Natalie, OT, DT

Natalie - 'Parents as Teachers' doesn't make it to this blog regularly... but we did have 3 sessions today. DS was acting out already this morning starting at 8:30. He is seeming to have trouble with Sissy being a part of things. She's a part of this (we'll call it an activity since she's not a therapist) activity because it is just a parent session talking about child development, brain development and activities to do with your kids. We usually do a craft and chat and she usually gives me some good tips for things going on this month. We barely cracked open the material because of 3 time-outs, 2 warnings, diaper changes, a bottle, and multiple meltdowns.
OT - Mitzi came in and did her normal thing. I told her how our morning session went, just to warn her. DS didn't really want to participate. He saw an alphabet game in her bag and only wanted it. He let us play cars (a game to encourage pretend play) for about 5 minutes, but continued to say 'All Done Cars'. Good sentance, Good words, but NOT what we were looking for. We finally let him play the alphabet game and he got really fixated on letters and never re-directed to anything else. I'm going to chalk it up to a bad day & he just needed his coping mechanism to help him through his day today.
DT - 'Oh How I love thee... let me count the ways....' Ok, that's a little far, but I DO love Suzanne. She is a breath of fresh air. She knows exactly where I am. She sees him in all his wonderfulness and all of his struggles. I don't quite know how she does it, but at the moment I'm going to call her my 'Superwoman/Supernanny'.
We started the session talking about 'Boardmaker', which is a program that helps make those PECS Picture cards that she and Ron have been talking about. She wanted us to get all the toys up and out of reach so DS would be forced, ok... lets say encouraged to use his words. Play is MOST of what a 2 year old is all about and (unlike food) they are GOING to get those toys somehow. So, I've been MORE than excited to get started with this new change, but didn't really know where to go past moving the toys. I took pictures of everything... bin by bin... so he could have a written word for each toy that he might have a choice of playing with. Her program easily formats a picture and a word label on a small square card. She is going to print them, laminate them, and velcro each one of them for us & next week we will have a 'storyboard schedule for him'. We can use it to show him choices for toys, foods, to tell him what we're going to do today etc... It might seem a bit extreme for our verbal child, but he is kinda stuck in his rut of specific phrases, so I think it'll be great. Eventually it is supposed to turn into him spontaneouly picking the card he wants (so he can visualize it first) and then come ask us for whatever he wants.


The Beach

Compliments of the Grandparents, we took the kids to the beach this weekend. We had a great time, and although out of his element DS had a hard time during parts, he really did have a great time. We'll never forget 10,000 requests for a ride in the elevator....but he also enjoyed rides in the wagon, holding hands up and down the hall, rides on Papa's belly in the lazy river, playing in the sand with Memaw, and the pool.


I asked Ron today about moving the toy bins out of reach (as Suzanne suggested). I wanted his take on it so we can make sure everyone is on the same page (since he uses picture exchange & Suzanne suggested using picture cards). What he explained to me was that to get someone to communicate, the conversation needs to be relevant. If we are at a table full of people talking about nuclear physics, we won't be nearly as MOVTIVATED to speak up, direct our conversation toward others, and participate. This is what he wants me to think about when we choose what to put away and what to keep down. He said that DS will need SOME stuff down in his reach, but the things he loves most and talks about most will encourage that spontaneous speech that we're looking for faster than anything else. I think that TEACCH may focus a bit too much on his likes because there are plenty of things we need him to talk about that have nothing to do with things he likes. However, I think it's a great suggestion - especially to get DS to understand this new system & what we are expecting of him. I am excited to get the toys re-organized tonight and get some amateur-picture cards made. Daddy will be home tomorrow, so we can both work on DS's understanding of where his toys have gone and how to get them. More on TEACCH later!! There is a lesson plan for each week, and I want to share the big points of each lesson... but I'll have to do it when I find more time.



So - THATS what a good DT is like.
Suzanne asked me about 15 min's in what my biggest concern that the other DT wasn't working on was and I said 'You've already done more than she did in 4 weeks'.
She came in and asked DS to sit under a little lap table. Game #1 was a peg board. His job was to choose which color peg he wanted, say 'Push In' as he puts the peg in, say 'On Top' as he puts the peg on top, and then follow her directions for 'in' and 'on top' as directed. She got a good feel of his hesitancy to answer choice questions with new objects. He also struggled to say the phrases and required prompting each time. When she asked him to 'push in right here' in a specific hole, it took a LONG time for him to follow the direction, but he finally got it. He was very good to look at her each time he knew he wanted help, but never asked for help. He reverted back to echolalia in his speech as she asked various questions today, but it seemed more as a coping skill to the hesitancy of doing something wrong for the new person. She said part of her strategy (this is different than the way we do speech) is to NOT repeat a task over and over and over. She wants him to LEARN not to REPEAT when possible. She said once he got the in and ontop correct she would stop, play something else for a minute, let the brain rest, and then do it again. She said this would facilitate her knowing when he actually learned something instead of him just repeating what she was doing. Second, we did a puzzle with firetrucks and dump trucks. What she did with this goes so far past anything I've ever tried, I was impressed!! She really got a good feel for where he struggles today. She said she wanted to see him match up the puzzle, but more importantly she wanted him to identify with different parts by her prompting. So, she let him assemble the puzzle and then asked him to hand her different pieces. 'Can I have the dump truck? What color is it? What kind of sound does a truck make?' 'May I have the yellow truck? No, the other one.' 'May I have the truck with blue windows, the ladder' She really pushed him to LOOK at what he was doing before just jumping at the first command. She allowed him to take his time and think. She allowed him to make a mistake and then corrected him. She was very graceful with him, and at the same time VERY firm and didn't back down once she asked him for something. We let him play free play while we chatted a bit. She noticed that he had taken the piggy bank toy over to the side. She engaged with him and told me that she sees that he is at risk to isolate himself while playing. At his developmental age, she wants to see him coming in between our conversation to interrupt us because he wants to play WITH us. She wants to see him improve on choice questions - yes/no for accuracy - more abstract choices with more language. She wants us to move the toy bins up out of his reach so he has to ask for them SPONTANEOUSLY. I think that is a KEY for him. Jen has gotten him to the point where he can say 'Mommy, I want juice please.', but he does it VERY choppy and it is 90% prompted - 100% prompted when the object is out of site. Suzanne wants to take him the step further where he KNOWS he wants something and he finds his OWN language to get it. This is another example of taking his language from 'repeated' to 'learned'. THIS is what he needs!!!! She said that our major challenge with a High Functioning child is to help him to NOT stand out in a crowd. She said that already, he fits in very well... but she NEVER made me feel like that meant he DOESN'T have a form of autism. She said that he will do really well in a classroom, she doesn't see any real behavioral issues, and he is very social. She caught onto him really quick. Before she left, her observation had told her that his eye contact was great, but not used the same way as typical children. She knew that his jumping/gross motor skills are lagging some. She knew that he is very social but he needs to learn more appropriate communication. She even knew that the little 'marching dance' that he sings to in the same pattern around the house was one of his coping skills... she said 'awwww' when she saw it and immediately knew... Every single motion, word, etc.. that she made was for a purpose. She made me feel like a great mom. She made me feel like we're going to get A LOT of work done. This is an awesome day!!!



I understood more about TEACCH this week. Ron really 'got his number' last week - watching him master the cognitive skills tasks. This week he brought alphabet matching, spelling, and the MORE important pretend play skill tasks. So, rather than this be a progressive learning experience (like speech where we do relatively the same stuff each week and I learn from that), this is more like an actual CLASS. Each week we have a lesson and I have homework. This week I am supposed to create a learning area and some stations for DS. The only thing I really need to BUY for this week is a collapsible bookcase or shelving unit. I forgot to blog just after Ron left, so I am forgetting major things..... DS did a great job transitioning, but already showed a preference for wanting to do the 'work' instead of play part of the routine... and I had warned Ron about that. We are also supposed to start thinking what kinds of choices we are needed him to make on a daily basis so we can get some picture cards made to facilitate him in more SPONTANEOUS speech.


WOW! One word says it all...

Yes, Mommy was in charge of dinner last night. Had Daddy been home, this game would not have carried this far, guaranteed. However, it was QUITE entertaining. He spelled multiple words and then ate them letter by letter. This is the only one I got a picture of: 2+2=4 (that's what he told us it said anyway). I can imagine 2's would be quite hard to make out of Lo Mein for anyone...... WOW!

SLP - Beaten Down

I'm glad I didn't have time to blog this morning after Speech. I felt so beaten down. I feel like Jen spends more energy trying to defend why everything DS does is normal than she does on working to figure out what challenges he DOES have. I feel like we've been doing the same games and activities forever because she doesn't branch out to find something new. Why is it necessary for me to focus on his strengths and NOT talk about autism with a therapist? It's as if she thinks that I don't recognize his strengths. I've done my best to point out how well he is doing, but that doesn't mean that he doesn't still need help. Sometimes I feel like I need someone who better understands ASD - especially High Functioning kids. Sure, she has plenty of cases (I'm assuming) with kids who are non-verbal, or don't pick up skills as fast as my DS, or maybe they have difficulties that will never improve. I'm not trying to compare my DS to everyone else. I'm just trying to do what's best for MY SON & making me feel like I'm barking up a dead tree isn't going to help. NORMAL 2 year old? I dare to say there is No such thing. She tells me that her little boy won't eat Strawberries either (this is in response to a comment that no, he doesn't eat strawberries.. just strawberry flavored things). Well, that's fine. I DIDNT say that DS won't eat strawberries b/c he has autism. I just answered a question. When you add 1+1+1, does it NOT equal 3? Autism is defined by the COMBINATION of factors. Well, if you have 1 factor... it doesnt add up to 3 now does it? So, his difficulties will ALWAYS be in combination with the normal behaviors as well. Geez. Give me a break!! Anyway.... after she left, I realized I am totally out of formula for DD. OOPS! Our 2nd therapy of the day starts in a littlewhile. So, I run up to Food Lion and think on this on the way there. I held back my tears as best I could..... geez....why am I so emotional today? On the way home I am harping in my head over and over about 'why is she against me'....which brings to mind Romans 8:31.... 'If God is for us, who can be against us?' So, my harp time, my vent time, my beaten down feeling leads me to prayer. Thank you Jesus for being for me. Thank you Jesus for covering all my sins. Thank you Jesus for the chance to be made whole and perfect in you. That's all that really matters. Again, I am comforted that one day my son will have that same chance to choose Jesus.