Team D: Developmental Check In

We had our third developmental assessment today. The last one for C. D qualifies for one more in about a year and a half (she qualifies by 6 grams based on her birthweight). We'll get the full results later (and yes, i'll probably post because I have no confidence that I'll keep the papers for posterity but I plan to keep this thing).

The short answer is that they did great. They saw the neurosurgeon first. He's definitely the weakest link. He's old and tells the same stories about himself ("I didn't walk until 18 months and look at me" yada yad yada) every time, gives the girls simple tests for about 2 minutes, and then makes these broad assessments. The winner comment from this visit was: "She (D) may be petite, but she won't be of the 'little people' genre." (Seriously buddy?)

Then they saw a nurse practitioner. Physically they are doing very well. They still have the heart murmurs and I have to get them checked out again this year to confirm that they are innocent. D is 25lbs and 35 inches tall, C is 28lbs and 36.25 inches tall. That puts them at the 50th percentile in both areas for preemies. On a standard chart it puts D in the 10-25th percentile in height and 5th in weight, and C in the 25-50th percentile in height and 10th in weight.

Finally they had their Bailey tests, which test cognitive skills, verbal skills, and fine motor skills. A took C, and though he didn't get specifics, he said "she crushed it." D tested very well on her cognitive and verbal skills. Her fine motor skills are just about at her actual age which is not bad, and her gross motor skills are a little behind her actual age. One of the things the therapist said was that we should watch out for her "compensating for any fine motor skills deficiencies by using her cognitive skills." A good example---she gave D a scissors and asked her to cut a piece of paper in half. D started to cut but found it too difficult to cut all the way through. So she took her hands out of the scissors, picked up the paper, finished ripping it in half, and handed it over to the therapist. I couldn't help but smile.

These assessments are both reassuring and upsetting to me. For the most part I am so grateful --to God, everyone who took care of them, my doctor, and the girls themselves--that they are doing so well and show very few signs of any long term issues from their in utero experience and prematurity. I KNOW how much worse things could be and I am so grateful that my monkies are ok. But there is a little part of me that can't help but think "what if?" What if D didn't get less 'food' in utero? Would she be bigger? Stronger? Different? The neurologist there said he was a preemie, and originally wanted to be a neurosurgeon, but then realized he didn't have the fine motor skill dexterity for it, and he thinks it relates back to some fine motor skill delays based on prematurity. (then again, the neurosurgeon likes to talk). Still, will either of them run into a roadblock based on their prematurity someday?

It is also weird to hear C being referred to as the "control twin." Meaning she was about the appropriate size for her gestational age while D was SGA ("small for gestational age"). D will likely always be smaller than C as a result of the nourishment she didn't get inside me (and maybe mild TTTS). The question is, how much smaller? It is frustrating because in this situation, comparisons between the two have to be made and I hate it.

I try to remember that we are the sum of our experiences. D has always had to work harder at things, and as a result she is very focused and determined. One of the projects she had in the Bailey test was to loop a shoelace through a series of holes. She spent 5 minutes on it, patiently working until she got it right. The OT said most kids (including C) give up quickly if they can't figure it out. D's a fighter, and maybe having to work a little harder to compensate for any shortfalls will serve her better in the long run. Somewhere in me I imagine a feature on ESPN or CNN that begins "She was born 2 months early weighing 3lbs, 4oz......"

Here's D, wearing the glasses from her doctors kit and the googley eye glasses she got at her first trip to the dentist.