OT and Speech Therapy June 24, 2015

This was not the most productive visit by a long shot,  but we got to talk a bit about the two year checkup. You can read about Monday's checkup here.

C. the COTA and M. the Speech Therapist came by and my son came to the door with me to greet them. The last few times he has an been very upset to see them. When I opened the door,  he smiled broadly at C. and grabbed her hand. He was babbling to her and was super happy, until we came into the living room.  As soon as we all sat down, he started crying and clutching at me. I got him some Annie's White Cheddar Bunnies and water as a snack and M. and C. observed him eating.  He picked up his little snack bowl and tipped it into his mouth.  M. stopped him from choking. My son countered by sticking his hand into the bowl and grabbing literally a fistful of bunnies and tried unsuccessfully to mash them all in his mouth.  C. started rationing his bunnies one at a time.

As he ate, I told them about the Pediatrician's concerns about his weight.  They both looked surprised and said he looks propionate and he has a pot belly. M. said both me and my husband are a compact little couple so we probably aren't going to have a large child.  C.  suggested giving my son Ensure as well as increasing the amount of milk he drinks from two cups to four, or more cups per day. M. suggested ranch dressing made with whole milk as a tasty condiment that also gives calories. C. suggested to use condiments and have him learn how to dip food in them so he slows down a bit while eating.  M. said that the same thing happened with her child and she gave them a scoop of ice cream after lunch. She said kids this young don't have cholesterol issues so it isn't that bad to do. I told hem I bought sour cream and I was stirring that into his food, only about a spoonful, and also I add olive oil to most of his food as well.  C. said we can use snack time as a way to connect.  We can work on eye contact, and fine motor skills, as well as language skills.  For example, I can make him ask for more using either sign language, or eventually words. 

I also told them about the Autism screening. M. looked surprised and asked why I think that is a good thing.  I told her if my son has Autism, it would be good to know so then we can start focus helping him instead of just giving general help for a delayed child, and if he doesn't have it, that is good to know too.  C. said that I should not be very surprised if it takes more than one visit to the CNDC to get a diagnosis, or to confirm he doesn't have Autism. 

When I told them about his potential upcoming surgery, M. said to let them know so all services can suspend until he is healed which takes about 2 days.  They both said it is pretty routine, and more than likely it would be laproscopic.

By this time my son was done eating/mashing bunnies into the rug and was drinking his water.  We took a quick time out for me to vacuum and finally, halfway through the visit his actual therapy could begin.

But my son was still not feeling it today.  They used the sensory ball which he usually likes.  Finally they were able to use the Melissa and Doug Peek a Boo Farm puzzle to get his attention.  

We had some actual success today.  My son usually just bounces on his legs but today he held my hands and actually jumped on the floor. He lifted his feet clear off the ground.  They are going to tell T. the Physical Therapist about this.

My son showed C. and M. how his climbing is getting better by climbing up on the couch all the way up so he could look out the window.

I told M. that my son said "hug I love hug" to me and then hugged me Monday night. It melted my heart to hear that.  I told C. how he paralleled played with three little girls that we know over the weekend. The girls range in age from 3 to 7 and they had a stuffed pig. My son watched them play with the pig and the four kids picked dandelions and shared them with each other.  That went so well, we are going to try to make with the parents so the kids can play again.

I think that is all that happened this visit.

Signs of more progress. OT and Speech Therapy 06/10/15

I was not sure how this visit would go today.  My son spent the weekend howling in pain from teething.  He is getting his two year molars right now and he is not enjoying it at all.  He also came down with a pretty nasty cold that resulted in a low grade fever. He never went about 101 which is good, but he was awfully miserable.

C. showed up and had A., a new COTA with her today.  I discussed the Sensation Station with them while we waited for M. the Speech Therapist to arrive.  C. was pretty excited because one of her professors opened the Sensation Station.  We discussed how my son is saying "go car" and how he is climbing now, by using me as a jungle gym.  M. showed up shortly after C. and A. arrived and I told them all how my son was under the weather and that I wanted to at least try to see if we could do the hour session.

My son started crying when C. and A. went in the living room. This was new behavior and it concerned me.  He shied away from C. when she sat on the floor to engage him.  He was also wary of M.  I could see him being shy with A. since he never met her before, but C. and M. he has seen multiple times.

My son has sensory balls, similar to the image below.  M. started the session off by rolling the ball along the bottom of his feet and down his arms.

This calmed him down and M. and C. played with my son using his sensory box. Because he settled right down, M. suggested doing deep pressure massage, or the ball on his feet to settle him down when I need his attention.  I think we will do this when we do ring bearer practice. He normally likes to just empty it, but he is learning what comes next, and he filled it back up.  

Because my son was irritated due to teething and being a little sick, M. and C. let him play at his own pace a little bit today.  

C. told me that there is going to be a sensory play group at the beach this summer.  I am not sure if we will be able to attend, but I think that is an excellent idea.  

Because my son was literally howling in pain over the weekend due to teething pain, I broke down and bought him some teething gel.  C. said many parents don't use it because sometimes kids swallow it and it numbs their throats.  She suggested  in addition to massaging his cheeks, to give him popsicles.  They make mini popsicles that would be perfect for him.  I told her I have been freezing fruit, like mangos as well and he seems to enjoy that.  

M. and I were talking and she mentioned my son paying attention to the world around him more.  I asked if that is what she wants to hear more about. When she answered positively, I told her that we were walking and my son saw a big black ant cross in front of him.  He wasn't sure how to respond, he just stood on the sidewalk with his arms raised wiggling his fingers. His eyes were wide and he wasn't moving.  I told him it is just an ant and I bent down to point at it.  My son also crouched down, eyes wide, staring.  He also reacts more to sirens and especially motorcycles.  Even if he doesn't look straight at them, he raises his arms and wiggles his fingers with his hands moving.  Or he stands still and shakes a little bit.  He really likes the sounds motorcycles make, he tries to find where it is coming from.  Over the weekend, we went to  a friends house.  My son engaged in back and forth play with an 18 month toddler by passing stuffed robots back and forth to him.  The two toddlers went on a little wagon ride around the house and my son maintained eye contact with him, and did back and forth play the whole time.  For my son, this is big.  There were four boys in total ranging in age from 18 months to 12 years old.  My son didn't really play with any of them more than the back and forth play with the baby, but he did watch them. In the past, he would not acknowledge other children.  At one point, the 18 month old and an eight year old were on a trampoline and my son wanted to join them.  He was fine until he realized I was too big for the children's trampoline and could not join him, at which point he started crying.  But he wanted to be near other  children.  Later in the evening, my son wanted something the 18 month old was holding so he walked over to him and grabbed it out of his hands. M. said she likes bad behavior. She said my son was aware that he wanted the object, he was aware someone else had it, and was aware of how to get it. That is three levels of awareness. She was really happy that he is progressing. 

This was a really good session as always.  Looking forward to next week. 

My son, the ring bearer.

My friend L. is getting married in October and I am very happy for her.  Her fiance is a wonderful man and I know they will be happy forever.  L. wants to have a moderately sized wedding, and she wants to have a full wedding party including a ring bearer and a flower girl.

L. is a spiritual aunt to my little guy and he loves her.  We will actually be signing paperwork soon that in the event me and my husband were to pass away, L. would become his guardian.  She has been close to him since he was born.  Before the wedding was announced L. said my son would be her ring bearer.  I got a little nervous because he didn't start walking until last December so I thought for a while he might need a wagon.  Now the wedding date has been announced, L. and I spent a little time hanging out and looked at suits and tuxedos and discussed her wedding colors.  I am so excited my son will get to be a part of her special day.

I am nervous though because of the developmental delays.  He does not respond to verbal instructions.  Also, he lives in his own little world. He might not want to walk down the aisle, but wander around the venue.  He might not want to give up the rings when the time comes.  He also gets bored with objects easily and when he does, he throws them over his shoulder and walks away. All I can see is my son getting distracted, tossing the rings, and me crying and apologizing like crazy on my hands and knees scrambling to find their rings.  L. is going to have him walk with a 10 year old flower girl so she can instruct him down the aisle.  We also will be doing ring bearer practice at home.  I have asked L. if we can have him carry plastic rings so if he throws them it won't matter.  I am very much looking forward to all of this for him, and he is incredibly photogenic so he is going to look great in her wedding photos.  Also L. and her fiance know that my son has some limitations so I know they won't get upset.  I think this is just my overthinking and everything will be fine and go smooth.

Does anyone have any tips for us?

June 4, 2015 PT/EI plus something exciting for my son.

This visit was supposed to be at the park, but me and my son had a rough morning. He discovered his nose and has been enjoying picking it.  When I woke up, his face was covered in caked up blood and he was having trouble breathing, like he was congested.  After I cleaned him up, I discovered he had given himself a nosebleed, and a bad one at that.  By the time we were done sitting together, it was about twenty minutes before the PT visit was going to start and I realized he hadn't eaten breakfast yet. So we had the visit at home.

It was supposed to be just PT with T., but A. the EI service coordinator called and said she had a cancellation and asked if she could come by as well. I told her that it would be fine for her to come by.

When T. and A. showed up, I had some cool news. My son has started saying "go car" a lot. Like all the time. More words are a good thing even if only the speaker understands them.  My son has also started climbing!  He uses me to climb on to the back of the couch to perch up there and look out the window. He worked with T. to climb from the floor to an ottoman to the couch  and then up the back.  I was standing behind T. just being quiet and watching them when my son got very nervous and started looking anxiously behind him.  He has become more aware of his surroundings which is also good development.  When he finally saw me, he calmed down.

He was very apprehensious of A. and T. this week for some reason. He usually hugs A. and smiles at her, this visit he screamed and cried.  He is getting his molars in and he grew about five inches last week, no lie he had a major growth spurt, so we were thinking he was just in pain.

T. said not to keep the ottoman static, but to move it from one side of the couch to the other so my son can practice climbing on both sides, using both legs.

We discussed potty training again, but a little more seriously this time. My son does not like to dirty a diaper he already soiled. He will hold his bladder until you change the diaper.  Also, he has started taking his diaper off more.  We discussed how this could be hard because he is non-verbal.  The hints they gave me was to give him a plastic "bubble" book that can be washed off to look at on the potty and then he will eventually relax and go.  Also, T. said to take a picture of his potty and put it somewhere visible in the living room/his bedroom/the kitchen, just somewhere visible, and when it is time to go on the potty to tap the picture and say "Time to go to the bathroom." Eventually he will make an association and should be able to point to the picture of his potty when he needs to go.

The other thing we discussed was my son joining a play group for non-verbal children aged two to five or four at the Sensation Station. (http://sensationstationus.com/).  The playgroup will do sensory play and use musical instruments.  T. and A. are both pretty excited about this. The playgroup will run for 8 weeks and I think it will greatly benefit my son.  I should be meeting with the director of Sensation Station June 9 , and I will definitely blog about it.  A. filled out a disclosure agreement so she can reach out to the Sensation Station to help chart my son's growth.

That was pretty much it this week, but there has been some progress so like always, I am looking forward to next week's therapy.  It continues to help both me and my son.

Hearing Test 05/18/2015

This was a pediatric hearing test done at the Rhode School For the Deaf.  M. the Speech Therapist suggested we get a hearing test done to rule out hearing problems as a reason for delayed speech.  A. asked if we wanted her to go.  Since she is my son's Early Intervention Service Coordinator, I feel she should come to all our specialist appointments.  Not only is she an advocate should we need one, she is also an impartial third party.  She would definitely ask us how the visit went, but I feel that I would give her opinions, not just facts and she needs facts to add to my son's record.


When we met the Audiologist we gathered in his office.  He asked who we all were and why we were there. He then had me and my husband take our son into a sound proof room and sent A. into the lobby.  My son sat on my lap and the Audiologist gave him a stuffed animal to play with.  With my son distracted, he checked his ears and said they looked fine. Being nervous, I asked how can they look good with all the potatoes growing in there? He said a few potatoes were fine.  He then did a small test to check the anatomy of the inside of my son's ears.  The scan was fine.  He then conducted the same hearing test given at birth to all children born in the state of Rhode Island.  My son passed. The next phase of the hearing test was the Audiologist left the room and went into a room directly in front of us.  I was reminded almost of a sound recording booth. There was a large sheet of glass in front of us.  We could see him, but could not hear him unless he activated a microphone.  He could hear and see us.  In our room there were three speakers. One if front of us, and two to the sides.  There were also three light boxes in the room. One directly in front of us with Mickey Mouse, one on the left with Donald Duck and one on the right with a third Disney character.  My son was still clutching the stuffed animal.  The Audiologist would activate the microphone for the speakers in turn, then flash on and off the light box.  My son was totally unimpressed and ignored everything except for the stuffed animal.  The Audiologist then asked if I could take the toy away. My son took that opportunity to toss the toy on the floor.  The Audiologist proceeded to say my son's name at different volumes through the speakers. For about half a minute, my son was responsive. Then it was all over.

We went into the lobby to join A. and wait while the Audiologist prepared the results.  When we gathered in his office, he asked what my son's developmental age was. A. said her agency does not assess developmental age, but stated my son scored 5 out of a possible 35 on his communication assessment at our annual review. That assessment was based on an average 2 year olds developmental level.  The Audiologist said the results were inconclusive. Because my son's ears are anatomically fine, he doesn't believe there is damage to the ears, but my son was incredibly unresponsive to the stimuli. He said if I want to 100% rule out a hearing deficit, we can sedate my son and then do a brain scan. I am not even a little ok with that.  I think at 2 years of age sedation for an unnecessary procedure is totally not ok.  I know for a fact my son isn't deaf.  When he is deeply napping, when I go to wake him up I rap loudly on his bedroom door. He immediately gets startled. I believe there could be some pitches he might not hear, but  I don't think he is deaf.  The Audiologist suggested we come back in a few months for another hearing test, no sedation.  He then gave us copies of the inconclusive results for the Neurologist, the Speech Therapist and the Pediatrician.

My mom has been reading up on autistic children and autism in general.  Based on several of the behaviors my son displays, I think he may have autism.  This is not a bad thing, but I think if he has it, then in order to help him succeed we need to mold his therapies around his abilities.  My mother is currently reading The Autistic Brain by Temple Grandin.  One of the topics discussed is hearing and autism.  Some people who have autism can only hear vowels, other only consonants.  Other people with autism can only hear certain tones and pitches.  Other people with autism are so into their own mind, or activity, they can't hear you.  I asked A. if she feels my son might be displaying some of the symptoms of autism.  She danced around her answer.  She finally said we can discuss my concerns with the Neurologist or if I can't wait until August to see him, we can call a different one.  I told her I understand she can't diagnose, but based on her experience does she think I might have an autistic child. She was quiet and hesitant and then finally said she has not worked with enough autistic children to give an opinion.

I know my son has sensory processing disorder. Maybe that is all we are looking at. But I want him to succeed and to live the happiest life he can. Although I think we are into labels, if I knew what we are dealing with, I feel I could better help him succeed.

Occupational Therapy 05/14/15

Sadly, this was  another short visit. My son had a low grade fever and was just miserable. I thought he could hold it together long enough for his OT visit, but he only lasted halfway through.

This visit, we saw C. the COTA and D. a student.  My son just loves D. She is very patient and funny.  I hope D. goes on to work with children because she will be outstanding.

This visit focused on functional play and attention.

I got very excited because C. brought  a bag full of toys. Then I got even more excited because she had a parachute that she pulled out. I do not know if kids today have gym class, or if said gym class uses parachutes but back in the 80s you knew gym was about to get awesome if a parachute was on the floor.  C. and D. tried to engage my son in playing with the parachute with hand over hand play.  At first he was very hesitant.  He wanted to walk on the parachute and C. was worried about him slipping and falling. (The last time C. came over he accidently hit his lip on  a toy and bleed a little. She felt incredibly bad about it.)  C. helped my son climb onto the parachute and set him down. She and D. then flounced up the edges making waves. They then both stood up, securing the sides and swung my son gently side to side. He did not like that at all. They picked up some of his stuffed animals and put them on the parachute with him, and made waves again.  Then they took him off the parachute and swung just the stuffed animals. After he saw that nothing happened to his toys, he allowed himself to be swung again.  He was feeling sick so he expressed frustration at this point and C. and D. took a break.

C. asked me if I thought the session had to come to an end. I said that I think OT is very important and I would like to try to continue.  I gave my son some water and pulled him up on my lap to remove him from the activity. I told her about my son's new habit of eating non-food items.    
We have a pussy willow tree outside and he ate a bud off the ground.  It must have tasted as delicious as it looked because he promptly spit it out. We went to visit a friend who has a dog, and my son petted him.  He came back with a large tuft of fur.  The same thing happens when he pets our dog so I thought he would drop it on the ground. Instead he tried to eat it. The fur had to be wrestled out of his mouth.  We went to my mother's house and she has a gravel driveway. My son was walking up and down the driveway, then he sat down to play. Boys play in dirt so this was ok with me. I was talking to my step-father then out of the corner of my eye, I saw my son's hand go up to his mouth.  I went to go investigate and he had all sorts of goodies in his mouth. He had sand, pebbles, bits of twigs, and bits of plants. She said to try to work his mouth the electric toothbrush. She asked if he could have been hungry or thirsty when he did this.  I know when he ate the dog fur he had just drank two cups of water, but for all the events I could not remember how long it had been since he last ate.  She suggested instead of using these events to give him a snack, maybe just add an extra snack into the mix everyday and make sure he is hydrated.

After my son had a good rest, C. and D. played with him with nesting/stacking cups. He tolerated that for about 5 minutes.  He doesn't always like being guided in play and he doesn't like stacking. He likes knocking over stacks.  He started flinging cups over his shoulder which upset me.  That is another thing he started doing recently. He flings toys backward, over his shoulder. He walks around the room doing that. He just paces and picks up toys and flings them over his shoulder. He does it with all toys though, and he has hit me a few times with wooden toys and some of the electronic toys  I am worried he will break.  Once he breaks a toy, it is going to be all over because I am not replacing toys simply because I don't have the money to do so.  I asked C. why he is doing this and she said he gets some stimulus out of it. She also said it is his signature move and she doesn't see any other kids doing it.

C. then pulled out moon sand.  My son was hesitant to touch it, then he gingerly plucked a small amount up with his thumb and forefinger.  He loved it.  They played with it for almost 15 minutes when he then attempted to eat some.  The only problem was, all the moon sand went on my rug and I have a cat and a dog and a toddler so our rugs no matter how much we vacuum are always covered in something.  The moon sand had a melange of animal fur and my fur and crumbs in it.  I felt really bad and that stuff isn't coming out of sand.  I asked C. if she wanted me to buy it off her because of the fur and she said no it was fine. Then I think she thought about it and then she said we could just have it.  Since she gave it to us, we have played with it outside on an old sheet.

The visit came to a very grumpy end after the moon sand was done with.  Hopefully the next session can be full length.

Speech Therapy 5/13/15

My son was very grumpy/upset today.

We got a visit from M the speech therapist and A the EI coordinator. M and A played with puzzles with my son. He got grumpy very quickly and A happened to touch his head. She noticed he was warm, so I took his temperature.  99.5 degrees,  not enough to be worried but enough of a temp to make him miserable.

I had some concerns about my son eating clearly not food items. We have a pussy willow tree outside and he ate a bud off the ground.  It must have tasted as delicious as it looked because he promptly spit it out. We went to visit a friend who has a dog, and my son petted him.  He came back with a large tuft of fur.  The same thing happens when he pets our dog so I thought he would drop it on the ground. Instead he tried to eat it. The fur had to be wrestled out of his mouth.  We went to my mother's house and she has a gravel driveway. My son was walking up and down the driveway, then he sat down to play. Boys play in dirt so this was ok with me. I was talking to my step-father then out of the corner of my eye, I saw my son's hand go up to his mouth.  I went to go investigate and he had all sorts of goodies in his mouth. He had sand, pebbles, bits of twigs, and bits of plants.   Of course I took him in the house and cleaned his mouth out.  The speech therapist said he is looking for input so I should give him something to eat. Something crunchy, or cold, or spicy, or sweet to give him input. I think this a good way to teach him to ask for snacks.  He doesn't get many non-fruit based snacks due a possible tree nut/pine nut allergy so its mostly fruit or fruit and peanut butter or Cheerios for snacks.  He does however eat a very well rounded healthy diet that includes crunchy, and cold, and spicy, and sweet 

My son responded well to the back and forth play and had a higher level of eye contact.  What we need to work on is back and forth play, then withholding a turn until he does something to indicate he wants to continue.

I also was the randomly selected parent of the month to do a survey.  As I have no complaints or problems with any of the services or service providers I think that should be pretty smooth and easy.

The visit was cut short due to my son being sick.

Physical Therapy 05/11/15

This was not a good session. Totally not on the part of T. the Physical Therapist, but because of the two year old boy who decided to throw tantrums and push his limits/show off in front of a stranger.

He decided he would toss wooden blocks as hard as he could all over the apartment.  T told him that is not good for a big boy to do amd made him put the blocks away. He did not like having to follow directions. The good thing was they played a bit and he stirred the blocks with a spoon for gross motor work.

I feel it has been a while since we had PT. There have actually been several updates we had for her, including that he now goes up and down stairs either with use of the railing or by holding hands.

The next thing for us to work on at home is climbing.  I am nervous about this, but he need to learn how to do it.  I am to assist him climb as necessary. 

Our next visit will be at a playground,  which I am looking forward to.

My son's EI annual review and OT 05/06/2015

Hard to believe my son turned two on 4/19/15.  It honestly feels like yesterday I held my sweet boy in my arms for the first time.  I love my son more than I love anyone else and I am so glad he came into my life

Even harder to believe, it is time for our last annual review with EI.

This visit we had A. the EI coordinator, C. the COTA, and D. a student.

The annual review is a long, long visit. Lots of questions are asked. Lots and lots and lots.  Also a lot of paperwork. Basically you have to revisit the objectives made at the last review, decide if they worked, decide if you need new goals.  The last review, my son was not walking, using a sippy cup, or eating on his own. Thankfully, all of that has changed. Our new goals are to have him talking, at least one word where he can identify an object/idea and use it appropriately. I made the goal, maybe I am aiming too low, but I want him to succeed because that is my primary goal, not to fail.

While I was talking to A. about goals, my son was playing with C. and D.  They did functional play, but honestly I missed about 98% because there were a ton of questions regarding my son's development. Not surprising, he got 5 out of 35 for communication. At least I was not surprised by the results but to see your child get scored can be very discouraging.

I did get educated about RIPIN (http://www.ripin.org/) and will get to meet with M. a parental consultant.

One thing I did get to discuss with C. was the fact that I bought the electric toothbrush she wanted me to buy. I have anxiety and I always worry I am going to mess things up, even simple things.  I went to Walmart and bought the cheapest generic toothbrush I could find, because I was told the brand doesn't matter. As a toothbrush, I think this is an excellent toothbrush. As a mouth stimulant so my son can get sensory input, not so much. It is loud. Like really loud. I think the sound scares him. The first time I used it, I ran it over my cheeks and hands, then my husband's, then my son's. He flipped out. We use it sometimes on his cheeks and hands, but he doesn't like it for long. C. suggested to use it on his stuffed animals to show nothing bad will happen. I tried it with his stuffed Woodstock.......he was a little more receptive to using it on his cheeks, but not lips yet.

Suggestions for things to work on, using the toothbrush as a redirect from mouthing toys and fingers, and offering support in play.

4/30/15 OT/Speech Therapy/EI visit

     Wow full house today.  We don't always combine this many therapies, it just worked out.

     M. the Speech Therapist was scheduled to come at 10:30. C. the COTA was scheduled for 11:00.  My son has a lot of electronic toys and he would rather play with them than interact with the various people who come to see him and I am really frustrated by it.  He only has a year left with these services and I want to take advantage of them. I moved all his electronic toys from the living room to the hallway that connects the kitchen to his bedroom.  Ten thirty came and went which was making me nervous because M. was supposed to be coming.  Ten forty sill no M. so I checked my calendar because maybe I was wrong. Shortly after 10:40 M. knocked on the door. She said she saw C. outside  and was going to come upstairs with her, but after 10 plus minutes realized C. was just early.

     I told M. I hid all the electronic toys and she was really happy I did that. She said she would take the batteries out of her kid's electronic toys and then they were just toys.  My son would at first not engage with her and instead held on to the front of the couch and danced.  I asked him if he could dance with M.  M. picked up a puzzle and the two worked on that for a little bit. My son mostly wanted to walk around so M. kept distracting him.  Since he wanted to play on the couch, she picked up a ball and put it on the couch and rolled it to him.

     I did get to tell M. about "gotta go".  (http://momlovesscifi.blogspot.com/2015/04/my-son-just-made-more-progress.html) She was duly impressed.

     At 11:00 C. the COTA and D. a student arrived.  Sometimes EI/PT/OT/ST will bring a student. They always ask prior to the visit if it is ok.  I am pretty laid back and have never had a problem with students coming.  I do have a tiny apartment (about 400 sq. ft.) so we were kinda becoming a little tight in my extremely tiny living room.

     What I like about having multiple services is that they can double up.  It makes my life easier.  Although for someone with social anxiety is can be overwhelming sometimes, they are not here to see me so it makes it easier in that respect.

     When C. arrived we discussed how my son is doing with baths.  She had suggested in the past that he gets placed in the tub first, then draw the water with him in the tub.  I was sceptical at first, but it worked.  He was fine until his hair was washed, then he got upset.  C. asked if he ever got laid down in the tub to rinse off and no he hasn't only because the tub is so traumatic that baths are kept as short as possible.  She said laying him in the water will rinse out his hair and some kids have an easier time with it. 

     M. and C. played with my son with his sensory box and they played with puzzles.  M. noted when given two puzzle pieces my son chooses quickly and doesn't hesitate like most kids.   When my son got frustrated and was done, they made him use sign language to signal he was done.  He played with D. with his toy where you push the beads along on wires.  M. noticed he would rock from foot to foot and asked if he does it with shoes on.  I really couldn't remember because we primarily wear shoes outside.  I put his shoes on and he continued doing the same thing.  M. played with sensory balls, the kind with rubber spokes all over them, by rolling them on my son's head, neck, and back. He loved it. Since bath time is so awful, I asked if it would be ok to bring the ball in the tub and massage him with it in the water.  They said sure.  M. even suggested textured bath mats.  M. and C. then engaged my son by having him play ball with them.  M. said to create opportunities for engaging him like this.

     At 11:15 there was a knock at the door.  It was A. the EI coordinator.  She was late because she had an appointment in another town.

     My son was mouthing a lot of toys and C. asked how brushing his teeth is going.  It is going well, except now he likes to bite the bristles of his tooth brush.  She suggested getting an electronic toothbrush and just rubbing the outside of his checks to give him the oral stimulus he needs.  She asked if he has a straw cup or a water bottle because that does the same thing.  He does have a water bottle with a straw but I don't know how to teach him to suck. She told me to put water in it, then drip a few drops on his mouth by holding the bottle upside down. He should open his mouth for the straw and once the straw is in his mouth,  run my fingers along his check to facilitate sucking. We are definitely trying this.

     M. commented this was an incredibly successful visit and credited my hiding the electronic toys.

     I am glad of our progress and looking forward to our next therapy/EI visit.

My son just made more progress!

As I have posted,  my son is in Speech Therapy.  He used to have about 10 or 12 words until last August when he lost them all after an ear infection.

Well, lately he has been taking to saying "gotta go". He says this when he is tired of whatever is going on. Saturday night I hung out with some friends and I guess we were boring because he would say "gotta go" and then leave the room.

I am so happy.  He is saying a phrase with actual meaning, he knows what it means,  and he knows the appropriate action to go with it.  It is only one phrase, but this is pretty much the only thing he is saying.  Well he says "dog", but it doesn't always mean dog.

My son turned 2 on 4/19. This is such a huge leap forward.

First Speech Therapy visit 04/15/15

     What a week for us! Monday was the first OT visit, and today was the first Speech Therapy visit.

     If you want to know why we added speech therapy some reasons are here  http://momlovesscifi.blogspot.com/2015/03/why-speech-therapy.html.

     A. who is the EI coordinator came with M. the Speech Therapist today.  My son just loves A. so much. He gave her a big hug again as his custom. We never met M. before so he was a little shy with her.

     Since this was the first visit M. told us what we would be doing today. She did not do a formal evaluation as my son is too young to really be able to evaluate. Also, given that he has been receiving services for a year now, she can base where he is based on the assessment of her coworkers.  In addition, the neurologist recommended her services.   She said she will do one later, unless I am really looking for her to asses him, but based on the background that she is aware of, we qualify for services so it is not really needed.  I told her I agree and we can do the official evaluation when she feels it is appropriate.  M. asked me what my primary goal is and I would like my son to identify at least one object. We are not shooting for the stars here, I like to set reasonable goals.  I would really just like to say, "Get the ball." for example and have him get it. Or at least look at it.  M. asked if he has had a hearing test and other than the one given at birth, no he hasn't.  She said she likes all her parents to get their children's hearing tested and gave me some numbers to do that.  A. did say that my son had a nasty ear infection last year and before that he had about 10-12 words he said. After the ear infection, he lost all his words. Actually, after the ear infection it was a source of major concern because my son lost all his skills. He wasn't walking yet, but he stopped crawling, he stopped being interested in a sippy cup, he had a major regression.  He had the flu earlier this year, and after he recovered, he didn't want to walk, he didn't want the sippy cup, and his language regressed even further.  M. suggested the hearing test will see if maybe he has fluid in his middle ear. She thinks he can hear fine, but if he has fluid in his ears, he may need tubes put in. Basically the fluid can alter how children hear sounds which affects language development.  She also wondered out loud (this is not her area) if fluid in the middle ear can be affecting his balance, if there is any, and that is why he doesn't want to walk after a sickness.

      A. read and played with my son while M. observed and asked questions. M. asked what toys my son likes to play with.  Basically he likes all the electronic toys, and all the other toys we have discussed here on this blog already. She also asked if he likes books. I told her he adores books. She said that is great.  She also asked how he interacts with other children. I told her that he doesn't even when he is around them.  She asked if there are any food textures he avoids and I told her not at all. He eats everything.

     I did ask her about television watching.  We only watch maybe two hours of children's television per day divided between Sesame Street, Daniel Tiger and Dinosaur Train.  The television doesn't hold his attention long and with all our appointments I try to get his play time in as more of a priority.  Also, now that the weather is nicer we go for walks in the mornings.  I basically wanted to know if television viewing is detrimental to a child with language delays and/or how to make less detrimental and what should we avoid.   She did answer my question, but first gave the disclaimer of not to add to his viewing habits based on what she said.  She also said that studies show children who learn from a traditional teacher and teacher on an electronic medium, like an I-Pad, the traditional teacher model is still more effective. I think that is interesting since so many schools want to veer away from traditional teaching.  Then she said shows like Sesame Street or Dora The Explorer actually use good language models since there is so much repetition and that is how we learn language.  She said to avoid shows like Curious George that the main character uses sounds not words.  She said except Curious George, most PBS shows are not detrimental to children with language delays.  Again, I am not using the TV as a babysitter, nor as the primary way for him to learn speech, I just use it for a little entertainment in the mornings when I am still waking up a bit.  She said music is a great way to learn language and some of her parents have enrolled their children in music classes. She also hinted that music classes would also be a way for my son to interact with other children.

    Speech therapy will occur three times a month.  Most of the visits will overlap with other services.
    For us to work on for next time, when reading, I am to point out some picture on each page and point to it and repeat what it is.  The hope is in time, he will point to that item when I say "Where is the x?".  Also, we are going to work on naming physical objects, like a ball or a cup.  So I will hold two objects, and name them, then ask him, "Where is the x?".

   I think this service is also going to help us greatly.

   

First Occupational Therapy Visit 04/13/15

     Mom fail, I completely forgot OT was coming yesterday. We went for a nice long walk, ate a late lunch and then my friend called. I was putting him down for a nap and chatting with my friend when someone knocked on the door. It was A. the Early Intervention coordinator. I was kinda surprised and let her in and then she said C. the COTA was on her way and should be here shortly.

    While A. and I were waiting for C., we discussed my son's weekend. Friday we went to the park with a friend and her daughter who is roughly six month older than my son.  He engaged in some parallel play but was far more interested in the wood chips on the ground than the little girl.  We did try the slide, but he wanted to lay down, not sit so I went down with him. He was laughing his head off.  We tried the swings but it got bad fast so we stopped that.  Saturday he went to the park with my husband while I scanned 173 old photos for a family tree project. He just wanted to walk around mostly.  Sunday, we went to the park as a family. He loved the slide, but the swing he is now deathly afraid of.


    When C. arrived, we discussed my son's history with A.  My son walked around, picking up a toy, looked at it, tossed it, repeatedly.  We have the Fisher Price Stride to Ride Puppy and my son played with that and one of those wooden activity cubes.  He also played with this A's help.
     (image from ebay)

A. read him The Very Hungry Caterpillar about four times.  My son loves turning pages and after each reading he would just sit and turn the pages.

    C. and I discussed my son's sleeping habits.  C. suggested giving him milk before bed as opposed to at supper which I meant to try last night, but fell asleep my self and messed up his night time routine. (I have been not feeling well at all for the last two weeks.)  C. also suggested writing down my son's schedule and scheduling in two snacks a day.

    We also discussed the sensory issues my son has. I discussed the terror inducing swing experience of this weekend. C. suggested taking my son to the park and having him help me push and empty swing to get used to how it works.  She also said taking a toy and putting it in the swing and showing him nothing bad happened to it.  She also suggested us sitting together on a regular swing and slowly working up to swinging together.  We also discussed bath time. My son shrieks in terror while having a bath. I am not using hyperbole. It is not the whiny cry kids use when they don't like something, it is full on blood curling shrieking and howling.  He clutches at you when you try to bath him and he tries to angle every part of his body out of the water.  She asked what temperature bath he gets and if we adjust it. We have tried everything from freezing to lukewarm baths.   She asked if we adjust the depth of the water. We have tried from a tiny puddle up to enough to float boats around the tub in an effort to make him play in the bath. It didn't work. She suggested not filling the tub prior putting him the water. She said put him in an empty tub and then put the faucet on. She also suggested showering with him, or turning the shower on when he is taking a bath. I will try all her suggestions and write about how things go.

   We also discussed me playing hand over hand with him, which I already do.  We discussed our weekend with his cousins and she suggested I play with the kids to try to engage my son. I told her I did that. I got on the floor and played with the toys with the kids to show my son how much fun it was, but he walked away.  I told her we do hand over hand play with all his toys but when he is done playing with something, he is done.  I showed her a sensory box we have:

She likes this because everything has a different texture. She suggested mixing up what is in it. Adding tissues and scarves for example.  I am going to do this several times a week. I will add/subtract items.  On her way out she saw this puzzle in a stack of toys I want to get rid of

She said this is a good sensory puzzle.  Instead of getting rid of it, we will keep it now.


   All in all this was a great visit,  I think working with C. is going to help us a lot.

PT/Early Intervention Co Visit 4/6/15

     Because of the sheer number of therapies my son is in, it is easier to have the visiys combined so we do not have 10 individual hour long visits a month.  I like the people that are working with us, but it is daunting sometimes.

     T. is the Physical Therapist and A. is the E.I. coordinator.  I told them both about the visit with the cousins we had and how I was concerned. (http://momlovesscifi.blogspot.com/2015/03/thoughts-on-this-weekends-trip.html)T. said that I should discuss my concerns with the Pediatrician and if needed, her and A. could recommend some specialists,  but to take my time and think about maybe if it was an anxiety thing and not necessarily a developmental issue.

     My son has a bit of a cold so it was even harder to engage him than usual.   We have been working on the "W" sitting and got to show T. our progress.

     Because my son is starting Speech Therapy on the 15th, we discussed M. the Speech Therapist. She works closely with T. so they will make several co-visits.

     A.  gave me the phone number of the pedatric optomitrist H. recommended on the OT evaluation.

     The next time we see T. will be at the park because the weather is nicer. Hopefully it doesn't rain.

     It was a kind of off visit only because my son was sick and tired and grumpy,  poor little man.  Hopefully Speech Therapy on the 15th will be more productive.  I am very excited about starting speech.

Thoughts on this weekend's trip.

Hi everyone! Oh wow does it feel great to be home! How was everyone's weekend?

I wanted to share how our little weekend adventure went.

My step-father has two girls, L and J from a previous marriage. They live out of state and L has three children; a newborn boy, J.H. a girl who is 14 days older than my son and D a boy who is 8. J has three children as well; C a girl who is 18, M a girl who is 8, and J.M a boy who is 3.  L and her husband just had a baby and I wanted to go to to meet him and bring my son whom no one in their branch of the family has met yet.

My parents showed up with their RV around 9 am on Saturday. I let my little man sleep until they texted that they were on their way. When my parents arrived it was snowing so we quickly loaded up and went to our first stop; breakfast.  My son and I shared an omelet and homefries. When the food first got there he was so excited he tried to grab a fistfull of potatoes. Being the learn by example mother that I am, I let him do it. They were too hot and he started crying. This did teach him that maybe we needed to wait a bit and it will be ok.  I gave him a hearty portion and he decided all the food on the table was his. He reached far in his highchair and grabbed my stepfather's toast. We need to work on being grabby.

When breakfast was done, we got back in the RV. It is a five hour road trip to where we were headed so I was prepared for crabbiness, but he was really good. He slept most of the way up. I did bring a few books and one toy for him for the trip. He greatly enjoyed his books.

When we got to L's house she was holding the newborn. After I said my greetings, I attempted to point out the baby to my son. He glanced at the baby, my mom started saying something cute, then he ran past everyone into the living room. All the children, except C who was at work were in the living room, so I thought he would play with one of them. All the kids but D, who was having a bad day, tried to talk to my son. He ignored all of them.

J.H who is 14 days older than my son played like a toddler. She engaged in parallel play with her cousins, climbed on footstools and furniture, talked in actual words not all baby babble. She listened and responded to her parents and the other children. She played with toys like they are toys. She used toys for their intended purpose.

Inside, I was frustrated. Not with my son, but with myself. Obviously I am the worst parent ever. I know my son has limitations, but they are never as apparent as they are when around other kids. Instead of engaging with the children, my son busied himself with taking magnetic letters off the fridge and tossing them to the ground. Except for J, L and either M or W. Those letters he took turns walking around and babbling to. My son wore a path from the newborn's room, through the kitchen, around the living room, then back again.  What am I doing so horribly wrong that he won't even acknowledge the other children? He walks around our tiny apartment clutching things and babbling to them. I took him on this roadtrip to see his cousins. After all, aren't cousins our first friends? I kept trying to redirect him to play with the kids. I sat him on the couch next to J.H who was watching Dora and playing on a tablet. He sat there very confused. I pushed him in the path of the friendly J.M and he walked past him. M asked me if he could talk. I said he has his own way of talking but he likes to sing and dance. I showed M  his way of dancing and he liked it. M was his favorite of the kids. He "hugged" her a few times. His way of hugging is to touch you on the leg and gently press his forehead into you. I felt horrible because since he was ignoring the younger kids, they ignored him. They tried to engage him, but he blew them off. I really would have felt better if they were mean to him, or teased him, or excluded him. They really tried to play with him. How I have failed him. I don't ever view his behavior as his behavior, I view it as me being a terrible mom. Obviously other kids his age who don't live with me are fine. He would not have delays if he had a better mother. Maybe it is those four days I missed my prenatal vitamins. Maybe its that 3 ounces of beer I had when pregnant. Maybe it is because I ate too many carbs, got gestational diabetes. It was the high blood sugar coursing through his veins in utero.  I made him this way. Yes, these are irrational thoughts. I know that on one level, but on another level, this is what my brain tells me at night when I am alone with my thoughts.

When J.H. was climbing on the footstool, and jumping off, my mother made a comment that my son would imitate her. I was so hopeful that he would. He doesn't climb yet, another area his is behind in.  He ignored her. The only attention he paid her was at some point, they had a baby babble conversation, a few lines back and forth. They also took turns following each other a little bit. Watching him with her though, it was not like watching two kids that were two weeks apart, it was like watching a 2 year old with a 9 month old. Her skills are where they should be.

My son did engage a little with L. She sat on the floor and read to the kids. She has medium/long hair and my son stroked it gently. He walked all around her several times caressing her hair.

I hope we can keep working on his skillset to help bring him to where he should be. This is too hard for me to handle sometimes. At least he is happy. He had a blast walking around by himself with the letters. His contentment is the most important thing.

I feel that he might have autism.  My mother has been reading books by Temple Godin and pacing is a way for autistic children to calm themselves down, to center themselves.  He also has low muscle town, which is a characteristic of autistic children.

I love my little guy more than I can ever put into words. He is my whole world.  I know he has some shortcomings, but to me that is his charm. When he looks at me and smiles, he is the most perfect little guy who ever lived. I just hope one day he chooses to let more people into his world of one.

I will continue to post about our journey.

EUREKA!!!

Today for lunch, I made my son a simple meal. It was just spinach, tomato, and chicken nuggets. I put him down so he could hand feed himself the majority of the meal. When he was down to just little pieces, I got a spoon. As is our routine, I gave him the spoon to see what he would do with it.

HE PUT IT IN THE BOWL, GOT FOOD ON IT AND FED HIMSELF WITH THE SPOON!!!

This is a huge breakthrough. I am overjoyed with this progress. It was hit or miss, sometimes he didn't get food on the spoon, sometimes the food was too far back in the spoon for him to get it in his mouth, but practice makes perfect. He is 23 months and this is the first time he did this.

We have been doing hand over hand with utensils for about a year now. I can't wait to tell EI and OT what he did today!

In Praise of Melissa & Doug

We have a collection of Melissa & Doug toys as you can see from above. We also have this:



But when my son realized that the point was to pound the pegs through the hole, he went to level two by removing all the pegs, tossing them under the loveseat, and hammering the floor. We had bought the peg pounder on the recommendation of the pediatrician to hone his fine motor skills.

I have previously written about this puzzle, also not pictured:

I love Melissa & Doug toys. They can be pricey. I did not pay full price for any of our toys. Most were hand me down, and I bought some on sale. The rest came from Bluum boxes (http://bluum.me/16QJhAC).

I love them mostly because they are durable. They are made from wood and whatever paint is being used has lasted for years on the hand-me-down puzzles and almost two years on the turtle, giraffe, and penguin. The colors are very vivid and enticing. My son is not gentle on his toys. They get tossed everywhere and they lasted. The puzzles were gifts from his daycare so they have seen many years of rough play.

The other reason I like them is, they help with motor skills. So many toys now are electronic it is disheartening. All you have to do is push a button and the toy plays with itself. We even have an electronic toy that all you do is turn it on and it never shuts off and it  plays without being touched.  Having a child who needed help with motor skills it was hard to look for toys. The giraffe in particular is one of my favorite toys. It is easy to manipulate and you can move it into several different poses. My son has some problems with the lock puzzle, but it is helping him to move his hands correctly. Children like looking under things which make the lock puzzle, and the farm puzzle particularly fun.

The toys are pricey, so if you want to purchase them, I suggest sales and yard sales. Benny's often has the toys on sale and from time to time so does Toys R Us. They are worth the price and they will withstand anything your child puts them through.

Occupational Therapy Evaluation 04/24/15

H. came from the same company that provides early intervention services for our son.

He was very excited to meet H. He was all smiles when she came over. The first thing he did after hugging her was to try to open her bags and he managed to rip a Post-It from deep within her bag and throw it on the rug. Being quite pleased with himself, he began diving deeper into H's bags. I told him he can't be doing that but she laughed and said its fine.

H. then handed me a questionnaire that was several pages long. The first section was demographic information about my son. The question that stuck out the most was about getting upset when their nails are cut. Every single time that is an issue.

While I was doing the questionnaire, H. attempted the test for my son. Parts of the test involved making a block tower. My son picked up one of the blocks and tried to eat it. Then he walked around the living room ignoring H. while giggling and trying to lick the block. There was also a puzzle of three simple shapes: a star, a square, a circle. He wanted to play with the pieces. She tried to direct him to put the shapes in the right place, but he got extremely agitated and started to cry because he wanted to play with the shapes. She then handed him a book and told him to turn the pages. He grabbed the book, sat with his back to her and started turning pages and looking at the book. She asked me if he likes to color. I told her that I can no longer give him round crayons because he likes to shove them up his nose but I will demonstrate what happens when he is given triangular shaped crayons. I set him up with some paper and his crayons. I already knew what would happen, but I wanted her to see this. My son took all the crayons out individually, held them up, and stared at them while rotating them and babbling to himself. I asked him to make me a picture and showed him how to make a squiggle. He dove into the pile of crayons again and started sorting them. H. said maybe we should only give him one. Then she and I made lines and squiggles and I attempted to help my son make a squiggle doing hand over hand. He was upset and just wanted to sort the crayons.  She told me that she could no longer do the evaluation because my son does not take direction or respond to verbal direction. I have known this for a while. She also said developmentally, he should be in the cause/effect and problem solving stage, but he is still in the exploratory stage. He does not understand that objects have an intended purpose or what they are. It is true. I can't argue or disprove that. 

We discussed my son's sleeping patterns. I know this is an issue. Right now he is "napping" which to him means laughing and bouncing on his back in the crib. I put him to bed every night at 8 pm. He then bounces on his back, or jumps up and down while laughing/babbling or lays in bed and babble/laughs. Sometimes he sings. He stays up until midnight-2 am. Due to the incredibly tiny apartment we live in, this means I am up till midnight-2 am.  Some mornings he is up between 6 and 8. If he doesn't get up on his own, I make him get up around 9/9:30 in the hopes he will sleep that night. He uses nap time as free play. There is nothing in his crib except a mattress and a crib sheet. He has a sound machine to help soothe. I believe in the cry it out method unless he is sick/screaming. He doesn't want to be in bed so crying is frequent and I make him work it out. She said that the set up I have and my not running in his room for every little whine is what she wants to hear.

My son sucks the index and middle fingers of his left hand.  She will order him an OT tool called a chew tube.

We discussed my son's eating habits next. I told H. that my son has a hearty appetite, but he eats with his hands. She asked if he uses spoons and I said although I put a utensil out with every meal he does not eat with it. It was discussed that I try to make him use utensils by doing hand over hand with him, but that he is not interested in doing it himself. 

According to her report, he has difficulty social referencing, limited joint attention, and inconsistent response to hearing his own name. Again, this is true. He lives in his own little world and doesn't like visiting ours. My son also rocks side to side and back and forth.

In addition to ot 3x a month, it was also recommended that my son get an eye exam and an optometrist was recommended

H. was very friendly and professional. Her assessment was dead on. .In two weeks I will hear from a COTA to start services.  I think we need this.

Early Intervention 03/17/15

Today A. the Early Intervention coordinator came. My son just loves her. We went to the door to meet her and he was all smiles.

My son was very vocal today. He sang to her and babbles up a storm. They read the same Bob the Builder book that T. read to him. They talked and throughout the visit A.and I discussed his development.

I told her that he identified a cat for T. yesterday and she was extremely happy. She said that she put in a request for the Speech Therapist to come out but they normally don't until the child is two. He will be two on 4/19 so she thinks later next month or in the summer speech therapy will begin. The Occupational Therapist is coming on April 7th for the o.t. eval and I will definitely be writing about that.

My son actually said a few distinct words to A. He said "Daisy" and "thank you" to A. The Daisy disturbs me a little because I had a miscarriage in January and had the baby been a girl, her name would have been Margarita which is Daisy in english. I nicknamed the baby Daisy but haven't mentioned Daisy as a word since January. He said "thank you" to A. after she handed him a puzzle piece.

We also discussed that soon, around 27 months, we will meet with the school department to discuss my son's needs as e.i ends when he is 3. I cannot believe that we are already discussing school at this point.

It was a good visit.  E.I is not as focused as P.T, its a more general discussion of how my son is growing. We have a good program and I really like the people that come out and work with us.

Physical Therapy 3/16/15 as well as another positive development.

The last time T. the Physical Therapist was here, she gave me some things to work on.
     1. My son "W-sits". He has low muscle tone so he sits like this : 

     (This is not my son. This is just a Google image)
I was told to correct this.

     2. My son doesn't like to feed himself. This is another developmental issue we are working on. I don't mean feeding himself with utensils, I mean he doesn't like feeding himself with his hands. I am to encourage self-feeding.

     3. My son has low muscle tone so I was to think of ways to encourage him to use his muscles by making him move in unexpected ways. The example she used was having him sit on pillows and then he would have to use his leg muscles to balance.


When T. came today we had lots to talk about. Since her last visit, we visited friends who have a sunken living room. My son learned that by putting his hands on the step in front of him, he could climb up the stairs. This used problem solving and helped used muscles.  He has been eating the majority of his lunches by himself. Today I made him chicken nuggets, celery bites, avocado and tomato slices for lunch. He usually picks out the chicken and makes me feed him the veggies, but today he ate it all by himself. To work on balance and muscle tone, last week I took him outside and held his hands and had him walk over our slushy, icy backyard. She had only positive feedback and agreed it is hard to think of a lot of outside winter activities for a toddler for pt purposes but soon we will be going to playgrounds for pt.

T. then played with my son. I got him this Melissa & Doug puzzle at a yardsale:

This puzzle is great for him because it develops fine motor skills and language.  They played with the puzzle and then she pointed to the cat and asked him what it was. His response? "meeo". Like "meow". This is the first time ever my son made an association. We both stared at him, then I started clapping. Then he kind of looked at T. and said it again like she should totally know that its a cat.

Then T. and my son read a Bob the Builder counting book. She is really pleased with his progress.

We discussed how we only have a year left of early intervention and then she planned a visit for April. I will share how that visit goes as well.