Becca Meets Baby James

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Developmental Update

Okay, I know I've been slacking on giving you actual information about our rock star preemie.  We've had a lot of assessments and change over the past several months as Becca turned 3, so let's rewind back to the spring, as we approached her birthday.

Becca received Early Intervention services from the time she came home from the NICU to her third birthday, and they made a TREMENDOUS impact of her development and our understanding of the ways we could encourage her to meet her milestones, albeit at her own pace.  Early Intervention is a federally-mandated, state-sponsored program, and it is worth every penny our taxes put towards it (and could use a lot more pennies thrown that direction).  Without it, Becca never would have made the progress she has made, and it's even more important to other kids whose parents aren't able or willing to go to advocate and care for them the (very difficult) way that kids with special needs require, because the Early Interventionists are able to (somewhat) step into that role and equip parents to, well, parent better.  So, we are fans of Early Intervention.

But once you turn 3, if you require "services" (therapy and/or special instruction), you are the responsibility of the public school system.  So beginning in January, we began transition meetings with the Williamson County school psychologist.  A few months later, Becca had a whole battery of assessments: one morning the psychologist and the speech therapist double-teamed; another morning the physical therapist and the occupational therapist worked with her.  We then had several meetings with me and John (and Becca), the psychologist, an OT, a PT, a SLP (speech/language pathologist), an early childhood special education teacher, and either the school principal or assistant principal.  These meetings were...difficult.  And at times, not-so-professional.  And definitely not family-friendly (like most everything in Early Intervention is designed to be), meaning that everything was at their convenience, on their schedule (or re-schedule), and flexible only on our end.  We even had to pull Becca out of therapy one morning to have a meeting about how Becca needs therapy.  Ridiculous.  BUT - in the end, we were (and are) VERY happy with the Individualized Educational Plan (IEP) that we have in place for Becca.  Here's what it includes:

• Physical therapy:  Becca's biggest area of delay continues to be gross motor (motor skills that use the big muscles, like walking, running, jumping, climbing, etc.).  At her assessment, Becca was 34 months old, and she scored 20 months in this area, so she obviously need physical therapy, which she will get at school 20 minutes a week.
• Occupational therapy: Occupational therapy mostly works in 2 domains: fine motor and sensory processing.  In her fine motor assessment (again at 34 months), Becca scored 28 months, which is actually considered the very bottom edge of normal, though there's still a delay.  However, we know Becca's sensory processing shows significant dysfunction, as she demonstrates "over-responsiveness to visual, auditory, touch and oral tactile forms of sensory input that impacts her ability to attend to task in busy or noisy environments, impacts her ability to participate in daily functional activities at home and at school, and impacts her readiness to learn;" "sensory seeking with visual, auditory, proprioceptive and vestibular forms of sensory input that also impact her ability to attend to task;" and "decreased perception of proprioceptive and vestibular sensory input.  Combined with her gross motor skill delays, this impacts her balance and coordination along with her higher lever motor planning skills."  The OT's rec?  "Becca needs consultative OT services integrated into the classroom."  Which won her a place in the...
• Early Childhood Special Education classroom:  While Becca was somewhat borderline in whether she qualified for services because of her strengths in the communication and cognitive domains (talkative genius that she is), she qualified for classroom instruction because of the ways that her particular delays impact her ability to access the classroom environment, appropriately attend to task and progress towards kindergarten readiness.  I was really happy that she qualified for classroom services because it is SUCH  a great program, and we L.O.V.E. Ms. Jamie, her teacher.  More on how the classroom program is structure below.
• Transportation to and from school:  Yep, she rides the short bus, and we're so proud of it! 

What it doesn't include:

• Speech therapy: Becca is no longer delayed in her receptive or expressive language.  In fact, at another round of assessment at the NICU follow-up clinic, when Becca was 36 months, she scored 42 months on expressive language.  That's my girl! 
• Feeding therapy:  Because everything done through the school is focused purely on helping the kids success from an educational perspective, they do not provide feeding therapy, I guess because you can be fully tube-fed and still participate in the educational process fully.  Not that it's totally disconnected; the sensory work they do in OT especially can help make progress in her sensory-based feeding issues. 

So, what is Becca's schedule like these days?  Well, on Monday, Tuesday, Thursday and Friday, she's in school from 8:30-11:30.  They have a morning and afternoon session, and Becca is in the morning session, since she (theoretically) still naps in the afternoon.  (You get to do one or the other.)  Wednesdays, they don't have class so that the teachers and therapists can do assessments and IEP meetings.  On Wednesday, Becca and I head out to her private PT and OT sessions anyway, so that worked out for us.  (But, yes, we are still going to PT, OT and feeding therapies at Vandy in addition to the school therapies.)  It's frustrating that the program schedule is SO not working-parent friendly, and Becca's teacher even said in one of the meetings the she wouldn't have been able to participate in a program like this as a kid because her parents both worked.  But part of that is a function of the community we're in, where there are many families who have one parent stay home with the kiddos - but it's living in this same community that makes being a part of the awesome program possible. 

And the program is awesome.  Half of the kids are on an IEP (a.k.a. have special needs) and half are peer models from the community (a.k.a. normal kids - by the way, it's FREE preschool for these kids, and I don't know why everybody doesn't put their kid in this program, particularly if the schedule does work for your family!).  There are always four adults in the classroom: a teacher, two teacher's aides, and one therapist.  The therapist alternates between speech and occupational because both of those disciplines provide integrated services, meaning that they build the therapy into the classroom program.  (The PT pulls Becca out for her session.  It's have to practice walking on a balance beam, climbing and jumping with 13 other 3-year-olds without it becoming pure chaos!). 

Everything they do in school is coordinated, but in such a way that the kids don't notice or feel confined. They work on 2-week storybook units, meaning that they base their different activities on one book for two weeks.  For example, they have been studying The Kissing Hand, which is a really sweet book about a little raccoon who misses his mommy at school, so she kisses his hand so that he always has her love with him.  So in OT, they stuffed "raccoon tails" (tube socks) with newspaper and painted them.  In art, they made a little raccoon mask.  In dramatic play, they wore their masks and tails and pretended to be raccoons.  Another time in art, they made trees by drawing rectangles for the tree trunk (because the rectangle is the base shape for the letter of the week, which was "F") and glued cotton balls on the top for the leaves (an activity Becca is averse to because it involves getting glue on your hands).  It's just so well thought-out!  So, like I said, it was a little frustrating getting there and working out the scheduling logistics so she can go to school and I can work, but it is so, so, so worth it.

And we're still busy outside of school.  Monday afternoon, she gets a super quick nap/rest time in before we head out to feeding therapy, and on Thursdays (starting this week), we'll go to ballet in the evening.  Add in Wednesday therapies and weight check and the regular Sunday/Wednesday church schedule, and she's one BUSY little girl!  And I'm one tired mama...but, thankfully, we've got a great Team Becca, including SuperDad, her second family (the aforementioned Lovells), and a new SUPER babysitter who - get this - used to play Mickey and Minnie at Disney World.  I mean, really, could you have any better credentials for playing with young kids?  :) 

We're slowly getting adjusted to the new schedule and working out some of the (pretty major) kinks - and relying heavily on the loving hands at church to make this whole mom's a pastor-dad's a pastor-Becca's got special needs charade work.  And after I had to steam clean the youth room carpet after Becca disconnected her tube feeding while "napping" in there while mommy and daddy worked, we're having to think creatively about scheduling.  But we'll get there.  And we're accepting any and all advice.  :) 

Here are some pictures of the big elementary school student!

"Bye bye, Mommy!"

"Tan I go NOW?" 

Time for one more goodbye on her first day

There's the short bus, dropping her off right in front of our house!

So tired after school - "No picture, Mommy!"

Becca at 3

Yep, that's right!  Itty Bitty Baby Becca is now THREE YEARS OLD!  Is anyone as aghast at the fact as I am?  I mean, when I think about my pregnancy, her birth, the NICU, etc., it seems like a long time ago - that could have happened 3 years ago.  But for her to be a 3-year-old?  No way.

But she definitely is!  How do I know?  Because of the questions!  For some (blessed) reason, the "why's" haven't started yet, but all. the. time. I hear, "Wass dat noise, Mommy?"  "Where going, Mommy?"  "Who's dat, Mommy?" and (possibly the cutest), "How you today, Mommy?" 

Three can be known as a tough age among parents.  I've always particularly loved 3-year-olds.  They are just getting to the point where you can have a real conversation with them, they are inquisitive (see above), and they are starting to play pretend and be more interactive in their play. Yes, they are also amazingly defiant and tedious, but I have preferred that to the know-it-all-ness of 4-year-olds and 2-year-olds' inability to communicate.  I'll go on record at the beginning of this 3-year-old year as saying that I love having a 3-year-old.  We'll see how that affinity develops (or deteriorates) as we move through the year, eh?

I want to save all of her medical and developmental updates for another post and dedicate this post as a snapshot of Becca's personality at the moment.  (And, as we know, the 3-year-old personality can change on a dime!)  So here's Becca at 3:

• Becca LOVES people.  Her first word was "hi!", and she remains as social as she was back then.  She is very mom-clingy right now, but once she's separated from me, she'll play and talk with anyone.  I see us introducing the concept of strangers very soon, though I kind of hate to do it. 
• She's very polite.  Kind of.  I mean, she'll scream bloody murder if you don't do what she wants, she'll stomp and collapse on the ground and throw a fit, etc.  But she loves to say "please," "thank you," and "you're welcome."  Oh, and "fuffe me," which roughly translates to, "Excuse me."  She particularly loves to say thank you and will say it about 15 times before she moves on.  She even thanks the elevator for taking her to another floor.  Seriously.
• She's still a water baby.  I'll have more photographic evidence of it for you later, but she loves all things water.  Bath, pool, hose, and, of course, drinking the delicious no-calorie water. 
• She's funny.  She's got a great sense of humor and loves to laugh and to make you laugh.  Sometimes she just laughs because it feels good.  She loves to be silly, and particularly loves to be a scary monster and roar at you, and THEN erupt into a full-body laugh. 
• Becca doesn't care about eating but loves chocolate chips.
• She's just really gotten the hang of playing pretend, so toys like her kitchen and dress up outfits are getting some new use.  She particularly loves to sell ice cream out of the window of her playhouse that Nana and GG got her for her birthday. 
• She's definitely in another Mommy phase but has SO MUCH FUN playing with Daddy.
• About 65% of the time, she wants to be an astronaut.  The other 35%, she wants to be a doctor.  I did hear teacher mentioned once.
• She's great at puzzles and like everything to be in its place.  Very John Hill there.  (Oh, and that's another question I hear a lot: "Wheres dat goes?") 
• Becca loves music and is a dancing QUEEN.  Specifically, she is the dancing queen of  a small South American village where they drum, stomp and spin a lot.  It's quite the sight to behold. 
• The current PBS obsession is "Sid the Science Kid."  I used to find this show annoying, but it's grown on me.  Especially when Becca walked up to the front door and said, "Science kid in the hoow-uuuuse!" 

I could go on, but I'm hungry and what you really probably want is pictures anyway.  So here you go!

At Sesame Street Live, doing what she did a lot of the show - not paying attention!

Wagon ride to the beach!  (More beach pics to come.)

Scaring the alligator!

Sporting her new dragon p.j.'s. 
She seems to prefer the boys' pajama patterns more than the girls'.  Whatever!



Pretty in pigtails!

Tinkle, Tinkle

Usually when I'm around Becca and hear a "tinkle" sound, it's her asking me to sing "Twinkle, Twinkle Little Star," which was the first song she ever sang along to and probably still her favorite song.  But on Monday, right before she went down for her nap in her big girl bed, I heard a different "tinkle" from Becca.  Yeah, that's right...wait for it...

Becca went pee-pee in the potty!

I was changing her diaper and asked her if she wanted to sit on the potty.  She said no, but after a few seconds, she said, "Pee-pee potty!"  After confirming that she did, indeed want to sit on the potty, I whisked her naked butt into the bathroom and sat her down on her squishy Elmo potty seat.  We then started to read our special potty-only Elmo books (a bribe to get her to actually spend a couple of minutes on the toilet), and halfway through Elmo's First Book of Airplanes and Rockets, I heard a little "tinkle tinkle tinkle"!  It wasn't very much; it might have even been only one "tinkle," but I was all over it!  I think it/I actually scared her a little bit.  She looked really surprised but then when I told her she actually got to USE TOILET PAPER (her favorite toy ever) to wipe, she got excited.  The rest of the routine is old hat to her because she does it every time she sits on the toilet: hop down (with Mommy's help - the toilet is very large when you are very wee), flush, watch the water go around and around (and talk about it), climb on the Elmo stool and let mom pick you up to "wass hans."  Except this time we had a massive potty dance in the middle of it, waving our arms, twirling in circles, all with her little naked booty poking out from under her Elmo shirt.  (You could say we're still a little obsessed with the furry red guy.)

I was so proud of her!  I don't expect her to be straight into panties or anything, but, y'all this is huge!  It's huge for any kid, but it's especially huge for one with gross motor delays and hyposensitivity issues.  Because she's under-responsive to sensory stimulation, it's hard for her to recognize the feeling that she's got to "go."  I mean, it's hard for her to actually feel that feeling.  But I think she did this time!  I know part of her wanting to sit on the potty was simply to put off her nap (she always wants to sit on the potty before bedtime!), but the diaper I had just taken off of her was really dry, and when she got to the potty, she started "tooting" (and told me every time she did) and, of course, peed, so I think she might actually be connecting the toilet with the sensation and the appropriate response to it.  She's associated the toilet with pee and pooh for quite sometime now - at least as the place where Mommy and Daddy pee and pooh.  But for her to realize that she can make things happen there, too, is awesome!

I'm not tossing out the diapers tonight, but I might just wait a little while before I decide just how jumbo a pack I should buy this week!

What Just Happened?

I remember now why I started blogging so much more when I stopped working - because I didn't have time to do it before.  And now that I'm back in the workforce, it's been difficult to sit down at the computer long enough to focus on a post.  But, wow, I've got a lot to write about.  Because here's what just happened: my Itty Bitty Baby Becca turned into a very BIG GIRL.  I'll try to knock out a few posts right now so that over the course of the week you can see what I mean.


So, first of all, let me update you on the big girl bed situation.


She's in it right now, napping.  Hopefully for a couple more hours.  She slept in it Friday, Saturday and Sunday nights with no problems.  Absolutely no problems.  She loves her big girl bed.  And she can't quite manage to climb in or out of it without help, which is (for my purposes) kind of awesome.  She also napped in it on Saturday and Sunday, and both naps were shorter than normal (but still about 1.5 hours), so I'm hoping that it's not being in the bed that is affecting the length of her naps.  She tends to nap longer when John isn't home (guess missing out on time with Daddy is just not worth the sleep to her), and he was home all weekend, so I'm hoping that's the issue.  I think we'll get an answer on that after today's nap.  I took Sasha, Buster AND Becca to the dog park and to Target this morning, so she's certainly tired, and SuperDad's at work, so if she's going to nap for her more typical 2.5-3 hours, today's the day.  Except that there is so much sunshine spilling into her room that that could be a disturbance...but I'm not about to complain about SUNSHINE after all of this snow!


Here's the last picture I took of Becca in her crib.  (One night this weekend I found her in her new bed sleeping in this exact same position.  Love it.)

And here's how excited she was when I brought her big girl bed home, followed by a clip of her testing it out once we finally got it together.  (This video is also awesome because you can tell just how well she listens to me.):

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And here's her first night in the big girl bed, taken right at bedtime so she's awake but squeezing her eyes shut...while saying, "Cheese!"  This kid's a hoot!

I'd say this is one growing up transition that's been easier than I expected!

Big Girl Bed!

(As opposed to the "Big Girl Bed?" post from last week.)

We did it!  I bought Becca's big girl bed today (after making 4 trips to 3 stores - ugh)!  She's sleeping in it now.  I just went and check on her - she's all snuggled up, just like she normally is in her crib.  It's a toddler bed (we figured she'd fit in that for quite a while!), but John managed to finagle a bed rail for a twin bed so that the whole side is fenced in.  With all of her blankets and pillows, it looks like a little Becca nest.  She was quiet by the time I walked out of the room and hasn't made a peep since.  I expect that she may get confused when she wakes up in the middle of the night, but we'll see.  It seems the hardest part of it all just may be the assembly process.  (That was...difficult.  I guess $58 beds aren't known for their ease of use, especially when a VERY excited 2-year-old is trying to help.)

But then again, the hardest part was probably the bittersweet/ambivalent mama staring at the crib and realizing that she likely won't ever be putting her baby girl to sleep in there again.  For some reason, I didn't see that coming.  BUT.  She is a big girl, and that has been the goal all along.  I'm supposed to work myself out of a job, after all.

But if I ask her, Becca still tells me that she's Mama's Baby Girl.  And she is.

I'll update tomorrow and add some pictures!

Developmental Update, 2 Years Adjusted

One of our appointments last week was Becca's 2-year visit to the NICU follow-up clinic. We were sad to find out that Dr. Daily had retired, but we got to once again see Odessa Settles, who I believe has been working with preemies at Vandy for 40-some-odd years. Wow. She's extra cool because she's a vocalist on the side, appearing as a regular cast member on Tokens, "Nashville's New 'Old Time' Radio Show." In fact, they are recording an episode at the Ryman on the Sunday before Thanksgiving, and the guests include Keb' Mo' and Shane Claiborne. John and I are going, so let me know if you'd like to join us...or if you want to hug an Itty Bitty that night. ;)

But back to Becca. This visit involved a complete Bayley exam, which measures development in 5 areas: cognitive (thinking and figuring things out), receptive language (words she understands), expressive language (words she actually uses), fine motor skills (tiny movements) and gross motor skills (big movements). (The previous link describes the 5 areas in more detail, if you are interested.) For each area, I'll give you 4 scores: the overall average for kids taking the test, her score based on her actual age (27 months), her score based on her adjusted age (24 months - remember, this is based on her due date "birthday"), and her age-equivalent.

Cognitive: Average = 85-115

Actual = 95

Adjusted = 105

Age-Equivalent = 25 months

Receptive: Average = 10

Actual = 10

Adjusted = 12

Age-Equivalent = 26 months

Expressive: Average = 10

Actual = 8

Adjusted = 9

Age-Equivalent = 22 months

Fine Motor: Average = 10

Actual = 8

Adjusted = 10

Age-Equivalent = 23 months

Gross Motor: Average = 10

Actual = 6

Adjusted = 7

Age-Equivalent = 18 months

When thinking about these scores, keep in mind a few things:

• These scores are a snapshot of the tasks she was able to complete on a particular morning. I'd say that she was pretty much herself that morning, though she did get tired by the end of the 2-hour exam (go figure).
• When looking at month-by-month age equivalents, our goal is still for her to track according to her adjusted age. Many doctors, schools, therapists, etc. stop adjusting for prematurity at age 2, but folks in the NICU follow-up clinic say to give micro-preemies (preemies born weighing less than 2 pounds) until age 3 to catch up. In other words, she will look more delayed because most assessments stop adjusting, but don't get too worried about lack of developmental catch-up until she is 3. (But then again, much of a child's developmental trends are well in place by age 3; that's why many public health organizations focus on the 0-3 years.)
• Given her history, every single one of these scores is absolutely amazing and far better than we even risked imagining 2.5 years ago.
• And the usual caveat: no developmental assessment (or any standardized test) is perfect.

That being said, these scores are okay. I wouldn't say she blew it out of the water or anything, but none of these scores is really surprising. Based on her adjusted age (24 months), she is delayed in expressive language (by 2 months), fine motor skills (by one month) and, most significantly, gross motor skills (by six months). Based on her actual age, she is delayed in every category, the most dramatically so being her 9 month delay in gross motor skills. This score is even more sobering when I realize that had she not started walking this summer or had we done the assessment at our regularly scheduled appointment (the day after her birthday), she would have scored at an 11-12 month level for gross motor skills. The positive flip-side of that is that she gained 6 months worth of skills in 2 months just by learning to walk. So I'm pretty sure that Jane and Ashley (our physical therapists) deserve a very big shout-out on that one. In fact, let's take a minute to thank ALL of our incredible therapists: Cindy, Jane, Caroline, Karla, Roxanna, Ashley, Tom and Melissa. Without their help, I shudder to think of how far behind we'd be. As much as I get sick of carting the kiddo around to appointment after appointment, I am so thankful for all the work and love these therapists have poured into my sweet child. It really does pay off!

Based on these scores, we're not sure if Becca is going to qualify for special education services when she turns 3. I don't know if I've mentioned it on here or not, but at age 3, kids with special needs shift from Early Intervention to the public school system for their services. When we moved, we made it a priority to live in a school district with a very good special education program in case we needed it (whether for Becca or for our other potential preemies down the line...and yes, John and I do plan that far ahead for such extenuating circumstances...at least when buying a house!). We'll begin our transition meetings with Early Intervention and Williamson County Schools in January, and they will do another round of assessments, but it looks like she may be borderline for services, depending on which ones they consider primary vs. related. (For example, in many school systems, physical therapy is a related service, meaning that you can't qualify for special education services on physical delays alone. However, if you qualify, say, on speech, you can receive physical therapy at the school as part of your Individual Education Plan.) I know, I know, I'm getting ahead of myself here, but, wow...that's really not that far away! I would be thrilled if she flat-out didn't need services, but I'm afraid that she will fall just above the cut-off and not end up getting the services that would really benefit her. Especially if we lose our TennCare at our next review in the spring, we'd be left with muchos therapy bills. (And therapy is NOT cheap. I opened a bill from PT recently, and each 1-hour session was running about $300. Holy crap.) For now, I try not to think about it too much!

The most important point, though, is that Becca is making tremendous progress. Given the incredible odds stacked against her, she has exceeded everyone's expectations. In fact, if she were taking her O.W.L's, I would have given her straight "O's," for "Outstanding." Yes, we have lots of therapy in our future. (Now that I think of it, I was really hoping that she'd come out with amazing scores and we'd be able to drop some sessions...but we're not there yet.) Yes, we have to do a lot of hard work at home. But yes, she is -- and will continue to be -- absolutely amazing. I'm very proud of you, little girl!

Becca is 2 - Again!

Today is two years from Becca's due date. That makes her two by virtually all definitions. Her actual age is 27 months, but her adjusted age is now officially 24 months. I have a 2-year-old. A lot of professionals stop "adjusting" for prematurity at 2; that is, they don't take into account the extra 3 months that she's been ex utero, but the doctors who deal most with micropreemies (preemies born under 2 pounds) suggest giving a child until 3 to fully catch up and adjust up until that third birthday. I figure at this point it's easiest just to refer to Becca as being 2, and I'll tweak when I bestow upon her 2 -and-1/2-year-old status. Unless, of course, she starts telling people her age herself. Could happen tomorrow.

I won't rehash the past 34 months for you and tell you how thankful we are to be here. I'd do it all over again in a minute if that's what it would take to have our baby girl with us today, and it's simply impossible fully to express our gratitude. I'll just skip to the best part. And here she is:

saying "Ta-Da!" (from gymnastics)

being beautiful:

telling Sasha "No!" while Daddy puts the smack down, Dog Whisperer-style:

and one more "Ta-Da!"

(The real-from-the-pro-shop leotard was her "other birthday" present...off the sale rack, of course! She loves that it's covered in stars - a big favorite these days!)

I would really, really love to write a long, eloquent post about how wonderful Becca is, give you an in-depth update on all her medical issues (some of which are non-issues now!), and tell you her birth story the way I now tell her, but, frankly, I don't have it in me tonight. I've got a million appointments this week, a trip in a day and a half, a sick husband, a very rambunctious 2-year-old with an ear infection, and 2 days of Clomid in me. Someday these posts will be written, but not tonight.

Tonight I'll just say that Becca is happy, so very happy. She loves the life that she almost never had. She takes everything she has to do in stride...and a stride that is more barreling than tiptoeing. She makes herself known and knows no fear. She has developed the funniest sense of humor and is just plain cheeky at times. She's stubborn and determined. She's everybody's friend and can charm a full waiting room in 5 seconds flat. She's a happy girl...and so am I.

I am so grateful.

But on the Other Hand...

...yesterday was one of the best days ever.

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She really walks now - not just a step or two or several more in therapy, but down the hall!  And it's not just to get from me to John or from one toy to another - she's walking because she likes it!  She really likes it!  I really haven't seen her crawl much at all in the past 48 hours.  When she's not walking, she's knee-walking, which is definitely a shift in the right direction.  I am so proud - beyond proud! - and wondering what it means that this huge milestone occurred in the hospital.  My silly old bear needed an audience.  (And yes, she did pause mid-video to wave at the nurses at the desk.  Pageant queen.)

Sumner Station folks, please make Jane watch this one!  Jane, look what a walker we've created!  Thank you!

Ummmm...

Have you noticed the LilyPie ticker in the sidebar?

Yeah, Becca is turning 2. TWO. TWO!

Wow.

In addition to our move (on her birthday!) and the upcoming Elmo-palooza, we have a string of 2-year appointments coming.

This week we've got final :( appointments with Jane (PT), Karla (OT), and Roxanna (SLP) at Sumner Station and will see Dr. Collins for the last time (at least in an official capacity) for Becca's 2-year-well CHILD appointment. (I think at 2, you're not a baby by anyone's definition. That's a little sad.)

Next week we move on Monday (EEK!).

Then see Dr. Dailey, the developmental physician in the NICU clinic, for a 2-hour appointment including a full physical workup and an in-depth developmental assessment. I'm really excited about this appointment. I'm a sucker for "objective" test scores - always loved getting those ACT and SAT and TCAP results in the mail as a kid! - so I'm really anxious to see how she scores. A few notes about such assessments, though: a) They tend not to be truly objective. If you work with kids a lot, you probably already know that child development is pretty fluid. Do you check something off the list if they do it once? Or twice? When they fully master it? b) Not all assessments are created equal. Even really goods ones can come up with different scores. For example, Becca's speech has been been evaluated recently through 3 different assessments. (I don't remember what they were called, but two were through Early Intervention and one was through her speech therapist, so it's not like I just downloaded random ones.) Her scores fell between 11 months and 26 months. Hmmm. So you can't put too much stock in them. c) Still, developmental assessments can be helpful tools, and as a mom, it's helpful to get outside professional opinions regarding the areas on which we need to focus and, frankly, to be able to give yourself an occasional pat on the back when we can see on paper that our efforts have paid off.

Okay, moving on. We'll also have a 2-hour physical therapy evaluation at the Vandy pediatric rehab clinic. After she's evaluated, we'll find out how long we have to wait until we can get in a slot (that is, if they decides she needs its...you know, if the 2-year-old who isn't walking needs PT). Hopefully it won't take too long, but we are exploring other options just in case.

On Thursday the 24th, John and I will be speaking at a conference on prematurity and infant mortality at Vanderbilt. Needless to say, I was quite surprised last week when I got a call from an acquaintance at the hospital who said, "Well, the governor was going to speak, but he had to bail, so I thought of you guys." What? Add that to the list of things I never thought I'd hear! :) I think she knew that since we are pastors, we wouldn't be too scared about speaking publicly on short notice. John and I will basically be telling our story and talking about how Becca's prematurity continues to affect our lives. The conference is open to the public, so if you are interested, check out their website. I'd love to see a couple familiar faces!

Also sometime next week we are supposed do a weight check at the GI's office and schedule our follow-up with them for two weeks from now, but I still can't get an appointment scheduled. Ugh.

Phew. Do you see why I'm so glad that Nana Dana and then G-Diddy will be here to help out?

At at the end of it, my baby will be two years old. Wow.

Hey!

I really am still here. Promise. But I'm buried under boxes and to-do lists and great expectations and itty bitty clothes and big toys and books and books and books.

BUT - Becca has officially taken some first steps. Wohoo!! She's definitely not "walking," per se, but now we know she's got it in her, and it's just a matter of time.

And no, I don't have video of it, silly. I'm too busy begging and pleading and cajoling and encouraging and stretching and clapping and reveling to take pictures. Besides, it hasn't happened very often.

But it's happened! She's going to be a walker! (I was seriously starting to wonder.) Perhaps by her birthday...??