High Risk Pediatrics

Normally, when the hint of a germ invades the house, I immediately revert to paranoid mommy mode (from within my Lysol wipes bubble of course). When Destroy began exhibiting signs of a stuffy nose on Monday I was calmer than usual. We had a doctors appointment on Tuesday morning.

Lest you think my hypochondriacle nature has gotten the best of me to the point that I now schedule appointments just in case of a rogue virus, I assure you – they called us.

Due to their prior engagement in the NICU, the muppets will be followed by the high-risk pediatrics department until age two. They are tested every six months via the Bayley Scales of Infant and Toddler Development (third edition). This measures their cognitive, language and motor skills to determine if they are developing on par with their peers or if prematurity has left any lasting scars.

On Tuesday, the muppets were officially 11 months and 6 days old. So the medical establishment wants to ensure that the muppets are hitting the milestones normally experienced by children 8 months and 4 days old. Age adjusted for prematurity. The Bayley III asked the muppets to perform activities, observed by the nurse (dance, muppet, dance!), to see if their thinking, language and movement skills are within “normal” range. (You can imagine my excitement about “normalcy” labels – those have not gone well for me in the past.)

Destroy weighed in for the match at 21 pounds and 2’3”. On the other side of the exam room was Search – 19 pounds and 2’3”. Their follow up sheet lists “unknown” for the amount of exercise per week, but I will state here for the record that it is a lot. Search never stops moving, and while Destroy doesn’t quite have the same forward momentum control – he rolls all over the place.

After the initial measurements were taken, the four of us marched into the exam room next door  – exactly the same as our current location, but with a basket of toys. Each boy took a turn. First was the cognitive scale. This measured how they think and react; they were given tasks that measured their interest in new things, attention to familiar objects and how they play.

We started with red blocks. Proud mommy moment: Search immediately picked up a little red block in each hand. He waved one around while chewing on the other. From the other side of the room I asked, “Search, can you clap your blocks together?” He looked up at me, grinned and clapped his blocks together. The nurse put the blocks in a cup. Search eyed her and took them back out. Destroy also picked up and waved the blocks around. When the nurse took a toy away, they followed her every movement – waiting expectantly.

The language scale has two parts: (1) receptive communication, which looks at understanding and recognition and (2) expressive communication, which evaluates how they use sounds and gestures. Destroy squealed, Search babbled. And both little guys smiled and laughed when we joked with them. (And this was with both of them having a fever!)

Finally we faced the motor scale. The first section looked at their fine motor skills such as muscle control, grasping and reaching. The first trick involved a rice puff. Both muppets are now excellent at this game; the bit of cereal was grabbed and shoved in the general direction of their mouth. And reaching/grasping is quite the elementary challenge for them. They immediately grabbed every item put in front of them. How else can they figure out how it’s going to taste?

The gross motor skills portion didn’t go quite as well. This measures how well they can move their body – head control, rolling, sitting and crawling. Search can do all of the aforementioned; Destroy hasn’t quite mastered the crawling, but everything else is old hat. I blame the fever, but the moment we put either of them down on the stage (red mat on the floor) they burst into pathetically hysterical sobs. Luckily, the examiners were willing to take our word for it.

There was a poignant notation that we live the motion picture of life at home, while this appointment was merely a snapshot.

While the pediatrician examined the boys to alleviate my concerns about the sniffles, the nurse and physical therapist removed themselves to yet another exam room to score the muppets’ performance.

The scores indicate how well the subject performs compared to a group of children within the same age range within the United States. The highest possible score is 19; the lowest is 1. Rankings of 8-12 are normal. (There’s that word again.)

Both muppets passed with flying colors.

This is a summary of our findings:
Growth: normal for corrected age
Interpretation: normal for corrected age
Assessment: Doing very well, no sign at this time of any complications of prematurity.

TAKE THAT! (And disease-wise? It’s the common cold. <AhChoo!>)