Dinner

Unfortunately Dad was sick all day today throwing up. We took care of him all day, but then decided to get out of the house for a bit. We ended up eating at Cici's Pizza (which has gone UP in price considerably!!) where kids eat free under 3. So, I only had to pay for me & if DS wasn't interested in anything - no loss.

It was the most peaceful, calm, enjoyable meal that I have had with my 2 children in I can't tell you how long. I am SO glad we went. I have been feeling like DS has been on the verge of some big breakthroughs recently & it has been so exciting to see the little tiny things that seem SO HUGE to me that he's put together for himself.

So, after getting both kids out of the car - wondering all the while what in the WORLD I was doing trying to go to a buffet with 2 small children - we headed inside the restaurant. The first obstacle is usually that I'm holding the baby & DS won't stay with me while I pay and get my tray (not that we ever go, but I'm thinking of other instances when I'm holding baby sister and I can't exactly hold onto DS). I walk in, greeted by a manager who is obviously in need of a serious chat, and DS starts to walk off.

"DS - Please come back, I need you to stand right here with Mommy"

The next part felt like slowmotion, because I fully expected to tell the manager, excuse me, while I ran after him and then tried to juggle the two of them while I paid. I was exhausted just at the thought of that battle.

Not this time. He came right back and stood by my side . . . .

GASP! That's NEVER happened before.

Then, we got our two rolling highchairs and find a good seat near the pizzas so I don't have to walk far away OR drag the two of them over to the counter.

I moved baby sister down the table far enough so her little 'sticky fingers' couldn't get into the pizza as I brought the plates, but didn't really think about moving my plate further away from DS. By the time I got back with his plate, he had already found the cinnamon buns. Oh, well. He enjoyed them.

The next GASP moment was that I got us all settled and questioned myself on whether to take the time to pray or not - and decided I had better. So, I reached out to grab their hands - both sticky at this point - and began to pray. As I was finishing up, I peeked out of the corner of my eye to see what DS was doing & his eyes were firmly shut - not doing anything else but praying. I've NEVER seen him do that either. At the end, he said AMEN and then opened his eyes.

My last GASP moments of the night were each time I asked DS a question.

Do you want more drink? No.

Are you all done? No.

Do you want more Pizza or more Cinnimon Roll? Bread. (which is what he was calling the rolls)

Can I wash your face? Yes.

Can I wash your hands? Yes.

Can you help Mommy cleanup? Yes.

Are you all done? Yes.

And he even helped pick up all the little crumbs Sissy left around her seat too.

It was just so much fun. See??? These are REALLY just a bunch of blessings. How many parents have children that do these things so easily - and it all gets taken for granted. Not with me. I pray I continue to see the Blessings - because it really is a lot of work too - but to see improvement of these proportions makes it all worth it.

Berry Trials

The book I got from Mitsy (OT) has some good insight. I have only made it a couple chapters in, but it sparked some ideas that I HAVEN'T tried on getting DS to eat. Evidently he is somewhere between a Picky Eater and a Resistant Eater. I will not jump to put him in the latter category, but it is definitely an issue that deserves to be revisited once I've read more of the book. Anyway.... I bought two containers of fruit that DS has not really been exposed to very many times. I decided that for a week, I will put Blueberries and Strawberries on his plate at every single meal. I will not focus on them. I will not force him to eat them. I will not make it stressful. They are the 2 items on his plate that he is allowed to do whatever he wants to do - as long as it's not hazerdous. If he wants to squish them, lick them, stick them in his ears.... I'm not going to make a big deal out of it. I want to see if the presentation of food and his confidence/stress level will affect whether or not he will eat something new. Day#1, Meal #1: Placed items on his plate. We named everything & he identified both berries. I got one of his books and showed him the blueberries, which he proceeded to spell from. I asked him what strawberries smelled like? He sniffed it. I asked him if he wanted to lick them. He did. Then, he tried to feed me. I took the bites he offered and then left the table. He counted the blueberries, but no bites. He seems MUCH more resistant to the strawberry than the blueberries. Day#2, Meals 2, 3, 4: Licked, Smelled, Fed Mommy. No bites Day #3, Meals 5, 6: Licked, Smelled, Counted, Held, Rolled around, Fed Mommy. No bites Days 4,5,6 - Lots of meals later... same stuff... never ate them. However, he ate Apple during our OT appointment (detailed above)

DT

Why oh why does this have to be so difficult??!! Ugh..... tantrum over. Mary was late today. I had this sinking feeling that she wouldn't come this week for whatever reason, and so even though I had already pumped DS up of what Mary would do and where we would sit and what we would play etc.. when she wasn't here 13 min's after the appt, I figured she wasn't coming. I already planned it in my head that this was her 3rd strike and I would call and get a new DT. (Strikes 1 & 2 were just plain out not doing things that she promised she'd do for us on 2 previous occasions. I dont remember if I blogged about those or not) 920, she pulls up. Traffic is her excuse. Im in a bad mood, trying to make the best of the appointment and be gracious (as I KNOW should be my reaction since Ive also been late to many things and traffic is sometimes a good reason-but mostly because God gives ME grace - that I never deserve). But, my skepticism gets in the way and I am not doing a great job of making the most of the appointment at all. So, my judgement was clouded today. 20 minutes is a LONG time to be late when your session is only supposed to last between 45-60 min. She did decide she was staying longer today since she was late... but she spent about 35 min's reading one book to DS. Would that have bothered me if she wasn't late? I don't know. I asked her at the end of the appointment if she was still trying to let him get used to her and feel him out and she said not really. She said she was trying to work on 'WH' questions with him (with the book). He does get very focused on things (like this ABC book she picked). I guess I'm used to more fast paced therapy that moves from one activity to another quicker and is more demanding. I guess I already know that he is great at labeling things in books (which is what they were doing together) and I should have spoken up then. I guess I was waiting for some groundbreaking therapy to come out of it & it never did. Then, they played with a dumptruck and some blocks, made up a game where they clean up blocks by putting them on their heads and letting them fall back into the dumptruck. And we discussed his newest issues with his reactions to 'Uh-oh' and 'Oh-no' (as detailed in the post 'new this week'). We agreed that Uh-oh and Oh-no are reactions that he will experience in the world all the time & that he needs to be exposed to those reactions in a setting that will allow him to understand WHY someone is hurt or surprised and that its OK and its not the end of the world. She really didn't give me concrete examples of how to do this other than to go to the library and look for books on emotions. About mid-sentance discussing these issues, she jumped up and said - well, I'll see you next week. It's almost as if we are important as long as the clock is ticking and she's getting paid. Then, as soon as those minutes are over, it doesnt matter that we were in the MIDST of discussing an issue that she thought was important & needed to be addressed. My experience this week - EH. Bad mood - Yes. Clouded Judgement - Yes. Try again- Yes.

OT

Somehow, I also missed blogging about our OT session last week. So, I'll just do BOTH of our OT sessions that we've had together here. Last week... Mitsy came out and wanted to have lunch with us. She wanted to see what kinds of eating issues he has and what games and tricks will work with him to get him to eat something he either doesn't want or is new to him. Well, the short answer is NOTHING works. We already know that... so she said she'd get some information together and bring me some help next week. She played playdoh with him and just got to know him better for this week. Her tidbit of advice for now is to just leave him alone, have him sit with us at dinner, give him a plate of what we're eating and just let him be. The hard part of accomplishing that this week has been that he STILL asks for his drink and we refuse to let him just have his cup because we KNOW he will drink, be satisfied, and then its a lost cause for him to even eat a bite of dinner. This week... First, she brought me a book called "Just Take a Bite." Yeah, that's how I feel most of the time. It's about challenging eaters & some ways to help us understand why they are so challenging at mealtime AND hopefully some ways to help. She advised me to read through it since she can't be here for all mealtimes. Then, it was on to the playing. He sits down in the spot where all the other therapy takes place, waiting patiently to see what new games this lady has for him. :-) She brought a bucket of McDonalds play food. We sorted through them, named them, sorted them into food categories and helped him pick out good meals. What a great idea. That's definitely a game we'll play more of. The second game was a Thomas the Train Aquadoodle. It has a little water pen that draws a track and the train follows the water track. How cool. Im not too sure what this is supposed to do - he kept picking the train up and examining the buttons. But, it was neat. If she brings it next time, I'll ask more questions. I guess it's just one more game to get him thinking about what toys do and why they do it. The third game, I was totally unprepared for. A tray, Cheerios, Whip Cream, and Straws. Hmm. This looks messy. She wanted to test him out on getting messy. We hid the cheerios in the whip cream to see if he'd dig for them. We stuck our hands in it, squished all around, ate some, sprayed it in our palms etc... After quite a bit of prompting, he started to pick out the cheerios that he could see. Then, he put one hand in. A second hand. and finally started rubbing around. He lasted a few minutes before he wanted that stuff off his hands. He did a good job and tried something NEW and MESSY today. I also secretly enjoyed having permission to play in a can of whip cream. Who never wanted to do that???

New this week....

The sassy side of him came out this week. Naptime yesterday, I was trying to put him and sissy down for naps at the same time. We had been out of the house & her naptime was pushed back, so it was a perfect time. Usually, they end up in seperate rooms, but I decided to give it a go of putting them both in their own beds. He was instructed to read books. She was swaddled and layed down. Well, about 20 mins later, I hear giggling. I walk in to find him passing books through the slats on the bed. THEN, I told him to get back in bed and I was taking the books away. (I was already holding back my laughter about has hard as I could, it was too cute...sharing with sissy) So, he looks dead in my eyes - glances a sly look at sissy - and says 'BYE BYE MOMMY' waving and all. It was all I could do to get the door closed before I busted out laughing. So, how come will he do a greeting without prompting when I cant praise him for it?? Baby steps, I know. Then, he was playing with blocks one night. He has all shapes and sizes, and usually either lines them up around the room, on the table, or sorts them through the top of the bucket. A line I remember from his IFSP is that he 'doesn't attempt block structures' which basically means when given a few blocks, he WILL line them up and he WILL stack them, but he doesn't attempt to BUILD anything with them. So, he takes 3 cylinders... stacks them... holds them all in one hand... starts to shake them & brings them over to Sissy. "Bottle" "Bottle" "Bottle" What an adorable sweet face he has, looking up at me and wanting to share his pretend bottle with sissy. Yep, I shed a few tears. It was wonderful to see him translate some of the imaginitive play we've been doing to a new game all on his own. And, last, is his newest aversion to 'Oh-No' or 'Uh-Oh' His feelings have always been extra sensitive, just like mommy. At the mere mention of being in trouble or getting hurt that bottom lip starts to quiver. Well, I forgot how awful he used to react to the two words mentioned above... until recently when he started to get super upset when someone reacted to them again. When he falls - I have to cover my mouth to avoid saying it & he's fine. If I slip up, he ends up getting So upset crying. Anyway, there were 2 incidents that really come to mind. One, he was watching Super Why - his new favorite. In the episode with 3 little pigs, I watched with him and when the Big Bad Wolf was changed into a Small Good Wolf, I said 'Oh no - the Big Bad wolf is sad that he was so mean to everyone. At that moment, he started to bawl and sob. I had to hold him and comfort him and finally he settled down. At the mistake of showing that episode to him again, his lip began to quiver and he said 'No, No, No'. The second was a book we were reading. 'Who will Fat Cat sit on?'. I thought it was cute & funny. The fat cat talks about sitting on all these other animals, and then it implies that he might eat the mouse. Of course, mommy says, Oh No - the cat will eat the mouse for lunch. And Goose Tears, sobbing, the whole works again. I've tried to read the book again recently and he just says 'No, No, No' with these big scared eyes.

SLP

OOps... I wasn't on the ball this week. I forgot to blog about Speech this week. Nothing mind-blowing. We played one new game (amongst old repetition). She forgot about his LOVE of numbers & brought a fishing game. At first, we couldn't pull his focus away from the 6 or 8 on the fish, but then we started calling them Blue Big Fish, and Red Little Fish and his focus shifted. This game was to teach turns. And, not just to teach him about taking turns, but that HE has a turn and its called 'MY TURN'. He was good at echoing 'My Turn', but never did it on his own. We've found that he will play the turn taking game with Sissy and their door toy quite well, and so we've found a good way to work on 'My Turn' at home too. This week was the first time he said 'BYE JEN' as she was leaving. Up until this point, he really wasn't even good at echoing greetings (hey, bye)... but he has started really picking up on Hey + waving and Bye + waving. Im quite impressed. Jen said it could take a long long time. I've also heard him say Bye-Bye ONCE without any prompting. He's on the verge of some new skills! YAY!!!

SLP: Goals

* increase pretend play skills while interacting with others * use words to label, protest, request, and comment in 3/4 opportunities * answer y/n and simple wh- questions in 3/4 opportunities * independently greet/say goodbye to others * correctly produce all early developmental phonemes /p, m, n, b, t, d, w ,h ,y/ in all positions of words 80% of the time.

SLP

Hi Jen. Greetings will still take a while, says Jen. He's not picking up on them, but she says this can take lots of work. He WILL repeat a greeting, but not do it on his own. He only does it when you say 'TELL JEN HI.' That's ok. We'll keep trying. One day he'll surprise us. Choices... Choices... We always work on choices. The game of choice today was Cars. She shows him 2 cars and asks him which one he wants. "Would you like a Green Car or a Red Wagon?" He did what he usually does, which is to say back to her "Green Car, Red Wagon......... Green Car...." and then... BREAKTHROUGH She modeled with ME "Would you like a Red Train or a Blue Jeep?" and I said to her "I want a Blue Jeep" (My choice was without the repetition) On his next turn... he chose what he wanted without repetition. He just said "Red Car" We also continued with greetings in a lift-the-flap book, and he focused more on the numbers than anything. He was already getting tired of the session, so we didn't push him too much. 9 weeks & 7 hours of Speech Therapy. Countless hours of us working with him at home. Part of me is frustrated that we're doing the same things over and over. Part of me understands that repetition is the best way for him to learn. We can't expect that something not coming naturally will be mastered in one 45 min session. I continue trying to not feel guilty for not spending MORE time working on all this stuff. I continue to try to tell myself that I am NOT a full time therapist... Im a mom trying to do the best I can with EVERYTHING that needs to be done... not JUST therapy maintenance. Now, help me remember that. In the meantime... he's not doing bad. He has had improvement. He is Much faster with choices. As we saw today, he is overcoming at least SOME of his echolalia (it did not translate into other situations, only with the car choices that I modeled for him. Translating it to all choices will take a lot more work) He is answering Yes/No questions without echolalia fairly consistently & accurately. He is getting better at processing our questions and focusing on what we're trying to ask.

DT

The New Developmental Therapist came today. I think it went well, but I am left feeling a bit confused too. Each therapist has their own style. Each therapist has their own opinions. I am getting confused because I want to trust them all & I also want to make sure the people we have coming to do therapy are qualified and a good match for our son. But when they disagree on things and say things that seem contrary to what another therapist believes, it is very hard for ME to distinguish between minor differences and vital beliefs. I will stick it out. I will give this new therapist and all the others some time. I will seek the opinion of our coordinator. I will learn new things about Autism, beef up on my knowledge, and try to be a better advocate for him. On to the Therapy session... I was very happy with the way Mary came in and greeted our son. When a new person (not just someone else...but someone brand new to him) enters his environment his atypical behavior escalates. Now, I don't mean to get off subject... but when someone who knows him says that they don't see anything wrong - THESE are the things that THEY dont get to see. So, she came in, watched and talked with him. She didn't jump right into THERAPY, she wanted to get to know him. What a wonderful strategy. She asked him if he had a favorite toy or book & played to get a feel for him. She also worked hard to ask me questions so that she would understand better - because of course she won't get the full picture in an hour session. She seemed like she just wants to take this slow and know as much as she can about him before jumping into 'therapy'. She seems very down to earth and also has some personal experience. She said that she was relying not only on her experience with Development, but also on experience with her nephew who has been diagnosed with Aspergers recently. She told me that she can't believe how similar they are (I think he is 10 or 11 now, but she is comparing them when her nephew was 2ish). My hope is that she doesn't rely TOO heavily on her experience with her nephew and just assume that what our son needs is the same as what her nephew needs. However, I have suspected Aspergers or PDD-NOS from the beginning, so that is ONE MORE clue that leads me back to the same suspicion. From what she saw today, she thinks one thing we can work at is helping him to understand that the other people in his environment are there to interact with, to ask for help, to play with, etc... This is one of those skills that rather than acquiring on his own, he is having to be taught. As for typical autism traits... this is one of those things that steers me towards Aspergers. With classic Autism, a child may not want to be touched, or not speak, or not make eye contact. In our case he doesn't really have trouble with those things. AutismSpeaks.org says "Many parents wind up with a multi-pronged approach to treating Asperger's Syndrome, choosing regimens and strategies that address their children's main challenge: inability to connect with others." Now, for him... it is more that he has a hard time with connecting to others - UNLESS he is very familiar with them. I don't know if this is the case with most Aspergers... but I have heard that they tend to really connect to their family members, so I think so. One example: We drop him off for Sunday School & when I go back to teach the second hour, he is not usually participating at all. He is either staring at the CD player, sitting alone reading, or doing something else off by himself. The first time I interact with him and show him to share with someone or help him understand what to do... he opens right up and at least makes an attempt at playing with the other children. What is Developmental Therapy all about?? Mary is taking the approach that in order for us to help his Development, we will need to look at every detail of our normal routine. Where does he participate? What is he participating with? What opportunities are there to help him participate more? Example: He loves to go 'bye-bye car'. We go bye-bye to the store, or to the mall, or to the park a lot. So, if we focus in on the grocery store... usually he rides in the cart. He enjoys singing or talking about fruits and veggies for a little while - and then he's not so interested anymore. We usually give him his calculator or other coping tool and allow him to do what he loves and cool off. So what can we do different to pull him OUT of his world of comfort with the calculator and actually enjoy the social experience more fully? We will have to come up with strategies that USE his STRENGTHS to make his experiences more involving of others. In the store, I can give him his own list. He loves letters and spelling. So, I can make HIM a list of things he can find on the shelves - and as I go down my list, we can talk about those things. This will allow his eyes to focus on something OUTSIDE of his cart. We will be in conversation and he will be 'helping'. Also, when we get to the checkout, he can help pass things to the cashier. We can greet the cashier and ask how her day is going. Etc.. Sounds like she will have some great real-life examples for us!

Breakthroughs and Challenges

Breakthroughs of the week: 'I see Sissy' 'I see Rain' He spontaneously made new sentances all on his own this week. I see is a 'carrier phrase'. All that means is that 'I see...' is the part that stays the same. He will then anticipate what comes next. He only has to plan for ONE change in the sentance. He in turn starts to understand what I see actually means. Since he was telling us what HE saw... I think we had a breakthrough in understanding what SEE means. Yes/No He has become quite quick at his answers to Yes/No questions. There are questions that we ask frequently that he used to have to repeat, think, and then answer. But, over the past couple weeks, he just answers. Examples: A few weeks ago - "Do you want to watch TV?" " TV......" "Do you want to watch TV, Yes or No" " TV... Yes or No" Now - "Do you want to watch TV?" "Yes"

Making Jokes

This was a new one too!

"Do you have a poopie diaper?" "No....."

"I smell something, you have a poopie diaper" "No....."

"Well, what smells then? I smell something. What is that smell?"

"Foot (pointing at mommy's foot)"

"Mommy, Help!" Daily, he is coming from anywhere in the house to find us to ask for help. This is a huge change for him & will be extremely helpful in his communication. He is fairly accurate at asking either of us for help when he needs it during play or during meals. Challenges of the week: Harping!!!! Two incidents. He just wouldn't give it up. #1. We were playing with a lift-the-flap book & he was having a great time opening the flaps to see what was inside. So, he went through Oval, Circle, Square, etc... opening - naming - closing... Then he got to an oval that LOOKED as if it should open, but it wouldn't. He came to get me 'Mommy, Help'. I tried every possible way I could to explain that the oval was not going to open, there wasnt anything inside, it doesnt open. After a literal 15 min's of 'Oval, Oval, Oval, Oval, Oval, Oval.." I finally stopped trying to explain, took the book & hid it, and distracted him with TV. :-( #2. Breakfast time. We had a small amount of Yogurt left, and something inside me said to just give him something else for breakfast. Well, I didnt listen and gave him the small bit of yogurt. When it was gone, he wouldn't give up asking for more. 'Yogurt, Yogurt, Yogurt'. Same sceneario. He would NOT give up. I tried telling him it was all gone, etc.. Finally we had to be all done with breakfast, I distracted him with something else and then fed him something else later.

SLP

Again this morning, he was still asleep at 7:20. I finally was able to coax him out of bed by turning the TV up. He popped up at the sound of the TV and gave me a very satisfied look. **rolling my eyes that THIS is what makes him happy when I have to drag him out of bed** After I told him Jen was coming, he was BOUND and DETERMINED that she was coming in the door THAT MOMENT. Jen always brings in a big bag full of toys and games. He picked up a basket full of toys, threw it over his shoulder, carried it to the kitchen, walked straight to the door, and started to whine. "What do you want?" "Do you want Jen?" "Yes (whine)... Jeeeeennnnn" "Jeeennnnnnn ..... Jeeennnnnn..." "I..... nant..... Jen.... pleeese... sniffle sniffle" Thank goodness she came early and I didnt have to explain for the 1000th time that he has to be paitient and she couldn't come in the door until she arrived. Jen comes to the door & you'd think she was Elmo LIVE or something. He lights up, runs over to the place they always play, and sits 'criss-cross applesauce' ready for a morning of fun. The therapy itself was pretty similar to how its been every week recently. However, he has started to realize that he has to work for everything with Jen, and its not actually all fun and games. We worked MOST on his /W/ sounds this week. Everytime he said 'nant' instead of 'want' she corrected him. He got frustrated at this VERY quick and started telling her he was 'all done' with that game so he could get past working on saying it right. There were even a couple times he just skipped the word alltogether so he wouldnt say it wrong. HOW SMART WAS THAT?? Or manipulative... you pick. The main theme of this week (other than /W/) was mixing up questions. So, in the lift the flap book, she wouldnt only ask WHO was under the flap, she also asked WHAT they were doing and WHERE something was. She said that he is anticipating her asking WHO is under the flap & that mixing up the questions and making him answer a different question than expected will help him to understand the differences between the WH words. Other games this week: Ball game - modeling asking questions with him. Not giving him the ball until he said 'want' correctly. Magnet game - making choices - which magnet, where it goes, asking lots of questions of where the people should go, what they're doing, etc.. Next week, she said she would bring me a printed list of his goals. (part of me feels like I should have had that list a long time ago, since I am responsible for upkeep of his therapy throughout the rest of the week) That will be hugely helpful to me so that I can have a list to look at that will tell me exactly what we need to work on for 6 months. The goals dont change for 6 months & hopefully he will meet all his goals within that period. Also, she asked how our OT eval. went. I told her a little about it and she blatanly disagreed with the outcome. As you can read below the OT thinks he has sensory issues. The SLP does not. She thinks that some kids just avoid certain things like raw fruits and veggies. I particularly liked the way the OT went about her evaluation (taking into account how NORMAL it is for a 2 year old to be picky) because she took it more from the point of view that once he is already upset by something seems to be more so when he is affected by being overly sensitive. At any rate.. I just told Jen that I will go ahead with the OT weather he has sensory issues or not & we will see if any part of it is helpful to him. If so, great. If not, fine. Either way, I dont think his 'LABELS' are what is helpful... it is the therapy and assistance that follows.

OT Evaluation

Exhale........Inhale......... Exhale................................ I feel a bit of weight lifted off my shoulders after our appt. today. I was told recently that it does not seem that he has any 'sensory issues' at all. There are things that have made me question that. The extreme pickiness of food. The way he is so delicate with pages. The way he wont allow one tiny morsel of anything that he isn't putting in his mouth to be on his hand, fork, or near his hand or fork. I can't think of them all right now... but I questioned it. So, today the OT specialist came to evaluate his sensory needs and see if he was functioning near the level of a 2 year old. The way she explains it is this: We all have sensory needs. We all have little quirks and likes and dislikes. Some of us dont like a certain texture of food or maybe its the smell or maybe its the taste. Some of us need our pants to not to be too tight or we dont like a tag in our shirt... but the difference is that when we have those needs, it doesn't affect our ability to function in the outside world. The world is full of different things that impact our senses. You know... Sight..Sound..Smell...Taste...Touch... Those are our senses. So, most of us fall somewhere in the middle. Most of us are either sensitive to light or sensitive to certain smells or need a little extra personal space. Then there are those who are either UNDER sensitive (meaning nothing bothers them... well beyond the norm) or OVER sensitive (meaning things overly agitate them... well beyond the norm). So, in her evaluation, there were a lot of questions. I made sure to tell her that I wanted to be as detailed as possible in answering the questions... but I didnt want to make anything out to be more of an issue than it really is. Is it pretty normal for a 2 year old to throw a fit and not want to do something? YES. But... there is a lot more going on than that. So, she asked a lot of questions to get a feel for how he functions when he's playing outside, playing inside, with a group of people, with other children, at home, at the store, etc & so on... But she also played some games with him that really showed her the bigger picture. Example 1: Spidery looking balls. Some are slick, some are sticky, some are prickly. They are all squishy. They are not like anything he already has to play with on a daily basis. He was interested in her new game. He pulled them out of the bag one by one - sorting them by color and size as he pulled them out - but as he felt of them he kept looking over at me, 'Mommy, is this ok? Mommy, why does this feel like this? Mommy, Im not too sure Im enjoying this new game'. He became very whiny very fast and went to find a game that he was more familar with. Ok. Her evaluation of this: It is normal for a 2 year old to seek approval from mom. It is normal for a 2 year old to not be too sure of something. But the normal reaction would be 'gung ho', dig right in, dont care if the sticky stays on the hands. She said he was very overly sensitive to these little balls and instead of just exploring and figuring out what they did, and how they squished and being interested in the balls... he was more interested in the residue it left on his hands. Example 2: Fingerpaint. Also, a new thing for him. She poured out several colors. Let him decide what colors he wanted. Allowed him to open the caps and help. Then she put HER fingers in the paint and rubbed them around. She mixed colors and encouraged him to also do the same. We finally got him to put his hands in and he spent the next few seconds whining and tryng to wipe it off on the carpet, his shirt, etc.. The normal response of a 2 year old would be more so of what does it look like when it mixes? Ooh..its squishy. Dive right in and explore. But he was so cautious - didn't want any part of this sticky slimy stuff on his hands. Within about 10 seconds we were at the point where we had to go wash his hands and be done. Example 3: Silly Putty. She has hidden some little colored disks in the silly putty and shows him how to retrieve them. She encourages him to find the little disks. We tried telling him to find circles (something he loves), we tried telling him to find the green (also usually loves colors). And, as long as he didnt have to touch the silly putty... he would pick the disc out. But, when we asked him to find it himself - you could see how bad he WANTED the little discs, but he refused to touch the silly putty whatsoever. I even tried to put his hand on the silly putty and he just yelled and refused. When we would ask him to touch the silly putty in any way he just looked up at me and asked me for 'Help.' Again, a 2 year old should have no problem at all at least touching the silly putty. Most of our conversations revolved around what foods he would and wouldn't eat. I had been advised recently that he eats enough variety of food that as a 2 year old, it was probably just him being picky. This was disappointing to me because it #1- hits me as something I have done wrong and #2- makes it MY problem to try to fix even though I feel like I have done EVERYTHING UNDER THE SUN to try to get my son to eat nutritious meals. She said that the 2 major textures for food would be crunchy and mushy. He will eat chips/crackers and he will eat Yogurt. Some people stop there when they are evaluating sensory needs. However she said you really need someone who specializes in these things to see the deeper issue. She sees that he will eat chips/crackers but wont eat fresh veggies (carrots, broccoli) as an issue. She sees that he will eat yogurt - but stops at the sight or even taste of the tiniest bit of strawberry or blueberry as an issue. He wont eat mushy banana. He will eat spaghettios, but sometimes refuses to eat noodles covered in sauce. She said we cant get inside his brain to see why he is refusing those things...but that it is well beyond the point of a normal 2 year old response to refusal or control. Her recommendation: She feels that a lot of children benefit well from OT coming to the house and doing therapy. She thinks that in our case, he would benefit much more from an outside setting. She is going to try hard to find him an outpatient OT session that he can be a part of and really work on him functioning in outside environments. She said there are more options when he turns 3, so if we need to do in-home OT until then, that will be more beneficial than nothing for now. She sees that he is functioning quite well in his home and normal settings - with his normal toys and people. However, the conversations we had about the way he reacts when we get out of our normal setting, our normal routine, our normal activities is beyond normal for a 2 year old and she thinks they can help. I wont pretend to totally understand this OT thing yet, or the sensory issues yet. But Im excited that maybe there is some hope at the end of a very long tunnel. Especially for feeding him.

DT

Today we met with our new Developemental Therapist. We decided that the best thing for him would be to meet with an individual to see what his DT needs would be and THEN decide if a group DT setting would be helpful. So, she came to the house when he was napping and spent some time filling out paperwork and asking a lot of questions. She seemed quite interested in what his schedule is like, what he does all day, and how he functions. She also wants to get on board with his SLP and both be working on the same goals at the same time. I was quite impressed at her explaination of what DT is supposed to be. Basically her philosophy of DT is getting involved in the everyday schedule, what he chooses to do all day, what he participates in, how he participates, and what he is most interested in, finding ways to get him interested in participating more and allowing him to learn to do things that are more functional. Most times with Autism a root issue is that the child has very high interest in certain things and their focus on that distracts away from being very interactive and social. If left to play alone, with no redirection, our son would choose to spell, write, count, and do anything revolving around those things. Don't get me wrong, he's not one-dimensional. There are other things he does all day... but that would consume the majority of his free time. So, what her plan for him is to see where he participates. Does he help with getting dressed? Does he participate in food choices or cooking? This therapy will help to incorporate him into very mundane daily tasks - using his interests to accomplish this. Most children develop an interest just in their own time - say to undress themselves or dress themselves. Well, this is one of those things that will have to be taught in our case. So, we will get him interested in some way (to be seen) and then help him participate, and then with repetition, he will learn to use his interests to participate in our daily routine and use his large bank of knowledge in a more functional way. Like she says, its not purposeful for him to just sit and label things and yell out numbers... but it WOULD be functional for him to sit in front of some playdoh.. make a car..spell car..and incorporate what he loves into a new game. There are a lot of things that we have already done that are similar to this, we also have some SLP goals that are working on this, and then with an added person helping him develop more functional skills... we will be on a roll. We have already seen a huge improvement in his ability to communicate to us... I am excited. Our first session will be Aug 14 On another note... she was interested in how we even came up with the idea that he needed an evaluation. She said her 10 yr old nephew was just diagnosed with Aspergers, and I then told her that while they won't make his 'label' any more specific at this point, my suspicion is that he will end up with a diagnosis of either Aspergers or PDD-NOS at some point. She saw many parallel's to our son and her nephew and was amazed at how similar they were at this age. She was shocked to see some of the transitions we had figured out on our own and that made me feel a little good, I wont lie. She was very happy about the way we're going about it... just keeping it under hat to those who don't know and love him very much. There are so many people who see a label and either don't understand or can't move past it, that it is not helpful to him right now. What IS helpful is that the 'label' is getting him services. The services will get him the little extra help he needs to function better in our family, in social settings, and in life in general.

SLP

This morning he slept until 15 Min's before our therapist walked in the door & I really didn't want to wake him up since he's been sick recently, but I woke him up anyway. He definitely needs that time to wake up and eat before she comes because he didn't participate nearly as well as he usually does. First thing, she asked if he wanted to play with 'Trucks' or 'Pet Shop'. The Pet Shop she brought was new to him, so he picked that. This is a little magnet board that has a background scene with all kinds of beds and homes for animals at the shop. Then there are magnetic animals, people, food, dishes, etc... So, she began by asking him 'Do you want Bird or Dog?'. They worked on choices for a few minutes to get him comfortable with this new toy before moving on. He is great at choices now. It only takes him a minute to pick up and he's on his way. So, after he picked a few animals and put them on the board where he wanted them, she began to bring out some more unfamiliar animals (hamster, turtle, rat). She asked 'Who is this?' (wait.... he doesn't answer...looks up for approval and help) 'This is Hamster.' 'Who does Hamster want to play with?' She places Hamster down next to the bunny and acts like they are playing together. Well, this game went on for a while. He has not yet grasped the 'WHO' question, so it was not successful. After seeing this, she backed off and went in another direction. He will need to see this played out several more times before he will begin to grasp WHO. Then she pulled out the people. 'Who is this?' (wait.... no answer..... looks for help....) 'This is Boy,' 'What does Boy want?' Well, he is great at the 'I want....' carrier phrase... so he picked right up on this. 'I want ball please' - he makes the little boy say. 'I want bunny please' - he makes the girl say. Today he was very successful at choices with a new game, and worked very well with WHat, but needs some more work on WHo. Then we played with cars, creating a pretend play scenario for him. We drove them around, talked about what tractors, wagons, and trucks do. We attached them together, let little bears ride and crashed into each other. The therapist said that we need to encourage that as much as possible. When we play enough with one game, he will pick up an interest in these new play scripts and will begin to realize that he can make up his own games as well. We have already seen this with his BUS, CARS, and PEOPLE. He used to only choose coloring, letters, books, and numbers when we let him have free play, but NOW he goes for those Cars and People almost every time. He's still more interested in putting people in and out than driving them around and pretending with them...but it's a step in the right direction.