This morning we had Raquel's Transition Meeting. It went really well. Found out that Raquel will most likely qualify for two schools in our area - one being conveniently on the way to Gabby's school. Sounds like she'll be going Monday through Friday from 8am - 11am. And the student/teacher ratio is only 2:1! I was so happy to hear that. She'll basically be getting the same therapy she's getting now, just in a school setting.
For the meeting, Ken (from the Regional Center) pretty much just briefed the District Psychologist, Lorraine, on Raquel's background and gave her Janine's initial report. Lorraine then went into details of the programs offered and prepared me for what was to come. I had to sign a release form authorizing Lorraine to go ahead with her assessments. We scheduled the IEP for Monday, January 5th.
Janine was also present to give her input and Raquel was the happiest, most affectionate girl throughout the meeting. She wouldn't stop giving me kisses and hugs, which they all enjoyed seeing.
My favorite part of Janine's report is her current observations of her: "Raquel is a bright, sweet and affectionate little girl who continues to make great strides in her development." I continue to believe with all my heart and soul that she will do just fine.
Thursday, October 30, 2008
Monday, October 27, 2008
Pretty Vocal Today
Raquel was a chatterbox today! It's days like this that make me wonder if she's going to turn in to Gabby #2.
She had a really good ABA session this morning with Cari. And she worked fast. Cari was pretty much done with her session probably an hour and half into it. A few behaviors, but for the most part, very cooperative and talkative. And, Raquel scored 100% on PECS! We've certainly come a long way in this program.
Raquel was very happy, interactive and talkative throughout her entire speech session. Today we played with dolls. :-) We took turns putting them to sleep, modeling "shhhh", and at one point Mary was pretending to sleep and snoring, and I'd ask Raquel to go wake her up. She listened pretty consistently, but one time said, "No" and went over to her toy box instead. After a few moments, Mary said, "Nita, wake me up!" so I did and then we both just cracked up laughing. I told her that I'll really miss the speech therapy. It's the one session a week that I get to act like a little kid, forget all my worries, and basically just play and laugh. I told her that I would be having the transition meeting this week, so she will be dropping off a report before that. She said that once I sign some kind of release form, she'll be able to discuss Raquel's case with the school district psychologist.
One side note to add: Last Saturday was my father-in-laws 80th birthday party (Happy Birthday Dad!). I prepared myself for the worst in dealing with Raquel - it was held at their community golf course clubhouse and had close to 100 people, the vast majority Raquel not even knowing. She did amazing! So great that she even was able to sit in a high chair at our table and have dinner with everyone. She was walking all around the place and wasn't the slightest bit scared. She even took a little nap while we were cutting the cake!
She had a really good ABA session this morning with Cari. And she worked fast. Cari was pretty much done with her session probably an hour and half into it. A few behaviors, but for the most part, very cooperative and talkative. And, Raquel scored 100% on PECS! We've certainly come a long way in this program.
Raquel was very happy, interactive and talkative throughout her entire speech session. Today we played with dolls. :-) We took turns putting them to sleep, modeling "shhhh", and at one point Mary was pretending to sleep and snoring, and I'd ask Raquel to go wake her up. She listened pretty consistently, but one time said, "No" and went over to her toy box instead. After a few moments, Mary said, "Nita, wake me up!" so I did and then we both just cracked up laughing. I told her that I'll really miss the speech therapy. It's the one session a week that I get to act like a little kid, forget all my worries, and basically just play and laugh. I told her that I would be having the transition meeting this week, so she will be dropping off a report before that. She said that once I sign some kind of release form, she'll be able to discuss Raquel's case with the school district psychologist.
One side note to add: Last Saturday was my father-in-laws 80th birthday party (Happy Birthday Dad!). I prepared myself for the worst in dealing with Raquel - it was held at their community golf course clubhouse and had close to 100 people, the vast majority Raquel not even knowing. She did amazing! So great that she even was able to sit in a high chair at our table and have dinner with everyone. She was walking all around the place and wasn't the slightest bit scared. She even took a little nap while we were cutting the cake!
Friday, October 24, 2008
Great Accomplishments With Physical Therapy
This morning was the last physical therapy session for hopefully just a few weeks. The Regional Center assigned Jan a certain amount of hours towards Raquel, and today she used all that were given. Jan will now turn in an evaluation report along with her recommendations to keep Raquel under her care until she turns three. She is hoping to start seeing her every other week instead of weekly, since she's made such progress. Due to the paperwork trail, this may take several weeks before she is authorized to do so and her therapy resumes.
But we had wonderful news this morning. After reviewing the paperwork, Jan noted that Raquel had met - or EXCEEDED - all of the goals assigned to her during her initial evaluation! What wonderful news to hear - especially given the fact that her delay in walking was the one thing that got her assessed in the first place!
Jan was so pleased with how Raquel was today. She was going up and down curbs and hills, climbing on the equipment, walking backwards, sideways, pivoting herself around - just obviously much stronger and able to do more things. She walked all over that place to near exhaustion. I could barely get her home and in clean clothes before she fell fast asleep. Jan showed me some more techniques to use when I'm working with her on the stairs, and asked me to tell the psychologist in our transition meeting that she recommends "Adaptive Physical Education" for Raquel. I guess this is therapy in a group setting. Not exactly sure. But our transition meeting is next Thursday, so I'll get more info then from the psychologist. I should also be given names of schools in the area (probably just a handful) that Raquel will qualify for and that I can hopefully start checking out.
This encouraging PT news was actually bittersweet to me. Earlier this week, one of her therapists made a comment during conversation that she didn't know if Raquel would ever have the ability to do something that I had asked about. It wasn't a specific task, it was just a general thing. So general that I don't even remember my question. It wasn't a huge thing at the time, certainly didn't bother me at the time, and I am 100% confident that it wasn't said in ill regard, but I became very emotional once I started replaying it in my head. And not because I'm being unrealistic about where Raquel is developmentally. I feel that I have a very accurate assessment of her abilities - especially considering I deal with her therapy on a daily basis.
It bothered me because I felt that she was already being labelled. And that part I hated. As a mother, I have never - not once - given up on her, even during her worst times. I've always believed in my heart that Raquel would catch up eventually and have a normal and productive life. I still feel this way. Look how far she has come already! That comment just made me start to not only question myself but also think about how people are going to judge her as she ages, if she continues to have these challenges. I see how she is judged by complete strangers that assume her sometimes distracting behavior is my lack of parenting. The rolling of the eyes, the "MY child would never hit ME" comments, etc. are very annoying, even though they don't bother me as much as they used to, or happen nearly as often. (Side Note: Cari told me that Elizabeth tells parents that the next time they get "the look", to give that person the "mental finger." It really does work!) Next time you see an upset child in a grocery store or mall, please think of me and Raquel. They may be going through the same thing we are. Again, it's 1 in 150 now. That equals a lot of people going through the same thing.
Janine overlapped with Cari for the afternoon ABA session. Raquel did really well - and was very happy throughout. We discussed how to integrate the sensory input into the session as well as developing her motor planning. Seems like we still need to play around with this a bit. Janine wants me to find out from Karin next week how she recommends transitioning a sensory child into a preschool setting. She also said that starting next week, we are going to be doing weekly outings, replacing one in-home session, to help with the transition.
But we had wonderful news this morning. After reviewing the paperwork, Jan noted that Raquel had met - or EXCEEDED - all of the goals assigned to her during her initial evaluation! What wonderful news to hear - especially given the fact that her delay in walking was the one thing that got her assessed in the first place!
Jan was so pleased with how Raquel was today. She was going up and down curbs and hills, climbing on the equipment, walking backwards, sideways, pivoting herself around - just obviously much stronger and able to do more things. She walked all over that place to near exhaustion. I could barely get her home and in clean clothes before she fell fast asleep. Jan showed me some more techniques to use when I'm working with her on the stairs, and asked me to tell the psychologist in our transition meeting that she recommends "Adaptive Physical Education" for Raquel. I guess this is therapy in a group setting. Not exactly sure. But our transition meeting is next Thursday, so I'll get more info then from the psychologist. I should also be given names of schools in the area (probably just a handful) that Raquel will qualify for and that I can hopefully start checking out.
This encouraging PT news was actually bittersweet to me. Earlier this week, one of her therapists made a comment during conversation that she didn't know if Raquel would ever have the ability to do something that I had asked about. It wasn't a specific task, it was just a general thing. So general that I don't even remember my question. It wasn't a huge thing at the time, certainly didn't bother me at the time, and I am 100% confident that it wasn't said in ill regard, but I became very emotional once I started replaying it in my head. And not because I'm being unrealistic about where Raquel is developmentally. I feel that I have a very accurate assessment of her abilities - especially considering I deal with her therapy on a daily basis.
It bothered me because I felt that she was already being labelled. And that part I hated. As a mother, I have never - not once - given up on her, even during her worst times. I've always believed in my heart that Raquel would catch up eventually and have a normal and productive life. I still feel this way. Look how far she has come already! That comment just made me start to not only question myself but also think about how people are going to judge her as she ages, if she continues to have these challenges. I see how she is judged by complete strangers that assume her sometimes distracting behavior is my lack of parenting. The rolling of the eyes, the "MY child would never hit ME" comments, etc. are very annoying, even though they don't bother me as much as they used to, or happen nearly as often. (Side Note: Cari told me that Elizabeth tells parents that the next time they get "the look", to give that person the "mental finger." It really does work!) Next time you see an upset child in a grocery store or mall, please think of me and Raquel. They may be going through the same thing we are. Again, it's 1 in 150 now. That equals a lot of people going through the same thing.
Janine overlapped with Cari for the afternoon ABA session. Raquel did really well - and was very happy throughout. We discussed how to integrate the sensory input into the session as well as developing her motor planning. Seems like we still need to play around with this a bit. Janine wants me to find out from Karin next week how she recommends transitioning a sensory child into a preschool setting. She also said that starting next week, we are going to be doing weekly outings, replacing one in-home session, to help with the transition.
Wednesday, October 22, 2008
Sensory Motor Planning
Jennifer had an early session today so she could overlap with Karin. One of the things discussed in our last Team Meeting was Raquel's limited motor planning and how the ABA Team could help develop this during their sessions. Motor planning is part of occupational therapy, so they needed Karin's input.
To help with her motor planning, Karin recommended that they do a few things during their sessions:
- Increase the proprioceptive input by doing the jumps, crashes, crawling out of the beanbag, etc.
- Increase vestibular input to help strengthen Raquel's muscle tone by primarily doing the fitness ball bouncing, but to only do this AFTER giving her the proprioceptive input. The timing is important.
A few other general recommendations from Karin were:
- PECS. She wants the ABA Team to help develop Raquel visually cross midline. So, if Raquel picks up the PECS with her right hand (which she is consistently doing), Karin wants their hand to be on the left so she'll have to reach over to the left. I guess this whole "crossing midline" thing doesn't fully develop until age 3. This is when a hand dominance typically takes effect. Even though Raquel is behind - I try to think of her as a year younger developmentally - it's not a critical thing to have this develop by her 3rd birthday. However, based on Karin's observations, she feels that certain tasks are becoming just a learned pattern and not a hand preference. Raquel consistently - and accurately, mind you! - throws with her left. If she has something in her right hand, I am never on the defense about getting hit because I know she doesn't throw right handed. But, she eats, drinks, and brushes her teeth with her right hand. She draws with her left. PECS, as mentioned, is a right handed thing.
- Keep Sensory Items - Sensory: Lately, the ABA Team have been using the ball bounces at times for both her interverbals and verbal immitation programs. They bounce her while singing a song that they want her to fill in with words or to make immitations of sounds they are demontrating. Karin recommended that they keep sensory related items strictly sensory, and not associate it with the working part of the session. She said to try to give her the sensory input first, then target all the verbals afterwards. We'll have to see how it goes.
- Less Time For Stimulating Items: I've posted many times about how Raquel loves the spinning tops. It's one of her biggest reinforcers. Today, she was having table time and playing with them, and Karin asked Jennifer to take them away because she noticed she was getting really wound up. The same thing happened a little later with the play phone. It appeared that the longer she was allowed to play with these items, the more overstimulated she would get.
- The "Song": If the song is needed during a session, Karin suggested that it be Raquel's break from therapy. She said that Raquel has associated the song to her self-calming, and to try to force her to work while the song is playing will only bring out behaviors. I could sense that today. Karin asked me to play the song at one point and Jennifer continued with her session. Raquel was arching her back and doing everything she could to get away from her. Once she was allowed to escape, she walked over to the radio and sat and listened. When the song was over, she came back and joined us.
Another fascinating day in regards to the sensory thing. I'm always so amazed at how well Karin is able to read Raquel.
Saturday, October 18, 2008
Fun At The Pumpkin Patch
We took the girls to the Pumpkin Patch at Bate's this morning. Of course, we had to take pictures.
Raquel didn't know what to make of those things at first. And there sure were a lot of them!
But after a few short minutes, she was walking all over the place enjoying herself and having fun with all the hay!
Friday, October 17, 2008
Social Group At The Park
Instead of our regular ABA session today, we had a social group at the park. What a great idea! This not only allowed Raquel to interact with kids her age also having learning challenges, but also allowed me to interact with families going through the same thing. It also showed Gabby that other families have kids like Raquel. And it was a very comfortable atmosphere. I didn't have to explain my circumstance to any of them since they are going through the same thing. And I didn't get the "look" from judgemental strangers like I get at the grocery store, mall, etc. on a regular basis.
Raquel seemed to really enjoy herself! She had to warm up to walking unassisted, but after about 5 minutes was really all over the place. They provided fruit, juice, and all GFCF diet snacks - which was wonderful. It is really hard for her to watch us eat anything that she can't have. We also received a bunch of information on some resources available as well as a listing of restaurants that have GFCF menu selections.
Here is Raquel and Janine - the supervisor for her ABA Program:
And Raquel and Jennifer (aka, J-Lo):
She had fun playing with the parachutes...
...as well as smearing the shaving cream...
...although it did get quite messy! Here's Raquel & Cari:
What a nice way to end our therapy week!
Raquel seemed to really enjoy herself! She had to warm up to walking unassisted, but after about 5 minutes was really all over the place. They provided fruit, juice, and all GFCF diet snacks - which was wonderful. It is really hard for her to watch us eat anything that she can't have. We also received a bunch of information on some resources available as well as a listing of restaurants that have GFCF menu selections.
Here is Raquel and Janine - the supervisor for her ABA Program:
And Raquel and Jennifer (aka, J-Lo):
She had fun playing with the parachutes...
...as well as smearing the shaving cream...
...although it did get quite messy! Here's Raquel & Cari:
What a nice way to end our therapy week!
Wednesday, October 15, 2008
Sensory vs. Behavioral Tantrums
Today during Raquel's OT session, I was able to get some insight from the Queen of Sensory (Karin) on how to determine whether or not one of Raquel's tantrums is sensory related or simply behavior provoked. Either way, they are hard to watch, but today I learned quite a bit from Karin - as usual.
Raquel was in a very playful mood this morning and greeted Karin at the door like she always does. It started out to be just another typical OT session but then a tantrum started for what I thought came out of no where. We both tried unsuccessfully to redirect her, so I picked her up, put the song on, and in a few minutes, we were back to work. Karin then asked me why I did that. My immediate response was that it was a sensory tantrum, and I didn't want her to get hurt. Karin disagreed. She said that it was definitely behavioral and that I should have gotten a pillow in case she threw herself back. She said that what I did was bail her out of a frustrating situation, completely reinforcing the behavior. GREAT. Now our occupational therapist is turning in to a behavior one...
Karin then described what she felt happened: They were working with these big, snap on beads. Raquel was sitting between Karin's legs, and Karin was having Raquel push in and pull off the beads. Raquel became frustrated because she couldn't do it without Karin's help, then walked away from it. Karin and I started having a conversation - not giving Raquel any of our attention - and the tantrum started, gradually escalating.
Then she asked me to describe the tantrums yesterday during Jennifer's session. I told her how Gabby was wound up from being at school, I was irritated at her not calming down and instead running through the house, and that Raquel just got way overstimulated - one time at the table when Gabby was sitting across from her and messing with her toys. Karin said that would be considered a sensory tantrum, a tantrum provoked by energy changes. She also reminded me how much Raquel feeds off my energy source and that I need to constantly remind myself to stay calm.
We were talking about all of this as Karin was working with Raquel. She took the visual over-stimulation one step further by showing me something. Karin was giving Raquel the plastic eggs to crack open one by one. Raquel was having a great time, being very successful, and had a huge smile on her face. Karin said, "Watch this" and dumped the whole bag of plastic eggs in front of Raquel. Her temperament completely changed. The smile vanished. She got extremely overwhelmed by it, and instead of picking them up one by one, she was just aggressively touching all of them with no kind of play action. Karin then put them away and got Raquel back to where she needed to be, but it was AMAZING to see the difference in her by such a simple thing. Karin wants me to notice what we are doing during the ABA sessions that is causing her to be the most frustrated, that it could be a visual thing with simply too much stuff being out at once. Me witnessing this was HUGE and makes me much more aware of how such sudden changes can really affect her.
She had a great session with Jennifer this afternoon. I tried to keep Gabby preoccupied for the most part and we didn't have one tantrum. After the session, we had our ABA Team Meeting. Again, very encouraging and we all seem to be on the same page. My biggest concerns right now are Raquel having the tantrums again (although they are much more mild), and Gabby interfering during the sessions she's here for. Janine put a "Gabby Plan" in place tonight, which I think will really help. It will allow Gabby to feel like she is a critical part of Raquel's therapy, but at the same time, confine her to the kitchen area or office to do special arts and crafts "needed" for the sessions.
Raquel was in a very playful mood this morning and greeted Karin at the door like she always does. It started out to be just another typical OT session but then a tantrum started for what I thought came out of no where. We both tried unsuccessfully to redirect her, so I picked her up, put the song on, and in a few minutes, we were back to work. Karin then asked me why I did that. My immediate response was that it was a sensory tantrum, and I didn't want her to get hurt. Karin disagreed. She said that it was definitely behavioral and that I should have gotten a pillow in case she threw herself back. She said that what I did was bail her out of a frustrating situation, completely reinforcing the behavior. GREAT. Now our occupational therapist is turning in to a behavior one...
Karin then described what she felt happened: They were working with these big, snap on beads. Raquel was sitting between Karin's legs, and Karin was having Raquel push in and pull off the beads. Raquel became frustrated because she couldn't do it without Karin's help, then walked away from it. Karin and I started having a conversation - not giving Raquel any of our attention - and the tantrum started, gradually escalating.
Then she asked me to describe the tantrums yesterday during Jennifer's session. I told her how Gabby was wound up from being at school, I was irritated at her not calming down and instead running through the house, and that Raquel just got way overstimulated - one time at the table when Gabby was sitting across from her and messing with her toys. Karin said that would be considered a sensory tantrum, a tantrum provoked by energy changes. She also reminded me how much Raquel feeds off my energy source and that I need to constantly remind myself to stay calm.
We were talking about all of this as Karin was working with Raquel. She took the visual over-stimulation one step further by showing me something. Karin was giving Raquel the plastic eggs to crack open one by one. Raquel was having a great time, being very successful, and had a huge smile on her face. Karin said, "Watch this" and dumped the whole bag of plastic eggs in front of Raquel. Her temperament completely changed. The smile vanished. She got extremely overwhelmed by it, and instead of picking them up one by one, she was just aggressively touching all of them with no kind of play action. Karin then put them away and got Raquel back to where she needed to be, but it was AMAZING to see the difference in her by such a simple thing. Karin wants me to notice what we are doing during the ABA sessions that is causing her to be the most frustrated, that it could be a visual thing with simply too much stuff being out at once. Me witnessing this was HUGE and makes me much more aware of how such sudden changes can really affect her.
She had a great session with Jennifer this afternoon. I tried to keep Gabby preoccupied for the most part and we didn't have one tantrum. After the session, we had our ABA Team Meeting. Again, very encouraging and we all seem to be on the same page. My biggest concerns right now are Raquel having the tantrums again (although they are much more mild), and Gabby interfering during the sessions she's here for. Janine put a "Gabby Plan" in place tonight, which I think will really help. It will allow Gabby to feel like she is a critical part of Raquel's therapy, but at the same time, confine her to the kitchen area or office to do special arts and crafts "needed" for the sessions.
Tuesday, October 14, 2008
The Transition Phase
I've always known that it was just a matter of time until we would lose all of our wonderful therapists we've grown so close to and would have to move Raquel on to her next therapy chapter. And here we are.
Last week when Janine overlapped with Cari, she asked me if I had talked to the Regional Center. I said no because why would I and they certainly don't call me. She said that Raquel is only 3 months out before she will be leaving her current ABA program at age three and that a "transition phase" is supposed to be happening now. This is when my social worker, Ken, sets up a meeting with me and our School District so they can start their own evaluation process on Raquel. Her current therapists are invited to this meeting, however, due to scheduling conflicts, may just send them a report with their feedback. Raquel will be assessed by all new therapists from the school district. She will have another evaluation (possibly) from the Regional Center psychologist in January to see if she can be given a diagnosis. They will also be doing an IEP (Individualized Education Program) at this point as well. This is when they detail specific goals for her to help her succeed in school.
According to Ken, this Transition Meeting does a few things:
Last week when Janine overlapped with Cari, she asked me if I had talked to the Regional Center. I said no because why would I and they certainly don't call me. She said that Raquel is only 3 months out before she will be leaving her current ABA program at age three and that a "transition phase" is supposed to be happening now. This is when my social worker, Ken, sets up a meeting with me and our School District so they can start their own evaluation process on Raquel. Her current therapists are invited to this meeting, however, due to scheduling conflicts, may just send them a report with their feedback. Raquel will be assessed by all new therapists from the school district. She will have another evaluation (possibly) from the Regional Center psychologist in January to see if she can be given a diagnosis. They will also be doing an IEP (Individualized Education Program) at this point as well. This is when they detail specific goals for her to help her succeed in school.
According to Ken, this Transition Meeting does a few things:
- Introduces me and Raquel into our School District.
- Introduces me and Raquel to the School Psychologist named Lorraine. Mary, our current speech therapist, works for the district and speaks very highly of Lorraine and says we will be in great hands. Great news! (Side note: Even though Mary works for our school district, she will no longer treat Raquel. Through the district, she only works with children who have Apraxia or who are hearing impaired.)
- Lorraine will review Raquel's abilities from the initial assessments and compare her to where she's at now. She will then assemble Raquel's new "Team" of therapists.
- I will have a chance to voice any concerns and ask questions.
Raquel's next assessment with the Regional Center Psychologist can take place anytime between the transition meeting and when the IEP is done. Ken also said I wasn't required to have her re-evaluated if I didn't feel it was necessary. I'll need to talk to our current therapists regarding this. I was extremely disappointed with how her original assessment at Regional was handled and a good part of me doesn't want her subjected to any more stress than necessary. Ken did state that the school district will be doing their own evaluations and could simply report their findings back to the Regional Center in order to continue their services.
So how do they transition her to all new therapists? Cold turkey! Since her 3rd birthday is on a Monday, she'll have her last ABA session the previous Friday. The therapists she meets with weekly will have their last sessions the week before her birthday as well. And then what? Well, we're not supposed to be in contact with any of them anymore and Raquel just moves on to her new program in the school district. It's kind of weird. You would think they would transition gradually - for everyone's sake. To have Raquel go from pretty intense, in-home, daily sessions to a school setting seems difficult - especially for a child so demanding of routine. But, maybe switching everything all at once makes it easier on her. We'll have to see.
I have mixed emotions about it all. On one hand, I'm concerned about not having the daily support I've become accustomed to. Every day I have a trained therapist (or two) in-house that I can ask questions, get feedback, learn techniques from, etc. And I take advantage of this a lot. On the other hand, I am looking forward to getting my life back to somewhat normalcy, if there is such a thing now, where therapy will take place outside the home so I will be able to dive back in to my work and have a break from it all. But thinking that way always makes me feel and sound so selfish.
Raquel has had decent ABA sessions so far this week. Unfortunately, Gabby triggered two sensory tantrums this afternoon so she may no longer be able to participate in Raquel's therapy - at least in the capacity she has been. Tomorrow night we have our next Team Meeting after her regular session.
Monday, October 13, 2008
A Funny Speech Session
This afternoon's speech session with Mary was the funniest session I've ever observed.
Even though Mary brought her three bags of goods last week, she still had a couple challenges with Raquel trying to dive right in to them - especially the bright yellow one. Today, Mary showed up with three PILLOW CASES instead! Raquel saw her pull up in the driveway and immediately ran to the door to greet her. As soon as Mary walked in with the pillow cases, Raquel cracked a big smile and started laughing. She totally knew why she brought them!
Once we sat down to start her session, Mary brought out these big animal puppets. One was a purple bird that made squawking noises. Raquel really took to that thing and must have played with it for 30 minutes. At first, she was startled by the noises. Raquel would go up to it and try to bite its nose and Mary would make it say, "SQUAAAAWWWK!!" really loud. Raquel jumped a couple times but then started doing it on purpose just to hear it scream at her. She was laughing and laughing and totally carrying on. And not just her typical laughing - we are talking about full on belly laughs where she was rolling on the floor and could hardly contain herself! It became contagious and pretty soon all three of us were laughing uncontrollably. Mary was so happy to see her demonstrate such an incredible sense of humor.
Mary also had these really cool magnetic animals. She had a cow, dog, horse & cat and this magnet stick that would lift them up. The animals (one by one) couldn't go back down until Raquel told them to do so, which she did. She was also choosing the animals by name. Mary did a couple tests for her Rosetti Assessment report that she has to turn in. One of them was Raquel picking out random items in a field of five. In the ABA sessions, she is required to pick the same item over again in a field of three. Today she had no problem identifying random items in a higher field. Mary also tested her on verb photos. She would show Raquel pictures of someone crying, eating, swinging, sleeping, etc. and ask her to choose what she was asking for. And she did great!
How were her vocals? Pretty limited due to all the laughing, although she was using functional speech when she was using it. Again, Mary is more encouraged to hear my list of words she uses in daily use instead of what she says during the speech sessions. I'm finally not offended when Raquel isn't vocal during speech. And it's only taken me 8 months to get to this point. :-)
Even though Mary brought her three bags of goods last week, she still had a couple challenges with Raquel trying to dive right in to them - especially the bright yellow one. Today, Mary showed up with three PILLOW CASES instead! Raquel saw her pull up in the driveway and immediately ran to the door to greet her. As soon as Mary walked in with the pillow cases, Raquel cracked a big smile and started laughing. She totally knew why she brought them!
Once we sat down to start her session, Mary brought out these big animal puppets. One was a purple bird that made squawking noises. Raquel really took to that thing and must have played with it for 30 minutes. At first, she was startled by the noises. Raquel would go up to it and try to bite its nose and Mary would make it say, "SQUAAAAWWWK!!" really loud. Raquel jumped a couple times but then started doing it on purpose just to hear it scream at her. She was laughing and laughing and totally carrying on. And not just her typical laughing - we are talking about full on belly laughs where she was rolling on the floor and could hardly contain herself! It became contagious and pretty soon all three of us were laughing uncontrollably. Mary was so happy to see her demonstrate such an incredible sense of humor.
Mary also had these really cool magnetic animals. She had a cow, dog, horse & cat and this magnet stick that would lift them up. The animals (one by one) couldn't go back down until Raquel told them to do so, which she did. She was also choosing the animals by name. Mary did a couple tests for her Rosetti Assessment report that she has to turn in. One of them was Raquel picking out random items in a field of five. In the ABA sessions, she is required to pick the same item over again in a field of three. Today she had no problem identifying random items in a higher field. Mary also tested her on verb photos. She would show Raquel pictures of someone crying, eating, swinging, sleeping, etc. and ask her to choose what she was asking for. And she did great!
How were her vocals? Pretty limited due to all the laughing, although she was using functional speech when she was using it. Again, Mary is more encouraged to hear my list of words she uses in daily use instead of what she says during the speech sessions. I'm finally not offended when Raquel isn't vocal during speech. And it's only taken me 8 months to get to this point. :-)
Wednesday, October 8, 2008
Great Input From OT
Yesterday's session with Jennifer was definitely not typical. It started out well but soon in to it, a tantrum started, which Jennifer thought seemed sensory related instead of behavioral. Once she calmed down, she was able to continue the session as long as I was out of the room, which was really weird. Even if I distracted her by walking slowly in the kitchen, it would set her off. So I pretty much spent the last half of her session hiding out in the kitchen and being as quiet as possible.
I was really looking forward to Raquel's occupational therapy this morning. She hasn't seen Karin in two weeks and since she has been so "sensory" this past week, I knew Karin would be able to shed some insight. And, of course, she did.
As soon as Karin sat down to start her session, Raquel began wondering around the room aimlessly. She was very happy and laughing, but just seemed a little overstimulated. Karin immediately said that she needed some vestibular input and got out the fitness ball. Instead of bouncing her on it, she showed me how to do "crashes", where I roll her off the ball and on to the bean bag. This sudden impact gives her strong vestibular input. She did this about five times, then sat back and watched. In about 15 seconds, Raquel sat down in front of her ready to play.
A little while later, Karin sensed that Raquel was about to start escalating and asked me to get a bed sheet. She folded it in half and layed it on the floor. She put Raquel down on the edge and rolled her up. Once she got to the end, she grabbed the other edge, and while Karin standed, unrolled Raquel. This is a way to give stronger input as well. She also spinned her in my office chair - not very fast - and just five times. One thing she did tell me today is to monitor what direction I am spinning and Raquel's reaction to that. She said it is very possible that she may like spinning left to right, but could become aggitated if I spin her from right to left. Weird how all of that works. She said to think of the ear follicles like blades of grass in the wind. The wind blows one direction and they go that way. Then the wind blows the other direction, and they go the other way. That's what I'm doing to her by the spinning. If I spin her to the right a few times then go to the left, I'm not giving her the input she needs - I'm actually even contradicting it in a way.
My assignments from Karin in order to get the sensory issues back under control:
I was really looking forward to Raquel's occupational therapy this morning. She hasn't seen Karin in two weeks and since she has been so "sensory" this past week, I knew Karin would be able to shed some insight. And, of course, she did.
As soon as Karin sat down to start her session, Raquel began wondering around the room aimlessly. She was very happy and laughing, but just seemed a little overstimulated. Karin immediately said that she needed some vestibular input and got out the fitness ball. Instead of bouncing her on it, she showed me how to do "crashes", where I roll her off the ball and on to the bean bag. This sudden impact gives her strong vestibular input. She did this about five times, then sat back and watched. In about 15 seconds, Raquel sat down in front of her ready to play.
A little while later, Karin sensed that Raquel was about to start escalating and asked me to get a bed sheet. She folded it in half and layed it on the floor. She put Raquel down on the edge and rolled her up. Once she got to the end, she grabbed the other edge, and while Karin standed, unrolled Raquel. This is a way to give stronger input as well. She also spinned her in my office chair - not very fast - and just five times. One thing she did tell me today is to monitor what direction I am spinning and Raquel's reaction to that. She said it is very possible that she may like spinning left to right, but could become aggitated if I spin her from right to left. Weird how all of that works. She said to think of the ear follicles like blades of grass in the wind. The wind blows one direction and they go that way. Then the wind blows the other direction, and they go the other way. That's what I'm doing to her by the spinning. If I spin her to the right a few times then go to the left, I'm not giving her the input she needs - I'm actually even contradicting it in a way.
My assignments from Karin in order to get the sensory issues back under control:
- Start bouncing her more consistently on the fitness ball - the same times every day and for the same length of time (singing the ABC song for instance, so she knows at the end of the song, the bouncing stops).
- Implement stronger vestibular input activities slowly, keeping track of the times I've done them, her reactions, as well as her delayed reactions. She said that some reactions could often take hours and that the only way I'll know this is by consistently keeping track of what I'm doing and when I'm doing it to see if a pattern develops.
- Continue having her push around her weighted push toy. This gives her the proprioceptive input she seeks.
So why are we having sensory issues again? Karin is convinced that it is because there was a change in routine - the biggest one being my husband going back to work and being gone all day. She said that all it takes is something slight to throw her off, and this was a pretty big thing. She also said that when he lost his job and was home, it happened then as well. Looking at probably a couple challenging weeks but am confident that I'll be able to get her back on track.
Monday, October 6, 2008
Out Of Sorts Today
Even though Raquel slept really well last night and woke up in a wonderful mood, it just became an "out of sorts" day - with me, most likely, to blame.
Once Mike leaves for work in the morning, I typically take the girls out for a quick 1-mile walk around the neighborhood. Today, as I was rushing to get going, I locked the door - with my keys still inside. Fortunately I had my cell phone and was able to call for help. So our 15-20 minute walk ended up being over an hour, and me barely having enough snacks to keep Raquel content. I didn't have her shoes on yet, just her socks, so she was pretty much confined to the stroller this time. I was amazed at how well she did, and even once Mike was able to come home from work and let us in the house, she continued to be very playful.
The session with Cari started out okay, but shortly after we got going, out came the behaviors. It was an odd session because overall, she didn't score bad data wise, even scored 80% and above on several programs. It was just hard with the behaviors. Today was the first day in a very long time that I needed to pretty much sit on the floor throughout the session. Everytime I'd leave to check my work, she'd either follow me or whine. It was weird. And we had to play the song. Actually, the album was pretty much background music for the last part of the session.
Again, don't exactly know what happened or what seemed to set her off. Cari did remind me of how in touch Raquel is to my emotions. It could have been me being stressed this morning and then rushing around once we finally got back in the house. Or it could have been Mike leaving for work, then showing back up unexpectedly. Or maybe she just wasn't in to therapy today. We'll have to see what tomorrow brings.
Once Mike leaves for work in the morning, I typically take the girls out for a quick 1-mile walk around the neighborhood. Today, as I was rushing to get going, I locked the door - with my keys still inside. Fortunately I had my cell phone and was able to call for help. So our 15-20 minute walk ended up being over an hour, and me barely having enough snacks to keep Raquel content. I didn't have her shoes on yet, just her socks, so she was pretty much confined to the stroller this time. I was amazed at how well she did, and even once Mike was able to come home from work and let us in the house, she continued to be very playful.
The session with Cari started out okay, but shortly after we got going, out came the behaviors. It was an odd session because overall, she didn't score bad data wise, even scored 80% and above on several programs. It was just hard with the behaviors. Today was the first day in a very long time that I needed to pretty much sit on the floor throughout the session. Everytime I'd leave to check my work, she'd either follow me or whine. It was weird. And we had to play the song. Actually, the album was pretty much background music for the last part of the session.
Again, don't exactly know what happened or what seemed to set her off. Cari did remind me of how in touch Raquel is to my emotions. It could have been me being stressed this morning and then rushing around once we finally got back in the house. Or it could have been Mike leaving for work, then showing back up unexpectedly. Or maybe she just wasn't in to therapy today. We'll have to see what tomorrow brings.
Friday, October 3, 2008
Not Prepared To Go Backwards
I don't know what happened yesterday during Raquel's ABA session with Cari, but it certainly brought back a bunch of unpleasant memories.
She had a wonderful day - was talking up a storm, was happy and laughing pretty much throughout the day. She had an early lunch, a nap, and even a snack before the session. I was looking forward to another sucessful day of therapy.
The first half of the session was business as usual - she was content and scoring very well. But then, the first tantrum in over 2 months occurred. And two more happened shortly after that. Since she hasn't had any for so long, it completely took me (and probably Cari) off guard.
Then, as I was holding her tight to prevent her from hurting herself (or me), all the memories started coming back. Instead of this being a truly horrible experience, it actually allowed me to see firsthand how much we have progressed since the beginning of her therapy - especially the ABA Program. Although Cari recorded these tantrums as being severe, the duration was brief - roughly 5 minutes each time - and the song being a big part of that I'm sure. But I hadn't realized how much of the bad behavior I had blocked from my memory. Of course, the "pillow thing" from her throwing herself back constantly remained, but when I watched Cari doing the squashes in the bean bag, and the deep joint compressions while Raquel screamed at the top of her lungs, so distraught and wanting to escape, I had a huge reality check.
I remembered how in the beginning, her tantrums pretty much were attention seeking towards me, where I would have to leave the room all together until they could get her to calm down. I remembered that half of her sessions in the beginning were spent dealing with the tantrums, and how I had to physically sit on the floor next to her while they conducted their session. She constantly seeked my acknowledgement and approval, so much that she would usually turn her back to them and show me what they were asking for.
I remembered our first Team Meeting, where Mike told everyone that his main issue was her being so physical with me and that she would follow me around room to room crying for my attention. And I remembered the constant walking and driving around. I truly can't believe how far we've come in a few short months.
So what happened during our session to trigger this? We really don't know. Like I said earlier, it started out very typical. Cari had Raquel sitting at the table doing her tasks (they do sitting for 4 minutes now, with 50% of the time being actual "work"). I was in the other room checking my work emails, as I always do during table time, and she just started carrying on. It immediately got more and more intense. Usually I let the therapists deal with the behaviors because that's what they are there for and by me interfering tells her that if she acts this way, she gets my attention. But yesterday I sensed something was a little different and went in the room. Once I saw her face, I just knew.
The only thing we really can say was different during the first and last parts of the session was Gabby being in the room when the tantrum first started. At the start of the session, she was in her room playing. Halfway through it, she came running down the hallway, being very loud, and sat down across from Raquel during the table time. That doesn't seem like it would be enough to cause a tantrum, but if she was having an overly sensory day, that could be all it takes.
Needless to say, I was a bit hesitant about going in to today's therapy. Although Raquel slept fine and woke up in a good mood, I could slowly see a change in her temperament. Little things seemed to aggitate her throughout the day, and she was crying and whining off and on. I cancelled PT (again), and was determined to get her to sleep before Cari's session. Of course this never happened. Raquel was also less vocal today, less playful, and much more aggressive towards me and Gabby. It just wasn't a usual day for her.
When Cari came this afternoon, I warned her that she hadn't had a nap, that she was very cranky, and pretty much - GOOD LUCK! Turns out that Raquel had another great session and is moving on in prompt levels for a few programs! She was very cooperative and happy. Not even close to having a tantrum. Gabby was present throughout the entire session but today Cari made her the "reward helper" so once Raquel performed a task, Gabby could give her a reward toy. I don't know if that could have made a difference or not. We'll have to play around with it next week.
I asked Cari if it was common for kids to regress a bit at times. She said it does happen, but also can be related to many other things - changes in routine, being sick, diet changes, etc. Regardless, I'm not ready to go backwards and refuse to let Raquel do so! Looking forward to a somewhat restful weekend with the hopes of getting her back on track.
She had a wonderful day - was talking up a storm, was happy and laughing pretty much throughout the day. She had an early lunch, a nap, and even a snack before the session. I was looking forward to another sucessful day of therapy.
The first half of the session was business as usual - she was content and scoring very well. But then, the first tantrum in over 2 months occurred. And two more happened shortly after that. Since she hasn't had any for so long, it completely took me (and probably Cari) off guard.
Then, as I was holding her tight to prevent her from hurting herself (or me), all the memories started coming back. Instead of this being a truly horrible experience, it actually allowed me to see firsthand how much we have progressed since the beginning of her therapy - especially the ABA Program. Although Cari recorded these tantrums as being severe, the duration was brief - roughly 5 minutes each time - and the song being a big part of that I'm sure. But I hadn't realized how much of the bad behavior I had blocked from my memory. Of course, the "pillow thing" from her throwing herself back constantly remained, but when I watched Cari doing the squashes in the bean bag, and the deep joint compressions while Raquel screamed at the top of her lungs, so distraught and wanting to escape, I had a huge reality check.
I remembered how in the beginning, her tantrums pretty much were attention seeking towards me, where I would have to leave the room all together until they could get her to calm down. I remembered that half of her sessions in the beginning were spent dealing with the tantrums, and how I had to physically sit on the floor next to her while they conducted their session. She constantly seeked my acknowledgement and approval, so much that she would usually turn her back to them and show me what they were asking for.
I remembered our first Team Meeting, where Mike told everyone that his main issue was her being so physical with me and that she would follow me around room to room crying for my attention. And I remembered the constant walking and driving around. I truly can't believe how far we've come in a few short months.
So what happened during our session to trigger this? We really don't know. Like I said earlier, it started out very typical. Cari had Raquel sitting at the table doing her tasks (they do sitting for 4 minutes now, with 50% of the time being actual "work"). I was in the other room checking my work emails, as I always do during table time, and she just started carrying on. It immediately got more and more intense. Usually I let the therapists deal with the behaviors because that's what they are there for and by me interfering tells her that if she acts this way, she gets my attention. But yesterday I sensed something was a little different and went in the room. Once I saw her face, I just knew.
The only thing we really can say was different during the first and last parts of the session was Gabby being in the room when the tantrum first started. At the start of the session, she was in her room playing. Halfway through it, she came running down the hallway, being very loud, and sat down across from Raquel during the table time. That doesn't seem like it would be enough to cause a tantrum, but if she was having an overly sensory day, that could be all it takes.
Needless to say, I was a bit hesitant about going in to today's therapy. Although Raquel slept fine and woke up in a good mood, I could slowly see a change in her temperament. Little things seemed to aggitate her throughout the day, and she was crying and whining off and on. I cancelled PT (again), and was determined to get her to sleep before Cari's session. Of course this never happened. Raquel was also less vocal today, less playful, and much more aggressive towards me and Gabby. It just wasn't a usual day for her.
When Cari came this afternoon, I warned her that she hadn't had a nap, that she was very cranky, and pretty much - GOOD LUCK! Turns out that Raquel had another great session and is moving on in prompt levels for a few programs! She was very cooperative and happy. Not even close to having a tantrum. Gabby was present throughout the entire session but today Cari made her the "reward helper" so once Raquel performed a task, Gabby could give her a reward toy. I don't know if that could have made a difference or not. We'll have to play around with it next week.
I asked Cari if it was common for kids to regress a bit at times. She said it does happen, but also can be related to many other things - changes in routine, being sick, diet changes, etc. Regardless, I'm not ready to go backwards and refuse to let Raquel do so! Looking forward to a somewhat restful weekend with the hopes of getting her back on track.
Wednesday, October 1, 2008
A Very Happy Speech Therapist
On Monday afternoon, I was very excited to see Mary for speech. We haven't had a speech session in two weeks, and I've been keeping track of all of Raquel's new words and couldn't wait to share them with Mary! These new words/phrases include: wait, hurry, don't want to, don't want it, all done, you do it, there you go, get it, go get it, look, so tired, going, match, bubbles and yes. And she's using them appropriately. Very great news!
Let's just say that Mary was beyond pleased. She hugged and hugged Raquel and told her how proud of her she was. And, Mary caved and returned with her bags of toys, making for a very happy 2 1/2 year old. Raquel even left them alone for the most part. Maybe she's learned her lession, but I seriously doubt it. Unfortunately, Raquel was not particularly vocal for speech. She had a great morning session again with Cari, and I thought she'd be raring to go, but no such luck. Maybe it's because she hasn't seen her in a couple weeks.
Tuesday Janine overlapped with Jennifer and she did great as well. Janine was very happy to see her improving so much on her PECS - that just sort of took off on Friday for some reason, and she's been pretty consistent ever since. Janine made a couple small program changes and was overall very happy.
She had another great session today with Jennifer. She was able to probe out of a few more items during ROL (receptive object labeling) so we'll need to find new targets tomorrow.
Let's just say that Mary was beyond pleased. She hugged and hugged Raquel and told her how proud of her she was. And, Mary caved and returned with her bags of toys, making for a very happy 2 1/2 year old. Raquel even left them alone for the most part. Maybe she's learned her lession, but I seriously doubt it. Unfortunately, Raquel was not particularly vocal for speech. She had a great morning session again with Cari, and I thought she'd be raring to go, but no such luck. Maybe it's because she hasn't seen her in a couple weeks.
Tuesday Janine overlapped with Jennifer and she did great as well. Janine was very happy to see her improving so much on her PECS - that just sort of took off on Friday for some reason, and she's been pretty consistent ever since. Janine made a couple small program changes and was overall very happy.
She had another great session today with Jennifer. She was able to probe out of a few more items during ROL (receptive object labeling) so we'll need to find new targets tomorrow.
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