3 Infancy, Toddlerhood, and Preschool 81neurological deficits. Basu (2014) reports that “Hemiplegic Cerebral Palsy has
implications for performance in activities of daily living, quality of life, and
self-esteem” (p. 516).
Once Nathan was discharged home, Melanie and Fran began the difficult
task of redefining what it meant to be new parents to Nathan, with all his devel-
opmental impairments. They had to develop a new set of expectations as parents
and shape the plan of care for Nathan. Frank expressed sadness that he may never
play sports with his son and Melanie wondered what kind of life Nathan would
have with peers. In addition to redefining their image of Nathan’s future, friends
and family had questions about Nathan that simply had no answers. Advice
regarding Lina and her new behavior was riddled with judgment and a lack of
understanding about the crisis that had impacted their family’s life. Eventually
the family began to shield themselves from discussions about Nathan; as a con-
sequence, some friendships were lost. Melanie was unable to return to her work
as a teacher due to Nathan’s needs and decided to take a 2-year unpaid maternity
leave from her school district. The financial burden was enormous. They decided
to liquidate the retirement fund Frank had accrued and that he would get a sec-
ond job to offset some of the household expenses.
During Nathan’s first 3 months at home, he remained on an apnea mon-
itor and medication to stimulate his underdeveloped brain to remember to
breathe. Nathan was a very lethargic infant, sleeping a great deal, and requir-
ing a regular sleep/wake schedule initiated by Melanie to ensure that he was
breast feeding/receiving formula and receiving the correct caloric intake.
Melanie had difficulty developing a breast-feeding relationship with Nathan
and spent many frustrating hours supporting his development of a secure
latch so he could have a better chance of feeding effectively. Melanie was com-
mitted to this milestone as it assisted her in feeling close to her infant and
helped manage her feelings of loss surrounding the birth and Nathan’s subse-
quent diagnosis.
At around 4 months of age, Nathan had a noticeable asymmetry in the
general movements of his body. He was unable to open and close his left hand
without manipulation from a caregiver. Lina had adjusted to her brother and
was interested in the attention being paid to his development. Lina immedi-
ately became an active member in her brother’s caregiving after her parents
were able to explain how his body worked differently and needed their help to
work like hers. Lina would grab her little brother’s hand and gently massage
it open, as she had seen her parents do to help him develop use of both hands.
Nathan regularly saw a pediatric neurologist as he had several seizures
after being discharged. The pediatric neurologist recommended that Melanie
and Frank have Nathan evaluated by an Early Intervention Program. According
to the Children’s Hemiplegic Awareness and Stroke Association (2014), early
intervention programs provide specialized health, educational, and therapeutic
services during the first 3 years of life for children who have a developmen-
tal delay or disability. The early intervention evaluation was completed and
Nathan started weekly visits by a team of professionals armed with the skills to
assist his development. Nathan received free or low cost services from physi-
cal therapists, speech therapists, social workers, occupational therapists, and
audiologists. By 14 months of age, he could walk independently. The team that