Conference moira::parenting_v3

    Richard, our very premie son was enrolled in Early Intervention at
    Memorial last fall, a couple of months after he got out of the
    hospital.  He was about 5-6 months old.
    
    One of the major problems with premies is muscle development.  So much
    of the activities for us has been physical therapy.  But we also work
    with all kinds of learning activities and he occasionally meets with
    the speech therapist.  He is only 13 months now, but the speech 
    therapist concentrates on eating habits (how they eat, not what) and
    sounds as these play major roles in later speech development.  Richard
    is significantly more flexible and stronger now.  I don't believe we 
    would have known how to work him to help him this much.
    
    Another reason that he is in the program is to keep track of him 
    developmentally.  Richard has "agenisis of the corpus collosum"; which
    means that the network between the halves of his brain did not develop.
    Doctors have found that many people have this problem but are 
    undiagnoised until later in life.  So, there is concern that his
    development may be slow so we want to stay on top of it.
    
    Richard, my wife and Janice, our primary care provider at EIP, meet
    together once a week.  Following the meeting, Janice writes up her 
    observations and comments and gives us a copy.  She also gives
    homework assignments for activities that should be continued.  We
    have decided that once Richard starts walking that the meetings will
    probably be cut in half, but we will continue.
    
    They provide an excellent, objective view and proven methods of 
    improving on whatever problems they have found.
    
    They are not cheap, but John Hancock pays 80%, then a trust fund
    absorbs most of the difference.
    
    My wife is much more involved with the going ons at EIP than I am.
    If you (or anyone) would like to talk to her, she would be happy to
    call you.  Please send me your phone number via VAXMAIL...
    
    cheers,
    jeff
    

    
    I guess I'm confused as to "connecting to EIP".  Is this something that
    the parent pursues ... or something that a Pedi recommends ...?
    
    Is it pursued when the "potential" for a discipline problem or learning
    disability is first recognized?
    
    Sounds like a good and beneficial program keyed towards helping
    kids and parents deal with a situation(s) ... but it's not clear to me
    as to "when and by whom" the ball starts rolling.
    
    Could someone please explain this to me?
    
    Thanks,
    Dottie
                                  

    We heard about it through Memorial Hospital's Special Care Nursery
    when Richard was there.  You tend to talk to the nurses quite a bit
    and they clued us in. 
    
    We then discussed it with our Pedi and he agreed that it might be
    beneficial and wrote the "prescription" for it.
    
    It is geared to possible and known learning/physical problems.  I
    don't believe that they deal with discipline problems as such.
    
    I don't believe there is one process to get it rolling, and according
    to the base note, it can be done up till 3 years old.   Someone
    sees a need and someone else (usually Pedi, I would think) suggests
    EIP.
    
    cheers,
    jeff
    

    I noticed that the definition of "early" also varies according to
    the program.  The Memorial Hospital program appears to be dealing
    with very early development, but some EIP's deal specifically with
    school-related learning disabilities; then "early" means "before
    the child starts having problems in school."
    
    Steven's best friend was treated in one of these programs when she
    was about 4.  Her preschool teacher noticed that she was a bit
    unresponsive and sometimes seemed bewildered by what was going on
    around her -- something I had noticed too, but I thought she was
    just a shy kid.  The EIP evaluation discovered that she couldn't
    hear well because she had a chronic ear problem that an ordinary
    checkup wouldn't normally detect.  She got tubes in her ears and
    almost overnight was a new child -- more confident, interested,
    reaching out to make friends for the first time, and not letting
    Steven bully her around.  She also went from being a sulky whiny
    child to being a cheerful flexible energetic one.
    
    She also had a few months of speech therapy to help her make up
    for what she had missed when her hearing was blocked.  They
    thought she would probably catch up by the time she started school
    even without the therapy, but with it, she caught up much faster.
    
    --bonnie

Our son Ben is 14 months old and has developmental delays.  He was born a 
month premature, and we were alerted about the risks of developmental 
problems for preemies.

When Ben was around 3 months old, we noticed that some developmental 
milestones seemed to be coming late, so we sought out the local Early 
Intervention program.  

In Massachusetts, these programs are community based.  The one serving our 
community (Framingham) is the Middlesex Child Development Center.  The people 
we saw were a Licensed Practical Nurse, a physical therapist and a speech 
therapist.  They found nothing _obviously_ wrong with Ben and decided to 
provide "monitoring" service, where the nurse would come into our home and 
observe Ben for an hour every few weeks.  

At 5 months of age, they did a formal evaluation and pronounced his 
development "age-appropriate" across the board.  We still noticed that he was 
not doing things other infants of that age were doing, like babbling, 
rolling, propping himself up on his forearms, but they advised us not to be 
concerned.  We went to Children's Hospital for a second opinion, and his
evaluation there revealed delays in his gross motor functions.  They did not
immediately recommend therapy but suggested regular follow-ups.  At 9 months,
given continued lack of progress on Ben's "transitional" movements, we began
occupational therapy with a private therapist.

When Ben started the therapy, he was not rolling over, sitting up or crawling.
The progress Ben has made is truly remarkable, and just this month he has
started walking.  The occupational therapist has done wonders for Ben, and I 
believe her NDT (NeuroDevelopmental Training) background has been a key to 
her success.  She is continuing work on his fine motor skills, which are also
delayed.

A follow-up at Children's at one year revealed that Ben has cognitive and 
speech delays as well as motor delays.  We have recently begun speech 
therapy, again with a private therapist with NDT.

The local EIP has taken a back seat while we were bringing Ben around for
outside evaluations and therapy.  Now that they have seen the report from
Children's, they are finally getting around to arranging a re-evaluation.  
They sponsor the only available regular program in our area for children 
under 3 years old with delays.  Ben is not eligible until he is between 15 
and 18 months, and we will be looking into their program in detail.

My impression of Early Intervention is that they have limited resources in
time, money and level of professional qualifications.  But I don't know
of anybody else who provides publicly available programs for infants and
toddlers with developmental delays.

    Hm.  I'm a little puzzled by how they can measure this stuff.
    
    At five months David wasn't babbling or rolling, and didn't show
    much interest in doing them.  He picked them up in the next month
    or so after that.  He just started crawling this month (9 months
    old), but he's been able to pull himself up on the furniture for
    weeks.  He's doesn't make talk sounds much at all (which pedi
    says is common in third children).  He's not very good at
    approaching a cup, though again the pedi says that many children
    are a year old before they can manage a cup.  

    So how do they tell the difference between a delay that's a
    problem and a normal baby who's developing normally but at a
    somewhat slower pace than average?  Is it that David is making
    steady although not precocious progress and a baby with a problem
    won't advance like that?  Or is it a continuum that at some point
    you say, "Although this child is making progress, he's now so far
    behind that we'd better give him help to catch up"?

    --bonnie

     
    >I guess I'm confused as to "connecting to EIP".  Is this something that
    >the parent pursues ... or something that a Pedi recommends ...?
    
    >Is it pursued when the "potential" for a discipline problem or learning
    >disability is first recognized?

    Dottie,

    In my case, my doctor recommended it. What happened was this: I expressed a
    concern over Kevin's speech and hearing to the nurse practicioner at MTHP.
    Kevin has had many, many ear infections. She offered to have 
    his speech and hearing evaluated. We had the evaluation done and the speech
    pathologist recommended speech therapy twice a week. 

    When my doctor heard that speech therapy was recommended he laughed. He
    said he couldn't imagine what they would teach a 26 month old to do. Said
    his own kids didn't talk till they were 3. But as our conversations went on
    and he observed Kevin's behaviour, he became concerned that there might be
    more of a problem than just a speech delay. He recommended I have Kevin
    evaluated at EIP.

    >Hm.  I'm a little puzzled by how they can measure this stuff.
    
    >So how do they tell the difference between a delay that's a
    >problem and a normal baby who's developing normally but at a
    >somewhat slower pace than average?  

    I don't think they would be concerned by only a later (within range)
    physical development. I think it takes a lot more than that to be
    concerned. My son Danny didn't roll over, sit up or anything till after 9
    months, but he caught up fast. There was never any concern there. 9 months
    is still considered within normal range.

    With Kevin I felt that there were several behaviours he should have
    displayed. It wasn't just speech, but overall communication.

    Just how expensive is EIP? YOu said John Hancock picks up 80%. Is there
    a limit? 
    
    I think Matthew Thornton picks up 100% but for only 2 months.
    
    G

    .0
    
    My girlfriend just went thru this with her daughter.  She has a serious 
    seizure disorder and is heavily medicated all the time.  She was tested
    at age three (city of Nashua paid) for physical, speech and
    occupational and she 'raised-hell' thru the whole procedure.  Any way
    here is another alternative that is free to all Nashua Residents and my
    girlfriend highly recommends this program:
    
    If you call the City of Nashua, and speak to Gail Baringer (881-4407),
    she is the director of special education division of the school
    system,.  She will set up an appointment for you and your child (must
    be 3) and have the evaluation done.
    
    Next step is the program at Broad Street School.  Director there is
    Cam Moran (881-4406) that is were they do all the physical, speech, and
    occupational therpy.  My girlfriend signed up her daughter (Megan)
    prior to her 3rd birthday, and scheduled an appointment the day after
    her birthday to be evaluated and enrolled in Broad Street School. The
    schedule is a 4-day progam, Monday thru Thursday (from 11:45 - 2:00 pm)
    and the school provides the transportation to and from each day.
    
    This is free for all Nashua residents and I have noticed that Megan,
    who couldn't say anything but a screaming sound, in 3 months, she could
    say mommy, daddy and about 30 other words!!! I was amazed.

    My son is an Early Intervention "Graduate". We became involved in
    the program and were referred by our pediatrician. We are located
    in southern Mass and there was no cost to us. My son has developmental
    delays - sensory integration, gross & fine motor and speech problems.
    We were in the program from the time he was 14 month old and have
    gone on to a Special Needs Preschool. We were given a choice of
    working with a center based nursery type of program or home visits.
    Work requirements mandated home visits - 1 hour/week. We also
    supplemented the EI visits with private therapy sessions at the
    Mass Hospital School in Canton for the last 9 months we were in
    the program. The benefit for me from participating with EI was the
    support system that I was able to develop. Its not easy coming to
    grips with the fact that there are "problems" with your child. Not
    only did I have the chance to vent on the emotional issues of what
    was occurring but they also taught me how to work with the various
    problems and we had several gains that might not have happened without
    the program. EI also were advocates and very supportive when my
    son turned 3 and we had to choose a Preschool. They visited different
    Preschools with me and gave input on the various schools. The hardest
    part of the EI program was the periodic evaluations they conducted.
    My son would never perform on cue so their evaluations didn't reflect
    everything he was capable of doing. We always talked about the
    evaluations with qualifications because what he did under team
    observation and how he performed at home were poles apart! Bottom
    line is I think it was beneficial to all of us to participate -
    there's really nothing to lose! and a whole to gain! 

    The weekly charge (1hr/week) that they charge John Hancock/Digital
    is $144.  This is for a physical therapist.  I couldn't find a
    recent charge for other services, but I seem to remember that it
    is about the same.
    
    With JH, they pay 80% of this, until you have accrued the maximum 
    out-of-pocket expenses.  After that, they pay 100%.  In NH, there is
    a state grant that picks up where insurance leaves off, so the grant
    pays the other 20%.
    
    A new referal is needed from the doctor every 6 mo.  This is generally
    easy to get, as our pedi is very supportive of proactive measures like
    EIP.
    
    cheers,
    jeff
    

    re: .10
    
    	Our son has been in speech and physical therapy since he was 4
    weeks old.  Your response took the words right out of my mouth.  EIP 
    can be what ever you make of it I think.  We decided that it would 
    be a positive experience and it has been!!!!

    Hi Gale,
    
    As a special education teacher I would highly recommend EIP.  There 
    is a great deal of research which has been done that demonstrates
    the benefits of early intervention.  In most cases, the earlier the 
    therapy begins, the better.
    
    I used to work at a United Cerebral Palsy Center where classes were 
    held four days a week.  Although I did not work in the EIP rogram
    itself, I heard nothing but raves from the parents who were very much
    involved (parents attended school with children if at all possible).
    The added benefit to EIP in my opinion is the support parents get from
    the parents of other children with similar problems.  Things always 
    seem a little easier when you know you are not the only one going 
    through this(I know that from experience with my daughter and her 
    medical problems).
    
    Whatever your decision, I wish you the best of luck with your son.  
    If you would like to talk just leave mail and we will get in touch
    with you.
    
    Eileen
    

    I'd like to add my two cents worth of experience on this subject. 
    Since AJ was born about 7 weeks early and had several surgeries before
    his first birthday.  He was at first followed by his visiting nurse for
    both physical and developmental milestone, then it was suggested by
    both his nurse and pedi that he be evaluated at Umass Medical Center in
    Worcester.  They have and excellent Child Development Clinic that
    followed him at periodic intervals until just recently.  Fortunately
    for us they said if we took his current age and deducted his
    prematurity (7 weeks or 2 months) he was developing on target for that
    particular age brackett.  After a year he was developmentally right-on.
    Last December they felt his visits with them probably wouln't be needed
    any longer, but one more to be sure which was this past April.  They
    have discharged him from their services saying he was developing
    normally.  The other problem still remains, borderline ADHD
    (hyperactivity and attention deficit)  for this they referred me to
    their ADHD clinic.  This is run under the UMass medical School, dept of
    psyciatry.  We recently had a wonderful evaluation that took the better
    part of 3 hours and recieved an evaluation of aprox 10 pages.  I felt
    it to be complete and more important unhurried.  John Hancock paid 80%
    of this, and if you have large or continuous medical bills the hospital
    will allow you to request the other 20% be written off.
    
    To the basenoter, I'd be glad to talk more on this to you directly.  I
    realize that Worcester isn't terribly close, but from all the people
    who recomended this clinic, even over the Boston Clinics it would be
    worth the time to explore.  Not to mention everytime we go for a clinic
    apointment the parking lot seems to have more out of state than
    in-state cars!
    
    Lyn
    

    Does anyone know the difference between MICE (I don't know what it
    stands for) and Early Intervention? I think MICE is just a New
    Hampshire state program. They  both sound so similar.
    
    G

    Federal law (PL94-142) and supporting state laws require schools 
    to provide early intervention services - including evaluations -
    at no cost to parents, for children that are 3 or older.
    
    In Massachusetts the supporting regulations are in Chapter 766.
    Chapter 766 provides for all children 3 through 21, no matter what
    type and/or degree of disability, if the child can not learn
    effectively without some special education or related services -
    like speech or physical therapy.
    
    If anyone wants to know how to get these free services let me know.
    
    --dick