Tag Archives: Therapy

March 27, 2011

Goodbye, Explorers

Nursery school graduate

Nursery school graduate

On the Friday before her birthday, The Little Empress  got to celebrate her third birthday with her classmates. I baked cupcakes for the kids to eat at snack time and then bought a pizza for their lunch. Sadly, this would be her last day with her classmates as her program only covers from ages 18 months to 3 years.

After nearly a year of watching her other friends graduate out of the Explorers program and sit in the special Graduation Chair, she was so excited to get to pick out her two Circle Time songs and be presented with a certificate, hat and presents. TLE absolutely basked in the attention.

TLE has made such incredible strides in the class that it was very hard to accept that she wouldn’t be attending anymore. She went from being a somewhat aloof, tantrum-prone toddler with very few discernible words to a lively, friendly and chatty preschooler.

Playing with blocks on her last day

Playing with blocks on her last day

But all good things must come to an end at after graduation and a round of goodbye hugs, we bid goodbye to her Explorers teachers and friends. Her main teacher, Lisa, teared up a little bit when hugging TLE goodbye. I had some problems holding back tears myself!

I’ve had the opportunity to volunteer in the classroom and have seen first hand how the teachers interact with the kids.  One thing I really loved about the school was that the teachers really cared about the kids. They spend over 25 hours per week with the kids, more than most other preschool kids. That’s a lot of time for such small kids but the work that their teachers do with them is nothing short of amazing. I can’t thank them enough for being such an important part of TLE’s life for the past year.

In some ways, being part of this program has sort of spoiled us for other preschools. The teacher ratio is VERY low — about three kids per teacher — so each child got lots of special attention and support throughout the day. There was also a lot of support for their particular needs, like speech therapy and occupational therapy sessions, that were built in to each school day.

It was a bit of a shock — and disappointment — for me to realize that TLE will never, ever, get that kind of attention from a traditional school program ever again. Even the best private schools don’t have such specialized one on one attention. The exception, of course, would be to homeschool where she would receive all of the attention because she would be the only student… which is exactly what we’ll be doing.

Yep, we’ve made the decision to homeschool… at least for now. But more on that later :)

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December 28, 2010

Speech delay? What speech delay?

Out of the mouth of babes

Out of the mouth of babes

I’ve been meaning to write about how The Little Empress’ vocabulary has really exploded in the last two months. Almost overnight, she began repeating more and more words and using new ones that we didn’t even realize she knew.  I attribute a lot of this to the visit with her cousins over Thanksgiving as well as the sheer amount of time we’ve been spending with her since then. The gain has been so significant, in fact, that I’m almost worried that she won’t qualify for speech through the school district anymore.

But all this was just leading up to tonight. Folks,  we just had a milestone of epic proportions. And what was that, you ask?

My lovely, darling daughter turned to me and proudly said, “Oh no! I farted, Mommy!”

Yep. As far s I’m concerned, she’s totally caught up to other preschoolers.

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November 15, 2010

Can’t Rush Me

TLE, the cheeky Empress

TLE, the cheeky Empress

The Little Empress recently added two new, long awaited words to her vocabulary:

“Mommy! Daddy!”

Before last weekend, she would say  “Mom” and “Dad.” Less often, she’d say “Mama” and “Dada”

I like the certain ring the words “Mommy” and “Daddy” have to them. I like this change.

* *

One of the more heartbreaking things about her speech delay is that we’re still waiting to hear her say, “I love you.”

We know she loves us. But sometimes, you just really… really… want to hear it.

But I can be patient for just a little while longer. If The Little Empress has taught me anything, it is that she does everything on her own terms, when she’s ready.  I know I’ll hear it, eventually. And when I do, I know that she’ll mean it and it will make hearing it that much sweeter.

Can't rush her -- perfection takes time.

Can't rush her -- perfection takes time.

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November 5, 2010

Two steps forward, two steps back…

The Little Empress and the Fountain

The Little Empress and the Fountain

The last week or so has seen a few setbacks for The Little Empress. We had started her potty training about two weeks ago. It was going well until she suddenly refused to use her potty one day. We’ve gone back from Pull-Ups to diapers; now she won’t even touch the potty. Her speech has also taken a hit. Though she still does talk, she’s been using less words and signing more, sometimes regressing into nonsensical strings of babble.We constantly have to remind her to “use her words” and have been met more with defiance and tears, much like we were in the beginning. She won’t say her name anymore when asked; she’ll say “me” or ‘baby” but refuses to use her name. Even though she has the words to get her needs met, she’s not using them. This, of course, means that she’s more temper tantrum prone than usual. This, coupled with her usual toddler issues — no means yes, yes means no, etc. — and we’ve just been run ragged.

I’m really at a loss for what can be causing this. There hasn’t been any major events or changes lately. It is kind of like she just decided, “Hey, I don’t want to talk, so I won’t…” and hasn’t. It has been frustrating all around and I’m finding myself really reminded of the days before we had her speech delay diagnosed. I’m sure it will clear up and we’ll be back to our normal soon. Until then, got to ride the wave.

I have to confess that this hiccup makes me a bit nervous about heading down to see the family for the holidays. TLE is notoriously unpredictable. Even though she sees my parents every week and my sister lives with us for part of the week, it is a crapshoot every week on how she’ll handle seeing them. For instance, TLE will sometimes walk through the house calling, “Auntie, where are you?” But when she saw my sister yesterday when we picked her up, she immediately started crying and even pushed her away when she got close. Sometimes, she’ll warm instantly and other times, she’ll be clingy for the entire visit. There’s just no way of telling how she’ll react to my in laws who, of course, love her to bits but who she sees rarely. All I can hope for is that she’ll warm instantly and save us all from having to explain her more… eccentric… behaviors.

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October 20, 2010

Transition Meeting

Paint

Paint-covered TLE

At three years old, The Little Empress will no longer be covered by the county’s Early Intervention and her special education needs will be covered by the local school district. So today, I met with her current program coordinator, early intervention coordinator and a representative from the district’s special education program to discuss beginning the transition process. Basically, she’ll be re-evaluated by the school district in the next few months to see if she qualifies for services. The program coordinator at her current school and the early intervention coordinator agree that she does need speech therapy but whether or not she gets it will all depend on whether or not the school district agrees. And if they do, she gets a half hour per week with a small group of kids. Eventually, I’ll be provided with a list of local preschools that may be options for her. (Though the co-op preschool seems to be universally recommended and may very well be what we go for.)

And now begins the uphill battle, which I haven’t been looking forward to. Unlike our early intervention coordinator, I’m not getting warm fuzzies from the lady who is handling TLE’s transition to the school district. I don’t know, that may just be a first impression and hopefully, I’ll find out differently in the months to come.

* *

Another thing that has been on my mind is whether or not to get her assessed for anything beyond her speech delay. It’s been driving me crazy wondering if her speech delay, especially when paired with her social delay and sensory issues, may be indicative of being on the spectrum. If anything, I’m just hoping they’ll rule out the possibility of being on the spectrum so I can put my mind at ease. It looks like getting an assessment may also be an uphill battle. The EI coordinator said that, on paper, they’ll just see the speech portion and not really look at the social since her cognitive levels are developmentally appropriate. But, she said she’d fight for an assessment so I’ve got my fingers crossed that hopefully, I’m closer to an answer (or at least a resolution) than not.

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September 17, 2010

Special needs or not?

TLE’s recent progress assessment meeting brought up some thoughts I’ve been having since she entered the center based program. Most days, I do my best to avoid labeling TLE. I keep my head down and think about what she needs in an individual sense. I do my best to not think about what kids her age “should” be doing and instead concentrate on what she is doing right now. For the most part, this works. The fact that I’ve never been around small children and have no idea what to expect sorts of helps. (Does this count as willful ignorance?)

For a month or so after her initial assessment with the county, I found myself in a terrible funk and riddled with guilt. Why is she speech delayed? What did I not do? Did I not stimulate her enough? Did I not play with her enough?  I blamed myself for her delays. I cried thinking that I’m a horrible mother than didn’t do enough. I cursed myself. I thought  I worried that maybe we could have caught her delays earlier, gotten her help earlier. But I realized something important: she’s developing at her own pace. Being able to accept that has allowed me to move beyond wanting to find a reason why. Now I just want to concentrate on finding ways to help her. That’s where the “special needs” label comes in.

I’ve always been torn on the “special needs” label. I always considered her “high needs” but for some reason, the idea of her being “special needs” has been very hard for me to accept. The fact is that she is developmentally delayed and attends a special needs nursery school. These realities have been very hard for me to deal with.

On days that I’m faced with the reality of her delays, I find myself mulling over what she “should” be doing despite trying not to. On these days, I spend every waking hour that’s not spent attending to TLE is spent poring over literature or researching information about speech delays , sensory issues and how to help her. I look for activities that will address her speech and sensory issues. I keep journals and notes of her progress, writing down what she is doing at home and sharing it with her teachers and therapists. It is on days like this that I think about the “special needs” label and consider that it may be appropriate.

Yet when I see TLE’s classmates and the variety of challenges that their families have to contend with, I feel like I have no right to feel as out of sorts as I do. TLE’s classmates all struggle with challenges ranging from autism to cerebral palsy. Each of these children and their families struggle with a totally different set of challenges, all far more complex and with longer reaching ramifications on their entire family’s lives. I remind myself that speech delays are by far the most common developmental delay and that TLE will likely outgrow this delay in due time. Most of her classmates and their families will continue to face their challenges, head on, for their entire lives. I can’t help but admire their families for being strong in the face of their challenges.

I also can’t help but feel a bit of a whining maggot myself for worrying about our own.

A lot of times, I feel like I’m in no man’s land. On one hand, there’s plenty of support for families with special needs children. TLE’s school provides the parents with local special needs resources, generally tailored for families coping with serious challenges like autism or Down’s. I am also part of a local special needs mailing list which is very friendly and full of warm, supporting people. Yet reading about the daily challenges all the families deal with makes me feel like I’m feeling stressed for nothing. THEIR families deal with so much more; what am I complaining about?

At the same time, I know that I deal with far more than most typical parents do. My day… no, my life… is really centered around her and providing for her needs. TLE is a whirlwind of activity and can be volatile. It used to be that just about anything could set her off, from an unexpected change in activity to an item being given to her in the wrong way. (I am so very grateful that her inconsolable tantrums have improved to the point that they’re no longer lasting hours!!) I spend a good chunk of time researching ways to help her with her speech delay, learning what I can about sensory integration dysfunction and being proactive about her sensory diet. And I have to do all this while reminding myself not to be a helicopter parent, to set realistic limits and expectations and remind myself, above all else, that she’s far, far more than just the delays. That she’s a loving, vivacious child that depends on me to guide her lovingly.

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September 16, 2010

Assessment update

The Little Empress, avoiding the camera

The Little Empress, avoiding the camera

Yesterday, The Hubs ™ and I attended The Little Empress’ assessment meeting to review how she’s progressed since we set some specific goals for her in June. Overall, her progress has been steady and consistent. Her gross motor and fine motor skills test at nearly 36 months old (!!); her cognitive and self-help abilities test at her current age level; but her social and expressive speech continue to be issues. At this point, she has more than a 50% delay in her expressive speech, which I wasn’t surprised about. What I was surprised about is that she is still testing at approximately a 50% delay socially. It is really sort of a head scratcher — she’s very friendly, she acknowledges that are kids around and she has some special friends that she shows appropriate affection with but she still doesn’t initiate play. New goals were set and now TLE has a bunch of new stuff to work on.We also confirmed that, yes, TLE will be at the center-based program until she ages out next March.

During the meeting, I was reminded about how absolutely lucky we’ve been with the county. When I joined a local special needs list, there was a lot of talk about how to advocate for your child and to push back when county denies services. Budgets are strained and they tend to try to cut corners were they can. We have a passionate case worker who advocates hard for her cases. She confessed to me that, if we had lived eleswhere chances are that TLE would have only gotten limited speech therapy which wouldn’t have helped her much at all. TLE’s speech therapist asked about the possibility of the county paying for more intensive speech therapy with TLE, considering her delays. I had already checked with our health insurance and they will not cover speech therapy that is not attributable to medical condition.

On the way home, The Hubs ™ and I discussed more things I can do at home with TLE to try to help her. That expressive speech component is important. I try my best not to compare TLE to other kids, reminding myself that she’ll gain speech at her own pace and that above all else, it is most important that she is healthy and happy. But it is still heartbreaking to realize that TLE isn’t like other kids; speech will be difficult for her for some time. While I know she’ll catch up eventually, I don’t want this to affect her self-esteem in the long run. And I know that the best way to do that is to continue to do what we’ve been doing: not comparing her to others, helping her when/where we can, using positive reinforcement and just loving and supporting her, no matter what.

Her therapists and teachers also brought up two more issues that we’re probably going to be dealing with for awhile. The first is TLE’s willful stubbornness. She simply refused to comply with many of the tests. The OT and her assistant had to jump through a lot of hoops to get her to do the gross motor tests. The program director, whom TLE loves, could not get her to comply with a simple game of peekaboo. She knew she could do it but TLE simply crossed her arms and shut her out. STUBBORN!! It is almost cute now but man oh man, I see a bumpy road ahead with her. TLE is very much about doing things her way. If it wasn’t her idea, it is hard to get her to go along with it. (I’d love to blame The Hubs ™ for this personality trait but sadly, I think she gets it from both of us. Add on top she’s an Aries cusp and we’ve got our hands full!!)

Another thing that the brought up was her attention span. Of course, toddlers don’t have much of an attention span to begin with but TLE’s lack of attention span also made it difficult for them to complete tests in a timely manner. Very easily distracted, she’d flit from activity to activity. And when she was done, she was done.

Oi. We’ve got our work cut out for us.

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August 7, 2010

Progress Report: Months 3 and 4

TLE feeding her baby

TLE feeding her baby

I didn’t get much of a chance to write about The Little Empress and her school so now that I’ve got a moment, I figure I may as well talk about that. During her third month of school, I had a few meetings with her teachers and program coordinators to discuss her developmental goals. It seems that she will be in the program until she ages out at 3 years old which is fine by me since she is making so much progress. She also had a home visit that went horribly. TLE is notoriously bad with transitions and the arrival of her teachers (who belong IN SCHOOL in her toddler world) showing up on her doorstep, was too much for her to take. She melted down into a tantrum that lasted over an hour. The upside was that her therapist and teacher got to witness first hand the behavior issues I’d talked about during her evaluation. They took some notes and talked to her OT. Later, her OT and I had a meeting of our own and developed a sensory diet for TLE which, so far, has helped a lot. She still has melt downs but the severity has decreased as has the length of her tantrums. (THANK GOD!! One hour tantrums nearly every day are not for the faint of heart.)

She had a mini-language explosion around the end of June and beginning of July. She went from having only a few sounds to suddenly she began mimicking words on a frequent basis — it surprised us as well as her teachers! The mini-explosion has continued through till August. She seems to be adding new words to her vocabulary every day. I don’t think she has more than 100 yet but she’s getting there! She’s begun to show that she likes animals, a lot. She seems to especially love monkeys! She still can’t say the word “monkey” but she’ll make the sign for “monkey” and make monkey sounds.

Two absolutely huge things that she’s done lately: Within the last month, she actually said her name!!! She won’t say it all the time if you ask her, “What’s your name?” but she has been able to say it once or twice when asked. AWESOME!!! Within the last week, she’s been using the word “me” and “mine”, something she hasn’t done before. I”m so happy that her language is improving so much! The upside is that now that she has more of a vocabulary, she seems to be far less irritable and less easily frustrated since we can better understand her.

I think one of the craziest things about her speech issues is the fact that she seems like she’s trying to say sentences. I’ve heard her say four word sentences like “Where did it go?” but this is rare. It is almost like she wants to run before she can walk. Another funny thing is that she doesn’t have a word for “yes”. She has plenty of ways to say “no” but “yes” is not a word she says. Her nod is absolutely adorable, though. Instead of just nodding her head, she has this funny tendency to nod with her whole body. It is pretty adorable.

Socially, she’s a little butterfly. She is the class hugger as she seems to like to hug just about everyone. She still especially loves her friend Mauricio — and will occasionally ask about him at home saying, “Muh-muh-muh” with this adorable little half smile — and loves to hug her teachers, too.  I was a bit worried when she first started school as she had seemed aloof and disinterested in other kids her age when I’d taken her to playgroups but it doesn’t seem like she’s this way with her classmates at all.

At home, she’s started to do a lot more pretend play with her dolls and toys in the last month or so. In the photo above, she’s playing with her baby doll. She happily rocked, nursed and cuddled her “baby” and even put her in her booster seat so she could feed her while she was eating her dinner! She never did this before so I was pretty amazed to see how loving she was to her little “baby”. She also seems to love Pixar movies. She loves all animated movies but Pixar’s Up and Monsters Inc. seem to be her favorites right now and she will constantly ask to watch these two movies over. and over. and over again. She likes pointing out the characters and telling me if they’re “happy” or “sad”. Sometimes, when she’s watching a TV show, she’ll turn to me and say, “Help, help!” if the character on screen seems like they need help or are sad. She gets very into her shows now!!

Of course, she’s on vacation for most of the month of August. Yikes! Nearly three weeks of her at home every day… I almost don’t know what to do! Luckily, the OT and the OT intern at school provided the families with lots of fun activity ideas. I hope I can keep up with her!

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June 28, 2010

Activity – Bottle + Pasta

Playing with pasta

Playing with Pasta

I’m always on the lookout for fun activities for The Little Empress to do after school and during the weekends. She does well in school but is very prone to meltdowns once we’re home. We’ve discovered that the key to preventing her epic meltdowns is to keep her busy with activities that appeal to her nearly insatiable drive for sensory input. As I am sure you can imagine, it is always better to provide a safe and fun activity rather than leave her to her own devices. (When left to her own devices shortly after she’d finished with this, she was upstairs climbing onto counters. Oi.)

This is a simple and fun activity that I copied from her school involving an empty parmesan bottle.

MATERIALS

  • Empty parmesan bottle (with two different openings)
  • Pasta (long & short)

NOTE: You don’t have to use pasta for this activity; it is just what I had on hand. Other fun objects that you could use include coffee stirrers, pompoms, chenille stems, whatever you have handy.

WHAT IT TEACHES KIDS

This activity helps teach kids about size (what fits, what doesn’t), fine motor skills (placing objects through small openings with precision) as well as provides tactile (handling the pasta) and visual stimulation (the shapes of the pasta and colors.)

HOW TO PLAY

Gather the materials and set them in front of the child. If they’ve never seen the activity before, demonstrate how the objects can be put into the container through the different sized openings. Have the child experiment with what will fit and what won’t fit. Another fun thing to do is figure out how to get all the objects out of the container once they are in.

The Little Empress showing off her handiwork

The Little Empress showing off her handiwork

She’s seen it before at school so she was delighted to play at home. She happily dove into the activity which kept her busy for about a half hour as she stuck pieces of pasta into the parmesan bottle and then shook them out. It is pretty rare for something to hold her attention for so long so I was more than delighted with the results.

Shaking it out

And here’s another adorable photo of The Little Empress as she shakes the pasta out of the bottle. I just love the expression on her face.

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June 6, 2010

Progress Report: 2 months

The Little Empress, chillaxin'

The Little Empress, chillaxin'

The Little Empress has now been in school for 2 months. Compared to when she first entered school in April, she has a much larger vocabulary both verbally and signing. Her vocabulary is still limited to mostly one word utterances with the exception of her “were’do” sentences as in “mama were’do” (Where’d Mommy go?). It seems that every week, she’s learning more and more at school and becoming far more confident. She seems to have some trouble with pronunciation which doesn’t surprise me given her delay. She does identify “fwah” (flower) and “tee” (tree) and imitates the sounds for car and dog. She mimics words a lot now and does try to repeat new words.

Now that she can talk a little, her frustration isn’t so much that she’s not being understood but rather that we’re not letting her do what she wants. So basically, she’s being a typical, stubborn toddler. We’re not having quite as many tantrums as we were before but the ones we do have are still major blow outs. She’s also much more assertive of her independence these days, making her will known, sometimes at the top of her lungs. One dismaying development is that she’s very prone to getting physical when she doesn’t get her way. This isn’t too surprising considering she’s still very much a kinesthetic learning/communicator but it is something that I really need to get under control, fast. She’s pretty skinny but extremely muscular and when her arms and legs go flailing, she’s really capable of doing some damage. She’s kicked me, hard, a few times as well as slapped several people. I’m having a LOT of trouble disciplining her. Redirection and gentle reminders are generally ignored, despite repetition. I have a 1-2-3 rule. First time, I”ll redirect, second time, I’ll remind with a warning and third time, she’ll get slapped on the wrist. Mind you, I’m not against spanking in general (which is about the only AP principle I don’t agree with) but I think for TLE, it is not as effective simply because she doesn’t seem to even feel hand slaps. She simply giggles and goes right on doing what she’s doing.

Socially, she’s improving as well. She’s still very much a “I’ll approach you” rather than a universally friendly toddler, she is definitely taking interest in other kids she sees around her which she didn’t really do before. Although, about a month ago, I noticed that when a kid at the playground fell and hurt himself, all the little kids rushed to his side to see what was going on… except for TLE who couldn’t care less. That was a bit concerning. I haven’t had her outside of her classmates lately so I’ll have to see if this reaction has changed any lately.

Speaking of her classmates, she is also quite attached to them! She likes the girls in her classroom and has lots of little friends. She has one classmate in particular named Mauricio — a cute little guy with blond hair and glasses — who she absolutely adores. If you name all her classmates, she may smile but when you ask her about Mauricio, she gets a goofy little grin on her face and says “Muh-muh-muh”. My little one has a boyfriend! At age 2! When I told The Hubs ™, he growled a little. In his humble opinion, baby girls aren’t supposed to get boyfriends until… well, ever. Or if they must, at the age of 25 and done with graduate school.

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