Jan202011

Gearing up for the annual IEP meeting

I confirmed the date for R’s annual IEP meeting.  We had an addendum IEP in October,  but this will be the first IEP with all of the current team present.  At next year’s  annual IEP meeting the decision will be made regarding kindergarten placement.  I feel kind of pressured to make sure that as many skills that she could possibly attain in regards to that transition are included now as opposed to then.

R.’s teacher and the general education preschool teacher have made changes to add mainstreaming and reverse mainstreaming opportunities during specific parts of the school day.  They are already integrated for all of their recess time.   Currently on her IEP, in the notes section, detailing the placement, it says there are opportunities for mainstreaming and reverse mainstreaming per teacher discretion.  I’m thinking of adding a specific goal related to mainstreaming, but I haven’t converted my thoughts into IEP-speak yet.

One of the things I’m learning from the classes I am taking is how to look at goals and see if they are attainable and measurable.  There’s a goal on R.’s IEP, under Developmental Skills R. will initiate with familiar adults or peers using appropriate eye gaze, body position, gestures or words as implemented by the Special education teacher, SPED staff, parents. It seems to me now, that initiating with adults and initiating with peers should be two separate goals.  The way the goal reads now, they may tell me that she has made 50% progress on this goal, meaning that 5 out of 10 times she initiated with an adult or a peer.  I know she initiates with adults at school and home, but with peers she rarely does so. If they are two separate goals the team will have to address and track her initiating with adults and peers separately.   She will have twice the programming and I’ll get twice the data.

Many of the goals in the Developmental Skills section are really pre-learning skills.  I’m sure she hasn’t mastered all of them, but I know from conversations with R.’s teacher that she is in agreement that we will be adding actual educational goals.   I would like to add a goal to this section about waiting.  I do realize that goals need to be individual, but I found this goal on the internet to at least get the idea started.   Will be able to follow an adult’s request to wait for her turn given materials to manipulate during the waiting period for two minutes. I’d also like to add a goal about playing with toys appropriately, and possibly a second one relating to playground equipment.

I’m searching for a book on this topic, suggestions are welcome.  But for now I found a simple article that outlines preschool IEP goals that is helpful.  I’m sure that I will be writing more about this.

Jan182011

Maybe she has x-ray vision

We went to a pediatric opthamologist a few weeks ago.   R. has one eye that wanders sometimes, especially when she is tired.   It took a few months to get the appointment.  I was seeing the eye wandering less by the time we finally went.

It was not a fun experience, but it wasn’t as torturous as I imagined.  We were there for close to two hours, and probably spent twenty minutes with the doctor, and they weren’t continuous.    All my special needs Mom friends locally had gone to this doctor.  But I was a little worried when the doctor started by asking R. all these questions, showing her pictures and waiting for a response.   Once I set her straight and R. demonstrated her sonic screaming ability,  the doctor agreed to do the exam with R. in her stroller, and that made things much easier.   The doctor said she could spend some time playing with R. and try to see what she needed to that way or we could hold her down and it would be over in a minute.  We opted to hold her down.

Both E and I wear glasses.  I started wearing them when I was six.  I expected to leave that appointment with a prescription for glasses for R.  I even asked the behaviorist if she could write us a behavior plan for wearing glasses.  R. won’t even wear a hat for more than a minute or two.  The doctor called R’s condition intermittent,  and just recommended a follow up appointment in six months.   So I asked her, at what age will you be able to determine she needs to wear glasses?   The doctor said she could already see that at this point R. does not need glasses.   I should do some googling, because I want to know how she can tell that by only looking at R.’s eye?   Considering her genetics, I’m sure glasses will be in R.’s future.  I’ll admit I’m relieved to not have to deal with it now.

I’ve always thought that R. has good vision.  She notices things that I don’t.   Like she will see that E. has his car keys in his hands and think it is time to go out.   Lately it is getting really hard to hide things from her.   I’m really careful not to let R. see me hide things.  No matter where I hide them, she knows they are there.  She will hand lead me to the spot and push my hand towards the cabinet or door.

I have some toys and things in a dresser so she doesn’t make a huge mess. She knows which drawer has the cds, the alphabet puzzle, the markers or whatever she wants.  And when I rearrange things, she picks it right up.   I don’t make an effort to hide what it in those drawers, it is more a matter of restricting access.  But lately she is becoming very demanding about candy (which she would not eat as recently as Halloween) and donuts (E. bought a dozen at Crispy Creme a few weeks ago, and she has been chasing the ghost ever since).   If I show her that there are none, she will be content with that.

E. bought R. a horn at the dollar store, I think it is a vuvusela.  It is loud and annoying and R. loves it. She will insist that E. blow the horn against her body over and over.    One night while she was eating dinner he hid it in the coat closet.  Not my first choice of hiding places,  I left our coats unhung most of the week so she would not see the dreaded horn.   Yes I should have moved it, but I only managed to think about it when she was around and watching.    It took a few days, but she did finally hand lead me to the coat closet and she did not seem surprised at all that it was there.

I think I may have to start digging holes in the back yard.  It works for dogs.

Jan132011

She sits

Last Tuesday the supervisor adjusted the potty training program again.  Instead of sitting on my lap, she had R. sit on the toilet ten times for one second.   R. fought the first few tries but by the end, she seemed resigned to do as asked.  A new, never seen Elmo potty training sticker book helped.   I should also mention that she is sitting while wearing her pants and diaper.

She did well all week, and by Friday she was laughing when the therapist sat her on the toilet, like she found the whole thing hilarious.    This week the supervisor extended the time to five seconds.  The therapist places her on the toilet, and she has to sit independently.  We count to five.   That doesn’t seem like a long time, but it is just long enough that she has to willingly decide to sit there on her own.

I’m sure we will have to start over again once her pants and diaper are actually pulled down.  But for the first time I’m actually letting myself imagine what a diaper free life might be like.

Jan082011

Reading material- Art as an EI Tool for Children with Autism

Thanks to the library, I recently read the book  Art as an Early Intervention Tool for Children with Autism by Nicole Martin.   Ms. Martin has a younger brother with autism.  She was trained by a behaviorist as a young adult to work with her brother.  As an adult she is an art therapist working with people on the spectrum.

The first chapter describes autism.   If you are like me and have read tons of autism books, this chapter seems unnecessary.  She does offer good descriptions of scripting (echolalia), perseverating and stimming.   I think my favorite part from this chapter is:  Children with autism hear “no” a lot from adults; helping them find ways to express and develop their talents lets them say “yes” to themselves.

She discusses how humans seem to have a natural tendency towards making art, and reasons that there is no reason to think that people with autism would be any more or less interested in art making then their typical peers.   She also mentions that symptoms of autism such as hyper focus or tactile defensiveness, can make it appear that the individual on the spectrum is not interested.

Ms. Martin outlines what she calls basic assumptions that  she writes need to be understood before using art as an intervention tool.

The adult is not “fixing” a child’s artwork, but using art to “fix” parts of the child that can be best engaged using art

The art itself (the product) is not as important as gaining the self-discovery, experimentation, tactile tolerance and so on (the process) that is required to make it.

Skills such as imagination and creativity are worth rehabilitating in children with autism.

You must believe that creativity can be learned.

The author describes “good scribbling” (focused, contemplative, experimental, sometimes even chaotic) and “bad scribbling” (symptomatic). She provides some really useful illustrations and easy to understand descriptions of children’s art development using the theories of Victor Lowenfeld and Rhoda Kellogg.

The author gives a number of good tips to help a child with autism move beyond scribbling.  She suggests reinforcing any scribbling or attempts at art work, but to give extra praise and reinforcement to attempt that are the best, or exhibit experimentation and variety.

Visual supports are also another tip- drawing a circle or line on the page can help jumpstart a drawing.  When a child puts art tools in their mouth she suggests offering an appropriate chew item. (I can attest that this works).

She also suggests that the parent (or therapist) make art along with the child.  She offers the idea of copying what the child is doing.  I found it really useful that she says the parent should attempt to draw at the child’s level, and to model appropriate scribbling and early drawing.  She mentions that a higher skill level can fascinate and frustrate a child with autism.  This reminds me of what John Holt wrote in How Children Learn, about how children lost interest in activities in which he clearly knew more then they did.

Ms. Martin lists nine autism symptoms and the corresponding artwork characteristics.  It is an interesting way to look at it.  One of the symptoms is sensory issues and the characteristics are – use of materials for self stimulation, tactile defensiveness and art material’s impact on regulation.

She also lists six major goals for children on the spectrum that can be best addressed using art.   One of them is sensory regulation and integration.  She writes Some children on the spectrum get “stuck” in the kinesthetic feeling of using art materials and are slow to move into representational work.    Her suggestions are to become aware of a child’s reactions to different textures and to take control of art activities.  She also suggests activities that create artwork using the entire body like tracing and masks.  I would have liked to read more details about how to work with this.

The author details what she calls tools of the trade, describing paints and other art materials.  And she also gives tips for providing the optimal environment for creating art, what she calls a quality art experience.  She writes An individualized directive with least invasive prompt possible is my personal rule of thumb when working with a child with ASD.  She gives a very good and detailed description of prompt hierarchy, and shows her knowlege of ABA with suggestions for problem behaviors and reinforcements.

Reference: Art as An Early Intervention Tool for Children with Autism by Nicole Martin, (Jessica Kingsley Publishers, 2009) Pages 25, 30, 31, 41, 59, 73, 113

Jan062011

Echolalia is kind of cool for now

R.’s talking is about the same.  We’re hearing a few more spontaneous words.  She’s saying uh oh and oh with a variety of inflections in response to things, and we’re hearing yeah and no more often.

Mostly though she is repeating what we are saying.  In a few months I may be frustrated  with this, but now I think it is quite awesome.  It means that she will say hi and bye to people if they say it first, and she’s paying attention.   I’m discovering that there are so many kinds of games to play where I get her to repeat what I’m saying.  I’ll give her stuffed animals one by one, getting her to repeat duck or whatever.  We’re actually playing with flash cards.

E. is much sillier with her and they play these games echoing babble phrases.  He touches his forehead to hers and says “bonk” and she says bonk and they play a head bopping game.  I’ve been trying to put a stop to this game, imagining her head butting one of her class mates.   But I think I end up sounding like a control freak because they are having fun.

Right before Christmas vacation the behaviorist said she was not doing as well with two word mands, they are working on want book, want ball.   She suggested I work on it over vacation.  I did and did not have much luck with any mand that started with want, she would just repeat the last word.  She would however repeat two words for requests like lights on, socks off and that kind of thing.  I also noticed that over vacation her response seemed to be a little slower, I had to work a little harder at prompting.   I was wondering if I was seeing a regression.  Monday when she came home from school she was back to responding to a verbal prompt almost instantly and it has been that way all week.   I can’t help but wonder if this is a part of having vacations or if we could be doing something else.

She also has new sounds.  Her screaming has become more dramatic.  She has this new angry, tearless scream that is so loud and high pitched, it must get the attention of all the dogs in our neighborhood.   No one told me that her voice could get louder.   She also has a new happy sound, I guess it is really a vocal stim.  She sounds like Arnold Horshack’s little sister.   She makes this sound and runs around grinning and being mischievous.

Jan042011

What ever it takes

We are in the beginning stages of potty training, it is like we are in the training for potty training stage.    Starting in November, we spent several weeks just taking R. into the bathroom at the end of her daily ABA session.

The supervisor decided that the next step was to get R. to lift the lid of the toilet seat.  She wrote the program so that R. was supposed to open and close the toilet seat lid ten times in a row.   I stepped in immediately and said no way are you having her do that ten times in a row.  I mean talk about teaching a repetitive behavior.   It did not take too long for R. to master lifting the toilet seat lid once.

Sitting on the toilet is a problem for R., she does not want to do it at all.   If I want to get her out of the bathroom all I have to do is suggest she have a seat on the potty. (Maybe I should stop doing that).   The supervisor’s suggestion for the next step, is to have me sit on the toilet and put her on my lap for 30 seconds.    I did mention that this happens during R.’s ABA session.

So yesterday here I am in the bathroom sitting on the toilet with R in my lap, her male therapist watching and counting.   Counting out loud to 30 was the only way to get her to stop screaming and fighting.   To his credit, the therapist did not seem the least bit embarrassed or flustered.     I’m just going to have to get over it.

Jan032011

Christmas vacation is over

The bus came five minutes early this morning.  That was right on time as far as I was concerned.  R. seemed just as happy to go as I was.   I think she had a good vacation.  We had some minor meltdowns, and she’s been a little stimmy, but generally in a good mood.

We had a chance to go to a tot gym that we used to go to regularly.   She remembered as soon as we got into the parking lot and held my hand and ran into the place.   I think we probably hovered a little too closely, she did not get into much trouble at all.  She used to just run around all excited and crash into kids.  She did not crash into one person, and I even saw her stop herself so she wouldn’t knock into another child.   She spent some time following these two little girls, I’m guessing were close to her age.  They were playing with those sticks with horse heads on them, I can’t think of what they are called.  She finally worked up the courage to grab one, and as I was about to intercept one of the girls handed her one.  They had an extra.  Of course she did not know what to do with it.  But that scene could have ended with a meltdown and two girls getting bopped on the head.

She also spent quite a while in the bouncy house.  A few small boys were in there.  One of them kept knocking all the other kids over, R. included.  She thought this was hilarious, and let him knock her over many times.  She also let a small boy, probably under two crawl all over her.   Part of me kind of hates those bouncy houses.  I never know what is going to happen, and it’s not easy to go in there after her.   She really likes them, and she’s starting to learn to get out of the way so it is easier.

I got my fill of bouncy houses, we also went to a party playhouse which is basically a giant bouncy house with several levels,  slides and ball pits.   She played for a while, but then wanted a drink and had a meltdown when she could not bring her cup into the play area.  She let me put her shoes on and was fine once we got to the car.  It was getting really crowded, so I’m sure she was overstimulated.

Jan012011

Conquering the library

About a year and a half ago we were at a playground with one of R.’s ABA therapists during EI.  There was a library having a story time in one of the rec rooms and R. was fascinated by the singing.  She went in and only wanted to run loops around the room.   The librarian told me that if she could not sit, we had to leave.  I attempted to hold her in my lap and of course she screamed.  The librarian told us to leave.

I’ve had this irrational fear of bringing R. to the library ever since.  When she started school last March I was able to start going to the library regularly by myself.   Over the summer I started by putting her in the stroller and just walking into the library to drop off books and then leaving.  I gradually increased the time, and now I can usually take her to the library for 10-20 minutes and actually spend a little time choosing books or DVDs and then check them out.

During Christmas vacation we have been able to actually use the library as an outing.  She is happy to be wheeled around the library and then will play with the toys.  I’ve had a little problem with her screaming about books, so I’ve been careful to only let her look at one at a time, and if she screams we leave instantly.

One day we showed up at the library and story time was already in progress.   She seemed interested and happy in the stroller so we stayed.  She sat through the remainder of story time- about half an hour.  She did have her fingers in her ears the entire time, but she did not complain at all.  The rest of the day she sang Old McDonald, one of the songs they sang.

The main city library was advertising a special Christmas train display in the children’s area.  They have a very nice and large children’s area, and we’ve been talking about taking R, so we went.    There were three trains on separate tracks, Thomas the Train, the Polar Express train and the Hogwarts train.  They were in an enclosed case and there were buttons on the front to control each train.   I have to admit I was bored in about two minutes, but E. and R. spent fifteen minutes watching and pushing the buttons.   We took her to the children’s area and she actually asked to get out of the stroller.   The play area was nearly empty and she played for quite a while.   We walked around another floor of the library and R. sang read read read over and over again.  That is from the Pirates who love to read song on the Elmo and the Bookaneers DVD.

Dec312010

Happy New Year

I’ve been thinking back on the past year.  2010 was long and eventful.  It’s funny how things seem so different and yet also the same.  I was looking through pictures and I found two that really illustrate this for me.

Jumping at Home - Jan. 2010

Jumping at School - Oct. 2010

Dec272010

Another Christmas gone by

We made it through Christmas 2010.    R. doesn’t really understand the concept of wrapped presents.   I ended up opening most of them, she kept going back to the toys she already opened.  But she definitely enjoyed getting a stash of new toys, she was giggling and saying yay a lot.   She also collected everything on the dining room table, like she needed to take inventory and guard it from being taken.

She really loves these Caring Corners furniture sets.   I see a doll house in our future.   I’m really impressed with these sets, one came with a doll (Mom I guess), a bed with an attached blanket, a nightstand with a working lamp (she loves this) a cat, a stool and a book.  The doll can hold the book if it is sitting, and once I did this, R must have asked me to do it 100 more times over the last day.  The other set has a doll (the daughter), present, pinata and a table with a birthday cake on one side and you can flip it over and there’s pizza on the other side.  Each side has two little triangular pieces of cake or pizza that can snap onto the plates on the table or into the pizza or cake itself.  R. was kind of frustrated at first that these pieces did not come off completely.  But now she is used to it and seems to like to fit the slices in like a puzzle.

Ernie tries the new cake table

She also likes the Fisher Price Flip Flop Egg Drop toy.  I have to thank Shannon De Rosa for the suggestion.    R. hasn’t figured it all out yet, but she is captivated.  It is a little tricky.  You have to line the egg up with the hole for each egg, and there are three levels one has a wheel, one a push and pull lever and one turns.  You can flip it over and do it again.   At the top there is a chicken (or a duck?) that comes out when you turn a wheel.  I think this will be around our house for years.  It is good for fine motor skills, problem solving and it is kind of stimmy watching and listening to those eggs.

This wasn’t exactly a Christmas present, but I bought a small plastic cabinet with three drawers.   R. has been really into opening drawers lately, and she has a growing assortment of play food and dishes.  So I filled the drawers with the food related items and she just loves it.