She wants me to go away

R. is talking a bit more all the time.  Her requests are becoming more natural.   For nearly a year we had to verbally prompt each word. Last month she started saying some words if we held the item she wanted up and waited.   Now for most items we just have to wait.  At mealtime she is just speaking up and saying what she wants.  It almost feels normal.  E. and I will be talking and she’ll just interrupt with her demand.   It is just one word, but I’ll take it.

She is also self correcting herself.  She’ll say cookie, bagel, or open, cookie.   She’s saying more words in response to situations, oh no, wow and after years of me working on it – she is saying hey.  I know that sounds like a silly word to be excited about.  But I’ve been trying to get her to say hey or stop instead of crying.

Her echolalia seems to be changing slightly.  Sometimes when she echoes she changes her intonation. It is subtle, but definitely deliberate.

She is very into spending time with E., and she wants him all to herself.  She’s been saying Hey!  What you doing? When I come into the room.   If she is being nice she will hand lead me into another room.  But often she just gives me a shove.  I’ll say, you want me to go away? And she will say go away! I think this is really funny, and it doesn’t bother me at all.

I feel like I’m documenting every second of potty training.  She is up to sitting for eight seconds.  The therapists tell her she will sit for eight, and they say only the first, middle and last number.  R. counts on her own, and insisted on staying until the count of ten once and twenty another time.  Nothing happened, but she was and is happy to sit there.  I’m almost looking forward to summer so we can devote more time to this.

I do have to say that I really hate pull-ups.  They leak like crazy, and trying to do up the sides makes me feel like I’m all thumbs.   Maybe it is because I have so many years practice with diapers.

Behold the ipad

Anybody know how remove washable markers?

R. was entranced by the ipad from the moment she saw it.  At first she just watched, and seemed kind of reluctant to touch it.   It is a little confusing to teach her, because each app works slightly differently in terms of what to touch and if she should press or swipe.     It works best if I show her hand over hand, but she prefers to watch me do it, and then use my finger as a stylus at first.

I don’t have a PECS program yet.  I’m going to research it a bit before spending the money.  I don’t think we will use it as a true AAC device if her language continues to progress.   But I think it could still be useful.  I would like to find something so that I could offer choices, like breakfast options or where she wants to go.

I’m kind of amazed how much the ipad inspires her to speak.  She echoes, she labels and even a little commenting if I can count Oh no.   In just a few days, she’s already used to a bit of ipad time before dinner.  We forgot the other night because we had visitors, and she actually started saying ipad, ipad, ipad, totally unprompted and with it out of sight.

I’m going crazy downloading apps, trying to find ones that are good and that she will like.   Many of them have intro or accompanying music that she hates.      Some of the apps do have settings to turn off music and other sounds.  I have to go through the apps before I show them to her.

The free flash card app My First Words by Smart Baby is helpful to show her how to manipulate things on the ipad.  They are flash cards of objects in different categories of items (more categories are available for purchase).  Each card shows a picture, the word and the word is also spoken.  The app can be set up to automatically scroll through the cards, or manually so that the cards only advance after you touch them.  I found setting it up manually really showed her how to use the ipad.  She is really interested in the pictures and words, she will repeat them and it just looks like she is absorbing everything with such interest.  Another neat feature about this app is that you can record your own voice for each of the flash cards.

Another free app, Z is for Zebra is helping to teach her swiping/scrolling.   A screen comes up with the letters of the alphabet, and when you press one it takes you to a page with the letter in upper and lowercase and a picture of an object that starts with that letter.  You can touch each letter or the object and hear the letter or word.  I wish they actually displayed the word too.    You can also scroll through the alphabet by swiping left or right, she really liked doing this once she figured it out.   If you touch the wrong place it just goes back to the alphabet screen.  Many apps have lots of buttons that when touched accidentally take you out of the app, or other places.

iWrite words was suggested by the school’s OT.  The free version gives you the letters A,B,C  in upper and lower case, the numbers 1-9 and a few three letter words.   I upgraded this for $2.99, now we have the full alphabet, the numbers up to twenty and more words.    It displays the outline of a letter, and a little crab appears at the start point followed by numbers showing the direction to write.  You drag the crab through the numbers (connecting the dots) and the line shows up on the screen.   After the letter is completed a copy of what is drawn shows up in the upper left hand corner, and a small box with the same letter drops down so you can either tilt or drag it to a wheel that spins and the letter disappears.  It doesn’t sound very exciting, but R. loves doing this.  So each letter has  built in reinforcer.  R. usually starts using my finger, and after a few letters she will do it herself.   I wish you could select the letter or letters you want to work on instead of having to go through them in sequence.    I wonder if they will come up with some ipad-friendly stylus for handwriting practice.

Color SlapPs is a free program to practice color recognition.  You can select which colors you want as options, (I removed peach) and choose from one, two or three colors on the screen at a time.   A voice says touch brown or whatever color is next, and when brown is touched it spins and disappears.  You can choose to cycle through five or ten times, and when the round is completed two stick figure children appear and jump up and down and the sounds of cheering and applause is heard.  I’m surprised how much R. likes this, she smiles at those little figures.

The Dr. Seuss interactive book apps are amazing.  When you select read to me, the words turn red as they are being said.  R. is so fascinated.    I am too, because while she might occasionally sit through part of the ABC book, she will leave the room if I read Cat in the Hat.   On the ipad, she is fully engaged with both books.   She actually likes them better than the sample of a Sesame Street book I downloaded.  I think it is the words lighting up red that is so engaging.   Who do I have to talk to for an app for Polar Bear, Polar Bear?

Here comes spring break

Spring Break has an extra day tacked on as a furlough day, so it started on Friday  The school department is trying to save money.   School actually ends for the year before Memorial Day, so it seems like we are getting into the last stretch before the dreaded summer.

I’m still waiting to hear about ESY.   I’m fairly certain it will not be at R’s regular school.   Which worries me a bit, but if they can finally finish the construction over the summer it will be worth it.

R.has been saying more spontaneously.   When I would normally prompt her with a word, I can wait and give her an expectant look and she is saying a word more often.  The word I prompt the most is come.  I make her say it every time she hand leads me.  She is starting to say something as she pulls my hand some of the time.  But with E. she’s doing it almost all the time.  A couple weeks ago she was saying what sounded like Da cuh then last week it sounded like Duddy come, and now it is really Daddy come.  She’s also saying Daddy no.

She is labeling things, which is new.  I mean just naming an object she sees, not saying the word because she wants it.  She has really only labeled numbers, labels and shapes before this.  Mostly she is labeling animals and food.

R. has also developed some separation anxiety or something like it.  She has to know where I am at all times.  I don’t think she cared too much before.  Especially when we go out, she is constantly looking for me.  E. will be pushing her in the shopping cart and she will be craning her neck trying to see where I am.   I remember during our assessment with the ABA provider for early intervention, the program director told me that R. should be referencing me (looking for me) constantly.    Of course she wasn’t.

Someone always leaves the gate open at the playground, and I usually spend most of my time trying to beat R. to the gate so I can close it.  A useful side effect of this constant looking for me, is that she is not running away at the playground.  She runs off and she comes back, especially if I don’t follow her.   She also used to run right for kids on the swings.  I think she really wants to know what it would feel like to be smacked by someone on swinging.   Lately she’s actually been just watching the kids on the swing, and I’ve seen her stop short so she doesn’t get run over by a kid on a scooter, or kids just running around.    It’s like I could actually sit down at the playground, if she would let me.

And another meeting

We had our monthly ABA team meeting yesterday.  R.’s teacher wanted to come with us, so we picked them up at school.   R. seemed to want to show me around the room, she kept bringing me over to different things.

She brought me over to the toy area, pulled out a play phone and held it up to my ear.  I think this is quite amazing because I’ve been trying to figure out how to teach her about the telephone.  Every time I call someone and get them to talk to her she looks at the phone as if it should have a screen, and usually hands it back.

The temporary classroom is smaller than their other room, there is no sink or bathroom.   The teacher said that they started taking the kids to the cafeteria for lunch and it is going really well.

The supervisor and one of the therapists were out sick, and the behaviorist had not seen the new IEP (yet to be signed, because I just got the final copy today.).  So there were a lot of things that did not get covered, but it was good to have the teacher’s input.

We talked even more about the manding progam, and moving beyond the word want and noun, to play, drink eat and more specific verbs.  It seemed to me like we were worrying the same bone as last month.  But the teacher and behaviorist were able to talk about the reasoning in detail, and I think that helped everyone.   The behaviorist wanted to make sure that enough time had been spent on one word mands, in case R. was thinking two word mands are just one long word.  She had the teacher and I list words we hear spontaneously, and thought there were enough to proceed.

The behaviorist said she observed during recess recently.  R. was playing a drum with some other girls (in the gen-ed glass)  She saw the behaviorist and approached her,  obviously recognizing her and showed her the drum.

The teacher said that she is teaching R. to tap her on the shoulder and say her name instead of tugging on her hand when they are seated together.  I saw this in action several times,  R. tapped the teacher on the shoulder and said her name!

January ABA team meeting

We had our monthly meeting today with the ABA team.  One of my concerns is that R. is over generalizing the mand, want book.  She is saying want book for nearly everything she wants.   The supervisor thought that this was typical for R, and she’s right. R. does have a tendency to over generalize specific mands when they are first learned.  She also said that they are working on an object identification program that will help R. increase her vocabulary, and this should help.

R. will come to me and say want book, while she hand leads me to what she wants, which is rarely a book.  If she wants a cookie, I’ll say want cookie and she will only repeat the word cookie.  I know it is common for children with autism to repeat just the last word.  I do find I can get R. to repeat two word requests when they don’t contain the word want.

We discussed this for quite a while.   They suggested that when she says want book, we should give her a book, even if we know that is not what she wants.  Then when she refuses the book we should prompt her to say the correct mand.  We decided that we should limit our use of want, okay I pushed for this, but it wasn’t hard to get them to agree.    So instead of want cookie, I’ll say eat cookie, instead of want water I’ll say drink water, instead of want open, I’ll say open door.    They modified their mand program so they will work on eat cookie, play ball and want doll.

R. has started saying Hi spontaneously, mostly to inanimate objects.    She was cold so I put a sweater on her, she looked at it and said Hi, with the most joyous, glad to see you tone.  She said Hi to the water in her shower, to the box of cookies, to the new straw I put in her cup, always with that pleased as can be tone in her voice.   The behaviorist and supervisor thought this was a little weird, but cute.  The therapists said they thought it was typical behavior for  an early talker.

They are increasing R.’s sitting on the toilet to twenty seconds, up from ten seconds this week and last.  Her pants are still on while she is sitting.  We discussed the fact that she needs to sit for the entire twenty seconds with out any prompting.  They are giving her a reinforcer after sitting, and they wondered if they should give her the reinforcer while sitting.  I said that I would like to keep reinforcing her after sitting, until we get to her sitting with her pants down.   Then when we switch to pulling her pants down, she’ll also have the addition of a reinforcer while she is sitting.  They agreed.

R. has been doing jigsaw puzzles with the image on the background, so it is really matching.  They are going to start doing the same puzzles without the background.  I’ve been doing a jigsaw puzzle with her lately with no background, and she is starting to get it.   I think she has memorized the picture, but that is okay, at least she finds it interesting.   She’s bored with her insert puzzles, so I’m looking for other activities like that.  It’s like it needs to be a little challenging, but not too easy or difficult.

They are working on a new tracing program.  R. is supposed to trace a dotted horizontal line.  She needs a little bit of a prompt but she seems to like doing this.   I know she likes to have me hold her hand and we do dot to dots or write the alphabet.  The behaviorist wants me to stop doing that until she gets further along in this program.   It bugs me a little, but I do get where she is coming from.  We’ll do more coloring.

I finally asked about being provided a list, even a short one of activities that we could do with R. on days off and sick days.  She seems to be bored and looking for more to do on those days.   They said they could give me a list of the programs that were on maintenance, and seemed to think it was a good suggestion.

One of our therapists is leaving, Friday is his last day.   It happens all the time, but it always makes me a little sad, and he says he is too.  R. really loves him, I hear them both laughing throughout their sessions.

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.

Encouraging Communication – What’s working Part 2

Play skills are directly related to communication abilities.

One of the first things that our first ST told me was that developing play skills is crucial for early communication.   I would like to understand the hows and whys better, but I have seen that as R.’s play skills increase so does her ability to communicate.
In the beginning I felt like I should always be working on something with her.  I’d talk to her constantly, follow her around reading books, doing all kinds of things that did not hold her interest.   One afternoon I just started with what she would like to do – I chased her, and she loved it, she engaged with me and was smiling and laughing.  I realized that although it did not seem to have anything to do with encouraging her to talk, our play was a step in the right direction.

R. like many children on the spectrum only engaged in exploratory play.  She would shake, hit, throw, mouth and examine toys.  Sometimes she would line them up.  I hosted a playgroup for a typical Mom’s group before R. turned two.  I did not know about the autism yet, but I knew R. did not play like other kids.  A baby who wasn’t even walking yet crawled over to the toy box, found a car and proceeded to drive it across the carpet.   His older sister put a doll in a play stroller, flung a play purse over her arm and said she was going out.  R. spent most of the time rolling around under the dining room table.

It is hard to figure out how to play with someone who doesn’t seem to want to play with you. When that person is your child, it can be even harder.  I had to realize that any kind of interaction was the goal, and any activity that she found enjoyable was worth pursuing.  I did not need to worry about if the activity was educational or appropriate or anything else.

Activities that require me or another adult’s participation were (and are) the easiest to engage R.   We still play “baby games” like peek-a-boo, chasing, tickles and raspberries.  In the beginning one of the few sure fire ways to engage her  was to let her knock over a tower of blocks that I stacked, she would do this over and over.   Bubbles, wind up toys, even a whoopie cushion all got her attention and made her want more of the activity.  The ABA therapists are really good at coming up with their own silly games.

A couple of silly games we are playing now- R. will lead me to a computer chair with wheels , I’ll prompt her to say come, and when she wants me to sit, I’ll verbally prompt her to say sit.  She will then climb in my lap, say ready, set go and then I have to give her a chair ride.   A variation of this is that she will lead me up the stairs, I’ll prompt her to say come and then up.  She then pulls me to sit down on the top step, and I’ll prompt sit.   She’ll climb in my lap and say down- again she wants a ride.  I’ll make her say down for every step.   With games like this that are consistent, she seems to be able to say a spontaneous word for the start of a desired activity  (ABA calls this manding) more consistently.  So she will say ready set go, or down with no prompt most of the time, but the lead in words -come, sit, still require verbal prompting the majority of the time.

I keep some toys out of reach, and some are in boxes or bags that she can’t always open, so she has to ask for them.  During EI, R. had a program that was just the therapists demonstrating different things to do with toys and taking data on her interest level and attention span.   I try to come up with interesting and different things to do with her toys, so she will ask me to repeat the activity.

Floortime talks about joining in a child’s play, and this is a good way to engage R. when she is perseverating or just on her own agenda.  When we started, one of her favorite activities was to carry all of something, like blocks or stuffed animals one or two at a time from one side of the house to another.  I would get in the way and hand her the animal or whatever, and just insert myself into her game.  I would also mess up her pile, which sometimes annoyed her, but hey I got her attention.

I think the reason that children on the spectrum are limited in their play is because they literally have difficulties imagining anything else to do.   It seems to me that the repetitive nature of her play was (and is) comforting to her.   Most people have an easier time in most situations if they have some idea about what is going to happen.  Perhaps for R. it is that she can not even conceive of a unique situation until she has seen it, and often she might need to see it several times.   If I pick up R. in the kitchen and run or spin her or do something fun, she will hand lead me back to the exact same spot to repeat the activity.  It doesn’t occur to her that I could do this anywhere, until I show her.

Thinking about pretend/symbolic play it makes sense that children on the spectrum would have difficulties in this area.  Why is symbolic play so significant?  I wondered this after our diagnosis, and I’m probably not the only one.   Symbolic play is essentially how she is perceiving and reenacting her experiences.   I think that when R. did not have any symbolic play skills, she also did not have much knowledge about or ability to manipulate her environment.   As R.’s symbolic play increases so does her expressive and receptive language abilities.  I think in the wait for spoken words, I kind of forget about receptive language.  It is so amazing to get responses to things I say, that tells me that not only is she understanding me, she can imagine and conceive of a familiar situation she is not experiencing at that moment.

As an example, We went to Home Depot recently, and as soon as we pulled into the parking lot R. started to cry.  It was clear she did not want to go.  A year ago she would not have even noticed where we were until we were in the store.  She could see the store and imagine (I’m guessing here) the last time we went.  She did not cry the last time, but we had been there the day before, so I’m sure she was tired of it.  I told her that Daddy would go to Home Depot and she and I would go get a cookie at the bakery.  I repeated this a few times and she stopped crying and she even said cookie a couple of times as she climbed into the stroller.

I think it has been the most difficult to encourage pretend play as opposed to other kinds of play.  Probably because I have a tendency to over think it.   R. really liked to set up toys on the dining room table, so it seems like a natural thing to encourage her to set the table with play dishes and food and have her dolls eat and drink.  She will set the table, feed and give drinks to her dolls (mostly Elmo and company).   She will try hats on Elmo or Ernie and she is starting to try out things that aren’t actually hats.  This is a great improvement over a year ago when this kind of play was non-existent.  But her symbolic play skills are still very much in the beginning stages.    She’ll brush Ernie’s hair for a few minutes and then go on to something else.  I’m not seeing many complex scenes acted out.  It is not always easy to interpret what she means by what she is doing.  When we are out she’ll have Elmo and Ernie try out things, she’ll dangle them over the side of the shopping cart and she will be babbling in a conversational tone the entire time.

I set up different play scenarios and I try to mix up the locations and how they are set up, so she doesn’t become too fixed on one way.   I also try to jump in and make her play sessions a little longer.  She will put a doll to sleep and I’ll pick her up and make her tell R. that she doesn’t want to go to sleep.  Or when she removes the doll’s clothes I’ll have the doll complain that she is cold.  R. is becoming very receptive to me playing like this.  She smiles and is very engaged and will give me items to use to play.

Say what?

Sometimes I can’t believe what I’m hearing coming out of R.’s mouth. She will occasionally say I know, in an annoyed tone, usually when I am indeed telling her something she knows. Yesterday morning she said sweet several times on her way out to the bus.

She’s also saying things I don’t quite get. A common phrase sounds like she is saying suck a duck. Only the last word is not actually duck if you get my drift. E. swears that he never uttered THAT phrase to her, so I’m going on the assumption that I’m clearly misunderstanding her.

Another one I hear fairly often sounds like Chigada chigada megadeth megadeth. Now I do like Megadeth, the first few CD’s anyway. But I’m sure I haven’t discussed the band with her. Again, another mystery phrase.

Encouraging Communication-What’s working Part 1

Find an alternative communication method.
We used PECS (Picture Exchange Communication System) with R.  We were fortunate that our ABA provider made all the icons and set up the binders.  We used a combination of the standard icons and actual photographs.  We started hand over hand and offered preferred items.    In the beginning the therapists would put her trampoline against the wall and she would have to hand over the icon for the trampoline to get them to put it down so she could play with it.   We keep two PECS books around the house,  one for food and the other for activities.  R. does not use them as much as she used to, I think she really understands it is easier to be prompted to say the word than retrieve the icon, but she will occasionally go back to them and bring us one of the cards.

Sign language is another option.  R. did not have the imitation skills when we began, so this really was not a good fit for us.  I have met other children with ASD who are as adept with signing as R. is with PECS.  One advantage to signing is that you don’t have to bring your PECS book everywhere and keep track of all of those icons.

Our former program director would talk about PECS enabling R. to learn the power of communication. It really is not possible to physically prompt a child to speak, but both of these methods can be physically prompted.  The advantage of being able to physically prompt the correct response, in ABA speak is errorless learning.  The prompt level will be gradually decreased.  When R. started using PECS the prompt was to hand over hand help her remove the icon and hand it over.   After a while the only prompt she needed was for us to show her the PECS book.

Several family members asked me if R.’s using PECS was going to delay her ability to speak.  They were concerned that it appeared easy for her, and she would become reliant upon the method.  I think PECS is what enabled R. to get to the point she is now with speaking.   She was not at the developmental point to be able to access language, but she was able to be taught how to communicate.  NT infants and toddlers in the pre-verbal stage are becoming experts at non-verbal communication,  R. needed to develop these skills before she could speak.  PECS enabled her to have the benefit of being able to communicate at her developmental level.

The ipad and other devices will be opening up new worlds in alternative communication for children on the spectrum.

Don’t reward crying/tantrums

Crying and tantrums are a form of communication.   They were R.’s main method when we started on this journey.  ABA was very helpful in teaching me that I should not give her what she wants when she cries, I should prompt her to communicate her wants.  I wrote about this a few months ago. I’ve read discussions on different ASD boards that describe this method as not acknowledging or ignoring crying/tantrums, and I think this is an incorrect interpretation.   Crying should be acknowledged for what it is, a complaint.  The message I want to send R. is that, I hear you, you are upset, but if you want whatever it is you have to say a word or give me an icon.  Crying may get my attention, but only communication is going to get you what you want.
At this point I can usually prompt R. to say a word if she is crying for something she wants.  This actually happens rarely, because most of the time she will start with a gestural communication (hand leading) and then will either say or be prompted to say what she wants.  But sometimes she can’t have what she wants, or she has to wait and then she will cry.  This is probably more accurately described as a complaint, she usually has no tears and there is babble and sometimes words among the yells.  I also try to explain why she can’t have what she wants and offer an alternative.  So if she’s crying because she’s impatient for the popcorn to finish in the microwave, I can show her the bag that is popping, the countdown timer and say we have to wait.   It’s always harder if it is something she can’t have, but it is getting so much better.  So if she is crying because she wants to go outside, I can tell her it is too late to go out and offer something else to do.  I’m still in awe every time this works.

Consider that communication is more than just words.
Shortly after we started ABA, R. began hand leading.  I realize now this is quite common among children with ASD.  At the time it seemed quite amazing, and now it is so much a part of how she communicates.  Prior to any gestural communication it seemed her only method of communicating was by crying or with a look or expression .   The first programs that ABA started with were what they called anticipation games.  They would do something she liked – tickles, spins, bubbles… and then wait for her to look at them to repeat it.    It wasn’t long before she would gesture by grabbing their hand to continue the activity.     These play activities taught R. that people could do fun things if she communicated.

In the book The Special Needs Child by Dr. Stanley Greenspan, he writes about closing circles of communication.   If I tickle her and she looked at me to continue, that would be one circle of communication.  I really liked this concept because it gave me a sense of actually doing something using skills she already had.    It still feels like a game to see if I can get her to close just another circle or two.   Floortime lite Mama writes about Floortime as a lifestyle, and that is how we do things around here.

Words, words, words

R. is talking more and more.  Most of it is still prompted, but she is saying more spontaneously.   Open is still her default request word, but it is being replaced with other words.   Last week she was saying Do this when she would hand lead me to something she wanted.   And as further proof that ABA is rubbing off on her, she said do this and made Elmo jump and then Ernie jumped in imitation.   This week she is saying want most often.

Sometimes she will really surprise me and answer a question.  She was crying and obviously looking for a particular toy, I helped her go through all her stuffed animals and I kept asking her what she wanted.  Finally she yelled Ernie.     I found him under a book, mystery and crisis averted!

It is still most frustrating when I don’t know what she wants.  She was clearly angry about something, she cried and then yelled you, you, you, you, you and looked me right in the eyes with an angry expression.