Discovering new things and learning to adapt

Between yesterday and today, we have made several observations, both on our own, and from Andrew's ABA therapist.

We started to spot that Andrew was uninterested in drinking from his dark blue sippy cup. It could very well be because he either can't see what's in there, or he has come to associate that cup with having water, like his blue Thomas straw cup.

When we shifted to putting his milk into his lighter, yellow cup, he immediately wanted to drink from that. We will have to test that by putting some Pediasure in one later today and seeing how that goes.

Andrew's ABA therapist observed something else today: when he gets upset, she started squeezing on his hands and arms and it allowed him to calm down much quicker. She went on to test that response several times, and it appears to be a means to soothe him. Next step will be to continue testing it, and if it turns out to work, teach him to squeeze his own hands as a self soothing activity. She said this can be tied to some of his own sensitivity issues and finding a means to contain this will be very helpful as he matures. She said that there is a whole market of body socks, compression vests, and other things like that which are designed to help highly sensitive children calm down. We'll have to think about that if this approach isn't enough.

Another behavior to work on is pairing. This is when we ask him to take a sip of Pediasure in order to get a yummy goldfish cracker. We'll experiment with that as well, although the cup issue might be solved in a different way.

All in all, this is the type of exploration that we are undergoing as his various therapists get to know him better and can fine tune things for him.

Busy day!

Tired Andrew after a full day

This morning, Andrew had a 2-hour session with Kathyrn, his ABA therapist. On the surface, it looks like they are just playing. But when you learn a little bit, you can see that Kathryn is engaging him in what Andrew wants to do, but she steers him into new angles, new ideas, and new types of spontaneous behavior. Towards the end, he was playing an interactive game on her iPad. He wasn't quite getting the concept of drag-and-drop, but I'm sure he'll get it soon enough.

Sara had "the day off". She had been pulling double duty last week while I attended my company technical conference in California. She earned a day at the spa. This made for fun time management. Pay it no mind that I still got a lot of work done!

Later today, Andrew had his first speech therapy session followed by occupational therapy. When his speech therapist came out to give me her report, Andrew was upset. It appeared like he didn't want to stop playing. It was a bit of a blur. He developed an initial rapport with his speech therapist and was introduced to several new sensational things with his occupational therapist. I have more to learn about this stuff.

He didn't get home and able to nap until around 3:00pm. Suffice it say, he was cranky by then, and fought me carrying him to his crib, but it didn't take long before he was out.

Here is what is so amazing. He is getting all types of help, but doesn't even know it. To him, it's all play. At dinner time, he was running around, and when we would say certain words, Andrew repeated one of them while pointing his index finger at his mouth. We quickly deduced that this was the gesture his speech therapist used. It is clear that all these things are sinking in and giving him what he needs.

In all this hub bub, there is something I never realized until Sara and I chatted with a member of our Sunday school class who happens to be an ABA therapist. Andrew might very well come out ahead of his peers. I was praying that he would keep his head above water and "catch up". I never realized this might be possible.

Small Victories

This week has been a whirlwind of activity for us.  Greg has been out-of-town all week and we've had a full schedule of therapy appointments and evaluations.

Andrew's therapy team is finally taking shape.  We added two members to the team on Wednesday as he was evaluated for (and recommended to pursue) Speech Therapy and Occupational Therapy.  He is, as we knew, quite delayed in speech - both in receptive and communicative language.  They will work with him to improve both his speech and his tolerance to a greater variety of foods.  The Speech Therapist did comment that he is great at repeating things, which is the basis of building language.  The Occupational Therapist was not overly concerned as his gross motor skills are nearly where they need to be, but his fine motor skills are at the level of a 21-22 month old.  Both therapists stated that he was easy to work with and very compliant, reassuring me that this would be of great benefit to him and us in his therapy.

All in all it was a rocky day for me.  Even though we knew he was delayed because of his autism, it's never easy to hear it.  But it did my mommy heart some good to be told over and over what a delightful boy he is and that he is going to be fun to work with because of his unique qualities (very laid back and easy going).

Thursday I went to pick him up from his preschool program to hear from his teacher that he'd had a bad day.  She said that he was "very sensitive".  It was not good to hear that, but I am thankful that this is not the norm for him, that he mostly has good days at school and even has been participating in class activities.

I was pleased to meet the "final" member of the team this morning, the ABA Therapist who will actually be doing his therapy three days a week for two hours each session.  She was very impressed with how quickly Andrew picks things up and how easy he was to work with.  They played with toys and books while she was here.  She would point out objects in the books and identify emotions that were displayed on the character's faces (happy, sad, etc).  We were shocked and pleased to hear Andrew spontaneously (not repeating her) point out a character as "happy" and also point out and say "moon" spontaneously.  It may seem small, but it was huge for me.  Andrew does a lot of repeating, but we RARELY hear ANY spontaneous language and he's never pointed to something in a book before an named it.

So, we are celebrating the small victories today, with every hope and prayer that the steps forward, though small, will become a consistent part of our life.  I know that there will be more small victories to celebrate and I look forward to looking for them daily.

Two Steps Forward and One Step Back

We are well into Developmental Therapy and, so far, Andrew is very receptive to his therapist, Megen, and to the therapy.  She basically does structured play with him.  They continue to work puzzles, working on the signs "more" "please" and Andrew continues to use that two word phrase to request more milk.  Megen also works with him to identify the animals and other objects in the puzzles and the sounds they make.

We ended up taking Andrew to see his peditrician last week due to his diet.  He's always been a picky eater (which is common for children with autism....they are sensitive to certain textures), but recently it seemed there was nothing solid he would eat (we have added Pediasure to his diet because of his nutritional short comings).  His doctor said that occupational and speech therapy will help with that, but until that time, he recommended we start a medication that will increase his appetite and, hopefully, encourage him to eat more things.  His diet now consists of:  yogurt, dry cereal, and goldfish crackers.

I was very encouraged on Monday when we went for his sister's speech therapy.  There was a young girl in the waiting room that took a liking to him.  He actually interacted with her and played a game with the chairs.  He hardly ever interacts with other children and NEVER with children he doesn't know.  So, it was very encouraging.

But on Monday evening, we had the biggest fit Andrew has ever thrown.  It broke my heart.  He absolutely wanted something and I could not for the life of me figure out what.  Then he got frustrated at his inability to communicate with me and the fit went on and on.  I could see what the ABA Therapist had described to us as the difference between a fit thrown by a "normal" toddler versus a toddler with autism.  It was awful.

All in all, I believe that Andrew is making progress.  We're adding more therapy and more evaluations this week and I'm hoping we can keep a good balance in our lives.

As for me, I've been struggling a lot with fear.  This is an old struggle for me.  And one I hoped I had put behind me.  These past weeks, it has reared it's ugly head again...fear of what living with autism could look like, fear that something will happen to my children or to my husband as he travels this week.  Thankfully, I serve a Sovereign God who knew this struggle was coming back around.  This week in the bible study I'm working through, was a focus on Psalm 121 which speaks of how God is my protector and watches over my life.  It was especially reassuring to me and I know the Spirit spoke to me through those ancient words.  I continue to quote this Psalm to myself when I begin to fear.  And He has been faithful to still my fears.

Meeting with ABA Therapist

Today we met with Andrew's ABA Therapist (Applied Behavior Analysis).  She asked us some questions to help her zero in on what areas needed to be targeted.  Then we had a chance to ask questions.  We merely wanted to know what to expect a therapy session to look like (which she won't know until they get a chance to work with Andrew) and how soon it will start (we are determined to get the ball rolling).  This is where we left things:  she needs to check with our insurance to ask how much therapy they cover and we will get a call this week to set up his therapy for next week.  We can expect 2-5 sessions a week (depending on insurance coverage).

We are starting to feel overwhelmed with how our schedule is shaping up.  Our daughter, Audrey, was evaluated for Speech Therapy today and we found out that she qualifies for assistance.  So, she will have Speech Therapy twice a week.  Andrew will hopefully start Speech Therapy soon at the same rate (twice a week).  And he already has Developmental Therapy once a week.  Then we will have to add 2-5 sessions of ABA Therapy starting (hopefully) next week.  This is all in addition to him attending preschool 2 days a week and my activities (a weekly bible study and MOPS twice a month.  We're feeling like downtime will be hard to come by.

We continue to expand our circle of friends and family who know about Andrew's challenges.  With that comes increased support.  We have been strongly encouraged to find an Autism Support Group, which is at the top of my to-do list (after the piling up laundry and cluttered bedrooms).

In the midst of all this craziness, I know that God is inviting us to something greater...not a life full of schedules, therapy, and housework; but a season of greater reliance on Him.  I know the days will be longer and more tiresome with our adding schedule challenges.  This is a calling to lean ever more on His strength and to follow His lead.

Andrew's first developmental therapy session

Andrew had his first therapy session with his developmental therapist this past Monday. Megan played with him for about an hour, focusing on teaching him to sign "more please", a two-word combination. We had gotten Andrew to repeat things in the past, but he didn't seem to make multi-word combinations.

Megan played a puzzle game with him, which Andrew responded well to. She took all the pieces of the puzzle, and hid them. Then she made Andrew sign "more please" to get a piece. He didn't sign that combination many times. But she kept reinforcing the combination before handing him a piece. They played it several times. Then they switched puzzles and repeated. And again. It seemed like a very small amount of progress was made.

But I had already read that we need to repeat the practices we observe in his therapies, so we started playing that game several times this past week. And then an amazing thing happened. Today we played it again, and he was starting to sign "more please". Not every time. But more than his first session.

Sara began playing the game with him, and his big sister, Audrey came over to me and wanted to play the same game. She is four and can speak and sign, and loved playing the game. First she would do the signs. Then she said it was my turn, and asked me to do the signs.

This afternoon we all went over to watch a football game. And towards the end of the game, Andrew came over to me with his empty sippy cup and signed "more please" with no prompting. I cheered, "Yeah Andrew!" That put a smile on my face.