Premature Multiples – A Perspective from Psychologist Dr. Fiona DesiraTwinsplus Arabia
Fiona Desira of Child Early Intervention Medical Centre
From the very beginning of your journey, being the parent of twins is amazing and challenging in equal measure, especially if your twins were premature. You’ve recovered from the (wonderful) shock of being told you are carrying twins, you’ve got through pregnancy, dealt with the trauma of your babies being born pre-term, and you’ve survived the anxiety of the NICU.
You are home. Babies are home. And so life begins in earnest.
Being a parent is incredible, but parenting is the most difficult job in the world, and anyone who says otherwise is not being totally honest. Parenting twins is even harder. Now add in the challenges of parenting pre-term twins. Now that I mention it, give yourselves a huge pat on the back for getting this far!
As your babies are growing, they are discovering new and exciting things each day, and it’s a joy to observe. However, what happens when things are not going quite how the parenting books say they will? All children develop at different rates, but there are guidelines as to when children will typically mean particular milestones. Evidence suggests that premature twins are likely to meet milestones differently to their full-term peers. Child development professionals talk about ‘corrected age’, which is a helpful thing to consider when thinking about your premature twins development.
Corrected age is when your child’s prematurity is taken into account when considering their development. So if your child is 12 months old, but was born 3 months early, their corrected age is only 9 months. That means we would consider their development in terms of what would be expected for a child of 9 months old. Typically, premature babies will catch up by the time they are 2 years old. But what happens if they don’t?
It’s important to try not to compare your pre-term twins to full-term singletons. Your babies have been through an awful lot in their short lives so far, and so may understandably need a little more time to reach their milestones. One important thing to remember is that your twins are not necessarily going to develop at the same rate. It’s easy to say ‘don’t compare them’, but it’s not so easy to do. However, it’s important to monitor each of your twins’ development, and keep an eye out for the areas that they may experience delays. These include (but are not limited to) language, motor skills, cognitive skill, and social and emotional development.
Language delays can relate to both speaking and understanding. You can help your twins’ language development by making sure your home is full of talking and listening. Reading to your twins and singing to them can help too. If you have one more verbal twin, try to monitor if they are talking for their less verbal sibling. Make sure both twins get plenty of opportunity to communicate independently.
Motor delays can relate to fine motor skills (the small movements involving hands/fingers) and gross motor skills (bigger body movement). It can also relate to motor planning and sensorimotor skills. Pre-term babies are at higher risk of major motor difficulties, including cerebral palsy. Keeping an eye on how your babies move is critical.
Cognitive development reflects thinking and learning from the world around them. The majority of premature babies have typical cognitive development, but those who are very pre-term, have extremely low birth weight, and have had a lot of medical complications are at higher risk of cognitive delays. Social and emotional development reflects learning to recognize and manage feelings, which helps towards developing friendships, working towards goals, and gaining autonomy. Play is critical for supporting your babies’ cognitive and social-emotional development. This is how they learn about the world around them, develop new skills, and learn how to express emotions. Making sure that you take time each day to play with your twins is one of the best gifts you can give them…and yourself, because lets be honest, who doesn’t love to play?
Monitoring your twins’ development is an important task, but if you notice that things are moving at different rates, try not to worry too much, this is totally expected. However, if you are concerned about one, or both, of your twins’ development, it is best to seek advice from a professional, as premature twins have increased risk of going on to develop Neurodevelopmental difficulties (e.g. ASD, ADHD).
Many parents worry that they will be viewed as ‘neurotic’ for seeking help too early, or decide to wait it in the hope that their child will catch up. While we do hope they will indeed catch up, and many premature babies do, if you are worried, discuss it with a professional. There are many great child development centres in the United Arab Emirates, where you can book an appointment with a child development professional for a chat, monitoring, formal assessment and early intervention if required. Also, the power of peer support can never be underestimated. Forums such as TwinsPlua Arabia’s Facebook group and chats on their website are the perfect place to seek support and guidance. When in doubt, get some advice.
That old saying is true: “it takes a village”. With pre-term twins, it might sometimes feel like it takes a whole city. But that’s ok, support is out there if you need it.
Dr. Fiona Desira