Raising Readers

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Categories Development, Developmental Geekery, Language, Toddlers2 Comments

Spending time reading to children isn’t a matter of convincing parents whether or not to raise literate children. That’s a no-brainer in North America; either be literate or be left behind in this big, fast-moving world. Fostering a love of reading, and setting the foundation for kids to easily learn to read, that‘s what’s on the table.

Love of #reading. Setting a foundation for kids to easily learn. That's what's on the table. Click To Tweet

I get it: It’s the end of the day, you’ve wrestled your multiples (and maybe their siblings) into the bath, into their jammies, teeth brushed and into their bed. Why, oh why, throw a book into the mix? Why not call it a night, tuck them in and head downstairs for some much-needed adult time?

Whether you choose to incorporate reading into bedtime routine (which is common and easy to stick to) or throughout the day, reading daily to children as early as possible has substantial benefits. Anecdotally, I have seen kids learn sight words from repetitive rhyming books (like Dr Seuss). Academically, study after study supports early reading as a pathway to early reading and writing, language development, ability to focus and self-regulation. Many hospitals send new parents home with a book for baby, pushing home the point that reading is just as important as basic necessities like diaper changes and bathing. It is!

With my twin girls, their interests differ, but they have learned to wait their turns to sit in my lap, having me read (and re-read) their favourite books. I’ve noticed they frequently choose the same five or six titles for months at a time, so while I may be mind-numbingly under-stimulated, their little brains are firing away, developing at a rapid pace with each reading.

As twins, their language development has been slow, (which is common for multiples). Daily reading, asking them open-ended questions about the story and encouraging them to finish sentences they’ve memorized has helped tremendously. It’s a calm situation, they know the story, and are eager to please me by contributing their own thoughts and words, few as they may be. As they prepare to start kindergarten later this year, I am less nervous they will be behind in their slower-paced verbal development, because I see the spark of early, voracious readers.

It’s so easy: five, 10 minutes tops. Everyone has access to books, in any social situation (go to the library, borrow books, start your own collection). There are a great many books about twins geared towards all ages, and my girls love identifying themselves in the pages of twin stories. (for a list of twin books, see a past HDYDI post here). Find books that pique their interest, make it a habit, and watch your little readers soar.

 

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Toddler Thursday: Two Year Check Up + Milestones

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Categories Developmental Geekery, Toddler Thursday, ToddlersTags , , 2 Comments

Last week was our 2 year check up.  I am desperately awaiting the once a year days.  We went from every other day when we first brought Jane and Emma home from the hospital 2 years ago, to twice a week, to once a month, to every 3 months, to every 6 months, and here we stand.  Some of the things that we look forward to these days at each check up include:

Weigh-ins.  The girls went from not even being on the growth chart at under 5 lbs each when we brought them home, to quickly gaining weight and staying steady.  At this past visit they weighted in at around 25 lbs., which is in about the 40th percentile for their age.  Tell you what, I’m just happy that they are ON the chart!

girls

Height checks.  Let me start by saying that I am pretty short.  I am only 5’2″, and my 6’3″ husband picks on me constantly for not being able to reach things on the middle shelf.  I am prefacing my daughters’ current measurements this way because they are only in the 10th percentile for their age.  They are peanuts.

Different Developmental Checks.  I had to fill out a very involved developmental survey prior to going to our appointment.  They asked about walking, running, jumping, different reactions in situations, speech, etc.  Turns out that not only are Jane and Emma just fine, but a bit ahead for their age.  They are speaking in simple sentences and following directions (sometimes), and can even “dress” themselves (although the clothes are usually backwards by the time they are finished, IF they haven’t thrown a total s-fit in the process).

janey

Vaccines.  There.  I said it.  The word ‘vaccination’ seems to have become a dirty word in Mommyville, but having our children vaccinated was not even a discussion that Hershey and I had.  We just said “YES” when they asked us in the NICU.  And we’ve followed the recommended schedule closely ever since.  And although we didn’t actually get any vaccines DURING this visit, the girls are scheduled for their 2 year old vaccines next Tuesday and we have to schedule some blood labs for them in the coming summer months.  Never a fun time when Daddy has to hold the unsuspecting ladies down and Mama cries even more than the girls do, but such is life.  They forget about the shots before we walk out the door, and usually only run little TINY fevers a couple of days afterwards, along with the crankiness and weepiness that is typical.

I like to ask every question that I can think of during these visits, knowing that the doctors specifically put aside extra time for wellness check ups.  This time around, I asked about

  1. eating (toddlers are only expected to eat one GOOD meal a day, and if they throw the other 2 meals all over the floor, “it’s ok, and normal”);
  2. milk (switch to lowfat at this stage, as they no longer need the full fat for their brain development and the cholesterol is no good for them);
  3. pacifiers (try to get rid of them, as they are damaging their pallets);
  4. SLEEP (toddlers at this age are expected to get 12 hours of sleep a day, between nighttime sleep AND naps, and getting up at 6:00 every SINGLE morning is “normal” – ACK!!!)
  5. potty training (get a potty seat for the toilet and spend some naked time in the summer, but understand that in America the standard age for potty training is 3 years old, so not to push them or get discouraged if it doesn’t happen now because 2 is considered “early” in our culture); and
  6. dentist visits (yup, it’s time!).

I was happy to hear that Jane and Emma are in the normal range, even a bit ahead, considering they can sing their ABCs from start to finish, count to 14, and are even starting to be able to identify letters.  Another thing that they do now that I think is REALLY cool is that they sit and read by themselves, reciting the words on each page of their favorite books the way I did when I was itty-bitty.  I’m hoping that this means that I have trained little fellow readers, because I am DYING to have someone to talk about books with, as my students are all sick of hearing me talk about how much I love reading!

emma reading

I also had to ask about the CONSTANT fighting, as the girls seem to have some sort of the-first-rule-of-baby-fight-club-is-that-you-don’t-tell-mama-it’s-baby-fight-club-time pact going on.  We were also assured that this is “normal”.  Not so sure about my hair loss due to baby fight club, though.

crash

What are some milestones that your little ones have reached that you are super excited about?  Anything shock you?  Anything worrying you?  I’d love to hear from you!

We are almost done with the school year which means that it’s almost summertiiiiiime, when the living is easyyyyy….

Happy Thursday, friends!

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Multiples in the Womb – National Geographic documentary

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Categories Developmental Geekery, Medical, Multiple Types, Pregnancy, Products, Science of MultiplesTags , , 2 Comments

As if we needed any proof that our multiples are miracles, National Geographic has a wonderful documentary about the life of multiples in utero. See 4D ultrasound of siblings interacting before they’re even born.

The In the Womb series also includes a video entirely about identical twins in the womb, which we just loved. Do be aware that there’s a scene in both films with a silhouette of the act of conception that you may want to skip through if you haven’t had The Talk yet. There are also diagrams of male and female anatomy. You may want to watch it all the way through without kids at least once.

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Toddler Thursday: Perspective Taking

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Categories Developmental Geekery, Education, Toddler Thursday1 Comment

At age 3 years, 2 months, my daughter J could spell three words without help: her own name, her sister’s and “No”. So, when she wanted to surprise me with a note, she was left with no choice but to ask for help—my help. She forbade me to leave the dining room, and yelled to me from the easel in the play room.

J: Mama, what’s after ‘S’ in “Sadia”?
M: ‘A’.
J: Then?
Me: ‘D’.
J: Then?
Me: ‘I’, then ‘A’.
J: How do you spell “from”?
Me: ‘F’ … ‘R’ … ‘O’ …
M: ‘M’.
J: Is ‘M’ the end?
M: Yes.
J: Mama, is ‘M’ the end?
M: Yes. Nice work, M.
J: How to you spell “to”?
Me: ‘T’ … ‘O’.
J: Then?
Me: That’s it.
J: How do you draw “don’t”?
Me: ‘D’ … ‘O’ … ‘N’ … ‘T’.
J: And “tell”?
Me: ‘T’ ‘E’ ‘L’ ‘L’.
J: ‘T’ ‘E’ ‘E’ ‘L’?
Me: No, ‘T’ ‘E’ ‘L’ ‘L’. Two ‘L’s.
J: Mommy, come see what I made for you! It says, “To Sadia from J. M, don’t tell.”

I’ve tried to help you parse this in the second image.

This 3-year-old has mastered neither linear writing nor secret-keeping. from hdydi.com
To Sadia from Jessica. Melody, don’t tell.

Toddlers are quite terrible at knowing what others know, their perspective taking skills still in development. I can report that now, at age 8, my girls are much better at keeping secrets. I’m not sure that’s the best thing, but it is fun to distract J at M’s request so that M can sneak a stuffed toy for her sister to the cashier at the toy store.

Sadia (rhymes with Nadia) has been coordinating How Do You Do It? since late 2012. She is the divorced mother of 8-year-old monozygotic twins, M and J. She lives with them and their 3 cats in the Austin, TX suburbs and works full time as a business analyst. She retired her personal blog, Double the Fun, but also blogs at Adoption.com and Multicultural Mothering. She is the Single Parent Coordinator for Multiples of America.

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What Is “Adjusted Age” or “Corrected Age”?

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Categories Developmental Geekery, Prematurity4 Comments

I recently witnessed an extremely heated and sometimes mean-spirited discussion of the term “adjusted age.” One side felt that the term was derogatory to preemies, while the other side felt that their families’ experiences with prematurity were being flippantly dismissed.

Of course, it all boiled down to a misunderstanding of what “adjusted age” (or the synonymous “corrected age”) means. I’d like to set the record straight.

Defining Adjusted Age

A premature baby’s adjusted (or corrected) age is medical shorthand for how old that baby would be if he or she were born at full-term at 40 weeks gestational age. What’s gestational age? The time since mom’s last period. Why since her last period? Because until relatively recently, that was the best indicator we had of when pregnancies began and it’s become a cultural norm.

Why Use Adjusted Age?

When a baby is born full-term, we don’t pay particular attention to the predicted due date. After all, 95% of babies don’t show up on the due date. The full-term birth window is two weeks on either side of that date. There’s nearly a month of wiggle room in there! I’ve seen due dates wonderfully referred to as guess dates.

So why would anyone care about a premature child’s gestational age? It comes down to development.

As any parent knows, every kid is on his or her own schedule. Still, there’s a general order of operations when it comes to human development. We start out as one cell and end up becoming neurotic adults. All that happens in between is pretty well understood by the medical and scientific establishment. Exiting the womb ahead of schedule doesn’t much impact that developmental schedule beyond putting pressure on immature systems to perform maturely.

Human babies develop in a predictable fashion, regardless of when they exit mom's womb.

Take my daughters, J and M, for instance. They were born at 33 weeks gestational age. They were born with spectacular heads of black black hair. They also had furry ears, foreheads and shoulders. The lanugo, or fetal body hair, that babies have in utero had yet to fall out. It didn’t get the memo that they’d been born. It was just doing it’s regular 33-week thing. This is J at 1 day old. Or should I say “-7 weeks adjusted”? She’s adorable, teeny tiny, and rather furry.

J is 1 day old here, born at 33 weeks gestation. She still sported lanugo on her ears and shoulders. Adjusted age: -7 weeks.

And this is her now. Just trust me when I tell you that she’s not furry. (I had to use this photo again. She was so adorably excited to learn how to sew.)

33-week preemie at age 7.

Adjusted age. That’s what we were talking about.

Let’s put prematurity aside for a moment. Imagine a 1-month-old. This baby can grasp something placed in his hand, but forget about him picking something up of his own volition. He’s probably rather bobble-headed, thanks to brand new neck muscles. Now, compare him to a 3-month-old. She’s not quite so bobble-headed, can get her hands in her mouth with ease, and swipes at toys and Mommy’s phone with gusto. Two months makes a huge development difference in that first year.

Now imagine my 33-week preemies. At 3 months old, they’re still as bobble-headed as the 1-month-old, because as far as their physical development goes, they’ve had as much time to develop from that single first cell as a 1-month-old. When it comes to predicting how much they should weigh and what they should be capable of doing, the pediatrician and I strike a balance between their birth age and their developmental (adjusted) age.

The adjusted age for a child born prematurely is measured from conception and takes into account that they’ve had less time than their birth-age peers to get up to speed. That’s all there is to it.

By age 2, there’s really no reason to use adjusted age any more. There’s not much that distinguishes a 24-month-old from a 26-month-old. By age 2, preemies are caught up, developmentally, to their birth-age peers, barring complications.

A premature child's adjusted age is a way to gauge where she is developmentally.

 As with the term “identical” twin, the non-technical meaning of the word “corrected” in “corrected age” (which is the term my kids’ doctors all use) leaves the concept prey to misunderstanding. So let’s all hug and make up.

Sadia (rhymes with Nadia) has been coordinating How Do You Do It? since late 2012. She is the divorced mother of 7-year-old monozygotic twins, M and J. She lives with them and their 3 cats in the Austin, TX suburbs and works full time as a business analyst. She retired her personal blog, Double the Fun. She also blogs at Adoption.com and Multicultural Mothering.

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Identical Vs Fraternal: What Your Doctor Didn’t Explain About Your Twin Ultrasound

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Categories Developmental Geekery, Fraternal, Identical, Multiple Types, Science of MultiplesTags , , , 68 Comments

My Story

(or skip to the basics or the science)

Ultrasound of identical twins at 7 weeks. You can't see the membranes in this image.

I was 7 weeks pregnant when I had my first ultrasound. The doctor pointed out the shared outer sac (chorion) and the two distinct inner sacs (amnions). I didn’t need her to finish. Thanks to Advanced Placement Bio class in high school (embryonic development) I knew I had a miracle in my womb: identical twins. Once we’d called everyone we needed to share the good news with, I hit Google, and quickly concluded from their monochorionic/diamniotic (mono/di) state that my little ones had split from a single cluster of identical cells somewhere between 3 and 9 days after conception. I’ll tell you how I made the calculation in a little bit.

The Basics

Most people don’t know a whole lot about twins or higher order multiples, and are intrigued by them. Folks I run into are usually aware that there are two basic types, identical and fraternal, but often don’t know precisely what the difference is. Part of this comes from the term “identical.” In casual English, “identical” means “exactly the same,” and so people often assume that identical twins should look alike, act alike, and think alike. This assumption often gets extended to fraternal twins, in that they should look different, act differently, and think differently.

I don’t argue with people about whether my children look enough alike to be “really” identical, and instead give them a quick science lesson. You’d be surprised how many medical professionals, even obstetricians, don’t remember the science of twinning they covered in the depths of college or medical school, and therefore jump to possibly incorrect conclusions about whether a set of twins is identical or fraternal. Next time you need to explain the distinction to someone, feel free to use the visual aids below.

TWINS! Understand the basics with this clear primer. Click To Tweet

The Science

Identical multiples grow from the same fertilized egg and therefore have basically the same DNA. Fraternal multiples come from different fertilized eggs, and therefore basically share 50% of the same DNA, as do siblings conceived by the same parents at different times. Sharing a DNA template makes it likely that identical siblings will look very much alike, but DNA doesn’t predict everything.

My daughters, for instance, share their DNA, but have noses of different shapes and different hairlines, due to developmental differences that don’t appear to have a genetic basis. They’re also different heights, likely because one is a pickier eater than the other and because dysphagia related to macroglossia (trouble swallowing because her tongue was too big for her mouth) meant that she ate less than Sissy after she weaned.

wpid-Photo-Feb-11-2014-841-AM.jpg

Vocabulary

Before I go much further into the science, let’s talk about the terminology we’ve been using.

Basic terminology to describe babies in the womb.

So, the embryo is inside the amnion, which is in turn inside the chorion. The umbilical cord traverses the two membranes to connect the embryo to the placenta, which collects nutrition from mommy for baby.

Twins in the Womb

Now let’s talk twins.

Monozygotic twins are identical ones. They started from a single zygote. (Mono means one.) Dizygotic twins are fraternal ones. They started from two zygotes. (Di means two.)

Monochorionic/monoamniotic (mono/mono) twins are monozygotic twins who share a single amnion and a single chorion.

Monochorionic/diamniotic (mono/di) twins, like my daughters, are monozygotic twins who have separate amnions and share a single chorion.

Dichorionic/diamniotic (di/di) twins are monozygotic or dizygotic twins who have separate amnions and separate chorions.

I try to make this clearer in the image below. With one egg and sperm, you can get one baby… or two babies who are mono/mono, mono/di or di/di. With two eggs and two sperm, you’ll always get di/di twins.

The different membrane configurations possible for twins in the womb. The chorion is on the outside, the amnion on the inside.

So here’s the trick. In the image above, you can’t tell the difference between the identical di/di twins and the fraternal di/di twins. And neither can the ultrasound tech. So, if you have di/di twins, chances are good that they’re fraternal, but you just don’t know for sure.

If you have di/di #twins, chances are good that they're fraternal, but you just don't know for sure. Click To Tweet

Reader Noura I was kind enough to share ultrasound images of her di/di identical twins, whose ultrasounds look just like those of fraternal twins. Remember, the mono-di stuff refers to the membranes around the babies, and not the numbers of eggs and sperm.

Dichorionic diamniotic identical twins at 6 weeks gestation.

di di twins 1st trimester

Reading the Ultrasound

What you can know about your twins zygosity from the ultrasound

So, in my little chart above, I had to note that there are extraordinarily rare cases of boy/girl identical twins, but this is a teeny tiny proportion of the population. If you ran across such a pair, you’d recognize them from the news. So, please, just assume that boy/girl twins are fraternal (dizygotic) or that one had a sex change. Either way, it’s not polite to ask. Girl/girl twins and boy/boy twins can be fraternal or identical.

Timing of Monozygotic Twin Split

Here’s a fun fact. The arrangement of amnion and chorion can tell those of us with identical twins when they split apart!

The membranes on your ultrasound tell you something about your identical twins schedule for splitting.

TTTS can be very serious and put both your babies at risk. The placental blood supply is shared unevenly, meaning that one has more than his or her share of nutrition and oxygen, the other less than his or hers. Many obstetricians will closely monitor mothers expecting twins to watch for TTTS. While it’s almost unheard of with fraternal twins, reader Halie H. wrote to us to say, “My di/di fraternal (boy/girl) twins’ placentas fused. They were born with one failed and one really really red placenta; they were sent off to be studied as an example of TTTS in fraternals.”

In #TTTS, the placental blood supply is shared unevenly between twins, putting both babies at risk. Click To Tweet

I’m not an expert on this stuff, but I do love genetics and studied it in college (although I ended up switching away from a biology major junior year). If you have additional questions, I’ll do my best to answer them.

Before I sign off, I need to give a big old shout out to Canva.com. I have been planning to write this post for years, but not having an artistic bone in my body, knew that I couldn’t do it justice without an illustrator. Thanks to the free online graphic design tool, Canva, I was able to create the graphics I’ve included in this post.

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