Tuesday, March 20, 2012

I have to brag for a minute

Michael is so advanced when it comes to numbers and math. This kid can add and (nearly) subtract in his head!

Tonight our conversation went like this:

M: Kobun's crazy! I'm crazy too! Two crazies!
Me: What if mama's crazy too, how many crazies?
M: Three crazies!
Me: What if daddy's crazy too, how many crazies?
M: Four crazies!

This went on and on until we hit 12. Then I asked him

Me: What if Ruger wasn't crazy anymore, how many crazies?
M: Um...10?

So he didn't get the exact answer, but he went in the right direction and was dang close! :)

Thursday, March 8, 2012

Progress Report

I forgot to update his progress report back in Nov. He'd only been in school a few weeks at that time so I forgot. I'll update the one from the other day now.

Functional Sensory Processing:
When given safe sensory motor experiences, sensory supports, and strategies Michael will tolerate classroom tactile materials, hands on assistance, and hand holding improving functional sensory processing from demonstrates defensive reactions (stiffening, resistance, and withdrawal) to without defensive reaction such as withdrawal or resistance on 4/5 observations as measured by bi-monthly observations and data collection by OT

This is the area that we have seen the most improvement and has been a primary focus. Once his sensory system is in better shape the fine motor and other skills follow. We know now that it is  critical to give Michael extra processing time in order to increase his cooperation and flexibility. Many children like Michael have shown benefit from private sensory integrative therapy. I am happy to provide some resources. A referral can be made through your pediatrician. Desensitization brushing and deep pressure are important to help override the pain responses that light touch activates in his system.

Social Emotional/Behavioral:
When given opportunity to participate in classroom activities Michael will follow classroom rules and routines improving ability to participate in large and small group activities from not able to, to 80% of the time on 3/4 data days as measured by monthly teacher/classroom observational data and checklists.

Michael sits for the duration of circle. He participates at least 75% of the time. He tends to need some "processing" time when asked to participate in a direct learning activity, usually protesting first, then coming to the table and completing the activity with minimal adult assistance.

Social Emotional/Behavioral:
When given a verbal prompt Michael will transition to next activity (clean-up/stop/move, etc) improving his ability to transition from one activity to another from not able to, to 80% of the time 3/4 times on data days as measured by monthly teacher/classroom data and classroom checklists.

Michael knows and follows our classroom routines. He transitions independently about 70% of the time after he has a moment to process the request. He will say, "No" most of the time, but when he sees his classmates cleaning up/lining up/etc he will transition on his own.

Adaptive/Self Help:
When given the direction "time to go potty" Michael will go to the bathroom, pull down pants and sit on toilet and empty bowels/bladder improving toileting skills from emerging (sitting on toilet a few times) to independently going to bathroom and following procedure to use toilet 90% of time as measured by monthly teacher data and classroom checklist.

Michael will go into the bathroom, but will not attempt to pull down his pants - he continues to be resistive.

Adaptive/Self Help:
When given unfamiliar or undesired food (fruit/veggies) Michael will accept a small piece of food improving tolerance for undesired/non-familiar food from gagging/refusing to attempting a lick/smell/or a tiny "no thank-you bite" 90% of time on 3/4 data days as measured by monthly teacher data and classroom checklists.

He requests all of our food items. He will allow them to be on his place mat and will take a "no thank-you" (tiny bit) depending on the food. He always requests water and has been drinking several sips from the paper cup!

Functional Fine Motor & Sensory Processing Skills:
When given scissors and cutting project with simple 1/8" bordered shapes Michael will position scissors correctly and cut out independently improving fine motor and sensory processing skills from uses two hands/lacks correct positioning & snips only to with 75% on line accuracy on 3/4 observations as measured by monthly observation and data collection by OT.

Michael has made much process in his following of the routine, management of the sensory environment, and cooperation. Although his tendency is to greet each direction with "no" when given a little extra processing time he is now complying with the majority of requests and tasks. I have been treating his severe tactile defensiveness with desensitization brushing technique. He truly enjoys it and it has made a significant difference in his ability to tolerate washing his hands, using tools, playing with sensory materials, etc. I would be happy to teach his parents the technique on any Tuesday or Friday afternoon. It is delightful to see Michael smiling and laughing. He is so bright. His fine motor is slowly improving as he is now able to tolerate the tools. His cutting is still at the snipping stage thus he has not made much progress towards cutting out shapes. But truly he is progressing nicely and once his sensory system is in better shape the fine motor will quickly respond. He adores puzzles.

Functional Fine Motor & Sensory Processing Skills:
When given writing/drawing implement Michael will use a tripod grasp and dominant hand to hold and draw beginning pre-writing shapes (i.e. circle, cross, square) improving functional fine motor and sensory processing skills from uses pronated fisted grasp, lacks hand dominance, and beginning copy skills to on 4/5 times as measured by bi-monthly observation and data collection by OT.

Michael is showing more willingness to use pencils and crayons. He continues to switch hands and does not yet have a mature grasp. He knows his letters and numbers and can imitate a circle and a square, but not yet a cross.

When given an appropriate classroom setting Michael will produce novel (non-echoic) responses improving expressive language from 50% of responses to 80% of responses as measured by classroom data and language logs.

Michael continues to bloom in preschool. A recent inventory of his language indicates that 72% of his comments are non-echoic. This is wonderful progress and indicates that he is becoming more independent in his verbal output.

When given a classroom instruction or direction Michael will follow the direction or instructions improving receptive language from 10% accuracy (compliance) to 60% accuracy (compliance) as measured by classroom data.

Michael is very compliant with classroom directions and instructions. He requires minimal support and reminders to comply with classroom-based directions.

When given an opportunity to interact with a same-aged peer Michael will engage in a reciprocal conversation improving social language from 0 turns per conversation to 2 turns per conversation as measured by classroom data.

He was observed taking two conversational turns with a peer approximately two weeks ago. When engaged in a high interest activity (building with Legos), he was able to take two conversational turns with a supportive adult (me) on multiple occasions. He is becoming more willing to engage with others, but this interest is typically seen when the activity is highly motivating for Michael and the conversational partner is dedicated to keeping Michael engaged.

Wednesday, March 7, 2012

Talked to the ST today

I told her about the conference with Michael's school and the suggestion for OT. She said that she doesn't think he should completely stop ST, but she thinks it might be good for him to put a hold on it for 6-8 weeks while he does some intensive SI. She gave me a card to an OT she recommends. So I'll be calling them and see where we can go from here.

Tuesday, March 6, 2012

First Parent Conference

Today was the first time since Michael started school that I've been able to attend a parent conference. It went pretty well. I really feel like his teacher, ST, and OT know Michael really well. The things they struggle with at school sound like the exact things we struggle with at home (no surprise!). Most the conference was the OT going over Michael's sensory needs. She actually told me that he is the most severely tactile defensive child she has ever worked with. She suggested we get him into sensory integration therapy. We then talked about how I was toying with the idea of dropping speech to pick up OT because I can't really afford both therapies. They didn't really recommend I do that as they also feel he still needs speech. So I'm not sure. They said there are low cost/no cost options out there for SI but they don't really recommend them for children like Michael because he needs a very experienced OT to work with. So right now I'm not sure what we will do. I might talk to the ST on Wed about what she thinks. I know she said a comment about seeing speech ending in the foreseeable future. Maybe I should put ourselves on a wait list now just in case.

They also talked about how most kids gain skills at a gradual pace, but Michael seems to plateau and then just JUMP to the next level. I noticed that as well. It's like one day something will click and he will just take off in that one skill, but then he will be stuck there for a while. They did however comment on how he is very smart and has great cognitive abilities. :)

Overall, he has grown leaps and bounds since starting school! I can't wait to see how far we are by the end of this year. And then we have 1 more year. I hope next year he has the same teacher and team of professionals because these guys are great.

Then at the end of the conference, the OT showed me how to do the wilbarger brushing protocol and joint compressions. It was a bit awkward when she had me do them on her, especially when she lifted up her outer shirt and I had to brush her under shirt, HA! According to her though, I am a natural. ;)

Meltdown over diapers

This is a fairly long video and I don't really expect everyone to watch it all the way through, but it's a pretty great example of Michael getting frustrated to the point of meltdown. This is actually pretty tame, too.

I left to the store the other day and James was home with the kids. He asked Michael to get a diaper with a number 5 on it, so he could change Rory. The diapers were stuck in that stupid plastic wrapping and he couldn't get it out. He had however, already decided in his head how it was supposed to play out, and since it was not doing so in that order, the world came to an end.

I don't know any other child that would freak out so horribly over not being able to get a diaper out. Most children would whine and tantrum to not even help! He was happy to help, but so frustrated with the situation from there on out, that he melted down. When it gets like this, we struggle with just doing it for him and dealing with an all out scream fest for 5 minutes, or dealing with 20 minutes of screaming and frustration so he can learn to do it himself. This happens with EVERYTHING. From getting cups, to opening doors (HUGE one there!!!), to getting his jacket on and off, to taking his shoes off... you get the idea.

If he would just let us show him how or help that would be amazing. But no, the whole thing has already played out in his head of him doing it ALONE, so he will not accept help. He has a hard time understanding verbal help as well so that is not really helpful. It just stresses him out more, because he has a hard time still with receptive language, especially when he is so focused on another task.

If you have the time to watch the whole thing, I recommend it.