Thursday, March 20, 2008

Birth Certificates, SS Cards, Home Visits and Assessments

If you've been following the blog or know much about us, you'll recall that early February marked our one year anniversary of Emily being "home" with us. Our Kazakh adoption was finalized in Kazakhstan so there was no need for us to do any further paperwork once we came home. (Many adoptive families HAVE to finalize their adoptions or re-adopt once they are back home in the U.S. with their children.) That was all fine and dandy until I realized that we will probably need Emily's social security number when we file our taxes... which we still haven't done yet!

This week, I made 2 trips to our county courthouse to file applications for Re-Adoption of Emily so that she will have a U.S. Birth Certificate. Not that I would ever lose her Kazakh Birth Certificate (which is all in Russian) but if I did, it would be nearly impossible to get a duplicate. We also wanted to get a U.S. Birth Certificate so enrollment for school, applications for future jobs, etc. won't be as complicated. Two forms, a couple of signatures and $152.50 later, we have the paperwork completed and should expect to see her new birth certificate come through the mail in less than 8 weeks. As part of this process we are also officially changing her first name from Emily to Emaliya even though we will continue to call her Emily. It seems funny to me that we've talked about getting this name change thing done since before we left Kazakhstan, but now, over a year later we're finally getting to it. Again, welcome to Procrastination 101!

After my final trip to the courthouse I made my way over to the Social Security Administration Office. Fortunately, I knew from prior experience when I had my married name added to my card that I would be in for a wait. I think they've been tutored by the folks down at the BMV! I patiently waited for my number to be called. I explained to the young man at the counter that we had adopted from overseas and needed a Social Security Card for our daughter. He asked me for the appropriate identification for Emily and then got a really confused look on his face when he realized it was all in Russian with translation sheets attached. I guess he wasn't really listening when I said "adopted from overseas". He politely apologized and said that he would need to refer my case to another lady that was more familiar with the process for internationally adopted children but that I would need to wait for 1o minutes or so for her to come back from lunch.

I respectfully took my seat, whipped out my cell phone and commenced playing quite a few games of Solitaire on my phone before my name was called. Thank goodness this lady WAS familiar with the process and thank goodness I had called the Soc. Security Information Line the night before and had asked what identification and paperwork I needed to bring with me to get this done. (I saw roughly half of people ahead of me being told they would need to come back with the appropriate identification before they could be helped!) And, for future adoptive parents, when I called, I was told to bring Emily's birth certificate, adoption certificate, immunization records and my I.D. I had the doctor's office fax me a copy of her immunization records and brought the entire packet of adoption paperwork with me and everything had the English translation stapled to the back of it. I left with a sigh of relief that I had everything necessary to get this project done and was told that I should receive her S.S card in under 2 weeks. Just in time to do our taxes at the last minute!

Not only have I been trying to work on the legal side of things, but in the past couple of weeks we've also had Emily reassessed at Physical Therapy, had another home visit and reassessment by Help Me Grow and we had a routine home visit by the County's Health Department since they are helping us check into BCMH (Bureau for Children with Medical Handicaps) to see if we qualify for additional medical assistance so we can continue with PT once our insurance runs out.

Physical Therapy is going well and is definitely needed since Emily went through her major growth spurt in January. She's learned so many things since we started PT last spring but our insurance only covers 20 visits per calendar year and with the growth spurt after our visits ran out Emily got fairly tight all over again. She's been doing a lot of tiptoe walking again after she had leveled out for a couple of months and she still really struggles with getting much rotation out of her upper body. For example, if she scoots out of a seated position on the couch and ends up on her back she can't seem to get her arms underneath her to flip over onto her belly. She just sort of lies there and flails until gravity comes in for the assist. She's also been walking for almost 5 months now and just last week was able to stand up on her own from the middle of the floor instead of crawling to a person or piece of furniture to pull herself up to stand.

We have home visits from Nikki at Help Me Grow every few months and she came out for her visit last week. We caught her up on all of Em's new tricks since her last visit and shared any concerns we had regarding Emily's development. We set new goals for Emily and scheduled an appointment for her reassessment. One of my goals for Emily over the next couple of months was to get her to start standing up on her own without assistance... my overachieving daughter decided that the very next day was the day she wanted to tackle that goal and did it repeatedly throughout the day like it was nothing new to her! Go figure! Another one of my goals was to have her using more words on her own. Right now, without prompting, we will hear Emily say, "Whatisthat?" and "Whatisthis?" as well as the occasional Mama, Hi, and her assortment of animal sounds when she sees pictures or if we ask what certain animals say. She has said Dada a few times but seems to struggle a little more with that. It usually comes out as Naanaa.

On the day of our HMG home visit, Nikki had just come in and sat down as we were getting Emily up from her nap. After just a few minutes of adjusting to waking up, Emily decided Nikki was her new best friend! She shared books and toys with her and carried on her own conversations with her. It was fun to see her interacting so openly with someone she doesn't get to see very often and of course Nikki had a great time playing with her and seeing all of her new tricks. We enjoy Nikki's visits.

Our Health Department visit was pretty uneventful. Mary Ann came out for her second visit. (I think she was out last summer.) She initiated the BCMH paperwork for us last year but we received our application in late October and it was more complicated and personally prying than most of the stuff we had to go through for our adoption! The previous application came right as we were gearing up for the holidays and the busy season for me at work and I just didn't have it in me to do all the legwork then. We're going to try to take a second crack at it and see if we can qualify to get some government assistance to help pay for Emily's medical treatments/therapies after our insurance runs out. If we don't qualify we have to find some creative way to stretch the remaining 17 or 18 visits out for the rest of this year and pray Emily doesn't run into any major snags or any more ginormous growth spurts. Emily's "delays" and struggles are fairly minor but all of our individual skills are built on each other. Gross motor skills need to be fairly mastered before fine motor skills are well developed and fine motor skills need to be fairly mastered before things like speech are well developed. It's interesting how it all works together and like building blocks they all come together at some point. Our hope is that with a little work, Emily will be able to do all the things the other kids are able to do by the time she starts school and that any limitations that she has will be worked through by then. At that point she may never need PT or special services again, but we're learning as we go since we don't truly know what we're dealing with yet.

Wow, I'm sorry I'm rambling and we still haven't covered her Help Me Grow re-assessment. It's been a busy couple of weeks! I took Emily in this afternoon for her re-assessment which is used to determine if she's on target for things like gross motor skills, fine motor skills, social development, cognitive development, etc. For 30-45 minutes Emily played with her new best friend, Nikki, and Lori, the other lady helping with the testing.

Nikki & Emily during Help Me Grow Re-Assessment

They had her do things like stack blocks on top of each other, unwrap a toy from inside a piece of paper, fold a piece of paper, walk on a line on the floor, throw a ball, walk up and down steps, put toys in a container, put a toy in a box and put a lid on it, point at pictures on pages, point to body parts, and they also asked me quite a few questions about things I had or had not observed her doing around the house and how she played with other kids. They will compile the results from these assessments and taking into consideration her adjusted age for premature birth and institutionalization will be able to get an idea of whether she is meeting benchmarks for her adjusted age. This will determine what types of things we need to work on and how far she has come since her last assessment that was done last March. I should get the results back in a couple of weeks and will let you know what we find out!

Phew. That's it. Yes, it was long, but I wanted to give you an update on the medical side of things since I haven't talked about that stuff in a while.

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