SLP

So, last week, I met with Tammy (coordinator) and we worked on updating some of DS goals. One goal we added to Speech was to begin working on 'function' questions. I will post all the new goals for SLP and OT once I have them in my hand.

Q: 'What do I need to open the door?'

A: 'A key.'

So, in order for him to learn the function of something (what opens a door? what cuts the banana? what do I need to call someone with?) we need to start using more complex questions -instead of just looking for a response to a question - we need to prompt him to answer these types of questions.

This morning, Jen used the 'Parents Animal Hospital' (one of my all-time favorites) to show us how to tap into this new concept. She would ask him 'What do we need', because he already knew he wanted the animals out. Then we would say 'We need the key. The key opens the door.'

Seems simple enough. We'll just try to add these questions to our vocabulary so that we're prompting him to answer the questions before we just give him a handout.

Reallife examples:

If he wants a drink.... 'What do we need to put the drink in?' 'A cup'

If he wants to brush his teeth... 'what cleans your teeth?' 'A toothbrush'

Still brainstorming...

Oh the Joy!!!

There have been a massive amount of improvements recently. In part - its the therapy & the constant working on of therapy (mostly speech). In part - its a 2 year old hitting some big language growth spurts. In part - its the stress leveling off and having a little sister who is more capable to be social WITH. In part - he's just a smarty pants (yeah, I said it ;) No matter which part adds which element - the fact that I am able to sit back and ENJOY my son is wonderful beyond words. Sometimes - the JOY cannot be contained. Yesterday, we took a trip to the library. It is getting easier and easier to get both kids in and out with enjoyable parts in the middle. Last night, Dad was able to go too. I headed straight for the 'Early Reader' section to pick out a few books that DS might want to read. Sissy was crawling around the floor and DS pulled a toy into the floor. A little girl (maybe 6or7) walked over to the toy DS was playing with and I asked him to share. He didn't care and grabbed a book to look at instead. Then he stopped what he was doing to observe her playing and walked over. He stooped down to get in her face and said 'Hi'. She looked at him like.... uh.... whatever... which I guess is pretty normal for a 6 year old girl. But, it was one of the most amazing things I'd ever seen. I just couldn't believe it. If I wouldn't have looked like a total fool, I'd have done a little dance.

OT

Today we talked about DS goals. We have been working our way through activities that will challenge his senses - therefore showing us if he has issues with sensory stuff or not. He seems to display a pretty good amount of hesitance when faced with a new sensory activity, but he eventually digs in and has fun. My amateur analysis is that he has some subtle sensory issues, but his age, other areas of development, and personality also factor into the equation pretty heavily. I think his resistance to trying new foods have something to do with sensory issues, but he's also got the 2yr old opinion going on. The 2 senses he tends to have the most trouble with are sound, and sight. He is very agitated when the sun gets in his eyes. If we're in the car, he'll start screaming and crying if its in his eyes for too long. Loud & different sounds also get him worked up. We decided to add: He will transition to Adult directed activities w/o displaying resistive behaviors and follow through with minimal cuing. And decided to discharge: He will play appropriately with new toys brought into his natural environment. Games today: Slide around the house on a sheet, play fort with the sheet, play on sit'n'spin, play in tunnel, roll ball through tunnel, swing laying down on the sheet. He loved swinging (she says he loves 'vestibular stimulation' and says that this type of thing is great for calming him.) We discussed that swinging would be a great activity to calm him before nap time. Now, we just have to work on the 'transitions' too so that he doesn't have a fit when we're done with the swing. PLUS he likes to slide even more than swing, but that gets him all worked up. The sliding around the house was ok. He didn't understand the sit'n'spin at all, the tunnel we already have - so he and sissy had a BLAST in that. New food: Yogurt... OOPS...thats his favorite food already. So, we just had casual conversation over lunch b/c he didn't have a 'new' food to try. That's ok....

SLP

Speech went well. Nothing huge. Nothing too different. Still working on most of the same things - 2 word responses. He did spontaneously tell Jen 'Your Turn' when they were playing with the cars and bears.

On another note, this weekend we found him reading 'Go Dog Go' on his own in his room. Of course there were a few words he missed, but for the most part he just sat there reading every word. WOW.

Genetics Testing

I called to see if any of the tests were back today. I should get a detailed report when all is said and done, but so far... Amino Acids: Normal Fragile X: Normal Chromosome Study: By end of the week Microray: 2 weeks

DT... or is that what it was called?

Well, today is un-noteworthy. The only things I have to say are negative. I hate being that NEGATIVE person, but I am assured that she is not the right fit for us after today. At least I feel confident in that. The part that makes me feel bad is I think she's that employee who gets fired and says 'What, but I didn't do anything wrong...' No, Mary, it's not that - its that you just plain didn't do anything. Maybe she'll fit another child better - moving on......

OT

I just have to say that Mitzi mentioned last week what a difference the taste of organic bananas is from the regular, and now my son is eating them whole - just peel and hand it to him. No forcing, No Peanut Butter, No tricks. He just WANTS it!! wow. This week, she wanted to focus on food. She brought a little shopping cart full of boxes to shop. They went through the whole process of shopping and then we did lunch. The new veggie this week was cucumber. Didnt try it at all. We avoided all the drama that we had last week by not making it too stressful and forceful. I will go get a cucumber and just try it several times this week.

Why can't doctors diagnose Autism?

This is exactly what I like to hear. Someone who understands. It's amazing that so many parents are sent home from the pediatrician with 'just give it some time, every child develops differently' - just like I was. http://www.npr.org/templates/story/story.php?storyId=94386599 LOVE the NPR interview (thanks Little Bit Autistic!)

SLP

SLP is postponed until Wednesday afternoon. Jen has an appt. The weekend has gone very well. On his own - he has said several things!! Sissy was in the bath - he walks in and says 'My Turn' I've never heard him say that!!! Especially Spontaneously. He is saying HI and BYE much more often now. He is still not waving as he says them, but they are 'greetings' all the same. It is cute to hear him say 'HI' - just like Jen does. We don't say HI, we say HEY. We are seeing his scripted responses generalize more and more each day. He was playing 'Happy/Sad' with a 1/2 eaten piece of bread today. (I did it with a Waffle the other day...silly Mommy) He identified OUR expressions accurately when we asked if we were Happy or Sad - when we WAY overplayed the emotion on our face. He was sharing his water with Patches the Cat, Bubba the Dumptruck Driver, and Sissy earlier. However we are dealing with some tummy troubles. On Thursday I was convinced that I had been on 'Maintenance Mode' feeding him Juice and Milk as he commanded too much and it was causing the upset tummy. But, he has had issues several times a day throughout the weekend. He has added some fruit to his diet - BUT has been eating MAJORITY of items that would stop him up - not the other way around, or at least thats what 'Toddler 411' says (Raisins, Nuts, Apples, Yogurt, Etc...). Once he leaked out of his pants this morning and then again at church - I decided we'll have to give the doc a call in the morning. I can't decide what to do. On ONE hand - if we give him only water (b/c we think juice/milk is causing it - overload on Casein/Gluetin/Sugars/Fats), and thats not the issue - he might dehydrate easily or not get the nurtriants he needs. On the OTHER hand - everything Recommended to treat the VIRAL reason would contribute to the SUGARS/FATS/and GC problem. Hmmmmmmm....

DT

Outcome = Totally different than expected. Ok, so this week I made a phone call to our old DT (group) owner/therapist. I told her I was just lost on what I needed to expect. I told her that I didn't see any therapy going on and described a couple of scenarios. She agreed and helped me to understand what my expectations should be. I was completely prepared to call our coodinator and switch therapists. This morning I spent some time stressing over the fact that I WANTED to do the right thing and tell her what I saw that was bothering me (you know, so she can fix it and actually be given a chance to defend herself), but I felt like I would probably slink back into my little corner of 'niceness', smiling & nodding. As usual, we started by reading books. However, she did ask DS if he wanted to read books or play blocks. He chose to read books. As a creature of habit, he already KNEW that was what Mary comes to do, so it was no surprise to me when he chose to read. There was a distinct difference though, because she was actually interacting with me and showing me concrete evidence of what she was doing and why it was supposed to help. She was working on 'preliteracy skills' of opening the book (he already does that well), reading Left to Right (he does this 95% of the time) and realizing the story goes with the words (which he is picking up on recently). She also worked on drawing his attention to the storyline (which he doesn't usually do at all). Then, I redirected and asked her if there was anything else she wanted to work on (because he was bringing her book after book after book) and so we asked DS if there was another toy he wanted to play with. He said 'Blocks', and went towards some little counting blocks that he likes to play with. She helped him to get them down and then tried to find a game that could go along with the blocks. Then, she caught on & realized (or at least this is what I thought happened) that I wanted to pick up the pace a bit. If you just let HIM pick the pace, he'll do the same thing over and over and over. He needs the redirection. I gave her the benefit of the doubt and tried to SHOW her that. I think she got it because shortly after he lost intrest in learning anything from the block game, she asked me for crayons and paper and told me that he seemed ready to begin working on emotions. We drew happy & sad faces, showed him our happy & sad faces, and then showed him the happy & sad faces in the book we were reading. It went over his head...but THATS OK... because that means its something worth working on. :-) Ok. So, I watched intently today and began my conversation on what changes I see that need to be made by saying 'What Im seeing in our sessions overlapps a lot with Speech, but it also seems quite outdated for him. I was the one who chose the objectives, but it was during our 2 hour evaluation in June. I was not prepared, nor was I qualified to be the one to make his objectives that day.' She agreed that they seem outdated and explained to me a bit about how the EI program works; they have to do what the objectives are. They write up what they did in the session, and really can't go too far outside the plan. I told her that what would work best for Me would be for her to bring me some questions that would identify where his 'developmental' struggles are. I feel like I do ok seeing where he struggles in things he already participates in, but there have to be some holes where we aren't supporting development at all & I can't see something I don't know about. I told her that we already do the books, we already do the blocks. Speech is doing a great job of working on imaginary play, etc. And, while its fine to focus on those things part of the time OR even as a part of something else - that if we do that at both Speech and DT each week, then I have nothing new to work on. At that point, she said that she was very thankful that I said something. She said that I am not typical of most parents - that what she typically sees are parents who expect her to come in week after week and do her thing for an hour and then its done. They don't ask questions of what to work on throughout the week. I told her that I just wanted to make the best of the time we have. EI is a short program. It's over when he's 3, and then we move out of EI into something else. So, here's what we came up with. Next week, we'll spend more time talking about what we need to work on than doing actual therapy. That was my suggestion. I told her that while I know she is held to a certain standard of what she is supposed to say or not supposed to say - that I want her to tell ME what he needs to work on. I'm not his therapist. I might know DS best, but SHE knows DT best. She already suggested that we add 'Self Help Skills' into his plan & just leave it broad so she has more room to play with. If we put very specific things - like work on desire to undress and dress himself - then she can't do other things (isn't that sad). We discussed the benefits of going to a group and decided that it would be great to get out of the house and do every-other week somewhere else (chickfila, the mall, grocery store, etc..) Her explanation is that she is supposed to be a support to the parents - working on anything that we see makes life a struggle for DS. The best place to work on this is his 'natural environment'. Her idea of natural environment is not just our house or church - also anywhere else that we go. Something that concerned me a bit; she mentioned at one point doing DT on a bi-weekly basis. I felt almost as if she wanted to take advantage of my willingness to participate. She said that she could come every-other week and work on new skills and then I can carry it over for 2 weeks. I was quick to tell her that there were other DT's that were offered bi-weekly, but I specifically chose weekly & I was not interested in cutting his therapy down anymore. I'll just keep this in the back of my mind. It also disappointed me a bit that she never brings any toys/games with her. I asked her about that, and she said her company comes from the point of view that a child's natural environment in the home includes that child's own toys as well. I told her I was split on how I feel about that becuase DS tends to focus much better when there is something new to focus on. However, since I understand that now, I asked her if there is something I can set up for next week that would facilitate a NEW topic (since he will always relate Mary=reads books if we dont). I told her I can set out his kitchen set & she added that it would be great to use a book we have about cooking to talk about cooking eggs and why we're doing that. Great! Now, that's what Im talking about! To work on this week: +Think about where he needs to participate that he's not already (on/off clothes, picking out clothes, chores, cooking) +Think about what he needs help with that he's already participating in +Work on Preliteracy skills, point to each word as we read it & Ask questions about the story as we read +Work on Emotions - Happy-Sad-Angry. Use any situation we can to point out these emotions. Point it out in books. On the faces of his animals. Etc.. Off to call Tammy the Coordinator.

Alright, here goes....

Mary should be here any minute. I'm mustering up anything in me to make it known that we're not happy with the therapy. I'm a softie - so we'll see how this goes......

OT

Its Rainy... the day was off to a good start. We all 3 ate a healthy breakfast together at the table. I have to admit that in my frustration at the rest of the day falling apart I am quietly sitting here contemplating on scripture & my role as a parent. Really, these kids and all the therapists are children of God. My children aren't even MY children. I am here - given a job from God - to raise these gifts the way HE would have me to. I am in no way in CONTROL of anything that happens, but I am responsible for my reaction and my job. I struggle, as does everyone else.... but I also hold onto the HOPE that God has promised - For I know the plans I have for you," declares the LORD, "plans to prosper you and not to harm you, plans to give you hope and a future. The chubby little fingers, the heartbeats, the smiles and the tantrums. It is all embodied inside the growing little children in my house. God put them together.. piece by piece. How awesome is that? He knew who they were - who they are - who they will be. That really does make it all better. The daily happenings around here are just a 'by-product' of the bigger picture. I'm going to sit back and try to enjoy the bigger picture instead of nitpicking on tiny details that get me off track into the world of negativity. OT today. Leap Frog Book - went well. Theraputty - went great. Fingerpaints - tenative, but successful. Back to Leap Frog Book - doesn't want to give it up. Lunch - meltdown - won't try the new food of the week 'carrots'. Total meltdown over wanting APPLES which aren't at the table and mommy can't give in. Back to Leap Frog Book - more meltdowns as Mitzi tries to escape without causing further damage. (not that it was her fault, he is just in a mood today). *Sigh*

SLP

'Hey Jen!' This morning I didn't talk about Jen before she got here. I didn't bring any attention to her coming in the house or anything. DS was looking out the front door and saw Jen when she got here, and when we walked into the living room he shouts 'HEY JEN!' How awesome! Praise, Praise, Praise. We had a great session today. Jen pulled out some new games and it showed us how far his language has come in 12 weeks time. It was awesome to watch. He's asking for help spontaneously. He's asking 'please' for things. He's answering Yes/No questions. We both noted that he is using the same questions and answers that we have supplied him with, but he is using them appropriately and getting quicker and quicker with them. He isn't just saying 'Need Help Please' spontaneously and RANDOM... he really does need help. He is understanding how to use those words functionally. Now, we move to more kinds of questions and more complex games. Jen made me feel really good because she said that she can tell when parents are really working on the goals throughout the week & that this type of progress doesn't happen without it. I turned it around and also thanked her b/c this also doesn't happen without the instruction that she provides. It is also MUCH easier to continue working on these skills when it WORKS. He has worked SO hard & is really blossoming on his receptive AND expressive language. The new game she brought today was a neat little puzzle board. There are lots of animals and when you put the front & back pieces (say of a cow) together on the board correctly, it moo's. Since it was a new toy, she let him practice his existing skills this week. He asked for help to open the bag appropriately. He asked for the pieces appropriately. He asked for help to get the pieces in the right position appropriately. It was great. Next week, i fully expect NEW questions with this game. We had a great time!

DT

Last week... I got busy and didn't post, but I just want to update that I have been advised that if someone comes to clean your house & they start fixing the computer, there's a problem. Im feeling confident on switching DT's, but now, how to go about it??

Misunderstoods of the Spectrum

When you say the word 'Autism', people most likely think about Lack of Eye Contact, Resistance to physical touch, Strict Routines, Lack of or Restricted Language, among others. I have heard this response on many occasions :

What! Autism! No way. But, he is so happy

and has such great eye contact.

He talks so well and is so smart too...

This response has come from many whom I know well. I don't go around telling every grocery cashier I see... just the people close to me. So, as you can imagine, it's hard to be left feeling confident in the diagnosis, in yourself, in the fact that you've got therapies lined up. Its easy to feel like everyone who knows looks at you like an alien. Sometimes I even feel bad for making a deal out of it. Like, in some regard that things are more normal than not, and I should just keep my mouth shut and deal. I DO know that there are people out there that deal with a lot more. I really feel for them. I can't imagine. But I have to constantly remind myself ~ that doesn't mean I can't feel too. At the moment, DS is only 2. He isn't feeling any of these effects yet. I feel it for him. But, I have to look forward to HIS future and make sure I'm making the right choices and educating those I can. It's NOT important that he has a label, but it IS VERY IMPORTANT that we do something about it. If there were a child who couldn't eat, you'd do something about it. This is just a little more difficult to understand. I am well on my way to a Google PhD, and find myself looking up anything that can help me to understand my son better. I ran across some descriptions of Aspergers and PDD-NOS that make good sense. These are 2 of the misunderstoods of the Spectrum. I'm sure there are more. In my Mommy Gut, I feel like DS will fit somewhere around one of these diagnosis as he grows and is re-evaluated. I will add that Therapy has made improvements in LEAPS and BOUNDS!! We are so thankful for catching this early and for all the help!!! I can communicate with DS without all the whining most of the time. We have tools to work with and things that work. From just a few months ago, this is a huge improvement! Asperger's "Children with autism are frequently seen as aloof and uninterested in others. This is not the case with Asperger's Disorder. Individuals with Asperger's Disorder usually want to fit in and have interaction with others; they simply don't know how to do it." As an overview, children with this disorder often have very limited interests, rely heavily on predictable routines, don't interact well with others, and have a hard time understanding the many subtleties of social interaction. At the same time, they often have impressive memory and language skills http://www.babyzone.com/baby_toddler_preschooler_health/autism/article/asperger-syndrome PDD-NOS A diagnosis of Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) serves as a kind of catch basin for the autism spectrum: If a child development expert does not see enough signs that fit into the diagnostic criteria for classic autism or Asperger's, for example, the child who has trouble with social interactions, communications skills, and demonstrates repetitive behaviors will be classified as PDD-NOS. The child could demonstrate problems in all three areas, but they appear less severe than children who receive a classic autism diagnosis. http://www.med.yale.edu/chldstdy/autism/pddnos.html Chromosonal Testing We recently took DS for some Genetics testing as well. The Pediatrician recommended it, I'm not 100% sure why it's important to know, but I also don't know the least bit about Genetics. I think I skipped that course in school. This link talks about ONE of the possible links between Chromosonal Abnormalaties and Autism. http://www.fragilex.org/html/autism.htm

OT

Again, Dad got to be in on another session. Mitzi (sorry, I've been misspelling it) is the type person who is much easier to warm up to - I think Dad joined in more because of that. We played with all sorts of balls, koosh, squirmy, wiggly, flashing, tiny, slick, sticky, etc... He did great. Just played. She brought out her sand and rice buckets. Hides little things down in it to get him to stick his hand in. He sorted through the sand and rice as plain as day and found all the gadgets and balls. He's not too sure about keeping the grains on his hands, though, he was pretty quick to wipe them off. Although, we do notice that most of the time he uses one hand to do things (open a box, grab for something). I posed the question to Mitzi, if she had any idea if that had to do with anything (since we're 110% sure its not a muscular or otherwise issue, we've seen him use 2 hands on many things). She said that we definitely need to encourage the use of 2 hands, so no big deal. On to lunch. We did another lunch date with Mitzi today. She brought an Apple and Peanuts. He's been exposed to Apple many times, but not peanuts. I fixed a plate of: Graham crackers w/peanut butter (the thing he will usually eat) Blueberries & Strawberries (things he never eats) Peanuts (new) Then, we let him eat. He ate the Graham Crackers w/peanut butter of course. We encouraged him to name all his choices, talked about peanuts, and all ate a peanut together on the count of 3. He finally stuck one in his mouth. That was it for him. No more, Please. Then, we cut up the apple & I encouraged him to help cut. We talked about smelling it - that it smells like Apple Juice and Applesauce. We asked him to lick it several times. He went back to wanting crackers. Then, all the sudden, he started licking the apples again & he PUT IT IN HIS MOUTH!!! We clapped and he looked a mix of startled and satisfied at that. He started putting more apple and more apple in his mouth. I was trying my best to hold back tears, but he was eating APPLE!!! I've tried that a gazillion times. What worked? We don't know. I'm just happy.

All in all, its been an awesome day!!!

O LORD, the king rejoices in your strength.

How great is his joy in the victories you give!

You have granted him the desire of his heart

and have not withheld the request of his lips.

~Psalm 21

SLP

Today went very well. Dad was home today for Labor Day, so he finally got to meet Jen and be in on a session. I think he enjoyed being a part of things. Games as usual. I could tell that we've played the 'put cars together in a train and then let bears ride' one too many times, becuase he got quite silly and way off course. That's what he tends to do with his own toys when we're playing and trying to practice his Speech Objectives - since he's so familiar with them. He tends to focus MUCH better when its a new game.

While we were still playing the 'put bears in train' game, he did several things that he doesn't typically do. He kept taking all the bears out of the train and throwing them on the floor, so I pretended that the bears wanted to jump. Jen pretended the bears wanted to sleep. DS decided that ALL the bears were sleeping, and as I would stand them up, he would lay them down and pretend they were snoring. That makes Mommy smile. During our session, Jen was telling us that he is mastering things Light Years faster than she ever imagined he would. She said that she never thought he would catch on to the concepts she is throwing at him so fast. She said that she wants to just keep going as far as he'll let her take him and keep adding new concepts. Jen wants to add as many different scenarios as possible, since he catches on quick but still has a hard time translating a skill over to everyday life scenarios. What do I mean by that? I mean that while he'll answer 'want green truck' during a game where we've shown him the only acceptable answer to get what he wants is 'want green truck', he doesn't say 'want red block' or 'want orange juice' to prompt me to come get those things for him. Now, I will say that he DOES ask for more and more things on his own. If we've repeated it enough times, he knows to say 'Mommy, I want Juice Please' - but if not - he usually comes barelling in the room going - Elmo, Elmo, Elmo, Elmo, Elmo, Elmo..... It's all a bit confusing... it still feels like a lot of this is just normal 2 year old stuff - but I get new confirmation of the reason he's 'on the spectrum' on a daily basis. I guess when you COMBINE all the issues... it = Autism. Nasty little A word. Why do you have to be so confusing little A word? No matter how great he is doing - I still see the importance of having the Speech Therapy. I hope Jen doesn't say 'ok, he's done' - I dont know why I fear that.... But, if we didn't have her to teach us what helps bring language out, we wouldn't know what to work on. It is only through DS's sheer Genious, repitition, and of course God's Grace that he is doing so well. He really really does need to be taught things that other children pick up on their own. Good for us, he's a QUICK STUDY! I feel for those mom's who don't get to see improvements so often.... I find myself thinking on that often... and I take a quick moment to be thankful for all of this. It will make me a better person. Jen commented that he's picking up on things that are well above his level of development. She said that 2 year olds will usually pretend play putting a baby to bed or feeding...but they dont pretend conversations between toys - and he's doing that more and more now. He has mastered questions with a one word answer: Want Truck or Car? Truck Jen wants us to move on to multiple word answers: Want Green Truck or Red Car? Want Green Truck As Jen was leaving... he MADE HER DAY! 'Bye Jen' He said it! Finally! Without anyone telling him to! Week after week, we walk outside to watch Jen leave, as I tell Jen Bye and tell him to say the same thing..... and sometimes he will give in to my request, but never on his own.