It was at our four month baby well-visit that our pediatrician diagnosed Brayden with
torticollis. "Torti-whaat?" I said to myself as I gave our doctor a blank stare. The short definition is that Brayden had a head tilt, caused by the tightness of his
sternocleidomastoid mucle (the muscle behind his ear that connected to his sternum). For us, this was likely an issue that started before birth when he got stuck in a "frank breech" position with his feet on his head while still in my belly. So the doctor prescribed Physical Therapy and sent us on our way. While we started our journey at the Children's Institute's PT clinic (also awesome), the twice a week appointments were especially difficult with twins. Packing up an infant, and driving half an hour away, to have a half an hour session, while leaving Julie at home, dealing with his massive reflux and my pumping schedule - urgh... the hecticness of it is making my head spinning just thinking about it!
As Brayden's head shape was also an issue, we were referred to a specialist a Children's Hospital who suggested that we get in touch with Early Intervention as a source for home based PT who were awesome in helping with torticollis issues. As an offshoot - this specialist also recommended a helmet for Brayden's plagioephaly (
wonky shaped head asymmetry) which you can read about
here.
So began our experience with
Early Intervention in Allegheny County. This incredible program offers physical, occupational, developmental and speech therapies to qualifying children within Allegheny County usually at no cost to the family. For us, the process included meeting with our service coordinator who met with us, explained the program, and had us complete some paperwork. Because Brayden already had a diagnosis, he automatically qualified for treatment, but children without this would also complete an evaluation of all sorts of elements (physical, social, and cognitive development) and if their scores fall below certain levels, they are accepted for services.
Brayden was matched up with an awesome therapist who came to our home weekly, and was truly fantastic with our son. She would stretch his neck, find his tickle spots, do massage, and play games with him. It was so fun that he rarely complained! Best of all, no long hauls to the outpatient PT office and expensive co-pays.
As Julie became more mobile, we realized that her crawl was a little "wonky" as well, and she wasn't rolling over normally. Brayden's PT checked her over and concluded that her tummy muscles were not as strong as we'd hope, and so Julie too was evaluated and qualified for services.
As the babies have grown, their needs have changed. Now VERY active toddlers, their need for physical therapy has passed and they are strong, flexible and very physically normal. But we have had some concerns about their speech delays. At 18 months, they each say only a small handful of words each (5-7). Although I narrate our every move, Brayden only says Dada, Mama, Nana, uh-oh and yum and Julie's vocabulary consists of the same, plus "hi" and "no" (a recent addition). Neither use these words to request food, nor can I get them to say "up" or "more" despite my efforts.
So yet again, we are thankful for Allegheny County's awesome Early Intervention program coming to the rescue. Both babies are working with a developmental therapist who weekly works with them to encourage speech through engaging play and mimicking.
Unfortunately, twin families often find themselves with similar concerns as those we've had. Smaller spaces as well as more time sitting is a frequent occurrence for twins and multiples. Twins are also
more frequently effected by speech delays although the true reasons for this aren't well established.
If you're a Pittsburgh family looking for resources, the
Alliance for Infants and Toddlers is definitely the place to call for support. Even if you do not have a doctor's recommendation, a parent's concern is enough for them to do an evaluation. While I'd never encourage mom's to panic, and there is a huge range of "normal" my personal belief has been "if they qualify, they need the services. If they don't qualify - even better as they'll be fine." I personally don't feel like there's ever a down side to having a concern evaluated for the simple peace of mind. If you're out of the Pittsburgh area, I have tried to find a directory for you but don't see one out there unfortunately. My best advice would be to google "early intervention" and your county as these typically run through the Education Intermediate Units.
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