Raquel had a really off day yesterday with Jennifer. She was overly tired and just not into it at all. She wasn't very vocal, either. I don't know if she's just getting bored with the same stuff or what, but it was very frustrating to watch her not do things I am constantly seeing her do.
Today Karin overlapped with Janine & Jennifer's ABA session. I thought for sure that Raquel would be aggitated by her being here and throwing off her routine, but that wasn't the case. Instead, she was incredibly calm - and happy. I think she enjoyed having so much attention! Karin showed them how to do some of the core strengthening exercises on the fitness ball so they can start incorporating this into their sessions.
At one point, when Raquel was doing one of her sitting programs, Janine brought out some new spinning tops that made noise and had bright flashing lights. Karin noticed how that was way too over-stimulating for Raquel. She immediately started stemming a bit and then began throwing things. Once they took them away, she was able to calm back down. Karin wants me to be aware of toys Raquel has that may be, unknowingly, aggitating her. She also commented on how solid Raquel is getting and that she seems taller than she was a week ago. I think so, too. I've definitely seen a growth spurt.
Everyone was very pleased with how Raquel did today. Karin said it was like dealing with a completely different child. I don't think I've ever seen her so calm and content during a session!
Wednesday, August 27, 2008
Monday, August 25, 2008
Not A Typical Speech Session
I wasn't able to observe the ABA session this morning due to meetings at work but was told that it went well. The data sheets say that she had some behaviors and wasn't very vocal. We'll see how she does with Jennifer tomorrow.
Speech was another story. Last week, since Raquel was beyond fascinated with Mary's three bags of toys, Mary told Raquel she wouldn't bring them this week. And she didn't. Let's just say that it didn't go over too well with Raquel. It was quite obvious that she knew something was very different today.
Although she was happy and calm throughout the session, she was definitely holding a grudge. She spent 90% of the time with her back turned to Mary. She wouldn't give her eye contact and pretty much just basically ignored her. Even when Mary and I would engage in really animated play to entice her, she'd look the other way. It was really funny. I asked Mary when she left if she was going to bring her bags again next time and she said, "No way." I guess my stubborn girl is going to learn that things aren't always on her terms one way or another.
Kind of like the waving. She refuses to wave hi or bye to any of her ABA therapists. But she clearly knows how to do it...
Speech was another story. Last week, since Raquel was beyond fascinated with Mary's three bags of toys, Mary told Raquel she wouldn't bring them this week. And she didn't. Let's just say that it didn't go over too well with Raquel. It was quite obvious that she knew something was very different today.
Although she was happy and calm throughout the session, she was definitely holding a grudge. She spent 90% of the time with her back turned to Mary. She wouldn't give her eye contact and pretty much just basically ignored her. Even when Mary and I would engage in really animated play to entice her, she'd look the other way. It was really funny. I asked Mary when she left if she was going to bring her bags again next time and she said, "No way." I guess my stubborn girl is going to learn that things aren't always on her terms one way or another.
Kind of like the waving. She refuses to wave hi or bye to any of her ABA therapists. But she clearly knows how to do it...
Friday, August 22, 2008
Another Great Session
Raquel had a great session yesterday with Cari. I was hesistant when she arrived, and even told her I didn't know what to make of it because she was extremely tired from not napping. She was a bit whiny at first but was very cooperative throughout the entire session. She wasn't talking much at all, but she was laughing and laughing throughout it. And she did really well. They changed a few things after the meeting Wednesday night, and yesterday it showed that the adjustments were made in a very positive direction.
She had another great session with her today. Again, not talking a whole lot, but very cooperative for the most part - especially considering it was her second day in a row without napping. It was nice to end the week on such a positive note.
Another great milestone happened today. One of the things Raquel's former physical therapist was working on with her was building confidence in walking on unfamiliar surfaces and at unfamiliar places. Today, she did great at the mall! Mike said it took her a little while to get used to it, but once she did, she was walking all over the place and playing with the other kids. Go Raquel!!
Here she is cruising down the family lounge.
And playing with big sister with some of their toys.
Playing in the "rubber room".
She had another great session with her today. Again, not talking a whole lot, but very cooperative for the most part - especially considering it was her second day in a row without napping. It was nice to end the week on such a positive note.
Another great milestone happened today. One of the things Raquel's former physical therapist was working on with her was building confidence in walking on unfamiliar surfaces and at unfamiliar places. Today, she did great at the mall! Mike said it took her a little while to get used to it, but once she did, she was walking all over the place and playing with the other kids. Go Raquel!!
Here she is cruising down the family lounge.
And playing with big sister with some of their toys.
Playing in the "rubber room".
Watching Gabby try on some really cool hats.
And here she is - ready for the nap that never happened.
Another therapy week comes to a close. Looking forward to the weekend and a couple days off. I'm so proud of my little girl and all of her accomplishments!
Wednesday, August 20, 2008
Second Team Meeting
Raquel had an interesting OT session today. Karin came with little one pound ankle weights and was having Raquel walk around with them. She did okay - made her a little wobbly until she kinda got used to them, but they were still a little big on her. She then put them on her arms, and that didn't work either because they kept slipping off. Gabby's smallest backpack is still too big, so Karin asked if she had a fanny pack. Gabby fetched hers and Karin put the weights inside and kept adjusting it until it was tight enough and she was able to walk. Karin was able to see a change in her walking by adding that additional weight. Now I need to fill a sock with some rice (so if she falls when she's wearing it, it won't hurt her), and start having her wear it off an on throughout the day. It is supposed to help with her balance and coordination as well as give her the sensory input she is seeking.
Because this was so different than her usual routine with Karin, Raquel became very aggitated when Karin was not playing with her and we had to play the song a few times. This is rare for her OT sessions, but it did calm her and they were able to get work done. Karin also mentioned that Raquel is noticibly stronger, which is a really good thing. She's getting more and more solid each day.
Raquel had a great session with Jennifer and Janine this afternoon. Janine was amazed at how much she was talking and how cooperative she was being. After the session, we had another team meeting. They put some programs on hold - the ones that she was doing consistently and then stopped because she is bored with them - and changed a couple as well to keep her more engaged. They are all still very pleased with her progress. They even removed the manding program because Raquel no longer screams and cries to get my attention. She is consistently tapping me on the leg and arm. My only assignment in this regard is to make sure she is doing it with Mike and Gabby as well. Next week, Karin will be overlapping on Wednesday's ABA session.
Because this was so different than her usual routine with Karin, Raquel became very aggitated when Karin was not playing with her and we had to play the song a few times. This is rare for her OT sessions, but it did calm her and they were able to get work done. Karin also mentioned that Raquel is noticibly stronger, which is a really good thing. She's getting more and more solid each day.
Raquel had a great session with Jennifer and Janine this afternoon. Janine was amazed at how much she was talking and how cooperative she was being. After the session, we had another team meeting. They put some programs on hold - the ones that she was doing consistently and then stopped because she is bored with them - and changed a couple as well to keep her more engaged. They are all still very pleased with her progress. They even removed the manding program because Raquel no longer screams and cries to get my attention. She is consistently tapping me on the leg and arm. My only assignment in this regard is to make sure she is doing it with Mike and Gabby as well. Next week, Karin will be overlapping on Wednesday's ABA session.
Tuesday, August 19, 2008
Just A Weird Day
Mary came this morning at 8:30am since she couldn't come for her regular session yesterday afternoon. I don't know if it was because she was here at a different time slot or what, but Raquel was just doing her own thing. She was very happy and laughing, and giving her hugs and kisses, but really wasn't very interested in participating - in anything. This was the strangest speech session I've ever watched. And for some reason, Mary's three bags of toys were beyond distracting. So distracting that Mary said she's not bringing any of them next week!
Jennifer came at her regular time and Raquel was talking up a storm and very cooperative. She'll be moving on in prompt levels tomorrow. Typically she sleeps right after Jennifer leaves, but not today. She was wide awake and refused to nap, which was unfortunate because the replacement physical therapist, Jan, came to do her evaluation.
Let's just say the evaluation didn't go so well. Raquel was very irritatable from being so overly tired and we were not able to even have much of a session. Raquel went to sleep (for 2 1/2 hours!) and then I just ended up answering a bunch of questions. Jan has to turn paperwork in to Regional as well as Raquel's pediatrician. Her first session is scheduled next Friday - at the park we used to go to with Trish. I am very happy about this. Jan says that with kids Raquel's age, she prefers that the therapy takes place in a natural setting, and not in a home environment. I agree 100%. Jan seems really nice and I'm looking forward to working with her next week.
Jennifer came at her regular time and Raquel was talking up a storm and very cooperative. She'll be moving on in prompt levels tomorrow. Typically she sleeps right after Jennifer leaves, but not today. She was wide awake and refused to nap, which was unfortunate because the replacement physical therapist, Jan, came to do her evaluation.
Let's just say the evaluation didn't go so well. Raquel was very irritatable from being so overly tired and we were not able to even have much of a session. Raquel went to sleep (for 2 1/2 hours!) and then I just ended up answering a bunch of questions. Jan has to turn paperwork in to Regional as well as Raquel's pediatrician. Her first session is scheduled next Friday - at the park we used to go to with Trish. I am very happy about this. Jan says that with kids Raquel's age, she prefers that the therapy takes place in a natural setting, and not in a home environment. I agree 100%. Jan seems really nice and I'm looking forward to working with her next week.
Sunday, August 17, 2008
Notes From Her Therapists - Then & Now
I've been asked a lot about what kind of changes I've noticed in Raquel since she started therapy. It's been six months since her therapy started and I don't even know where to begin. It's like having a completely different child. So I got out the first notes from each therapist and thought I'd share what they said then vs. now.
BEHAVIOR THERAPY. Remember, I was given the most hours for this in the beginning because Raquel was so challenging. Here's Elizabeth's notes after our first meeting: "Discussed her behaviors at length, including pulling out her hair and eating it; aggression (hit, scratch, throw objects at, pull hair) toward mother; sleeping issues (refusal). Discussed replacement behaviors and the need for consistency across all settings."
Six months later, here's the latest comments from Cari: "What a great day! She did 1-2-3-Go 100% Independent! She also scored 100% on drawing, body parts, manding attention, non-verbal immitations, pointing, receptive commands, and sitting. Great day. Tomorrow she'll move on in prompt levels for many programs."
Side Note: I also want to add that her trichotillomania (hair pulling/eating) is 100% GONE. After the koosh ball didn't deter her from doing it, Elizabeth suggested that I cut off her curly locks, which I sadly did. She did look really cute with short hair, though.
As her hair has grown back in - and, again, curly - she doesn't do it anymore. The habit has been completely broken. If anyone reading my blog is going through this or knows of anyone who is, please contact me! You are not alone and things will get better.
SPEECH: We've had Mary the longest. Here is her take on day one: "Raquel used good eye contact and showed interest in the toys introduced, although she primarily threw any toys that were small enough to manipulate in her hand. Raquel was friendly and did not show a fear of interacting with me. She showed anger when her sister put away toys that she wanted and laughed when interacting with Mom during play. Raquel used quite a bit of jargen and produced a few true word approximations. Mom and sister were shown some beginning signs to try and help alleviate communicative frustrations (e.g. "mine", "all done", "milk", "more", "eat") also emphasizing a head shake for no."
And now: "Raquel had an awesome session today. Words that she used were: baby, look, cup, nook, put in, hey, moo, buk (for the chicken), come, no, nope, ball, play, boat, plane, me, and bye. These were through imitation or delayed imitation. Raquel exhibited some great things in her play today. She reached inside a mystery box to take things out, which she did one thing at a time. When she pulled a little train out, she carried it to the kitchen and pushed it on the floor. She also pushed the big train as she crawled behind it."
Side Note #2: I failed to mention last week that Gabby looked out her window anxiously awaiting Mary's arrival to tell her the good news (Raquel saying "Gabby"). I have never seen Gabby run so fast to greet anyone before. I don't even think Mary was able to get out of her car! Needless to say, she was very pleased.
OCCUPATIONAL: Becky wrote on her first session: "Raquel was able to sit and play for several minutes. She tolerated hand-over-hand to place toys in and for musical instruments. She placed one object in independently and placed her hand in container while still holding the toy several times. Showed Mom how to do core strengthening on her lap over her legs. Also demonstrated pulling her on a towel while she's sitting to work on balance and core stability."
Now: Well, I can't understand Karin's notes. :-) But I do know this - Raquel is not only independently putting items in and out of containers at her request, but also doing puzzles and doing them correctly - putting the circle where it goes, etc. Puzzles are still very frustrating for her because her fine motor still needs a lot of work, but she is showing great progress.
PHYSICAL: From one of Trish's first visits: "Raquel displayed extreme behavior, as she cried and screamed unconsolably. Attempted to do the following exercises to not much success: squat to stand exercises, walking across couch and mattress, which she needed contact guard assist/minimal assist for. She is also now able to climb on to the couch when she steps off a 4" step."
Trish's last session: "Raquel did great today. She did not have any upset moments. She participated in all activities and never complained. She was happy to play and walk around the park. She has markedly improved her ability to walk on grass. On inclined grass, she is now able to walk up without hand held assist. She is also making huge gains in her ability to walk up stairs with only one hand held assist. She walked up and down a curb by herself without holding on."
Hope this gives you a little insight. I'm very excited to see how much she improves over the next six months.
Friday, August 15, 2008
Breaking Routine - Not Always Easy
Elizabeth warned me over and over again about the dangers of having a daily routine with Raquel. I agreed with what she was saying but continued to walk, drive, walk, drive, walk, drive. And I met the majority of our neighbors - again, not always a good thing.
We have slowly been trying to break the vicious routine cycle and have made some serious progress. She no longer has to go for a walk or drive before she naps. And we don't play "I'm Your's" nearly as much for calming. But one routine that we are still pretty consistant with is her morning walk with Mike, Gabby and Annie. She typically starts to get more and more impatient when it doesn't happen when she wants it to, and then the behaviors happen.
Today was different. She started getting a bit unhappy and I asked her what she wanted. She went to the back door and pulled off her PECS for Annie. She then went to the living room and sat down, holding and looking at the picture. I told Mike and he immediately got ready and off they went. Again, PECS is what I'm constantly struggling with and this morning I felt that she was actually communicating functionally with them.
And it happened again this afternoon. After her nap, I gave her the usual snack. She seemed very bored with it so I asked her what she wanted. Then I heard the velcro come off the fridge (remember, the PECS are affixed to some doors and our fridge by velcro), and she was holding the applesauce PECS. I immediately praised her and gave her the applesauce, and she was very happy.
Today Janine overlapped with Cari's session and was very pleased with what Raquel demonstrated with the PECS earlier today as well as how the session went. Raquel was very cooperative and somewhat vocal. She was even pretty affectionate with Janine, which Janine loved. Raquel was still very stubborn and continues to want to do things on her terms. Wednesday is our next Team Meeting - I can't believe it's been a month already - and we'll be able to discuss any of our concerns then.
I also finally heard from a replacement physical therapist. She will be coming next Tuesday night to do her assessment of Raquel and what she feels she needs as far as therapy goes. I'm hoping she'll be willing to do therapy at the park like we did with Trish.
We have slowly been trying to break the vicious routine cycle and have made some serious progress. She no longer has to go for a walk or drive before she naps. And we don't play "I'm Your's" nearly as much for calming. But one routine that we are still pretty consistant with is her morning walk with Mike, Gabby and Annie. She typically starts to get more and more impatient when it doesn't happen when she wants it to, and then the behaviors happen.
Today was different. She started getting a bit unhappy and I asked her what she wanted. She went to the back door and pulled off her PECS for Annie. She then went to the living room and sat down, holding and looking at the picture. I told Mike and he immediately got ready and off they went. Again, PECS is what I'm constantly struggling with and this morning I felt that she was actually communicating functionally with them.
And it happened again this afternoon. After her nap, I gave her the usual snack. She seemed very bored with it so I asked her what she wanted. Then I heard the velcro come off the fridge (remember, the PECS are affixed to some doors and our fridge by velcro), and she was holding the applesauce PECS. I immediately praised her and gave her the applesauce, and she was very happy.
Today Janine overlapped with Cari's session and was very pleased with what Raquel demonstrated with the PECS earlier today as well as how the session went. Raquel was very cooperative and somewhat vocal. She was even pretty affectionate with Janine, which Janine loved. Raquel was still very stubborn and continues to want to do things on her terms. Wednesday is our next Team Meeting - I can't believe it's been a month already - and we'll be able to discuss any of our concerns then.
I also finally heard from a replacement physical therapist. She will be coming next Tuesday night to do her assessment of Raquel and what she feels she needs as far as therapy goes. I'm hoping she'll be willing to do therapy at the park like we did with Trish.
Wednesday, August 13, 2008
Finally - A Good Session This Week
The first half of Raquel's session with Jennifer yesterday wasn't very typical. She was somewhat cooperative, but pretty much whined for the first hour and Jennifer wasn't even able to perform some of the programs. She was really tired, though.
The second half was a little better. She wasn't talking a whole lot, but yesterday they moved her on in a couple of areas and she's doing really well in that respect. She's still very impatient when it comes to opening "the box." They have to fill out paperwork first, and as soon as Raquel sees them walk through the door, she's ready to work.
Today was much better. She was even laughing throughout the session. Still, not as vocal as usual, but at least Jennifer was able to record data. And Wednesday's are often a little more challenging because she has OT earlier in the morning. By the time Karin leaves at 11:30am, Raquel is ready for her nap. And then when Jennifer is finished at 4pm, she'll often take another one. They really do make her work. She didn't take a second nap so hopefully she'll go to bed at a decent hour and sleep all night. She's been challenging in the sleep department this week.
I've been asked about the box and what's inside and how they do the trials. So, here's the infamous "box of goods" - with her 3-ring binder on top:
The second half was a little better. She wasn't talking a whole lot, but yesterday they moved her on in a couple of areas and she's doing really well in that respect. She's still very impatient when it comes to opening "the box." They have to fill out paperwork first, and as soon as Raquel sees them walk through the door, she's ready to work.
Today was much better. She was even laughing throughout the session. Still, not as vocal as usual, but at least Jennifer was able to record data. And Wednesday's are often a little more challenging because she has OT earlier in the morning. By the time Karin leaves at 11:30am, Raquel is ready for her nap. And then when Jennifer is finished at 4pm, she'll often take another one. They really do make her work. She didn't take a second nap so hopefully she'll go to bed at a decent hour and sleep all night. She's been challenging in the sleep department this week.
I've been asked about the box and what's inside and how they do the trials. So, here's the infamous "box of goods" - with her 3-ring binder on top:
And here's some of the toys used during the session, kept in a ziploc bag:
The bag of pictures for "familiar people." Some are very unfamiliar, thanks to Janine, and they make us laugh. Today she chose both Gabby & Mike when they were in the same line-up.
This is her PECS book. This still is the hardest for me to stay consistent with and is by far the most frustrating.
The maracaas - one being an empty water bottle filled with beans. They use these during the non-verbal imitations, objects program.
Having to choose "car" from a field of three during receptive object labelling. Or they will give her an identical car and have her match it by either putting it down with the other, or picking the one on the floor up while holding the other at the same time.
What they sometimes use for the receptive commands. Today she was putting the ball in as well as throwing the ball when asked to.
Monday, August 11, 2008
Bummer Sessions Today
Today's sessions really weren't typical. First, Cari came at 9am and Raquel was full of behaviors and not wanting to participate at all. She hasn't seen Cari for a week, so maybe she wasn't comfortable. She had a really great weekend and I thought for sure today would be a good day.
Raquel was really happy to see Mary for speech, but again was a little off. She wasn't talking much at all - but very affecionate and giving her hugs and kisses. But the goal of speech is the talking, and she really wasn't saying much. She was playing very functional - rolling and pushing proper toys. She also was doing a lot of pretend play, such as drinking from a toy cup, and Mary liked seeing that and wants me to write down these types of things that I see her doing so she can review them next week.
Over the next couple of weeks, Mary will be completing the Rossetti Infant-Toddler Language Scale for Raquel. This is just an assessment test that scores the language skills of children from birth - 3 years. Once she turns 3, they do another one to see her progress. This helps them determine what type of program she will need to go in to come January.
Raquel was really happy to see Mary for speech, but again was a little off. She wasn't talking much at all - but very affecionate and giving her hugs and kisses. But the goal of speech is the talking, and she really wasn't saying much. She was playing very functional - rolling and pushing proper toys. She also was doing a lot of pretend play, such as drinking from a toy cup, and Mary liked seeing that and wants me to write down these types of things that I see her doing so she can review them next week.
Over the next couple of weeks, Mary will be completing the Rossetti Infant-Toddler Language Scale for Raquel. This is just an assessment test that scores the language skills of children from birth - 3 years. Once she turns 3, they do another one to see her progress. This helps them determine what type of program she will need to go in to come January.
The Return Of A Special Word
Raquel started to lose speech when she was around 2 years old - shortly after her 18 month check-up and shots. I know this could be just a coincidence, but again, autism has gone from 1 in 10,000 to 1 in 150 these days...
Slowly over this last year, her speech has been returning. The one word that I have been working with Mary (speech) on is trying to get her to say Gabby again. It is has been heartbreaking to watch Gabby begging her to say it.
Yesterday, it happened. They were playing on the floor and Gabby went in the other room for a minute. Raquel was waiting patiently for her to return, and when it took longer than expected, said softly, "Gabby." I totally freaked out - hugging and praising her and repeating it back. Gabby came running in from the other room and when Raquel saw her, said it again! This is when Gabby tackled her on the floor, giving her hugs and kisses.
She was just a little excited. Such a little thing, but so huge at the same time. Gabby can hardly wait to see Mary this afternoon and give her the good news!
Slowly over this last year, her speech has been returning. The one word that I have been working with Mary (speech) on is trying to get her to say Gabby again. It is has been heartbreaking to watch Gabby begging her to say it.
Yesterday, it happened. They were playing on the floor and Gabby went in the other room for a minute. Raquel was waiting patiently for her to return, and when it took longer than expected, said softly, "Gabby." I totally freaked out - hugging and praising her and repeating it back. Gabby came running in from the other room and when Raquel saw her, said it again! This is when Gabby tackled her on the floor, giving her hugs and kisses.
She was just a little excited. Such a little thing, but so huge at the same time. Gabby can hardly wait to see Mary this afternoon and give her the good news!
Wednesday, August 6, 2008
From The Hubby's Point Of View
Mike was talking about my blog today and how he feels that I'm not focusing on what is going on outside of therapy. So I decided to post tonight on his point of view, because he is very much involved in all of this and his thoughts definitely do count. But first, here's what happened today.
We had another very insightful OT session. I'm feeling more and more comfortable with Karin as the weeks progress and, again, this week she was able to give me a lot of feedback.
Remember how Raquel used to throw herself back and the whole pillow thing? Yes, I did say "used to" because it's something she doesn't do anymore, which is awesome! But, what she's doing now is hitting herself on the head when frustrated or overly tired. I asked Karin about it, and she said that hitting herself is obviously more preferred than the throwing back, but still related to the sensory thing. This one being the proprioceptive sense, that Raquel is seeking proprioceptive input. This is the position sense, the one that deals with body awareness and motor control & planning.
Karin gave me ideas to help with this, such as wearing ankle weights, a weighted vest, or a back pack. She said that having that additional weight on her will help give her that proprioceptive input that she is seeking. By constantly having this input, it will have a calming effect on her. Other ways to receive this input is by lifting slightly heavy items. Today Karin brought a medicine ball that Raquel would roll and throw to me. This helps to develop arm strength. She also brought a bolster pillow that she used in rotation to her fitness ball. Again, just trying to develop arm and core strength. She also used it for the wheelbarrel walking. She also suggested that I create a mini-obstacle course in the living room. Raquel seems to know the placement of everything and can be clumbsy and not watch where she is going. Today, she tripped over Karin's legs, but demonstrated her saftey response by putting her hands down to protect her face before falling. This is a good thing. A lot of kids don't show this yet and end up getting hurt. An obstacle course will help develop Raquel's motor control and coordination.
We had another great session with Jennifer this afternoon. Jennifer commented on how much more alert, aware, and present Raquel was today. I noticed it, too. It's like she's coming out of a fog. She was very interactive, very vocal, and seemed to really enjoy the entire session. She was laughing and smiling the whole time.
Jennifer did say that she is noticing a pattern with the data. She said that Raquel will do about 5 independent trials and then choose not to and will get not only a negative score, but also marks for behavior. She thinks that we need to adjust the program to only record her at 5 trials. The goal is to do as many as possible up to 10. Jennifer rotated toys today and doesn't feel that she's getting bored with the toys - just bored with the task. She said by adjusting the program a bit, we'll see more progress and she'll continue to improve. And of course, that's the goal. Today, I was working at my laptop in the other room for probably half of the session. In the beginning, I had to sit on the floor next to them the entire time and every time I'd leave, she'd follow me. I can tell she's starting to build a rapport with the ABA team, and is getting more and more comfortable around them.
Okay, Mike's take on all of this...
Mike feels that I am doing a little bit of, let's say, sugar coating. He says that I'm talking only about how well she is doing in her therapy but I don't mention how difficult it still is when we don't have a therapist in the house.
Today will be the example. Raquel woke up at 6:15am on obviously the wrong side of the bed. We normally call her our "kissybug" in the morning because she is happy and overly affectionate. Not this morning. She woke up in a mood and was just a big pain and using the "me mad" talk all day. Mike took them for a walk and to the mall and got her back 15 minutes before Karin showed up. He walked in with her carrying on. We played "I'm Yours" and when Karin walked in, she settled down for her session, but was still a little aggitated.
Once Karin left, she immediately went down for her nap, which I was really happy about. But then she woke up and was again, really fussy. She didn't want to be held, kept telling us she was mad, but we couldn't figure out why. More "I'm Yours." I must have heard that song 10 times today.
She was completely freaking out right before Jennifer came. I really didn't know what to make of the session but as soon as Jennifer walked in, Raquel was ready to work. And about an hour after Jennifer left, she started up again with the "me mad" talk and was very challenging for most of the night. Trying to guess what she wants is often very much a struggle because she's not able to use the PECS functionally yet. I will be talking to both Mary and Janine about this next week.
So, even though we are seeing a lot of progress when recording the data during the sessions, she still can be a little overwhelming at times. I contribute this to her lack of vocabulary - she's frustrated by not being able to communicate her needs. And, if we get frustrated, she picks up on our vibe and it escalates. We are constantly reminding ourselves to stay calm, and keep a quiet house. But, isn't that everyone's goal? :-)
We had another very insightful OT session. I'm feeling more and more comfortable with Karin as the weeks progress and, again, this week she was able to give me a lot of feedback.
Remember how Raquel used to throw herself back and the whole pillow thing? Yes, I did say "used to" because it's something she doesn't do anymore, which is awesome! But, what she's doing now is hitting herself on the head when frustrated or overly tired. I asked Karin about it, and she said that hitting herself is obviously more preferred than the throwing back, but still related to the sensory thing. This one being the proprioceptive sense, that Raquel is seeking proprioceptive input. This is the position sense, the one that deals with body awareness and motor control & planning.
Karin gave me ideas to help with this, such as wearing ankle weights, a weighted vest, or a back pack. She said that having that additional weight on her will help give her that proprioceptive input that she is seeking. By constantly having this input, it will have a calming effect on her. Other ways to receive this input is by lifting slightly heavy items. Today Karin brought a medicine ball that Raquel would roll and throw to me. This helps to develop arm strength. She also brought a bolster pillow that she used in rotation to her fitness ball. Again, just trying to develop arm and core strength. She also used it for the wheelbarrel walking. She also suggested that I create a mini-obstacle course in the living room. Raquel seems to know the placement of everything and can be clumbsy and not watch where she is going. Today, she tripped over Karin's legs, but demonstrated her saftey response by putting her hands down to protect her face before falling. This is a good thing. A lot of kids don't show this yet and end up getting hurt. An obstacle course will help develop Raquel's motor control and coordination.
We had another great session with Jennifer this afternoon. Jennifer commented on how much more alert, aware, and present Raquel was today. I noticed it, too. It's like she's coming out of a fog. She was very interactive, very vocal, and seemed to really enjoy the entire session. She was laughing and smiling the whole time.
Jennifer did say that she is noticing a pattern with the data. She said that Raquel will do about 5 independent trials and then choose not to and will get not only a negative score, but also marks for behavior. She thinks that we need to adjust the program to only record her at 5 trials. The goal is to do as many as possible up to 10. Jennifer rotated toys today and doesn't feel that she's getting bored with the toys - just bored with the task. She said by adjusting the program a bit, we'll see more progress and she'll continue to improve. And of course, that's the goal. Today, I was working at my laptop in the other room for probably half of the session. In the beginning, I had to sit on the floor next to them the entire time and every time I'd leave, she'd follow me. I can tell she's starting to build a rapport with the ABA team, and is getting more and more comfortable around them.
Okay, Mike's take on all of this...
Mike feels that I am doing a little bit of, let's say, sugar coating. He says that I'm talking only about how well she is doing in her therapy but I don't mention how difficult it still is when we don't have a therapist in the house.
Today will be the example. Raquel woke up at 6:15am on obviously the wrong side of the bed. We normally call her our "kissybug" in the morning because she is happy and overly affectionate. Not this morning. She woke up in a mood and was just a big pain and using the "me mad" talk all day. Mike took them for a walk and to the mall and got her back 15 minutes before Karin showed up. He walked in with her carrying on. We played "I'm Yours" and when Karin walked in, she settled down for her session, but was still a little aggitated.
Once Karin left, she immediately went down for her nap, which I was really happy about. But then she woke up and was again, really fussy. She didn't want to be held, kept telling us she was mad, but we couldn't figure out why. More "I'm Yours." I must have heard that song 10 times today.
She was completely freaking out right before Jennifer came. I really didn't know what to make of the session but as soon as Jennifer walked in, Raquel was ready to work. And about an hour after Jennifer left, she started up again with the "me mad" talk and was very challenging for most of the night. Trying to guess what she wants is often very much a struggle because she's not able to use the PECS functionally yet. I will be talking to both Mary and Janine about this next week.
So, even though we are seeing a lot of progress when recording the data during the sessions, she still can be a little overwhelming at times. I contribute this to her lack of vocabulary - she's frustrated by not being able to communicate her needs. And, if we get frustrated, she picks up on our vibe and it escalates. We are constantly reminding ourselves to stay calm, and keep a quiet house. But, isn't that everyone's goal? :-)
Tuesday, August 5, 2008
Think Good Thoughts ...
... And Good Thoughts Will Happen.
This is something my Mom has instilled in my brain for as long as I can remember. I remember being a little girl, probably Gabby's age or a little younger, and having a nightmare. My Mom came in and sat on my bed with me, assuring me that everything was okay. When I asked her how I could go back to sleep without being scared, she said, "Think good thoughts and good thoughts will happen." Of course she stayed with me until I fell fast asleep. As an adult, I constantly remind myself of that, and say the same thing to Gabby when she's scared, worried, or feeling a bit insecure, regardless of the circumstance. I MISS YOU MOM!!
And that's how I feel about Raquel. It is very easy for me to get sucked in to the whole pity pot of having a child with "challenges." But I choose not to. I think good thoughts and good thoughts will happen. I'm grateful to have such a beautiful girl that is able to do as much as she can, and who is so affectionate and so loving. Of course, things could be much better, but they could also be much worse. And this is what I am constantly reminding myself of. Again, who knows where we'll be in another 6 months.
Raquel was really tired when Jennifer arrived at 11:30am, but, again, I refuse to have anxiety about this time slot because Raqi really takes to Jennifer, and Jennifer has great ways of redirecting her when she's overly tired and it's never an issue. And it wasn't an issue today. They had another great session.
I cannot say enough about our ABA team. We are so blessed to have them in our life and helping Raquel. We miss Elizabeth & Wendy so much but are so happy to have such a great group of people here now, working with Raquel on some really wonderful things. I'm so proud of my little Raqi!
This is something my Mom has instilled in my brain for as long as I can remember. I remember being a little girl, probably Gabby's age or a little younger, and having a nightmare. My Mom came in and sat on my bed with me, assuring me that everything was okay. When I asked her how I could go back to sleep without being scared, she said, "Think good thoughts and good thoughts will happen." Of course she stayed with me until I fell fast asleep. As an adult, I constantly remind myself of that, and say the same thing to Gabby when she's scared, worried, or feeling a bit insecure, regardless of the circumstance. I MISS YOU MOM!!
And that's how I feel about Raquel. It is very easy for me to get sucked in to the whole pity pot of having a child with "challenges." But I choose not to. I think good thoughts and good thoughts will happen. I'm grateful to have such a beautiful girl that is able to do as much as she can, and who is so affectionate and so loving. Of course, things could be much better, but they could also be much worse. And this is what I am constantly reminding myself of. Again, who knows where we'll be in another 6 months.
Raquel was really tired when Jennifer arrived at 11:30am, but, again, I refuse to have anxiety about this time slot because Raqi really takes to Jennifer, and Jennifer has great ways of redirecting her when she's overly tired and it's never an issue. And it wasn't an issue today. They had another great session.
I cannot say enough about our ABA team. We are so blessed to have them in our life and helping Raquel. We miss Elizabeth & Wendy so much but are so happy to have such a great group of people here now, working with Raquel on some really wonderful things. I'm so proud of my little Raqi!
Monday, August 4, 2008
Raquel's Mid-Year Review
Today we had Raquel's mid-year review. Mid-year is her halfway point to her birthday in January. Once she turns three, she moves on to different programs.
We didn't have an ABA session today because of Cari's vacation and then scheduling conflicts. Raquel had a great day - very happy, very vocal, and very content to play in her room or in Gabby's room. It was refreshing. She took a late nap and I didn't know how she'd react to, first, Janine observing speech, and second, to Ken from Regional being here for a routine session. For the most part, she did really well.
Ken & Janine arrived before Mary. Raquel went right to Janine and kind of just checked out Ken for a few minutes. She's only seen him once before - several months ago. I have to say, she warmed up to him to the point where she was giving him kisses when we were all done. I don't know what it was - I asked Mike if he thought Ken reminded Raquel of my dad - but we have no idea what she was thinking. She was very affectionate with Mary, too, but that isn't unusual.
Unfortunately, she didn't have a great speech session. Raquel was very quiet and not interested in most of the activities. She didn't even want to play ball, which is extremely rare. At one point, she was mad at Mary for talking to Janine and not playing with the wind up toys and, in a mad voice, said, "Mary!" Mary asked what she wanted, and Raquel said, "Me!!!!" They were taking turns and it was Raquel's turn to choose a toy. Mary opened the bag of wind up toys and instructed Raquel to only take one. Raquel looked at her, contemplating, then reached in and pulled out just one. Janine liked how she was listening to what Mary was saying and following instructions.
We also asked about the whole "apraxia" thing. Mary said no, that she currently treats several kids with this and that she absolutely does not see Raquel having it. Yes! Mary said that Raquel's vocabulary is showing more and more communicative speech, and with apraxia you really don't have that. She also said some other stuff, but speech can be like OT sometimes - kinda technical. I'm just glad that Mary doesn't see it. I love good news.
The mid-year review wasn't exactly what I thought it would be. I thought Ken wanted to observe speech and then discuss with Janine her progress in the new program. Not the case. We basically just talked about future plans and filled out paperwork. Once Raquel turns 3, she will no longer have the in-home therapy program we currently have. He asked a bunch of questions about what I currently invision her transitioning to, but I had to keep saying that it really depends on where we are at in January. Her progress is what is important and I can't make decisions now based on not knowing where she is going to be in another 5-6 months.
What are our options come January? She will be transferred to the school district system at that point. Depending on her condition and current therapy load, we'll have the option to put her in a public therapy facility catered to her needs (at no out-of-pocket cost because we live in California), full or part-time, or we can pay for continued in-home sessions. I told Ken that we will do whatever is best for Raquel and that I would like to have information on all programs. He said that would not be a problem. We'll know much more in a few months as to the direction she is going. She's already made some tremendous progress. Who knows where she'll be in another 6 months.
As for right now, Elizabeth and the ABA team will be reassesing her in two months. Regional will do a medical as well as another psychological assessment in 3 months, before her transition actually occurs, to determine whether or not she can be offically diagnosed. An actual diagnosis affects the on-going therapy as well.
A good day. Let's see what tomorrow brings.
Enjoy the music. One of our favorite songs from Jason's album. Video isn't that great but the vocals are - especially at the end when Toca is singing. Great job guys!
We didn't have an ABA session today because of Cari's vacation and then scheduling conflicts. Raquel had a great day - very happy, very vocal, and very content to play in her room or in Gabby's room. It was refreshing. She took a late nap and I didn't know how she'd react to, first, Janine observing speech, and second, to Ken from Regional being here for a routine session. For the most part, she did really well.
Ken & Janine arrived before Mary. Raquel went right to Janine and kind of just checked out Ken for a few minutes. She's only seen him once before - several months ago. I have to say, she warmed up to him to the point where she was giving him kisses when we were all done. I don't know what it was - I asked Mike if he thought Ken reminded Raquel of my dad - but we have no idea what she was thinking. She was very affectionate with Mary, too, but that isn't unusual.
Unfortunately, she didn't have a great speech session. Raquel was very quiet and not interested in most of the activities. She didn't even want to play ball, which is extremely rare. At one point, she was mad at Mary for talking to Janine and not playing with the wind up toys and, in a mad voice, said, "Mary!" Mary asked what she wanted, and Raquel said, "Me!!!!" They were taking turns and it was Raquel's turn to choose a toy. Mary opened the bag of wind up toys and instructed Raquel to only take one. Raquel looked at her, contemplating, then reached in and pulled out just one. Janine liked how she was listening to what Mary was saying and following instructions.
We also asked about the whole "apraxia" thing. Mary said no, that she currently treats several kids with this and that she absolutely does not see Raquel having it. Yes! Mary said that Raquel's vocabulary is showing more and more communicative speech, and with apraxia you really don't have that. She also said some other stuff, but speech can be like OT sometimes - kinda technical. I'm just glad that Mary doesn't see it. I love good news.
The mid-year review wasn't exactly what I thought it would be. I thought Ken wanted to observe speech and then discuss with Janine her progress in the new program. Not the case. We basically just talked about future plans and filled out paperwork. Once Raquel turns 3, she will no longer have the in-home therapy program we currently have. He asked a bunch of questions about what I currently invision her transitioning to, but I had to keep saying that it really depends on where we are at in January. Her progress is what is important and I can't make decisions now based on not knowing where she is going to be in another 5-6 months.
What are our options come January? She will be transferred to the school district system at that point. Depending on her condition and current therapy load, we'll have the option to put her in a public therapy facility catered to her needs (at no out-of-pocket cost because we live in California), full or part-time, or we can pay for continued in-home sessions. I told Ken that we will do whatever is best for Raquel and that I would like to have information on all programs. He said that would not be a problem. We'll know much more in a few months as to the direction she is going. She's already made some tremendous progress. Who knows where she'll be in another 6 months.
As for right now, Elizabeth and the ABA team will be reassesing her in two months. Regional will do a medical as well as another psychological assessment in 3 months, before her transition actually occurs, to determine whether or not she can be offically diagnosed. An actual diagnosis affects the on-going therapy as well.
A good day. Let's see what tomorrow brings.
Enjoy the music. One of our favorite songs from Jason's album. Video isn't that great but the vocals are - especially at the end when Toca is singing. Great job guys!
Friday, August 1, 2008
Not How I Wanted To End The Week
Yesterday, Raquel had an awesome session with Cari. She was talking up a storm, extremely cooperative, and scoring really well. I was hoping for another day like that today when Janine came and overlapped with Cari.
Let's just say that didn't happen. They weren't even able to record data on half of her programs. Raquel was cooperative enough at first and didn't get upset when Janine arrived, but really wasn't into it. Yesterday, she scored at a 100% independent level on the "ready, set, go" intraverbals. Today, Cari would say, "ready, set" and Raquel would look at Janine and tell her to "go away." That obviously doesn't count. I don't know if it was because Janine was there, if she was just done for the week, or because I went to the office this morning and her routine was different. But today was definitely an off day.
Janine did say, after reviewing the data sheets for the week, that it appears that Raquel is getting bored. We dug through the toy box we use for the session and took out some items that she seems to have lost interest in and will add them back to the rotation next week when they are more appealing. I guess right now it's all about rotation, rotation, rotation. I'll also look for toys around the house that she hasn't seen in awhile. Maybe those will work, too.
Janine also asked if Mary (speech) has ever mentioned something called "apraxia" about Raquel. This is the first I've ever heard of it, but from what I briefly googled, speech apraxia is when you are unable to execute speech movements because of motor planning and coordination problems. Janine was the first one to say that she's not a speech therapist, but also noted that if this is the case with Raquel - she often times seems unable to mentally organize enough to produce the speech - that it would warrant program adjustments. On the other hand, it very well could be behavioral issues because she's consistently using "no", "no way", "do it", etc. at appropriate times. Something to ask Mary about on Monday.
Next week Cari is on vacation so we'll only have 3 ABA sessions instead of 5, but Janine is still coming Monday afternoon to observe speech.
Let's just say that didn't happen. They weren't even able to record data on half of her programs. Raquel was cooperative enough at first and didn't get upset when Janine arrived, but really wasn't into it. Yesterday, she scored at a 100% independent level on the "ready, set, go" intraverbals. Today, Cari would say, "ready, set" and Raquel would look at Janine and tell her to "go away." That obviously doesn't count. I don't know if it was because Janine was there, if she was just done for the week, or because I went to the office this morning and her routine was different. But today was definitely an off day.
Janine did say, after reviewing the data sheets for the week, that it appears that Raquel is getting bored. We dug through the toy box we use for the session and took out some items that she seems to have lost interest in and will add them back to the rotation next week when they are more appealing. I guess right now it's all about rotation, rotation, rotation. I'll also look for toys around the house that she hasn't seen in awhile. Maybe those will work, too.
Janine also asked if Mary (speech) has ever mentioned something called "apraxia" about Raquel. This is the first I've ever heard of it, but from what I briefly googled, speech apraxia is when you are unable to execute speech movements because of motor planning and coordination problems. Janine was the first one to say that she's not a speech therapist, but also noted that if this is the case with Raquel - she often times seems unable to mentally organize enough to produce the speech - that it would warrant program adjustments. On the other hand, it very well could be behavioral issues because she's consistently using "no", "no way", "do it", etc. at appropriate times. Something to ask Mary about on Monday.
Next week Cari is on vacation so we'll only have 3 ABA sessions instead of 5, but Janine is still coming Monday afternoon to observe speech.
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