Adam automatically qualified for the Easter Seals Regional Development Follow-up Program (RDFP) because of his grade 3 brain bleed (intraventricular hemorrhage - IVH). Grade 3 and 4 are considered severe. In grade 3, the bleeding is substantial enough to cause a swelling or obstruction of the narrow channels feeding into and out of the ventricles of the brain, which may interfere with the normal replenishment and flushing of the fluid in the brain. Long-term effects often include impairment of vision, hearing, motor or cognitive skills, cerebral palsy, or learning delays.
As a side note, it's interesting to me that Sara doesn't automatically qualify for anything. She had no medical issues and apparently 2lb 9oz 12 weeks early is too heavy for their low birth weight charts! That's okay, we know she's a wonder twin.
As time passes, we keep jumping over hurdles and crossing things off the list. Adam has passed all of his hearing tests. Our recent visit to the eye doctor showed 50% improvement of his vision. Physical therapy over the past 6 months has worked through the tone that was in his legs - there are no traces of that now. The biggest excitement for me was when I asked the doctor about cerebral palsy - how long do we have to wait to see if that will be an issue. She said typically around 1 year of age they start seeing signs. Nothing has popped up with Adam so it is not a concern. The doctor did talk to us about learning issues and that we should pay close attention when he starts school. Preemies earlier than 30 weeks sometimes need extra attention and you want to catch that early so they don't fall behind.
It was also nice to be reassured as parents. Both the doctor and the therapist assessing Adam can tell by his progress that we are very involved parents who get on the floor and play with our kids. Part of why they are both doing so well is because of us. How nice to walk away with a gold star ourselves!
As far as testing that Adam experienced, I think he would have done better in the fine motor skills if she would have given him a little more time before saying he couldn't do something and move on. She either didn't give him much time or left the toys out from the previous exercise and then he was distracted with all the things around him. He put items in a container, stirred a little spoon in a metal cup, knocked little blocks over, picked up more than one block at a time, and pulled a peg out of a board. He wouldn't put the peg back in but it was only about 1" in diameter. He also wouldn't color - he preferred to try to rip her paper. The last test he wouldn't do I am not sure why they even try it. She gave him a small bottle about the size of a prescription container and then handed him 3 Puff snacks and asked him to put them in the bottle. You take an educated guess - did they go in the bottle or in his mouth? So she scored him at 12 1/2 months for fine motor skills. He is currently 16 months old but they rate him for his corrected age of 13 months. If you have ever seen him eat, you would know fine motor is not his preference!
As far as gross motor skills - she mostly just watched him crawl, walk, sit, stand, bend over, etc. She gave him a 14 1/2 - 15 month score. We do have to watch that he doesn't sit on the floor in a "W" sit. He can sit with his legs tucked directly under him with his heels on his butt but she doesn't want him to spread his feet out and put his butt on the floor, making a W with his legs. This stretches your knees and hips and can cause problems in those areas as an adult.
They would like us to continue seeing our physical therapist once a month. Since he is just starting to walk they want to make sure that develops with no issues. We return February 15.