She said the magic word!

Most children say “mum” or “mama” or “mummy” as one of their earliest words, apparently.  Not our little bundle of joy - her first word was cat, followed by woof-woof, book and duck.  I understood that these were all very important concepts, but I started to get impatient when her vocabulary expanded to include shoes, bike, chook, daddy, milk and okay but still didn’t include anything that was a name for me.  I use the word mummy all the time, and if I asked where mummy was, she would point at me - so I knew she understood the word and what it meant. But months passed and if she wanted me, she just said “euuuuurgh!”  As if that wasn’t bad enough, Talia went on to count from 1 to 10, her vocab expanded to over 90 words and she had words for orca, frog and dolphin… and would occasionally point at me and say maaa.  Then just when I thought my ego couldn’t take it any longer, out it came last Thursday - clear as day, with a loving smile that made my heart melt - MUM!

Looking back at 2008

How did it get to be the middle of January 2009 already?  It feels like the last 12 months have gone past in a blur, so I thought I would do a quick recap of some key milestones.

January 2008 (10 months, 7 corrected).  Talia reaches 6kg.  She is able to sit confidently and rolls from front to back (to avoid tummy time!)  Breastfeeding comes to an end but she is able to hold a bottle by herself.  We start baby sign language classes.

February 2009 (11 months, 8 corrected).  Her first flight, to Sydney.  First time in the rain, first trip to a restaurant.  Our 8 month paed check-up rates her development at slow but within normal ranges, except for possibly speech where she has no consonants yet.

March 2008 (12 months, 9 corrected).  Talia cuts her first tooth, celebrates her first birthday, passes the 7kg mark and is given the all clear by the opthalmologist at PMH.

April 2008 (13 months, 10 corrected). We start one-to-one physio sessions at KEMH to help Talia develop the skills she needs to be able to reach, turn, crawl and stand; at the moment she just sits in one place like a little Buddha.  Talia decides to stop accepting food via spoon, and becomes almost entirely self-fed on finger food (plus bottles of formula).  2nd tooth arrives.

May 2008 (14 months, 11 corrected). 8kg.  Talia rolls back to front for the first time, cuts 2 more teeth and starts to crawl.

June 2008 (15 months, 12 corrected).  Talia starts cruising and clapping. At her 12 month corrected developmental review she assesses at 10.5 months on the Griffith’s test, but she is making good progress.

July 2008 (16 months, 13 corrected).  Talia can now push a cart, climb up and down a step and shows some understanding of words such as names of her favourite toys.

August 2008 (17 months, 14 corrected).  9kg.  Talia starts pointing and waving and climbs up the slide for the first time.  She transitions to cow’s milk and one nap per day.  She babbles a lot but only has 3 recognisable words (book, dog, cat).

September 2008 (18 months, 15 corrected).  Talia says her fourth word (”dut” = duck).  She loves going on the swing, reading books, balls, balloons and bubbles.  We start baby swimming lessons.

October 2008 (19 months, 16 corrected).  Talia takes her first few steps and her vocab reaches 20 words.

November 2008 (20 months, 17 corrected).  Talia stands up without pulling herself up, walks independently for as far as she feels like, stacks boxes and scribbles, all for the first time.

December 2008 (21 months, 18 corrected).  Talia’s vocab blossoms to over 50 words and she joins in singing nursery rhymes.  She has all teeth apart from her 2yo molars.  She can post shapes in a sorter and starts using the Auslan sign for “more”.  She only crawls when in a hurry, or to go down steps.

It’s been a pretty amazing year.

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!