Nice Talking!

Raquel continues to be more and more vocal as the days progress. Even this week with her not feeling well, she was still talking up a storm not only during her sessions, but pretty much all day long. It is definitely music to my ears.

I cancelled this morning's physical therapy at the park because I didn't think she was up to it and wanted her to be somewhat refreshed during the ABA session this afternoon. I thought for sure she'd nap early, but again, not a chance. But she had a really great session with Cari regardless of being tired.

And we heard new words during the session today. First, when she was choosing between two preferred objects (the manding for reinforcers), she chose tops, which is her usual preference. Since she was being so vocal, Cari then held up a yellow top and a green top and asked her if she wanted yellow or green. Raquel said, "Green." A few minutes later, Cari asked her the same thing and Raquel said, "Yellow." So not only was she choosing a preferred object but then she was also choosing a preferred color. Very cool. And during the gross motor immitations, Cari would clap her hands and Raquel would do the same. She did this several times and on one of the last attempts, Cari said, "You do!" when she wasn't immitating. Raquel said to her, "Don't want to!" Just proves how stubborn she is and how she continues to want to do things on her terms. That's my girl.

Hoping for a nice and restful weekend and that both my girls will be back to 100% health wise come Monday.

More Insight About What's To Come

I've been thinking a lot about what's going to happen to Raquel once she turns three in January. Even though we speak so highly of her current therapists, the reality is that they will be leaving - and fairly soon - especially considering we are just days away from being in October. And everyone knows how fast the holidays come and go. After we ring in 2009, Raquel will be three in just a couple weeks. Her last ABA session will be on her 3rd birthday.

And then what? I've been asking our ABA Team a lot of questions because pretty soon the Regional Center is going to start getting involved during our "transition phase" - and you know how I feel about Regional.

Today Janine overlapped with Cari during our afternoon session. Janine did the Brigance Assessment Test on Raquel. This is what Elizabeth did back in mid-June as a baseline when we were switched to the ABA Program. Even though we have noticed huge changes in Raquel, the Brigance testing is speech based so I thought she scored pretty much the same as she did on her first assessment - low. And this test also wants her to stack ten small blocks on top of each other by the time she's three. This is very unrealistic - especially for a child with fine motor issues. Regardless, this is one of the tests they are required to use.

Her session was a little off because it started out with Janine asking me a bunch of questions for the Brigance assessment and they did not start the session right away. As soon as her therapists show up, Raquel is ready to get started, so her waiting patiently got less and less patient as the time passed. Once we opened the box, she did pretty well - especially considering she still isn't feeling very well and refused to take her afternoon nap. Janine reads her data sheets every week and continues to be very pleased with her progress. And Raquel was very vocal throughout her session.

So what happens down the road? From what I've questioned over the past couple of days, Raquel will most likely be transitioning to a preschool. This will be through our school district. There are many types of schools and I'll be able to get a list and physically go check them out one-by-one before I enroll her. Because she is not able to effectively communicate, it is critical that I find a place that I can trust. Classrooms apparently will be small - in the 8 to 10 range - and she would most likely be going around 4-5 hours per day. We will also have the option of continuing in-home care, but this would no longer be covered by the state. I'm still not making any decisions either way until we get much closer to her transition date. I'm determined to find the perfect match for her!

Not Feeling Well - But Still Good Sessions

Raquel caught the cold Gabby's had all weekend. Fortunately, she hasn't gotten the fever part of it and it's limited to pretty much a head cold. But she's a trooper - even sneezing and with a stuffy nose, this girl is ready to work.

Unfortunately, this morning started for us at 3:30am. When you've already listed to "I'm Yours" five times before 7am, you start to figure out how your day is going to go. And today we had OT in the morning, then ABA in the afternoon. Let's just say I wasn't feeling too optimistic.

She actually had a decent OT session, but was easily frustrated at failed attempts when performing her tasks. Karin said she was tolerant to vestibular input but had poor tolerances to both tactile and proprioceptive inputs. Fortunately, she had a good lunch and napped shortly after Karin left.

Raquel was very happy and vocal throughout her ABA session with Jennifer and displayed just a few behaviors. And she is getting so much closer with the PECS!!! This continues to be the hardest part for me but I am definitely seeing progress. I will post on these challenges soon.

Tomorrow Janine overlaps with Cari for her afternoon session.

Just Bad Working Conditions

I usually love the physical therapy at the park. It gives the girls a chance to run around outside and play, and this is the one therapy that I'm not having to directly participate in. I am able to sit down and observe from a distance for the most part.

Jan had a cancellation this morning and called me to see if I wanted to do our session earlier. Of course, I said yes. We pulled up to an empty parking lot and pretty much had the entire park to ourselves. The problem you ask? The grass and play equipment were still wet from the morning dew and sprinklers. If that wasn't bad enough, the gnats were out in full force, which was absolutely horrible. They were flying in our eyes and ears and I kept having to pick them off of Raquel's face. GROSS. Another problem was her slip on shoes - she kept slipping out of them, which became very distracting.

The session went really well. It started with Jan greeting us at our car. One of the challenges I have right now is needing to carry Raquel to and from places until I can put her in a shopping cart or stroller. Jan is all about easing her into new situations. She suggested that I, first, tell her what I was about to do, then second, grab both her hands and walk her, slowly loosening my grip, then letting go with one hand. It took awhile to get to where we needed to go, but it did work. She said that as long as I don't mind the weird looks from strangers (she obviously does not know me yet - she should see me at Petco!), that I can do this anywhere. The more comfortable Raquel gets with me doing this, the more she'll start to improve.

After the parking lot, we moved on to dry portions of the play equipment. Jan asked me to step aside - said I was giving Raquel guidance without her asking for it - so I did what I was told and sat. Jan was very pleased with how much improvement she saw in her climbing. She no longer has to nudge her foot to encourage her step up, she does it on her own. She also is walking down steps with just one hand held assist instead of two. Today, I noticed she was stepping down with her left foot first. I asked Jan if this was typical of someone who is left handed (again, me going back to the left handed thing). Jan said no, that a person most likely steps up with their strongest leg, and down with their weakest. So we started watching her climb, and she was stepping up with her right foot consistently.

I was very happy to see her walking across the wobbly bridge. She actually seemed to like it once she knew what was going to happen when she set foot on it. And she was laughing a lot and having fun playing with her sister.

Next week we are going to try out another park to see if we can avoid the bugs. If it's too hot, we'll go back to the mall. I've also been told to bring real sneakers.

Third Team Meeting

Tonight we had our third ABA Team Meeting. Again, it went very well and everyone is definitely on the same page and not only happy, but encouraged, with Raquel's progress.


Today Raquel had her occupational therapy with Karin. Karin noticed big changes in Raquel in the two weeks' she hasn't seen her. She said that Raquel is visibly stronger, more cooperative, less resistant, and was basically just a much happier child than she was used to seeing. She didn't get aggitated on the fitness ball and is demonstrating much more core strength. One thing she did do was fill the seat of one of Raquel's pushing/riding toys with rocks. She wants Raquel to push this around the house, which will continue to strengthen her upper torso and arms.

Janine overlapped with Jennifer for her regular ABA session today. It really wasn't a typical day for Raquel. She woke up at 3:30am and did not nap - not even after her OT session, which is extremely rare - until 1:30pm, only 30 minutes prior to her ABA session. One thing I have been consistently noticing is that when sessions occur directly after a nap and especially if we need to wake her up before one can start, she is just not vocal at all. Unfortunately, that's what happened today. I was pretty disappointed because I wanted Janine to hear all the words she's been saying. For the past week and a half, Raquel has been the most vocal ever and truly communicating with her words functionally.

Besides the lack of speech, she had a great session. Janine was really happy to see her perform her tasks so well at the table without even the slightest behavior. And overall, Raquel was pretty content throughout the session.

After the session, we had our third ABA Team Meeting. We pretty much talked about her progress and how well she is doing and how much improvement she has shown in such a short amount of time. I told them that it was like night and day, her then versus now is so extreme that I seriously have to go back to my earlier blog posts as well as reading their notes from the first ABA sessions to remind myself of how much she has progressed. The "Pillow Thing" seems like years ago to me. And to have my girl yell from her room at the top of her lungs, "Mom-meeee! Come play!" is more than rewarding.

Again, I can't say enough about our ABA Team. I continue to appreciate their compassion and dedication to their work. And how they help Raquel on so many levels speaks volumes. Thanks ABA Team!

Doing Tasks At Her Table

Wednesday, Jennifer conducted the majority of her session with Raquel sitting at her table. And Raquel really seems to enjoy it and is scoring very well!

Here she is picking out Gabby during familiar people.

And choosing between pictures or the spinning tops. This is called Manding for Reinforcers.

She chose the tops - which continue to be one of her very favorite items in the box.

Today Raquel had physical therapy at the mall. This was the first time I was able to observe her with her replacement PT. She seemed to take to Jan very well. When I took her out of the stroller, Jan asked me to walk around the area holding her to get her used to the environment. After a few minutes, I sat down on one of the benches and put her down. She stood there holding my legs for a minute or two, then both Jan and I took one hand and slowly started walking with her. Then I let go and watched them walk for a few minutes. In no time, she was off and playing. She was crawling through tunnels chasing other kids and going up steps and sliding down with Jan holding one hand. Jan seems to think that she is doing wonderful and just needs to have more practice in unfamiliar areas. She said that the time it takes to warm up will slowly start to decrease as her confidence builds. Next week we will go back to the park.

Raquel had an awesome session today with Cari - by far the best they've ever had. Again, she's now doing most of her tasks at the table and I was amazed at how many trials she was doing without any kind of behaviors. And she was talking up a storm and laughing throughout the entire session. Great news - especially considering she had PT earlier and again, no nap.

Monday she has an early speech session and then Mary will be overlapping for her ABA session with Cari.

Speech Therapy - Not Typical Again

Raquel had a good session with Cari this morning, although she seemed pretty aggitated at times and most of her talking was saying "no way". She scored well though.

We had another interesting speech session this afternoon. Mary is continuing to come empty handed. Fortunately, this time Raquel actually participated in the session and didn't keep her back to her the whole time. Mary played in Raquel's room with her Barbie kitchen and did a bunch of pretend play with that. She'd also follow Raquel from room to room to keep her engaged. We could tell that Raquel was taken back a bit because her routine with Mary was off, but she did really well.

At one point, I was talking to Mary about something and not giving Raquel any attention. She yelled, "Mom-meeeee" at the top of her voice. Mary was so excited to hear that. She says that this means Raquel is trying to control the behavior of others by using her words, which is pretty huge. She's been doing this for a couple of weeks but since we didn't have speech last week due to the holiday, I forgot to tell Mary. She was also happy to hear that one day last week, Raquel told me to "stop it" when I was flipping her upside down. I really have to start writing this stuff down. These little details are very important and allows Mary to give me some great input.

Mary came today with her digital camera and began taking pictures of Raquel doing activities throughout the house. She is going to be making a book of Raquel doing things and then I will give her the action language when I'm reading it with her ie. "Raquel is eating", etc. She wants to start out with me using pretty much 3 words and then adding more details later on.

And today when we were ending the session, Raquel started to walk down the hallway to go to her room. Mary said, "See ya!" and Raquel stopped, turned around and with a big smile on her face, WAVED. Sorry ABA Team. I know we're still doing the partial prompt for this. :-)

Not Ready For No Napping

I've been trying to remember how old Gabby was when she stopped taking her afternoon nap. She was in daycare at Raquel's age, and I know that naps were not required so to speak, but if the kids chose not to sleep, it was considered "quiet time."

I am so not ready for having just a "quiet time" with Raquel. I need this kid to sleep - and for a good hour! This is sacred time - when I can catch up with work, return calls, do homework with Gabby or play games, plan dinner, etc. I'm not ready to give this up!

This last weeks' nap schedule has been beyond out of the norm. When Jennifer leaves after her Tuesday session, Raquel is usually asleep before she backs out of our driveway. Last week, she has been consistently taking her nap around 4:00pm, which means a later bedtime. I do not want my 2 1/2 year old staying up later than my 6 1/2 year old! But, I'd also rather her nap at 4pm instead of not napping at all. She needs the down time to recharge herself.

Could the Cheerios have thrown off her system a bit in this respect? I'm hoping that's all it is...

Physical Therapy - Resumed

I am very happy to report that physical therapy started up last Friday - after a lapse of two and a half months. Happy not because I think she is needing this so much but happy that she has resources, again at no cost to us until her birthday in January, to help get her to where she needs to be. And I still hear Trish's voice in the back of my head during our final PT session when she told me that Raquel is just a little behind, and that it was pretty amazing considering she started walking so late.

Unfortunately, I was not able to attend her first or second sessions with her replacement therapist, Jan. They both took place at Kit Carson Park and Mike said they went very well. Since Jan was not able to evaluate Raquel at our initial meeting, she brought a couple things to try out at the first session - such as this pack/vest thing.

For some kids, it gives them a sense of security when they are outside their own elements. According to Mike, Raquel didn't particularly care for it and Jan only tried it out for a short time.

What I did like seeing, atleast from the pictures, was that Jan seems to be doing therapy pretty consistently with how Trish did it - part of the sessions with shoes on and then part of it with them off to allow Raquel to feel different textures on her feet.

And I've noticed a HUGE change in her walking at the mall. Here she is keeping up with Daddy while he looks for the tile Gabby painted when the lounge was built several years ago. She is getting more confident as the day's progress.

Therapy wise, it has been an interesting week. Raquel was the most vocal I've ever heard her all last weekend through Tuesday. Wednesday not so much, Thursday not a peep, and then today, started back up a bit. I've been thinking about what could cause such a fluctuation and talked to Cari and Janine about it yesterday and then Cari today. Yesterday, we thought it could be inconsistencies with the ball bounces & deep joint compressions. Today, we think diet may be playing a key role in this as well. Earlier this week, we ran out of one of Raquel's snacks and Mike gave her some Cheerios, which she absolutely loved. Unfortunately, Cheerios is not on her gfcf diet. And neither is the string cheese I gave her as well. So, no more slacking. This weekend, I am going to reorganize our pantry, refrigerator and freezer. Raquel will now have her own separate shelf in each, just to make things easier for all of us. I should have done this a long time ago.

Speech should be interesting Monday afternoon, since Mary will continue to come empty handed for her sessions. Hopefully Raquel won't be holding a grudge.