Tuesday, April 15, 2014

Andy's IEP was today

Andy's Individualized Educational Plan (IEP) meeting was today. His preschool teacher spoke with
Andy's future kindergarten teacher during the meeting and gave tips on how to soothe Andy, and spoke of his likes and dislikes at school. I also informed them of Andy's new Autism diagnosis, and of how I am going to give Applied Behavior Analysis (ABA) therapy a try with him as well.

I also brought up concerns of possibly needing bus transportation next year for Andy, despite living very close to the school. Unfortunately, there are big physical challenges/obstacles to getting him to the school in his wheelchair. One of which used to be missing sidewalks! This issue was resolved, but ramps/approaches still need to be added to current school walkways as they are not handicapped accessible.

The weather has also been a huge issue this year, more so than ever. This winter has been a terrible one, and it makes me worry of how I am going to get Andy to school next year in his wheelchair without constantly getting stuck in the snow all the time. This prompted me to add a transportation statement into the IEP, which notes that "Transportation by bus with a lift and tie downs needs to be available at the request of the parents". The reason for this is because I don't expect to be needing to use a school bus for Andy unless we have bad weather conditions.

This winter 2013-2014, Michigan has had record breaking snowfall of 94.8 inches. This has surpassed the old record of 93.6 inches in the year 1880 to 1881! Which for me, meant that I had trouble getting my son to my daughter's school in his wheelchair at times. His wheelchair became stuck in the snow on several occasions, due to my subdivisions lack of clearing the common area sidewalks, and my daughter's school not doing their job of clearing snow away properly. It was very nerve racking and hair pulling to say the least. Luckily, I didn't have to bring him to the school very often, but next year I will have to daily.

The picture above shows me at the park with Andy just days before the final record breaking snowfall. We were at the park enjoying a lovely 70 degree day, and then several days later the temperatures plummeted down to 30 degrees and we got two inches of snow. I know the weather has been crazy everywhere, and I have come to expect the totally unexpected as normal for the past few years now.

I'm very excited for the upcoming school year, and I think Andy will be too. I think we are going to start seeing some wonderful changes in Andy. It will be so great to have him involved in highly beneficial programs that will help him flourish.


Wednesday, April 9, 2014

Exercising is helping me be a better mom

It never fails, I was trying to get my new routine started of working out a couple times a week, and I picked up strep throat somewhere along the way. Which I then gave to Andy. It was a bit of a road bump.

I went to some exercise classes for a couple of weeks, and the results of feeling less stressed about Andy and family life were immediate. I really enjoyed exercising and taking time for myself. I seemed much better able to handle the stresses that Andy deals out. I was also happier towards him, more understanding, and sleeping better through the night.

I've also been working on trying to be more understanding with my daughter. A lot of times I am not very forgiving with the fact that she is only six, and doesn't have a lot of logic and comprehension of things. I find myself having a very short fuse with her every day.

My bowling league is coming to an end, which was a night out that I got each week. I should really substitute that night by doing something with my daughter, but I'm sure it will rarely happen. There are always so many things that come up, and it is just easier to stay home.

In more exciting news, Andy is occasionally attempting to put random syllables together! They sometimes sound like real words. He blurted out in the grocery store today after a lot of high-pitched squealing, "Haaaay, ebb-er-body" and then nothing else. It was exciting to think he is attempting to talk.

I am currently on the kick again of giving him the fish oil squeeze packs once a day. I think it is stirring up something in his brain. I am going to try to keep it going a bit longer this time, before giving up on it. It's so easy to throw in the towel with it and think, it isn't showing me any results, just forget it. But I think it has a cumulative effect and you really have to just keep up the faith and give it daily no matter what you are seeing come out of it.

Any other tips on how to get him to talk to us would be great!

Saturday, March 29, 2014

Andy's been officially diagnosed with Autism

It has been recommended to me by several health professionals to have Andy evaluated for Autism. I was told this would become more important around age 4 or 5, but the concern wasn't heavy at 18 months old, but mentioned to me. I recently realized that a lot more services could become available to Andy, should he receive a diagnosis of Autism, so I was interested in pursuing it, as he is approaching five years old.

My insurance company, Blue Cross Blue Shield of Michigan (BCBSM), has to have several things
happen before they will accept a diagnosis of Autism. Once all of these things have happened, a case can be presented to them for the approval of the need for Applied Behavioral Analysis (ABA) therapy. These things are: psychological evaluation, speech evaluation, and neurological evaluation.

The DMC Children's Autism center extensively interviewed me first, as part of the psychological evaluation, asking me "yes" or "no" questions about Andy's behaviors. A lot of the questions were, "since he was four years old, have you seen this..." Or they would compare when he was a newborn or toddler, compared to, since he was four years old. The next part of the psych eval involved a one-hour observation of Andy.

They wanted to see if Andy would share things with them. He did not. He keeps to himself while playing. They wanted to see if he would respond to his name when called, he does not. They mimicked having a sick baby in the room to see if he would show compassion or concern, he did not. They tried to see if he would try to draw them into his play, like extending toys to them, giving them something if they asked for it, would he look at them to want them to come join his play, he did not.

They met with the speech pathologist, and neurologist and looked at all the psychological reporting and observations. They had me come back in for a feedback visit. They told me they feel that in addition to Andy's mental and physical impairments, that he also has Autism. They said that it can be difficult to tease out what behaviors are from his developmental delays, and what is from Autism.

Andy also exhibits lots of hand flapping by his face, putting objects and his fingers to his mouth, covering his face due to loud noises or when he's frightened, and they feel these behaviors could be from the Autism part of it. He has self-injurious behaviors, such as head banging, and face scratching. He has frequent meltdowns, at any time , and at any place. He doesn't show awareness of what is socially right or wrong.

I have never had an opinion on whether Andy has Autism or not. I went through with these evaluations, because I want Andy to receive the maximum amount of services that he deserves. Now that he has this diagnosis, he can possibly start to receive intensive ABA therapy, which has been shown to very positively help children with Autism, developmental delays and other disorders.

The paperwork they sent home with us also shares several Autism websites and techniques that can be used to increase Andy's communication with us. I will list these below. The PhD delivering the news told me that one of the main goals of the ABA therapy is going to be to increase communication. Other goals include: increasing peer-interaction (responding to children, interest in peers), socio-emotional reciprocity (offering comfort), play and leisure skills (imitation, pretend play), shared enjoyment and offering to share. I cannot schedule any ABA visits until my insurance company approves it, which will take a couple weeks.

The documentation will also be helpful to submit to the school because it states that according to the American Academy of Pediatrics (AAP), for young children with a diagnosis of the autism spectrum the AAP recommends:

  • Intervention consist of a low student-to-teacher ratio to allow sufficient amounts of 1-on-1 time and small group instruction to meet specific individualized goals. 
  • Provision of intensive intervention, with active engagement of the child at least 25 hours per week, 12 months per year, in systematically planned, developmentally appropriate educational activities designed to address identified objectives.
  • Inclusion of a family component (including parent training as indicated)
  • Promotion of opportunities for interaction with typically developing peers 
  • Ongoing measurement of child's progress toward objectives
  • Incorporation of strategies to apply learned skills to new environments and to maintain functional use of these skills.
For further information regarding the American Academy of Pediatrics' recommendations on treatment of children with ASD, please go to:
http://pediatrics.aappublications.org/content/120/5/1162.full.pdf+html

Here are the web resources they shared with me for Autism:

http://www.autismspeaks.org

http://autismallianceofmichigan.org

http://autism-mi.org/

http://michigan.gov/autism

http://www.asatonline.org/  (Association for Science in Autism treatment)

http://www.ninds.nih.gov/disorders/autism/detail_autism.htm   (NIH Autism fact sheet)

Saturday, March 22, 2014

Speech sounds are improving, Andy's been drinking from a cup

Over the past few weeks, we have slowly been hearing Andy babble more and more. It used to be extremely rare for me to catch Andy babbling. His choice sounds are ma-ma-ma, or ba-ba-ba. For the
last year, the only babbling we would hear Andy doing was usually in the bath tub. Andy's speech therapist told me that being immersed in water is very stimulating for kids, and this is why we see the vocalization kick up when they are in the tub.

Still it was rare, I would even try to catch him on video babbling and couldn't get it. By the time I put my phone on the video setting and hit record, he would already be done babbling. Recently, I've decided for the tenth time to revisit trying to have Andy drink from an open cup. I filled a dixie cup to the top with water and put it to his lips. He actually cupped his lips this time and got a sip.

We celebrated and told him what a big boy he is. This motivated him to want another turn. Lately, every day, I've been trying to offer him a cup to drink from at least once a day. Andy's current preference for drinking is a cup with a straw in it. He will not lift the cup. I offer him drinks when I think he's thirsty, or if he eye gazes at the cup. Sometimes he will overreach for the straw cup and knock it over, and I take this for him wanting a sip.

According to a feeding (oral-motor) therapy presentation I read by Renee Roy Hill,SLP, it is important to offer kids different methods of drinking liquids. Different facial muscles are used for drinking from a straw, and drinking from a cup. The muscles of the tongue have to be used differently as well with different drinking methods, and this is important in children learning to develop different speech sounds.

I even learned from this presentation that choosing the right cup can be important. I noticed that Andy only likes to drink from paper cups right now. He doesn't care for the feeling of glass or plastic cups. Hill also suggests that having your child start out with drinking thicker liquids at first is better. She notes that thickened liquids are easier for patients to control, when learning a new muscle skill. You can then move to thinner liquids as their skill level increases. I noticed that the chocolate whole milk you can buy in stores is quite thick, so I am going to use that, plus maybe some smoothie mixes.

The last few weeks have been exciting for us, because Andy is now babbling at all times, and it is not just limited to the bath tub. He wakes up saying "ba-ba-ba", as if he is so excited to get all these new sounds out. He babbles more in the car, and around others. It seemed before that if you interrupted his babbling to even say,"good job talking", then he would stop doing it for the day. Somehow though, he is becoming less shy about it, and even babbling when I have him in public.

I really do feel that us offering Andy the cup to drink, has been helping with him wanting to babble more often, and his ability to babble. However, Hill notes that feeding therapy should not be the only thing used when working on speech production. She stresses that oral-motor therapy/feeding therapy should be used together with other speech therapies to continue to gain speech production from the patient. Andy continues to receive speech therapy twice a week at school, along with my feeding efforts at home. We seem to be seeing results!

Thursday, March 20, 2014

Clearing up constipation for less irritability in low-toned kids

A common problem in low muscle-toned kids is constipation. For years, my son has suffered with constipation and still does. Lately, it has been way lessened due to dietary changes.

I never realized before that constipation does not mean "no bowel movements". So, when asked by doctors if he was constipated, I would say answer "no". I didn't realize he was experiencing cumulative constipation, and passing of small bowel movements was a sign of this.

Doctors showed me how to feel on my son's belly while he is laying flat on the floor. While feeling on his left side, they directed me to take a feel just below his hip. It felt like a bag of hard marbles was under the skin. This was hard stool waiting to be evacuated. I was told to buy a pediatric enema at once and administer once a day until he produced large stools. The enema worked right away.

Constipation can mean small bowel movements, which aren't giving relief. It can also mean, hard to pass stools. For my son, this lead to inconsolable crying and high irritability. Andy is non-verbal, so he can't tell me that his stomach hurts. However, I could see that he was straining to go, and making grunting noises and crying with his legs bent up to his chest.

Here are some tips on what I do now to manage his constipation:

Try to mimic movements: For my son, I have to get him standing several times a day. I may bounce him around on his bed, or on my knee. He enjoys the motion. I also try to get him into a crawling position, which is good for passing gas and building up bowel pressure. I lay him on his back and bend his knees and straighten out his leg again, doing a bicycle motion with his legs. This helps the bowels to move through.

Introduce more fruits and veggies: I have slowly added healthy snacks to his diet, such as fresh pineapple. I buy it already skinned and I cut it up. He ate a half a cupful the other day, and he was moving his bowels in no time shortly after. The acidity of the pineapple really gets the bowels moving as well.

Introduce fiber: I was instructed by a physician's assistant that you have to add fiber very slowly, as well as fruits and veggies. She said that slamming a bunch of fiber into your body can make you miserable with bloating. I found this to be true when eating part of a fiber bar. She told me that you might have to cut up the fiber bar into small pieces and just eat a small amount each day for a week. During the week following, you can try to add a small bit more. This will allow your intestines to get used to this new fiber coming in and manage it. Since Andy is non-verbal, I have to look at his cues to see if he is in any discomfort from the foods I'm giving him.

Use stool softeners as directed by a doctor: For my son, he requires stool softener once a day in cold water. I give it to him at lunch time with his meal when he is quite thirsty. This way he drinks it all at once.

Offer plenty of water and juice: I have to push for Andy to drink water, because he will not reach up and grab for a drink himself. I was told to offer grape or apple juice in the morning and get it out of the way early. The juice helps the bowels to get moving. Then I continue to offer more water, and the water with stool softener in it once a day. Water is very important to not creating a hard to move stool problem.

Last but not least, enjoy being more healthy! Watching over Andy's eating habits has helped me to eat and feel better too. I can tell that I've executed a job well done when he is is happy and cheerful more often than irritable.

You will find what works best for your child as you monitor and change their diet. Some things that work wonders for some people might not do anything for you or your child. You just have to keep trying different things and stick with what works best for you. I also consult with a doctor, when I feel that Andy's stomach may be bothering him, and I have been unable to help him.

Monday, March 17, 2014

Cleveland Clinic bound to see Dr. Parikh




We were told by our Physical Medicine and rehab doctor, "It's time for the big guns. You've seen a lot of specialists, now it's time to see someone that is smarter than all of us". She wants me to take Andy to the Cleveland clinic, to see Dr. Parikh. He is a neurometabolic geneticist. He specializes in mitochondrial  disease, and has been very successful in diagnosing other genetic syndromes in undiagnosed children. We will be going in June, unless there is a sooner cancellation. It is about a three hour drive for us, which isn't too bad. It's worth a shot. I would like to know if Andy's syndrome can be passed on to future children. It is important for me to know. 

Also, we received a call today from Andy's current geneticist's office telling us he is now retired. When we saw him in January he reassured us he would search for anything he could do to help us. Looks like he decided to get out of town instead...

Saturday, March 15, 2014

IEP meetings can be recorded, according to United States law

Someone from a behavioral disorder Facebook group shared the following article. It states that according to Federal law, laws regarding conversations not consented to being recorded don't apply to IEP meetings. It also further states that the school may not retaliate against you for recording an IEP meeting conversation.

http://www.disabilityscoop.com/2014/03/14/feds-retaliation-not-ok/19191/


Sunday, March 9, 2014

We went to Castaway Bay Waterpark in Sandusky Ohio




We optimistically scheduled a road trip 2.5 hours

away to go to a waterpark/hotel. It turns out,
it was just what Andy needed.

His behavior is always dicey in the car, and when we are away from home. However, Andy was really great on the way there and at the hotel.

We stopped every hour to let him out of the car. When we got to the hotel and had to wait a while to check in, he was so happy in the stroller. He was just squealing and looking around at the big pirate ship and fireplace in the lobby.

We didn't get our room until 3pm, but we were able to change in a bathroom and put our stuff away with the front desk to swim until the room was ready. Andy even took a nice nap as soon as we got in the room, and the next day, which really helps his behavior.

We travel with a blow up bed we bought from Walmart. It comes with a pump and a canvas bag to carry it in. He isn't able to get out of the bed and he is able to roll around and army crawl. However, he doesn't know how to sit up on his own and stays contained in this bed which has sides on it that are about 6 inches high. Andy is 39 inches long, I think the bed is 48 inches long, not including the inflatable sides.

We got a room with a bunk bed in it, in addition to a bed for my husband and I. My daughter really enjoyed it, because she could play with her cousins in there. They had a desk with three seats and their own TV, which made them very happy. The bunks had rails on the top, so even Andy could play with his toys up there on his belly.

The wave pool was great, and it was where Andy and I were most of the time. He was even allowed in the hot tub with me. He only had to be in it a few minutes, then he would fall asleep in my arms. It made him so cozy.

We had a great time and decided we should do this more often.

How to prepare for a colonoscopy using Go Lytely

This may be TMI for those looking for special needs info only, however, if you are preparing for a colonoscopy let me share my tips! This is the second colonoscopy I've had, and it was much better the second time around.

Colonoscopy Prep Tips



Try the prescription Go Lytely, instead of buying over-the-counter. The first time I did this, I bought an over-the-counter tiny bottle of cleanser. It beat the heck out of my stomach and made me feel like someone was kicking me in the gutt, while having a terrible stomach flu and hangover. On top of all this, the doctor told me I still had debris inside, even though things looked clear to me. The Go Lytely was so mild, and easy on my system. Don't be afraid of the amount you need to drink. It makes the cleanse so much less painful, I didn't even feel any cramping! Once your stomach starts emptying out, you will find it much easier to continue to take down the first half of the solution. This rule may not apply for those who already have constant diarrhea, in which case, they won't need much help getting cleared out.

If you have to have a clear liquid diet, you don't have to starve. Buy some good tasting chicken broth, like Campbell's broth in a can. It tasted way better than others I've tried. It was very satisfying for my dinner. For lunch, I ate Lime green Jello. I bought it at 9am, and used the speed set method with ice to have the Jello ready for lunch. I ate half the Jello for lunch, and some for a snack before dinner, and I didn't starve all day! I also drank Faygo cream soda in between for breakfast, along with the clear color-free fruit punch gatorade. The calories kept me from feeling dizzy and wanting to eat real food.

Drink the Go Lytely Warm, not cold. I first tried drinking the solution cold, and it was awful and very hard to take. This solution is salty tasting, and who wants to drink cold soup? When I got the idea to put it in a coffee cup and warm it up, it went down so much easier. 

Drink the Go Lytely through a thick straw. After I warmed it up, I put it in a big container with a thick straw. This made it so much easier for me to "down" it. I actually had to slow myself down, because at one point I had drank 24oz in 30 minutes, and started to feel nauseous. A 15 minute break made me feel better. Sticking to 8oz every ten to 15 minutes is best.

Shhh! You don't have to finish every drop... As long as you drink it until your bowels are running clear for a couple of hours, you will be good! I had 20 oz remaining and I felt I couldn't get my body to take any more in. I saw the pictures from my colonoscopy and I was clean as a whistle!

Now onto getting your IV, then the worst will finally be over! I was put to sleep and woke up in the recovery room. I didn't feel a thing! They took a biopsy to check for colitis, and I didn't notice it either. 

In the days following, I felt minor gas pains here and there. I was told to watch out for a 100 degree fever or higher, which could signal an infection due to bowel perforation. I didn't seem to have any complications though. Now I just have to wait to see if I have colitis, or if this irritable bowel, and crazy colon problems are just due to stress. Either way, I have to press on with my stress-reducing activities.

Sunday, March 2, 2014

Andy army crawling

Here's a video of how Andy currently gets around a single room. He only goes about five feet and doesn't venture far. I have not seen him crawl down a hallway or into another room without being coaxed to do so. He doesn't seem to be interested in exploring, only in getting to his toys within reach. He doesn't really "get into things", which is good, but it would be nice to see him wanting to explore the house.