being fussy - unusually clingy and difficult - followed by a period of time when they are much happier after passing through a stage of development.

We’ve definitely had one of those wonder weeks! After several days of extreme crankiness, the last few days have seen Talia

- trying to walk dozens of times a day (whereas beforehand she went for days without trying) and usually managing at least 4 steps per attempt - sometimes up to 8.

- stacking boxes for the first time, including one 4 box tower. Previously she was only interested in destroying any sort of stack.

- standing up in the middle of the room (not pulling herself up on anything) for the first time

- scribbling for the first time (using an etch-a-sketch I bought second hand today)

She has been very pleased with these achievements, with lots of smiles and clapping, and as doting parents we are also very proud of her.

12 month corrected developmental review report

Babies born at KEMH under a certain gestation and/or weight are assessed by hospital paediatricians at term, 4 months corrected, 8 months corrected and 12 months corrected. The first three assessments are fairly short but the last one is longer and a written report is sent out afterwards. Here is ours:

DEVELOPMENTAL REVIEW OF:
NAME: Talia
DATE OF BIRTH: 20/03/2007 EDC: 20/6/07

SEEN IN.-THE KEMH DEVELOPMENTAL ASSESSMENT CLINIC ON 25/06/2008
Talia was seen for developmental assessment today as part of the neonatal follow up programme. Talia was born at 26 weeks gestation weighing 855gm and is now 15 months of age equivalent to 12 months corrected age. Neonatal details are shown on the discharge summary. Features of note included: Chronic lung disease requiring supplemental oxygen and CPAP for a long time. Normal cranial ultrasounds, no IVH, no retinopathy of prematurity.

RECENT MEDICAL HISTORY
Talia has been healthy with no hospital readmissions since she was initially discharged. She is seen regularly by ophthalmology and they have no concerns. She has also been seen in audiology for hearing testing - there has been some middle ear Eustachian tube dysfunction and she is due to be reviewed again for hearing testing. Immunisations are up to date. Health is otherwise satisfactory.

DEVELOPMENTAL PROGRESS
Talia has demonstrated developmental delay across all skill items at each of her developmental reviews, however she is beginning to make some considerable gains and her parents are pleased with her progress. She has now been crawling on all fours for about a month and did not ever commando crawl. She pulls herself up to standing and is cruising around the furniture and will walk when she is led with fingers. She does not yet walk behind a trolley toy and is very reluctant to climb up any steps or pull herself up over a ledge or onto a sofa. Hand preference is not yet clearly established. She claps hands in imitation but is not yet waving ta ta or pointing at objects of interest with her index finger. She can pick up small objects with a bilateral pincer grip. She does not yet use any words specifically apart from possibly cat and does not say mama or dada. She, however, responds to her own name, enjoys music and singing but does not vocalise to herself with this. She does not consistently shake her head for no. She is normally a very placid and happy little girl. She is not particularly affectionate, however plays interactive games and helps with dressing. She fingerfeeds herself and can drink from her own sipper cup, is not yet using a spoon. She sleeps right through the night and has two short daytime sleeps.

ON EXAMINATION
Talia’s height was 70.1cm (3rd-10th percentile), weight 8.56kg (10th-25th percentile) and head circumference 46cm (50th percentile).Talia is now well established on the percentile chart and tracking along the percentile lines.

A Griffith’s Test (Revised) was carried out, with the following results:
A Locomotor 31 - 10.25 months
B Personal / Social 35 - 11 months
C Hearing / Speech 26 - 9.5 months
D Eye / Hand Coordination 31 - 10.75 months
E Performance 31 - 11.25 months

Age Equivalent 10.5 months

During testing Talia was beginning to demonstrate concept of object permanence and roll a ball in reciprocal play. She currently drops a cube for a third, clicks bricks together and is starting to put blocks in and out of containers in play. She made attempts to play with the formboard puzzles but was not able to complete these. She was trying to replace the bricks back in the box and demonstrated normal fine motor dexterity.
Neurological examination shows no evidence of focal neurological signs or asymmetry. She has normal muscle tone and power but reflexes were difficult to elicit. Parachute response was symmetrical.
General examination of cardiovascular, respiratory and abdominal systems showed no abnormality.
Normal female genitalia. No birthmarks or scars of note.
Vision was assessed using Stycar mounted balls and she followed diameters down to 2mm suggesting normal visual acuity.
Hearing screening was carried out using visual reinforcement audiometry and this produced prompt responses on either side at 25dB level suggesting normal auditory acuity. Tympanic membranes and Tympanography were not done. Dentition was normal.

At just 12 months corrected age, Talia is making satisfactory developmental progress following her extremely preterm birth and low birthweight. I think she would benefit from involvement of Play and Learning and understand that she has also been referred onto CDC Physiotherapy for monitoring of gross motor skills in recent months.
As part of the neonatal follow up programme Talia will be seen on a regular basis until school age and the next anticipated review is at 2 years corrected age at the State Child Development Centre. I would be happy to review Talia again in 6 months to monitor her developmental progress should there be any concerns in the meantime.
DR XXXX Developmental Paediatrician

Happy one year corrected Talia!

On the move!

Less than 2 months since Talia first crawled, she has started to walk and push a little cart along! We loaded the cart up with bricks, phonebooks and a street directory to make it easier to push without running away from her.

This video was taken on July 13, a day after she first pushed the cart herself.

http://www.youtube.com/watch?v=zchY3DSIteI

If you’re happy and you know it…

A wonderful thing happened this weekend.

I’ve been clapping to Talia for months, probably about 5 or 6 months, since she started sitting up. Apart from general applause and renditions of Pat-a-cake, I would clap three times and say “clap, clap, clap” as I did it, over and over again. She would smile at me with the sweet but slightly worried expression that says “mother, I love you but you look like a crazy lady hitting your own hands together like that.”

Then suddenly, yesterday while visiting my parents, my father clapped for her and she clapped back again! Then we all joined in - three generations of family clapping. It was very cute, and a lovely moment for us to share.

Then this morning came one of those wonderful “my child is a genius” moments.

Talia was in our bedroom, full of early morning energy, and, without moving my hands myself, I said “clap, clap, clap” and she started clapping!! She knows the word clap!! And it wasn’t a fluke, I’ve been saying it on and off all day to the same reaction (because I’m so excited I just can’t get enough of it!!!)

Woooooooooo hoooooooooooooo!