Tuesday, March 30, 2010

Spring Break Blues

Nora's Spring break...a week to be outside! Sleeping in, going for walks, and working in the yard! It's what Nora and I do...or rather, its what Nora and I planned to do.

The week before her break, the weather was pure bliss. The snow piles that had been on the ground since the first week of December didn't have a chance against the 50 and 60 degree temps. The crocuses popped their sunny heads out of the ground, and Nora and I got to work. Hooray! Finally, the three veggie beds I laid out last year would finally be put to good use.

After digging in some compost and manure, Nora and I got out there, seeds in hand. I took a broom handle and carefully pressed it into the ground in order to make nice, straight rows just like my Organic Gardening book instructed. We planted peas, carrot, parsnip, and spinach seeds with mathematical precision. I also planted 60 onion sets in perfectly straight, rather lovely rows. Oh the excitement! According to the package, all these things can tolerate light frosts. Why, in 50 short days, we're gonna have a feast! Or so we thought.

It snowed 2 inches the first day of Nora's break. We sat, staring out the window, as the snow covered the ground, the swing set, the frozen pond. The temps got out of the freezing range during the week, but not the wind chills! It was hard most days to take a quick walk without our hands and ears going numb. But the worst part was waiting for those seeds to sprout. Everyday we went out there to a whole lotta nothing. Nora kept saying, "Mom, it takes time. It's ok," when my excited smile turned to a frown. Who's the adult and who's the impatient kid?

Her break is over, and so of course it has warmed up once again. Unfortunately I've given up on our seeds sprouting. I'm not quite sure, but the footprints in the garden seem to indicate that perhaps the squirrel has done something with the seeds, and half the onions too. I'm also pretty sure that Nora and I planted the carrots and parsnips too deep, and its too dry, and well, I suppose we just won't have those things this year.

I'm not too disappointed with our gardening failure, however, because its a learning process. And, in addition to planting all that stuff outside, Nora and I decided to take advantage of the cold and start some seeds inside as well. Those are doing awesome! We have an entire tray of flowers that will be ready for outside in eight short weeks. Every morning I drink my coffee and Nora has her breakfast next to the little flats, and she tells the seedlings how adorable they are, and how she is so proud of them. I know of no other plants that get a daily pep talk. But I'd recommend it if your plants are a little wilty, she seems to be on to something!

Sunday, March 28, 2010

That's it???

Nora came home from school the other day and asked me how the dentist knew she was a girl. I was a little confused; it had been a few weeks since the dental hygienist had visited their school, and I really couldn't figure out what her teeth had to do with being a girl. I asked her a few questions, and determined what she was really asking is how, when she was born, did the doctor know that she was a girl. Ahhh...well that's a different question all together.

I think its really important to be honest about these questions with our children, no matter what the age. Of course its also really important to be age appropriate...which is really hard to do with Nora because she's so darn smart and sometimes I forget she's only five. Anyways, I responded with, "The doctor told us you were a girl because you have the body of a girl". Nice, to the point, answers the query.

"But Mom", she retorted," what's a body of a girl? What does that mean?". Oh dear.

"Boys and girls have different body parts Nora. You have the parts that make up a girl". Smooth.

"What parts? Mom, I don't get it." Crap. Time for the big guns.

"Well Nora, boys have a penis and girls have a vagina." Oh my God I just said penis to a five-year old girl.

"Penis????? Gaina??? WHAT is a penis???? What's a Gaina????" What have I done?

(Deep breath) "Ummm...well, when girls and boys go pee pee they have different parts. The boy's part is called a penis. The girl has a vagina". Well that's not a very good description Ivy! That is not really how girls go.

"That's it? I know THAT. Girls have a flat butt in the front, and boys have a funny belly button thingy when they pee. "

Well, good to see I'm not needed around here! And BTW, thanks Jett at school for forgetting to close the door when you go to the bathroom. You made that conversation a whole lot shorter and easier than I imagined!

Monday, March 22, 2010

Emily's OT Evaluation and Assessment Report

A lot of you have been asking questions about some of the diagnosis information I've received from the occupational therapist. Since most of this is new to me, and foreign in many ways, I thought I would include part of her assessment report for you all to read. Indeed, many of you have a lot more medical background than I, and perhaps you can help me understand some of the things that seem to be going on with my little stinkerbelle.

The following excerpt was taken from the "Early Intervention Evaluation/Assessment Report" dated 2/19/10 and 2/23/10.

"Clinical Observations:

Musculoskeletal: Emily presents with range of motion within normal limits and adequate strength to complete basic gross motor tasks of carrying a toy across the room and pushing a door open. Muscle tone appeared in the low end of a typical range as evidenced by tendency to assume a "w" sit pattern for floor play and palpation.

Fine Motor/Grasping: Emily demonstrated functional ability to manipulate objects with both hands using age appropriate distal prehension... (this continues but it was all normal)

Visual Motor Integration: Emily reportedly loves puzzles and was able to place 3 puzzle pieces correctly in a form board when placed in random order. She was able to build a tower of 6 cubes agter demonstration and minimal assistance to begin (i.e. counting first 2 blocks placed). Emily was unable to imitate vertical or horizontal lines with marker and paper. When asked to snip with sissors, Emily touched the scissors to the paper but was unable to produce cuts.

Communication: Emily demonstrated inconsistent eye contact with the therapist which may have been related to high level of visual distractions in the therapy room. Once acclimated, Emily several times took the therapist hand, leading to a toy she wanted and pointed and looked, verbalizing "this this". When given additional processing time, Emily on several occasions would repeat back a word when modeled by the therapist, i.e.; "ball, green, clean up, swing, down, up". She had difficulty initially expressing what she wanted without modeling and would try to use other means to express i.e. pointing, gesturing, leading the therapist, etc. but would become quickly frustrated if she did not get what she wanted.

Sensory Processing: Sensory processing refers to the way an individual registers, modulates, and uses incoming sensory information for appropriate use (adaptive/functional responses). Adaptive responses are seen in how an individual reacts to stimuli (i.e. Movement, visual, touch, etc.), events (i.e. transitions, open spaces, room or schedule changes), and toys or utensils (desire, avoidance, preference, etc). Organization of sensory information is needed to adapt to, deal with, or respond adequately to environmental demands.

Emily has significant difficulty transitioning out of desired activities, waiting for a desired activity or toy. She often results with creaming, tantrums or aggression towards her mother. Her mother reports that they currently use time outs in her room for 2 minutes with her door closed. They have begun to incorporate transition songs learned from her musical therapist Angie for goodbye with success. When extremely upset, she will reportedly use her silky blanket for soothing and suck her thumb.

Auditory: The auditory system receives, organizes, and utilizes auditory information to facilitate communication and cognition. Integration of the auditory system with the vestibular system and proprioceptive system has affects on the central nervous system functions that include arousal, attention, motor functions, spatial awareness, and motor responses.

Significant difficulties noted in this area both in the understanding of more than 1 step directives, and ability to prioritize sounds in her environment. Per the sensory profile, Emily's family frequently has to speak loudly to gain her attention or touch her; she frequently takes a long time to respond, even to familiar voices, and frequently appears to be ignoring her mother when she is talking. It was also reported that this has improved a little since beginning therapy over a month ago. She seldom startles to sounds and seldom appears affect by busy or noisy environments.

Visual: Per the sensory profile, Emily almost always enjoys looking at moving or spinning objects and almost always prefers fast-paced brightly colored TV shows. Her mother reported they have removed all TV's from their home because she will persevere on watching and will become hyper-focused and not engage with others with the TV is in the house.

Vestibular: The vestibular sense responds to and provides information related to the changes in head position, gravity, and movement. Vestibular input plays a role in the integration of an individuals's balance, extensor muscle tone, and equilibrium responses. It affects the ability to use both sides of the body together, and coordination of head, neck and eyes moving together. It also has an affect on the processing of auditory-language information, and behaviors related to the arousal system.

Per the profile, Emily almost always enjoys physical and rhythmical activities (i.e. being bounced, swinging, rocking or car rides), almost always becomes upset when placed on back for diaper changes and almost always resists having head tipped back during bathing. In the evaluation, Emily frequently jumped from activity to activity and did not engage for very long with trampoline jumping or swinging, especially when movement was imposed by the therapist.

Proprioceptive: Proprioception allows awareness of the position of muscles and joints. Proprioceptive input provides us with information as how far to reach, with how much pressure, timing, etc. It also provides us with feedback as to where we are in space and our relationship to things outside of ourselves.

Emily reportedly takes risks in play without regard for personal safety inclduing climbing on things, etc. She was reported by her development therapist to often engage in proprioceptive seeking activities.

Results/Implications: Emily's strengths include a supportive family and mother who appears interested in the therapy process and in helping her daughter, age equivalent grasping skills, good strength, functional mobility and interest in engaging with adults if motivated by activity and clear expectations are set. Her challenges include atypical sensory processing which impacts her ability to prioritize sensory information and respond appropriately to it, specifically proprioceptive, tactile and auditory. Emily appears to have trouble modulating her responses to input and either under-responds (not noticing) or over responds. Her over responses pose a safety risk for herself and others and limit her ability to problem solve situations adequately. In addition, Emily present with visual motor skills below age level which may be impacted by her difficulty following adult directed tasks and processing verbal instructions.

Emily presents with signs indicative of mixed responsiveness to sensory input and atypical modulation of responses. These significantly impact her ability to engage appropriately in home and community tasks with her family and peers. In addition, she resorts to non-functional behavior within her activities of daily living including toileting issues and food intolerances. Emily's visual motor integration skills are recommended to be re-assessed as her sensory process is addressed to determine accuracy of age equivalency."

Friday, March 19, 2010


Once again its been awhile since I've written, and as always, its because there are just more things to do around here than there is time in a day. Nora and her Brownie troop are keeping me busy, my new online class and its 15 students are keeping me busy, and of course Emily's therapy is keeping both Emily and I busy.

In the last two weeks, Emily and I have started using a tool called PECS both in Speech Therapy and at home. PECS stands for Picture Exchange Communication System. It was developed as a means for autistic children to communicate their wants and needs by handing pictures of different items to an adult or other caregiver. A side effect of using this system is that many children start to learn the words associated with the pictures, thus leading to verbal communication. Since Emily is a visual learner, we are hoping that by using PECS we will be able to cut down on the tantrums associated with her lack of verbal skills, as well as teach her some important vocabulary.

At first, as mentioned in a prior posts, Emily was not very keen on using this system. She has been pointing and grunting at the things she wants for over a year, and she didn't want to change her routine. When learning the system in Ms. Shelly's office, she had several major meltdowns, and I suffered the loss of a tuft of hair that she yanked out of my head. When I introduced the pictures at home, the look she gave me was one of pure disgust. She hated the PECS book, and she kept throwing it and its pictures right back at me.

Of course I probably should have watched the DVD video explaining PECS before trying to use it. After Ryan and I watched the show, I realized I was approaching the whole thing wrong. I needed a secret weapon: Root Beer. So the root beer picture went into the book. Then I showed Emily that if she handed the picture of root beer to me, she would get her tiny mug filled to the brim with brown foamy goodness. It only took her about 20 minutes to figure out the whole system. Now she is able to "tell" me what she wants to eat when she's hungry and what toy she wants to play with simply by handing me a card. I love PECS. She has learned several new words including book, root beer, raisins, animal crackers, and fish (for gold fish).

This has lead to a new set of issues, however. Now that Emily has a means of expressing her wants, she thinks she will automatically get them. I'd tell her "no" or "all done", and then I'd put the picture back in the book. The problem was that she would retrieve the picture, and hand it to Nora or the dog! Of course I had a good belly laugh when I realized she was trying to get root beer from Lacey, but then Em got angry when the dog didn't deliver. I've taken to hiding the PECS pictures of things she can't have too much of, like fruit snacks. She doesn't take no for an answer. I am thinking we need an "all done" bin to get the idea across that the PECS book isn't her personal all you can eat buffet. Until then, I suppose she can keep asking the dog for a snack, and who knows? Maybe Lacey will help her out after all.

Thursday, March 4, 2010

Brownie Troop 64 is off and running...

And I do mean running. I am still out of breath!

But let me begin at the beginning. After the excitement of becoming the new leader for the Brownie Scouts in our troop, it began to dawn on me that I really didn't know what I was doing. I asked Nora repeatedly for information about her other meetings, and determined they knew the Girl Scout Promise, bringing the snack was a big honor, and that everyone liked to do crafts. As someone that hasn't quite grown out of crafting, or snacking for that matter, I could appreciate what these girls needed. That information, along with some helpful tips found online from other Brownie leaders, helped me plan out our first agenda. And yes, I did type up an agenda just like I was back in college leading the art history student organization.

I made a cute poster with the GS Promise, the GS Law, and the GS Motto. The Motto, Be Prepared, was the theme of the meeting. We talked about what it meant to be prepared if it was rainy, sunny, or if someone got hurt. We played a band-aid relay race game that didn't really work, considering it is hard to have a relay race in a room that is only 12 long and full of tables! We made friendship bracelets, most of which have probably fallen apart at this time due to my inability to tie durable knots with an audience watching. Despite the fact that some of these activites did necessarily work out as I'd hoped, I think we all had a good time.

The thing that stuck me most about these girls is how excited they are! They were just bursting with enthusiasm. I asked a question, and I had nine hands waving in the air, "Pick me! Pick me!" They all seemed to warm up to me very quickly, more so than to Mr. Ryan, who was in the room trying to keep Emily from totally destroying the place. Overall I think it was a success. At the end we formed a friendship ring, holding hands and passing a squeeze from girl to girl. They liked that, and seemed happy that we would be meeting again in two weeks.

To see photos from our first meeting, click this link: http://picasaweb.google.com/duck560/2010_02_FirstBrownieMeet02#

Wednesday, March 3, 2010

A few helpful links

For my parenting readers out there, I personally found these articles helpful and wanted to pass them along. Enjoy!

PS I am not adverse to the idea of putting out a hit on the extra toys...