Do My 10 Months Old Twins Need Physical/ Occupational Therapy?

I am the mom of a child that required early intervention. Please understand that what I'm about to say may sound harsh and that is not my intention, it's just the reality of having kids. I am a full time working mom and absolutely understand the push and pull time demands of kids and work. Having said that you need a reality check. If your Dr. and the therapists are reccomending OT/PT that's what you do. If your child had diabetes you would not even be questioning whether you had time to deal with it, you just would do it. The therpist is right, they're not going to wake up and just be like all the other kids. They will be with help and as their mom it's something you need to do. You have an oppourtunity now to make a long term lasting change to your childs life. It's not even a question.

Check with your HR department. I have a feeling that there may be some sort state mandated required time off to look after a sick child etc. Explain to them and see if you can work something out. Maybe you have a family member that can help, a support group at church etc. Perhaps a closer place? Good luck.

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My son was given the same kind of prescription, but due to his premature birth and also position at birth his Pediatrician and Podiatrist both recommended him beginning OT/PT. My son at 11 months old had started to scoot rather than cruise, and had been continuing with it. He was beginning to crawl again, when he had started to support himself and walk around the room.

We went to a Pediatric OT/PT Specialist, who did both in their facility out her in Valencia. I was skeptical and even sad that I hadn't picked up on the signs that he was lacking in something.

Well, it was the best six months I ever spent sitting and waiting and being worried. My son within the first two weeks of our two days a week for 45 min was walking, stopped scooting and by the time we were done was making marks on ALL milestones.

People told me I was crazy too, and to get a second opinion. Which I did, and the Developmental Specialists at Glendale Memorial said the same thing. So, it was not just overreacting on my son's doctors part.

I think as parents, it's our job to give our kids every advantage possible and while this may be tough on our schedules in the end it was totally worth it. I had to leave work two days a week to maintain his appointments or get to work late, and my boss was not SUPER thrilled but it was what I had to do.

Yes, babies develop at their own pace and should be allowed to do things in their own time. But, in this case I would see if you can get a second opinion and go from there.

For us it was worth it, and while he didn't love therapy it was amazing when he did start to flourish and make moves to walk and even run on his own.

Best of luck!

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Doctors don't just "prescribe" PT and OT to be "safe", they usually do it for a good reason. Early intervention in developmental delays is crucial. DO NOT WAIT. If finances or time is a challenge, there are agencies to help you with this. The most notable in the State of California is the Frank D. Lanterman Regional Center. In LA they are at 3303 Wilshire Blvd, Suite 700, Los Angeles, CA 90010. Contact them immediately. Funding does take time. If you want an accurate evaluation right away by an immensely qualified team of PTs and OTs, contact CAN DO KIDS 3638 Motor Avenue, LA CA 90034, ###-###-####. Speak to Leslie. They have been treating my son since he was 12 months old, and they are AMAZING. It is worth the initial co-pay, these are your CHILDREN. Early Intervention. Early Intervention. Early Intervention! It's important! Much love and luck to you and your family.

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Can't talk at length - but yes - make sure you do the therapies. Look into early intervention - a program where they come to your home and work around your schedule. I am new to CA but I did use the eary intervention porgrams that were avaaible in both PA and IN - where my son had to get ST,PT,OT,DT - well worth it - you have to think about their future. My son stopped services around 2 but is now receiving speech again at age 7. Call around and ask where you could get this information,try preschools - they might know. Or call local/state/government health offices. Don't get discourged my sone started at 9 months - I know it is alot of work but it is a decision that is in the best interest of your children and you are the only person they have to depend on - they don't have a voice right now. A.

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I think not sitting up by 10 months is def. a concern. The ped. and therapist have nothing to gain by suggesting your children need help and you should listen to them. It may be inconvenient and a hassle, but overall your babies will benefit from the therapy that is suggested. No, you shouldn't have to lose your job over this so try to find a new clinic or other arrangement (could you and your husband alternate? are there any weekend appointments? can they show you what you would need to do at home? I know if your kids were premature they qualify for lots of fed. and state programs. A friend of mine had the OT come to her house when her twins were infants. Try to find out more about this. It was part of a program called Early Start. Good luck with everything.

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My advice is to do it. My oldest son needed OT (when he was older), and although it was very inconvenient for the year that he needed it, it made a huge difference in his life. The gains in his motor skills helped eliminate the frustration he had over things he couldn't do or couldn't do as well as other children. Early intervention is definitely the way to--and I personally believe that tackling the problem early shortened the course of therapy that he needed. Good luck to you!

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J., I am sure you are confused about all of this. My middle son had both PT and OT very early on for a completely different issue than the your twins. Both my husband and I worked too and I know it is hard with how the clinics schedules are. I can say from our experience that OT and PT helped us to know how to help our son at home more than anything. Even if you can go a few times and get some home program started, that might be very useful. My friend who has twins who were a bit "slow to develop" on some developmental milestones had them in OT/PT for a short time and it benefitted them tremendously. You are right, children do develop at their own rate, but sometimes early intervention can assist in maximizing their potential. You are the mom and you will make the best choice for your children and family...If you do decide to do the therapy, you can get FMLA leave for it I think...

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has the dr. mentioned concerns previously or did this just come up. You can ask him to reevaluate at 10 months to see if there has been progress.
Drs. can tell the difference between a baby being a bit slow and a delay that needs attention. Get a 2nd opinion just to see what is said. It may be harder for dr. #2 to diagnose accurately since he hasn't seen your children's progression from birth as your current ped. has.
If your babies need this, it must be done whether your job allows it or not. Jobs come and go but your kids are forever. Mommy is your #1 job now and don't let a boss make you feel bad or guilty for taking care of your kids. I've been through that and it is so wrong for companies to act that way.
Home therapy is an option but may not be covered by insurance so check into it.
Good luck.

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J.,

I have a 5 year old son who has autism and sensory integration disorder. We knew very early on (prior to age 1) that something was wrong with him. He hit all of his developmental milestones at the absolute end of the "normal" range, didn't sleep much, would scream endlessly in the car and in public, etc... It wasn't really any "one" thing that tipped us off that he had issues, it was all little nagging concerns that all together were very unusual. Any of them by themselves would have been quite normal. I, unfortunately, have quite a bit of experience with therapies, therapists and developmental delays and all the issues that go with it at this point.

1. If professionals are telling you your children need help, they need help. All of the therapists we deal with are very, very busy. They don't need to recommend therapy for kids who don't need therapy. They've got lines of kids waiting for services who do need it.

2. If you need to rearrange your entire life to get help for your children, do it. Kids with developmental delays typically don't catch up on their own, their problems usually get worse and their delays get progressively greater as they get older. The earlier your start services the better long term results you will see. The more you delay, the further behind they get, the harder it is to catch up. All kids do develop at their own pace. But kids with developmental delays develop at a much slower pace than their peers. The lags become considerably more evident the older they get. So the question is can you risk your childrens' future by not getting them the help they need?

3. If you are in Las Vegas, call Nevada Early Intervention. They are in the phone book. If you aren't in Las Vegas there should be a similar service where you are at. You can get the number from your pediatrician or local school district. Early Intervention is a state agency that provides services for developmentally delayed children from birth to age 3. At at 3 the local school district takes over. Here, you can self-refer (you just call and make the appointment, you don't need anyone's permission) and the evaluation and all follow up services are free. They come to your house (or they'll go to your child's daycare) and they will work around your schedule.

4. In my experience, private services that you pay for are almost always better than the free public services. BUT therapies are expensive (many of them run $150 an hour and up) and are rarely covered by insurance (my husband and I pitched out in the neighborhood of $18,000 for therapies for our son last year - we've refinanced our house and totally rearranged our lives and our finances to be able to do that - we have no car payments and we buy NOTHING that isn't absolutely necessary - and no, we don't make all that much money, we've just prioritized our lives that way). Take all of the free services you can get and supplement around that. If your children are significantly delayed and it sounds like they are, this could be the start of a very expensive and stressful adventure for you and your family. Network with other parents in the same situation. Other parents are a completely invaluable source of support and information. They tend to be more "expert" than the experts you will be dealing with because they have a better understand of the overall "system" and how it works. The "experts" just know there part and they tend to NOT volunteer information.

5. Whether it is convenient or not and whether or not you want to do it, you need to get services for your child. One of the hardest things you will ever do is wrap your brain around the fact that your children may not be "normal" but you've got to let go of your own ego and do whatever you can to help them. I know with finding out my son had autism, we've gone through a huge grieving process. I had a really hard time accepting that my child isn't "normal" and he's not going to have a "normal" childhood and I'm not going to be able to be a "normal" mom that bakes cookies and watches my children play happily while they grow up. Autism (and probably most other significant problems) are a whole different ballgame and you really mourn for the life you didn't get. You still love your child but life isn't really what you fantasized about when you got pregnant. I guess in a round about kind of way you mourn the loss of a lot of your dreams and you have to reshape your reality. Hopefully your children's problems will be "fixed" in 6 months. But if they aren't, it can be a real roller coaster. My son is 5 and we've been doing therapy and living this life for close to 4 years now.

6. Over the years we've done speech therapy, occupational therapy and physical therapy at different times. They focus on different issues and approach problems differently even though the problems they address may be similar (or even seem to be the same), if they say you need more than one type of therapy, you do. Most "issues" don't have one cause or one solution. My son has sensory issues (sensory integration disorder), communication issues (speech delays, processing disorders), and eating issues. These issues are all stand alone issues but also related to each other. We've used a variety of different therapies (speech, occupational and physical) to help him deal with them. In a nutshell, one type of therapy isn't a substitute for another. They often work hand in hand.

7. You may want to check around and see if you can find a clinic that has Saturday hours. Some do. Another thing to ask is if both your babies can see therapists at the same time. If it is a clinic with multiple therapists, that would save a lot of time and help a lot. You can also ask if you can have their therapies back to back. That may or may not be a good thing. We currently are doing occupational therapy with my son on Monday and Thursday. So he's getting 2 hours a week. And doing it twice a week for an hour is doing him way more good than doing 2 hours one day a week would. He's so worn out by the end of the hour he wouldn't get anything out of the second hour and a full week between appointments is too long. But it is worth asking your therapist if it is an option for your kids.

Good luck! I know it will all fall into place and work out once you make up your mind to do it. I can tell you that when it needs to be done, you just figure out how to make it work.

T.

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Hi J.,

I don't want to be too repetitive because you received alot of great advice... but I'm very big on investing in our childrens health, growth, development etc. I think a 2nd opinion would be great, but in the meantime I think you have a doctor that is erring on the side of caution. Many have doctors that prefer to wait, and quite frankly, we can't "wait" when it comes to our children. Your work will always be there - if you are able to address things early, only your children will benefit in the end.
I agree that children develop at different stages... my daughter walked at 9 months, which is extremely early, but my nieces and nephews some didn't walk until 14 months. But at the end of the day, I believe my daughter walked early because I was constantly building her muscle and did alot of my own PT with her at home.

Good-luck I wish you and your family the very best.

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Check to see if they can go to where your children are being watched or at your home when you are not working. I do day care and have had 2 kids that got it (one with down syndrome & one who was sick alot as a baby) and both were done in their homes and even came to my home to do it also. Both of the kids are amazing and doing well. If you can wing it why not. It can't hurt them only help them. Best of luck to your family.

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It is really important to take your twins to the appointments. The doctors write perscriptions in order for insurance to track and approve the referrals. They do not give out these easily. It is difficult to qualify for services. If the evaluations come back and say that the children need assistance then there is a valid concern. I have worked with several foster children from 7 weeks to 4 years and without help children don't catch up and when they are behind the other kids their age everything is more difficult later on - play dates, school, sports. It is true that the milestones are averages and some children will reach them early and some later, but get them tested and help them early. I have found that the earlier the intervention the more successful the treatments. I am sure that you and your husband can find a way to make it all work and it will be great.

J.,
We took out little girl for OT, she had tortocolis (SP?) Once we learned what to do after only 2 visits we did the OT at home on our own schedule. Take the doctor's advice and see the therapist and learn what to do. You will see the difference in only a few weeks. Good luck and don't stress over it, it can be a bit overwhelming at first.

J.
If they are offering the help, take it. My son is 15 months and still playing catch up. I've tried to get him to O.C. Regional and they say he is not delayed enought. Now I am taking him to p.t. once a month and the neurologist every three months plus his peditrician wants to see him every couple of months. I know it's hard, my husband and I both work. Fortunately, his off on Mondays so I schedule his neurologist and pedritician appt. on that day and I take Wed. off here and there to take him to the p.t. I have to say my son is catching up, but he is still delayed and I know if he didn't receive p.t. he will never be where he is right now.
I suggest, ask them if you can reduce the p.t. and o.t. services to twice a month. If you have a family member or friend you trust, maybe they can help out with taking them when you can't. Just make sure to write your questions and send them with them. Also, see if they can help you apply to O.C. Regional-I heard if your child qualifies they make home visits. This is why I was pushing for it, to save me from missing work.
I understand its hard, you want whats best for them while trying to provide for them also. Pray that they catch up soon and try to meet them somewhere in the middle.
Good luck,
Ceci

Hi J.,
You've already gotten lots of input encouraging you to take them to therapy.
I know that it can be difficult time wise to imagine fitting even more thing into your already demanding schedule, but it's just one of those things that goes along with the demanding (and rewarding) job of being a mom.
I'd like to add a few points.
1. It may be a huge gift that your pediatrician recommended therapy at an early age, rather than waiting,and then having bigger challenges at hand. Early intervention is soooo important! This therapy may help to get them back on track, and to give you tools to help them yourself (that you might not have known about).

2. Try holding a more positive approach to working out the logistics. You might be able to get a combination of therapy sessions and home exercises, or might even get home visits. Also, maybe the twins can in together, rather than 4 appointments per week. I'd recommend setting a positive intention around having a graceful therapy schedule, with the right resources, that also provides the greatest benefit for your children.

As a preschool teacher, I remember the heart breaking times when children couldn't get the help they needed because parents were in denial, or felt embarrassed that their child needed help. There is nothing wrong with your kids needing therapy. Really, it is great news that they can get it at 10 months, rather than finding out at 3, that they should have had it a long time ago.
Hang in there, you'll get through it. I know that your hands are probably unbelievably full already, but really, you do have the inner strength to handle this.
Blessings to you and your family,
M.

take them in for a consult with pt and ot. At first it will be a lot of time taking them but as they advance the therapists will give you mor and more stuff to do at home. Even from the begining you may be able to tell them your concerns for time and they can give you things to work on with them at home. 2 hours each once a week won't do much if you aren't working with them at home anyway.

Hi J., I know that it may be difficult to arrange your schedule to take your children for OT. However for their sake, do it! Since not only your pediatrician, but also the OT recommended therapy- it is very important that they receive help. Early intervention is so important.

I work with preschoolers ( and older) who need services. The earlier kids can be helped, the better. Sometimes parents "are in denial", and then expect/hope kids catch up right before they start kindergarten. Development doesn't work that way.

Hi, i have worked with many children and of course they all develop at their own pace. I would suggest for them to get plenty of floor play in your home and believe me, you will see a difference. Perhaps, because you work and they are twins you are exhausted and dont provide plenty of floor play for them. Thru floor play and with appropiate toys they will explore with all their senses and become very curious about their environment. This will help develop their large and fine motor skills and soon reach other milestones, you will see. :) If several weeks pass and they have not improved buy attemtpting to crawl on their belly etc., then i would get a second opinion. Good Luck & dont stress this will only bring more problems, and us women, do not need another number with our daily roles. :)

I'm a mom of twins. I have had speech concerns & had them checked out. Turns out they are fine.

BUT--- It is better to give your kids all of the support and potential support they need. This will be a sacrifice but it is necessary. Wouldn't you feel guilty if they really didn't catch up & you didn't get them help because you didn't have the time? Kids (and even parents) can be cruel & you don't want your kids to have to feel like they always are lagging behind.

I also recommend keeping your DR. He sounds like he knows his stuff & doesn't like to be asleep at the wheel & let things get out of hand. I'm sure you could change to another doctor who might tell you what you what to hear, but ultimately your kids are the ones who suffer.

Good luck.

i'd do it! my son has a speech delay. i didn't want it to be real either. and i got the same reaction from all my friends and family: oh, he'll speak when he's ready, blah, blah, blah. i was in denial for a long time, and i dreaded taking him in for evaluations and stuff, but now he's been receiving speech therapy for 6 months and that has really helped him. and in retrospect, i am VERY GLAD i took him in because i didn't want to regret it if i hadn't. if i had the opportunity to get him help but i passed on it, what if he really needed the help? i would feel soooooo guilty. so i understand your hesitation and your fears and doubts, cuz i had those feelings too. but from where i'm at now, looking back, i'm again, VERY GLAD i followed my pediatricians recommendations. so do it! make arrangements and take your kids in for those 2 hours a week. you will not regret it. and if your kids excel like crazy after just a little while, you can always terminate those therapy sessions later. good luck!

I would get another opinion if I were you. At 10 months your little ones are still well within the norm for learning to crawl. Every baby develops at a different rate, and it is normal for the boy to do things slower than the girl. You did not mention if your twins were born early or not. I know sometimes twins come early, so then you would have to adjust for their real gestational age. For instance, if they were born 1 month early, then they would only be expected to be performing at an 8 month level.
They sound fine to me, but I am not a pediatrician, nor a specialist, just a mom of two. Check around your area and find another dr. who is highly reccomended, and seek another opinion. It is possible your current Dr. is an alarmist, or maybe they do see something that needs attention. Either way, it never hurts to trust your gut and to check for more than one opinion.

Personally I would take them to therapy. It won't hurt them at all and they will get some one on one attention to help them meet their needs. I took both my kids to gymboree at that age so they would develop good climbing skills and agility. Maybe you can ask the therapists if you could do some of the activities at home with your twins. OR maybe you can ask your boss for some needed time off so that you could spend more time with the babies. It must be very hard to work full time with two babies that age.

J.,
Honestly, if this were me (and I'm due with twins any day and have 2 older children,) I would follow the recommendations of both professionals. While overtreatment and diagnosis is common with some situations (add, autism, etc.) it is not normally seen in a milestone delay. If your twins were born early, you know they have adjusted ages for meeting their milestones, but if your pediatrician is aware of all this and still feels they need pt/ot, I'd make it a priority. I know it can be tough to make adjustments when both parents work, but think of how it might impact the kids down the line when they have difficulty with fine/gross motor skills that could hold them back from other interesting and important childhood experiences.
As for risking your job, I would suggest that each of you be responsible for 2 hours of therapy per week. Present the need to your respective bosses and see what they might be able to work out. Also, ask your clinic if they can work with you on hours/availability of therapy times. Remember, NOTHING is ever written in stone and you'd be surprised how understanding and accommodating people can be if we just ask!
Good Luck!
T.

I have heard that if the babies don't get the proper PT/OT they could fall further behind. It's better to get them the proper care right now. Did you check the Regional Center in your area? My twins OT and PT comes to our house each week. If you have any other questions, please send me an e-mail. I can ask their PT next week when I see her. Good Luck!

I am not an expert and I don't have twins, but my boys didn't hit the milestones you mentioned at 9 mos and there has never been any concern. My oldest is almost 4. He was crawling at 8 mos, but he did not claps hands or wave (on a consistent basis) until closer to a year. He has no developmental delays in any area and I think he is rather skilled now and amazing in many areas. He loves running and he is incredibly advanced in his speech. My younger son seemed delayed as a baby. He finally started dragging himself along the floor at about 9 mos, but didn't crawl on hands and knees until 12 mos, and I don't even remember when he clapped or waved, but I think it was closer to 12 mos. I was never worried, he was just a little slow. I had thought he was slightly behind in speech for a while, but he is 2-1/2 now and he is perfect in every way (I am a biased mommy, but the doctor and my family agree:). He was a little slow with some things, but you would never know it now. He is very physically adept, has amazing concentration skills and hand-eye coordination, great speaking ability, not to mention he is ridiculously cute! (sorry, biased mommy again).

Like I said, I am not an expert, and it is really hard to give advice to a stranger about something like this, but I can understand your concern about missing so much time from work if these are just normal delays and they will catch up in their own time. Hopefully all of the advice offered here from the other moms will help you make a decision you feel confident about.

Yes, babies develop at their own pace, however, they do need extra stimulation if they are a little behind. I would rather err on the side of caution and what is best for them. I've worked with too many special needs kids and the best thing is therapy. Friends of ours who had triplets 2 mo's premature received OT services right away. The services where through Regional Center and they came to the house. My friend also worked with special needs and knows how any kind of therapy is so beneficial. They are toddlers now and on track. Only one is a little bit behind. You want the best possible future for them. You could wait a little while and see, but I wouldn't wait too long. Yes your jobs could suffer, but try talking to your employers and see what you can work out. Or find a family member or close friend that may be willing to help. Good luck and hope things work out.

In reading some of the other responses, waiting too long could hurt the babies. Like I said I worked too many years with special needs and you could tell the difference with kids who had early intervention. Early intervention is the key for any kind of development and/or disability. It's better to be proactive. Educate yourselves. Talk to other professionals. Go on sites for parents with children who are developmentally behind, no matter at what stage. Call Regional Center in Calif. They can also do their own evaluation and you may qualify for free services at your own house. What ever you do, don't wait too long. Sometimes a little sacrifice on our part is what's best for the kids.

If your twins were premature then developmental delays are to be expected and early intervention is critical for their development. 90% of the brain is developed before three so what you do now could make a difference in them being able verses disabled. I know this story well since my twins were born ten weeks early. You may also want to hold off on anymore vaccines. Or at least wait until they are older.
D. Merlin
Mother/author
www.victoryoveradhd.com

You sound overwhelmed. Please take a breath and look at your options from all sides (2nd opinion, FMLA leave, resources, etc.). Remember, you're the mommy. It's up to you to protect them and provide for them. And do your best. That's all you can ask of yourself! God bless!

It could be a delay all babies do grow at their own rate. But do you really want to take that chance. Wouldn't you rather take them to therapy now and find out that it wasn't necessary than not take them and find out they really did need the help. Why not take to at least a few sessions, it will give you and the doctors a chance to really get to know your twins and better figure out if they are just slower than others or if there really is a problem.

Do whatever you can to get your kids into therapy. We did it for our premature baby when she was four. We would have done it earlier, but it wasn't presented as an option. I agree with you that children develop at different ages. My daughter was a mixed bag for both early and late development -- early on speech and late on motor skills like walking and writing. Therapy, in our opinion, was an adjunct and support system to her natural growth. We always made it "okay" to be at whatever stage she was, but professional support educated us as parents and supported her natural development.

Find your local "regional center" for help. Your pediatrician can help. In west LA, it's Westside Regional Center in Culver City. They can help you with financial support for the therapy (private insurance is of limited value) and they also provide money for "respite care" that can be used to hire a college kid or nanny to take your kids to therapy. Also if you're on the west side, try to get a referral to Therapy West for therapy. They are an AMAZING, caring group, who I give tremendous credit to for our daughter's development.

Can you afford to risk the development/well-being of your children? You should always take the advice of the medical professionals, especially if they are in agreement, over the advice of your friends and family, who will tell you what you want to hear. You should find a way to make it work, no matter how inconvenient. Your children are depending on you to make the choices that are in their best interest. Good luck.

J.-
As a mum who has had a daughet in PT for almost a year, I say do the OT and PT if you can. My husband and I went back and forth with the diagnosis for our daughter (who had helmet therapy and pt) but at the end of it all we wanted to be able to say that we did everything that we could to make sure that she was everything that she could be. Every child does develop differently, however I think there are certain things that may be indicators of future struggle. If you are hesitant, get a second opinion. I don't think it hurts to do all the therapy. We had to rearrange our lives for it. And if it makes you feel better I did it all with our two year old in tow, by bus, on two or three different days a week. I worked around my work schedule. As parents I think it is our responsability to do everything we can- no matter how difficult it may seem. I wish you the very best. I understand what a hard decision this is for you.

i dont think it will hurt them any to go. babies do develope at different rates yes but there is an alloted time that babies should be doing things. try your best to work with your littles ones when you are home outside of the ot and pt. also remember not all babies crawl hands and knees. my twin nephews did not crawl hands and knees till 9 1/2 months old. they did the army crawl. i would go through with the sessions and try to get them to do both babies at once. they should do well and learn with time. also if your babies were premie just remember if they were born 1 month early then they may be one month behind. so at 10 months they are really like 9 months (does that make sence?). just be patient and take it slowly. good luck to you and your family :)

You can wait until they are ready for Pre-school. In this way, the school can test them for both, and they will get the services in school.

J.

J.,

Doctors will look over things because baby's do grow and develope at diffrent stages. But My kids were walking at 9 months. Yours are barely sitting up. Doesn't that concern you a little. I don't know if they were premies and how premie they were. But you want the best for your kids maybe they only need a little help now. But in the future it could be way worse because you didn't start early. Do whatever you have to now, maybe they will be quick learners and graduate quickly. Or maybe they can teach you the things that you and your spouse can do at home to help them instead. I do know that you don't want to look back one day and say I should have done this. The guilt will eat you up. Besides you got a second oppinion from the OT they agreed with the doc. Your family comes first. I think if you talk to your boss and tell him/her that you need to do this and you will keep them posted on progress, they will understand you need to leave work early a few days a week. See if you can go in earlier on those days. Also see if your spouse can do the PT appointments, do you have grand parents or family who might be able to take them instead. Do you go to Church, maybe you could talk to the women their and see if they could help you out. Give others the chance to do service and get Blessings. I live in Corona/Eastvale, CA. If I can help in any way. I'm avalible in the afternoons, I work in the mornings. Email me back if I can help, I can always use the blessings. Then I'll give you my phone number. God bless you and your family. J.

You are right that every baby develops at different rates, however if the Dr and especially, the OT have noticed/evaluated them to be in need of the therapy, then I think you are going to need to find a way to do it! Early intervention in any kind of delay is ALWAYS the key to later normal development. Is your therapy being provided thru Regional Center? Just want to make sure you know about that service that is provided free of charge to you if your children qualify and I believe they can provide the therapist to come to your home even. Although for OT they probably have specialized equipment that they will benefit from in the facility. (My child had a speech delay and we went thru Regional Center for the speech therapy. And everyone told me I was crazy too. He'll talk when he's ready,etc...but he NEEDED the therapy and it was wonderful for him - hard to get him there for me - YES, but necessary!) Good luck!

Hi J.,
Who watches your kids now while you and your husband works? Can your caregiver bring them in?
In my opinion, it sounds like the twins may need some support from OT. Yes, milestones do have age ranges and if there's obvious delays, I think the earlier the intervention, the greater the kids will benefit. Wish all the best to you and kids.

Hi J., Although I do believe all babies reach milestones at their own rate & every baby is an individual, I would listen to my ped. He must be making this "prescription" off other signs also. Maybe you should have a deeper converstation with your ped to get more of a detailed analysis from him/her. Ask your ped if there are any exercises you could work on at home to help your babies out. He might give you some options. Hope everything works out for you.

Dear J.,
I was an occupational therapist. Your children sound like they would benefit from therapy, but they could give you a home program and you may not have to go in as often. Most of it is stimulation and placing them in positions to encourage certain movements, muscle control and muscle strength. I evaluated a child that was about that age and was not sitting up at all but eventually caught up with walking. I was more concerned with with the mental and social development. The child was not focusing on toys and not grabbing and desiring to explore the world and she does have mental limitations. Are your children doing these things..showing interest in toys, attempting to imitate in "patty-cake", trying to roll a ball back to you, starting to babble meaningfully such as "mama", etc.? Do you spend time with each working on the floor and encouraging them to try to get a ball or put blocks into cups, rolling balls to them and talking to them, having them take a specific toy (such as ball from you when a ball and a block are offered)? Do they roll over both directions easily (my other son rolled to get toys for a while)? Do you hold them on your lap in the standing position so they will develop more trunk control? Give them lots of opportunity to try motor skills instead of leaving them in a seating arrangement that supports the back? Actually my oldest son was premie and it took him quite a while to catch up with peers, especially in the sport area (we kept him back a year which did help and he was still the smallest in his class until about 8th grade). Often in clinics there a more than one therapist and they could take the children simultaneously, but then you could not observe them as much. I would definitely speak to them about a home program and both husband and you should be there when it is explained. They should catch up into "normal" range quickly if you spend lots of time working with them. The girl sounds like she isn't far behind...my oldest son would get on his hands and knees then flop forward instead of crawling...finally crawled for just a week before pulling up and trying walking. I would be more concerned about the boy not sitting well...his trunk muscular is not developed.
Who is taking care of the children when you are not with them? Do they get stimulated in the above ways while they are not with you or just lay in the crib or sit in a supported position? You many need to have that person at the session explaining the home program too and change who is caring for them if they are not willing to spend lots of time with them in this way.
If you have questions about development you can go to various sites on line. Generally it is as follows:
6-12 Months and they are halfway through this phase:
Cognitive:
Objects can be held in memory (if you hide something, they will hunt for it); learns through routines and rewards (knows what to expect with dressing, puts out arm, feeding..tries to finger feed, etc) ; recognizes name; says two to three words besides “mama” and “dada”; imitates familiar words.
Social:
Separation from mother (usually about this age really makes a fuss when mommy leaves); begins to develop a sense of self (aware of body, may point to feet, show hands when asked); learns to get needs met (usually by pointing or simple words...my one son made slurpy sounds and pointed to the sink when hungry); trusts adults; stretches arms to be picked up; likes to look at self in mirror. Rolls over (both from tummy to back and back to tummy; stands with support; creeps/crawls; walks with help (holding hands); rolls a ball in imitation of adult; pulls self to standing position and stands unaided; transfers object from one hand to the other; drops and picks up toy; feeds self cracker; holds cup with two hands; drinks with assistance; holds out arms and legs while being dressed.

I hope this helps and may God bless you as you work with your children on development in all areas.
H.

Hi J.,
I am a pediatric occupational therapist, and I would recommend to follow the advice of your pediatrician as well as the OT who evaluated your twins. If your twins' motor skills are delayed, it's best to have a therapist monitor them. The next 6 months are filled with huge motor development, and so it is best that they have good foundational motor skills, especially with crawling and using their hands and arms (weightbearing in crawling, waving, clapping, grasping objects).
Also, your children may not need OT for 6 months, and your OT should monitor your child's progress. Start with OT, and then see if PT is needed.
Also, if scheduling is an issue, are there any other service providers in your area? Any weekend or evening availabilty?
Are your children in daycare while you and your husband at work--and if so, can a therapist come out to where your twins are at--do an offsite therapy session?
Check with your pediatrican or your local regional center to see if there are any other OTs/clinics in your area, if the clinic you are referring to is difficult to schedule with.
Good luck and feel free to e-mail me if you should have any other questions/concerns.

You've received a lot of great advice here. I just wanted to offer my opinion as a mom of a special needs child. Our older son was speech delayed and has sensory integration issues. We got him into therapies at 3 years old. After going through the "system" we have seen many children who were not put into therapies young, and their ability to catch up is severely compromised. Our son is 6 and now in general education kindergarten (he has been in special ed school for 3 years). In his class are 2 children who are clearly behind, but have had no intervention. I've spoken to the parents and their children are resistant and uncooperative with the therapies. They don't want to be seen as "different" since the kids are taken out of class or the therapist is right there in class. Our son has no problem with his speech and OT because he's been doing it so long for him it's part of his routine. Not only that, these kids who did not receive help have some serious social issues, and it's effecting their ability to fit into class. Our son fits right in despite his continued speech delay and sensory issues.

Early intervention is KEY to success in helping kids overcome developmental delays. I wish I'd had help when my son was 6 months old. I still feel guilty I waited until he was almost 3. I would follow through on the advice you are getting as in these cases it's my opinion it's better to be safe than regret it down the line.

Good luck,
B.

I would recommend getting the services for now. It will not hurt them if anything it will make it easier for them in the future. The docter know that all kids grow at different rates. If they are recommending they need a little extra help I would not second guess them.
Good Luck

My little girl (18 months) was late on everything too. Started clapping after a year old, crawling at 10 months, etc. She's now not really talking to my pedi. told us to call the regional center to get extra help. He said it's free (tax payers money) and we pay plenty of that so it'll be nice to see some of that benefitting our family. The lady just came to evaluate her and said she will most likely qualify after she takes it to the board. One friend mentioned, why not have her get help (it can only help). I'm not worried, but any extra help is good!!! Some babies just mature slower and that's ok. My friend used the regional center when her little boy wasn't turning over (until 9 months). They helped her work with him and then he learned it quickly!!!

J.,
I would say to take them to their appointments, I am a teacher with upper grades in elementary and when children are in whatever therapy they need early on it really makes a difference later on. You don't want your twins to be behind in school and have to play catch up for many years because they didn't get what they needed when they were babies. It will pay off in the long run even though it may be difficult to get them to their appointments now. Good luck!

Get a second opionion from a good institution - Scripps, Childrens, etc. Then do what the doctors say.

Good luck!

I am a pediatric OT and considering your pediatrician is on top of the services out there, I'd first of all stick with that doctor. I would get the help now, and get them caught up. There are things that the body does naturally, but often if babies are premature (you didn't say, but I am assuming they may have been), the pathways don't have enough time to completely form, and some need to be taught things that may develop naturally in others.

I am not sure where you are located, but the Regional Center can get an in home therapist to see the children. Many go to daycares. Unfortunately you would miss out on the direct information provided by the therapist, but if you have a caregiver who will follow through and is a reliable reporter, your kids will benefit from their time with them as well as when your husband and you are with them. Please feel free to send me a message with any questions you may have, but as I have said many times on here, if you are in doubt, seek out the services. The child can only benefit and better to do it now. Who knows, they may not need services very long, but even if they do, you will be glad you got in early!

The "slowness" would have more to do with how early they were more than the fact that they're twins. You didn't mention - were they premature? And if so, how much? That would influence my decision!

My son was 6 weeks early, and he didn't crawl until 10 months. Unless there's more to this that you haven't told us, I would tend to agree with your family that all babies grow/develop at their own rate. That's pretty much our pediatrician's attitude as well... there's definitely some leeway here.

As for the prescription - there's usually a prescription for physical therapy. It's typically for the insurance companies - think of it as a referral. I'm assuming you have HMO?

Perhaps you should get a second opinion if possible? Depending on your insurance, this could be easier said than done though. You could probably see another doctor in the medical group, but I'd call your insurance company to make sure it's covered.

Good luck!

My twins were preemies, and the doctors have been all over me about stuff like this. I got a second opinion and would advise you to do the same. Some docs give preemie twins a year to "catch up" but others don't. The truth of the matter is that it could take your kids until puberty to truly catch up to their peers. My boys are still a little bit behind, but they are making a lot of progress. Also, keep in mind that boys do not develop certain abilities as early as girls, so don't compare your kids to each other. I think 9 months is a bit early to begin OT/PT. Give them a few months, since they are still within the range of "normal", and then have them reassessed. Good luck!

Hello, I also have twins and One of mine is way behind the other due to medical ____@____.com have been doing OT, PT and picking up speech in the next few wks. I know its hard and stressfull, 3days a week we have therapy. Even if you dont think they really need it TAKE it. Every bit of help from outside the house helps. My son Ryan didnt walk untill he was 2. Without therapy 2x a week it probably woundt have come untill he was 3. You might want to look into Regional Center Of Orange County. They provide services for childen that have Therapy needs. These PTs and OTs can come to your home which makes it alot easier then clinics.
Twins are always a little behind, but why not give them the extra help and make them a head of the game :-) Good luck!!

J.,
Of all people, your pediatrician would know if your kids need help. He has seen and sees more children their age than any of your friends or family - with his training, knowledge and experience, he is in a pretty good place to judge if they are just developing at their own pace or if they truly need help. The range that their progress is measured by is really broad - so below average is pretty serious and really something to be concerned about.
This age is the most crucial for their physical, emotional and mental development - if they don't get the help they need NOW, they will NOT just catch up on their own. Take the time to help them now, their lifelong ability is being impacted by your decision.
If they were my children, they would come first - if I had to leave work to make sure they were receiving the care they needed, I would.
Good luck to you and your family.
G

Hi J.. Have you considered taking them to another pedi for a second opinion? Also you didn't mention if they were full term or premies but my niece is a surviving twin born at 30 weeks and her development was always measured at her corrective age so at 9 months she was about where a 7 mo old would be. She is still catching up a bit at 2 years now but the gap grows smaller and smaller.

Were your twins preemies? My son was 2 months premature and was delayed by at least 2-3 months on everything. He didn't crawl until 12 mo and walked at 18 mo. We had him evaluated by the regional center at 1 year and they said he was fine considering his prematurity. He is now 20 mo and running around and starting to talk up a storm. If both the doctor and OT say that need extra help, I would definitely get it for them. The faster you get help, the more likely they will catch up with their peers by the time they hit school age. My husband teaches special education and has seen studies saying that OT can be beneficial to all children, even those without serious delays. Look into your local regional center. If they qualify, the therapy is at no cost to you.

J.,

You have received lots of advice and you have to do whatever is necessary to protect and raise your children to be the best that they can be. The Regional Center is there for specifically this kind of problem and should be able to help with alternatives and information on what to do. A second opinion is always good.

Please, also do the research into vaccinations and that you should delay anymore shots for your babies. Twins have a higher risk of autism, and boys are even higher than girls.

Here is some information for you to start with:

The Vaccine Book, Dr. Robert Sears
What Your Doctor May Not Tell You About Childrens Vaccinations, Dr. Stephanie Cave
Evidence of Harm, David Kirby (investigative reporter)

www.909shot.org
www.tacanow.org go to Vaccines listed on the right
www.generationrescue.com

I would certainly get another opinion. I have twin boys and although they did start walking at 9 months my friend who has a little boy that is 4 months older than mine did not start crawling until 10 months. My boys did not start waving until 11 months and have just only started really clapping at 12 months. Each child is different. I would get a second opinion and then find ways to encourage your girls to move around. Encourage them to roll around on the floor, give lots of praise for moving and make sure they are still getting lots of tummy time.

Hi J.,

In response to your concern with your job, I know times are tough for companies these days and it seems as if no one has a secured job, however you should know that as long as you've been with your company for one year and have worked 1,250 hours in the last 12 months and your company has over 50 employees, you should be eligible for FMLA. FMLA is a job protected leave which allows you up to 12 weeks of leave to care for yourself or immediate family members, even if it is intermittently (to cover doctor's appointments). You should check with your Human Resources department/person about this. Best wishes!

First, if your doctor wrote a prescription, you might be eligible for services through your county education center. In San Diego, you would be served under the HOPE infant services. They will come to the house for therapy. Second, I teach special ed and I hear parents all the time say they have family members that dismiss a doctor's concern. This always concerns me as the doctor has obviously recognized a need and is using his/her expert opinion in making this evaluation. I can tell you they don't hand out such prescriptions like they hand out antibiotics. As a parent and an educator, I would definitely look into the therapy. Parents often have to beg for these services and you have already been given that option. There is no harm in the therapy and your children can only benefit from them. There is such strong research supporting early intervention services that it would be doing your children a disservice to "wait and see". Good luck!

J.,
One option for you is to find out where your local early intervention office is. I noticed that you are in California, and I can't advise where it would be for you, but here in Nevada it is through the state. Each state has this for 0-3 year olds. What you need to do is ask someone (I'm surprised that they didn't tell you this at your pediatric appt) who to contact, or even look it up in the phone book. If you don't have any success finding it easily you could try calling your school district. Let me explain. My daughter has developmental delay, and didn't meet milestones socially or physically. She also has seizures and has since she was a baby. When she was about 2, her doctor told me to contact our local early intervention office, and there they did testing free of charge. If your children qualify then they will be eligable for PT or OT services and those services will be preformed either in your childs daycare or in your home, whichever environment is the babies natural environment. If they still require services at 3 it gets turned over to the local school district and your child will go to preschool at the public elementary. My daughter has been in this program here and it is fabulous.
The reason I bring up going through your state or county, whichever has the program, is number 1 a second opinion, and number 2 the services will come to you. The idea is that early intervention can help the children and if they don't receive it early sometimes they miss their critical learning time. I hope that helps. I wish I had numbers to give you to call, but my friends mother works as a teacher in CA and has said that they have programs for 0-3 year olds in OC so I know that they have the same type of programs that they do here in Nevada.
Also, for what it is worth while I was in college I was a nanny for twins, and the mom read that sometimes twins will develop a little later on milestones, but that doesn't mean that they couldn't use some extra help. The testing through the state is not going to cost anything and it will be piece of mind to you. Good luck!

J., If you were learning a foreign language and needed extra help would you take some extra tutoring?
Of course you would!! Your children will benefit from the wonderful people that do PT and OT. They need some help now to develope the muscles and co-ordination to do the normal physical functions that we take for granted.
Are you willing to forgo the extra help they need now for your convenience? They may only need the extra help for a few months or a year, you are paying a babysitter anyway now, find one that can help with this situation now. Do you have parents? or anyone that can help drive them and wait? Usually they schedule the therapys at the same time for siblings. Don't think they don't need the help, your MD, OT and PT experts know what they are doing. You need to go and find out what you can do to help them at home to foster the proper development.
Be the Mom you would want to have...
Deb My son has autism, I have been in similar shoes.
your boss will understand if you need to go for a longer lunch and stay later, or your husband does the same.

Hi, J.. I don't have twins, but had a similar situation with one of my sons. Do get a second opinion, but if the doctors agree that therapy is the best option, try it. Our local university has great OT/PT programs and my insurance covered it. You should be able to take both kids at the same time, and may be able to have them show you exercises you can do with your kids at home to minimize the number of times a week you take them. Do you and your husband have different work schedules or can you stagger your lunches so one could get the kids and take them and the other could meet there and take them home? Just some thoughts...

Get the help. Just get it. Both of my kids were born perfect (I thought) but my first had torticollis (her head was tilted to one side) and she was not developing her gross motor skills because she was crooked. I took her to physical therapy at a children's hospital - CHOC and it was a very good experience, but very expensive. After we moved to Hawaii, she was re-evaluated and determined to have delays in her speech. This time, the state intervention agency provided the therapy and THEY CAME TO MY HOME to do the therapy and IT WAS FREE. I found out that kids from 0-3 that exhibit developmental delays are eligible for free therapy in your home. Most states have this agency, so ask your pediatrician. The paperwork does take some time, so start right away.

You really need to do this right now. You don't want your kids to fall farther behind when the help is available. I know it will be hard for you, but this is your children's future!!! Didn't you realize that your life might change when you had twins? Find out what will be required, look into the intervention agency and then talk to your employer. I worked it out to work later on Monday and Tuesday, but leave early on Wednesday to take my daughter to therapy, then I worked from home on Friday so I could take her again for her second session. You can do it and you will. Between you and your husband you will do what it takes for your kids to develop normally.

Sit your kids down next to a group of other 10 month olds. I know kids all develop at their own rate, but you will probably notice that most kids are pulling up on furniture or walking a few steps, then falling and getting up again. They are self-feeding with a spoon, waving bye-bye, etc. You need to do this for your kids. You will find a way.