PT and OT and Developmental Therapy, Oh My!

This week the boys had their Physical Therapy, Occupational Therapy evaluations. After some finagling, we were able to get services through Butte County Office of Education, which is great, as they provide a more comprehensive and organized early intervention program than other options we were given.

We met the Occupational Therapist and the teacher/case manager first, on Monday. Both were really excellent, and I was especially impressed with the OTs knowledge and calm, gentle way with the boys. Noah isn't always a fan of being held by people he doesn't know, and she was able to hold him for over an hour, demonstrating different ways to soothe, and commenting on both boys skills. She was impressed with their ability to self soothe (mostly by sucking on their hands), and seemed optimistic about their ability to catch up developmentally to their actual age. In case you're wondering, an occupational therapist helps families and babies with the skills they need in daily life, which for babies, includes self soothing behaviors, sleep, eating and play. We made an appointment to meet every week, and she will co-treat with the teacher/case manager each time, allowing me the opportunity to really focus on what she is doing with each boy without having to worry about the other one! After she left I felt soothed myself, and encouraged about the future of these little guys.

That optimism was shaken slightly by our Physical Therapy appointment, however. I had initially asked that just Oliver be referred for PT, as he seems to have more trouble with physical strength, especially when it comes to tummy time. However, knowing how different the boys are, I also asked that Noah receive a formal evaluation, in case there were things he needed to work on as well, though I expected that Oliver would be the main focus of the PT work. I was impressed with the knowledge and competence of the Physical Therapist- she has alot of experience working with preemies and multiples which is great.

Unfortunately, her results showed the opposite of what I expected. She evaluated them for over an hour, and concluded that Noah has the most muscle tone issues, too high tone to be specific. This means he is too tight in the way he holds his muscles, and tends to arch and hold himself stiffly, whereas Oliver is more flexible and loose. She did a couple of great demonstrations showing the importance of rotation, which was the main focus of the exercises she assigned us. It was all rather overwhelming and frightening, as high muscle tone is associated with CP. She said they are too young to be able to tell if they have it yet, and that many of the muscle tone problems in multiples are due to the cramped uterine environment and/or could be due to his reflux, both of which can be corrected with work.

This means new ways of holding, changing, picking up and playing with Noah, which is frustrating because I feel like we have just gotten to the point where we can treat him like a "normal" baby, instead of like a fragile preemie. But if its going to help him, of course we'll do it. She is going to recommend seeing Noah weekly, and Oliver once a month.

All in all, it was a pretty exhausting week, with alot of new information and sensory overload for the boys. I'm grateful to have the opportunity to receive such great services, but also saddened by the need for them. I'm hoping it all gets easier as we incorporate it into our busy lives. More than anything though, I'm proud of my boys: how far they've come, and how hard they work every day (and PT and OT are hard work!). Keep it up little guys!