When I was progressing through my teacher education classes at MSU, I was focusing on early childhood and Deaf Education, so IFSPs – Individualized Family Service Plans, were of particular interest to me. Granted, I expected to be on the “other side of the table” during these meetings! IFSPs are done when children are from 0-3 years old and are in need of early intervention services. Once a child reaches 3 years of age (keep in mind this differs state to state, so this information is at least true for Michigan), they transition to the school services and if support is needed they go through a process to get an IEP – Individualized Education Plan. IFSPs and IEPs are created through collaboration between parents, teachers, and other professionals. They include an evaluation of the student and then various pages of measurable results/outcomes and other details that outline what the district is going to provide to assist the student. In an IFSP, not only are the child’s needs reviewed but the needs of the family are also considered, since some of the services may take place at home or in the child’s daily environment.
Colten’s eligibility is pretty straightforward. Anyone with Spina Bifida Myelomeningocele will typically qualify for EarlyOn and Special Education due to having physical disabilities and physical development delays. Colten started out doing EarlyOn back in Lansing via the Ingham County Intermediate School District; he received physical therapy at home about two times each month (thank you April, we miss you!). When we moved out of Lansing, Colten was just shy of one year and so the Ingham ISD did his one-year evaluation in order to help speed up the transition to the new ISD. With the chaos of our move back in September, we never checked up on the transfer until we finally settled into our new home in December. Better late than never though, Colten’s new intake evaluation took place when he was 14 months. The short version of the evaluation is that he scored a little behind in motor skills and self-help (as we anticipated) and a little ahead in cognitive, social and emotional skills (which we gave ourselves a little pat on the back for):
Fine Motor – 13 months
Gross Motor, Stationary – 11 months
Gross Motor, Locomotor – 9 months
Gross Motor, Manipulation – 12 months
Cognitive/Thinking – 15.5 months
Communication – 15.5 months
Social Emotional – 15.5 months
Self-Help – 13 months
By the way, not sure what the criteria is that makes him score 15.5 instead of just 15 months, but hey, if he wants to be an overachiever by ANY amount, we certainly won’t stand in his way! Just to expand a bit on the Gross Motor sub-categories, since I had to look up what the definitions were, here you go… STATIONARY: ability to sustain control of his body within his center of gravity and retain equilibrium; LOCOMOTOR: ability to move from one place to another using crawling, walking, running, hopping, and jumping forward (well that explains why he only scored at 9 months!); MANIPULATION: ability to manipulate balls – catching, throwing, kicking.
The hard part about doing the IFSP is that Colten is Colten and he gets around GREAT for what his body is currently capable of doing. We aren’t concerned. We know he’ll figure things out – he shows us that every single day. We aren’t concerned when or if or how he stands up, walks, or any of that. However, early intervention of any kind can have positive impacts down the road. The earlier and sooner that children can get support, the better. It is part of the reason why we started Colten in ABM lessons (Anat Baniel Method) at only a few months of age. So, support we are getting!
Colten already goes to outpatient/clinic physical therapy through Beaumont once per week. It is possible with the new services through Macomb ISD that we may reduce the frequency of these so that appointments are not consuming Colten’s (and my) entire life. Starting this week he will get PT once every other week at one of the ISD buildings from now until he turns 18 months, then he transitions to more of a preschool programming and he’ll go to a school twice a week for an hour each day for therapy services. The goals of the PT are:
— #1: In 3-6 months, independently pull to stand while wearing AFOs (oh SNAP! he already does this! CHECK!). [watch video of Colten pulling to stand with AFOs on]
— #2: In 6 months, stand at a support to play for at least 5 minutes with flat feet and UE support as needed (I think UE is upper extremity; currently Colten stands for probably no more than 2 minutes, with feet in any direction they land in)
— #3: In 9 months, stand with an appropriate assistive device such as a walker for at least 2 minutes with minimal assistance (This would require some stable weight baring and a stronger upper body; this seems very far away from us at this point so we’re really just looking at #2!)
— #4: In 12 months, progress to taking steps forward using an appropriate assistive device and physical assistance as needed (I don’t know how accurate they are with goals, but this basically puts Colten taking his “first steps” at a little over 2 years old)
Colten currently qualifies for a special education teacher to help keep him on track cognitivaly, emotionally and socially, even though he scored quite well in those areas. He will only see her once each month (at home) and it’s more or less to make sure things are maintaining along the current trajectory. Over the next six months she will work with him on identifying two objects from a group of familiar items and matching objects to pictures. Extending over 12 months, she’ll want to see him follow a two-step direction (“Get the ball and bring it to Momma”) and demonstrate awareness of classroom routines.
Fine motor skills are just a touch behind for Colten so he’ll work with an OT twice a week right in our home, at least until he turns 18 months – then just like PT, we transition into the preschool programming and if he still needs OT support he will get that during his two visits per week to the school. Over the next 3-12 months, the OT would like to see Colten do the following:
— release objects into smaller openings such as slots and shapes
— stack blocks 3-5 high
— imitate horizontal and vertical strokes with a crayon
— feed himself independently using utensils and cup
And so our new routine of appointments begins. We’ll hang onto the weekly Beaumont appointments for now, and we are hoping to start back up with our ABM lessons again soon but need to feel out this new schedule first. Colten continues to change and grow every single day – learning new words and climbing higher and higher obstacles. His spoken words include Momma, Dada, nana (banana), up, ni-ni (night night), ba-ba (bottle), hot, Papa, Ya-Ya (his version of Ga-Ga – for Grammy)… and he barks like a dog and growls like a dinosaur. He signs MORE, PLEASE and THANK YOU. He went sledding for the first time recently and decided that body-sledding was WAY more fun than actual sledding [watch video]!
On other fronts, he’s adjusting well to his new helmet, appears to be sprouting about 5 new teeth (ouch!), has figured out how to go forwards and backwards in his Bumbo wheelchair, and is supposed to get evaluated tomorrow for his dynamic stander (basically a stand-up style wheelchair). Stay tuned!