Siblings

One child demands attention, while the other one needs it. As a parent, how do you balance your time with each of your kids without making one feel pushed aside for the special needs of the other? At first, I felt like this is what I was doing --- pushing one child out of the spotlight, while bringing the other one to the forefront. But, what I have discovered pretty quickly is that I just need to involve both children in the experience.

Sometimes Katie comes to John's pre-school class with me. She can participate in most of the group activities, such as circle time, snack time, and make her own project. They just let the 'big' kids know that the little kids have to go first. It's a good lesson for anyone, but especially for those that always want to be in the spotlight.

I let Katie be a part of the in-home sessions with John's teachers. John has also qualified for services in the home - 8 hours a week. A teacher comes into the home, using play therapy and "floor time" (sitting on the floor and playing in John's environment, allowing him to dictate what they play). Katie, now 4 years old, doesn't completely understand why John gets a teacher to come and play in the house. I encourage Katie to be a part of the session, although at times, she can tend to 'run the show'. I allow her to start with them and then pull her away to play on the computer or read books with me on the couch.

I set aside time with each child to do our "work" in the home, where I pull out my bin of toys and work with them on different skills. Many of you may think that they are having to "work" too much, but seriously, they love it, and it is all just play---doing puzzles, stringing beads, matching colors, building blocks, etc. They love the one-on-one mommy attention, as well as the special toys they get to play with.

Katie's activities are structured different from John's. she has 'tasks' that need to be completed following a series of directions, whereas John's goal is to increase his attention span. For Katie, I have puzzle cards that are opposites that she has to match together, she creates patterns when she strings beads into necklaces, we do projects (on Tuesday we made a rainbow), and she makes geometric shapes from other shapes. Katie's work is more about the skills---working with scissors, creating a project, understanding a pattern.

For John, he needs to build an 8 block tower before we can put the blocks away, he has to string at least 3 beads before moving on, he has to finish the entire puzzle, he has to put all of the shapes into the shape sorter before he gets bubbles, etc. It's not only the specific skill that he is learning, but also about sticking to a task. When we are working on flash cards, it's more about "just two more" than it is about what he's learning. The flash cards are about recognizing objects and increasing his speech as well, but completing the task is the ultimate goal. Once he completes things, the sense of accomplishment is taught, and he begins to initiate the task on his own. The other morning, I was having a hard time getting out of bed and John was running around my room. It got quiet, so I thought I better go check and he was in my closet with the box of work open and he was string the beads on his own. He had 12 frogs on his string! That right there is a success! When John takes the time to slow himself down, he learns. The last two years, he hasn't slowed down enough to learn how to do things right.

Katie is always wanting to help John. This week she has told me she is teaching him to get dressed by himself. One day she told me, "John's talking now. He's really talking". I have even caught her telling him, "look in my eyes when you say that"!

Siblings should be a part of the early intervention. The whole family needs to be a part of it. Although the classes and therapy are the foundation for John's developmental success', family life is where it all has to be reinforced.

Good Days and Bad Days

With any child, there are good days and bad days. Everything on Monday seemed to lead to what I am now calling a bad day. It started with John's refusal to eat his eggs. Katie came with us to Early Start Pre-School on Monday morning. All John wanted to do was "check his schedule" and skip all the activities that the schedule told him to do.

I think John is getting bored with all of the "un"scheduled activities in this class. Mom sure is getting bored with it! Sometimes it feels like we are trying to "pass the time" until John gets his one-on-one work time with the teacher. Some of the other activities, which include Imaginary Play, Outside Time, and Gross Motor skills are led by the parent or caretaker of each child.

Imaginary Play involves a play kitchen, which doesn't always have the food, pots, pans, and plates. There are only so many things you can do---open the microwave, put the corn in the refrigerator, wash the dishes, etc. The girls play the kitchen well. John will attend for a few minutes, but usually is ready to move on to other things. I don't blame him. He did really well last week, washing dishes in the sink, putting them in a bin that he called the dishwasher, putting them away, putting food on the plates, and starting the process over. But, this Monday, he didn't want to play with the Kitchen. SO, I let him go outside.

Outside time includes riding bikes, wagon rides, playground equipment, a play house, etc. John usually will fit everything in to his scheduled 20 minutes. About 2 weeks ago, John discovered the swing. Well, on Monday, the swing wasn't set up. So, he busied himself with running back and forth between the playground side and the bike side. Katie couldn't keep up. She just wanted to sit and play. At first, I kept making her join us. Finally, I gave up and let her have fun on the playground equipment without my immediate supervision. She's old enough now for me to just check back and forth. It's hard having them both at class. John doesn't like it when I give Katie any attention at "Ja's Skool".

Circle Time, Fine Motor skills, and Table Time are led by the therapists. Circle time went fine and Katie got to participate, which made her happy. Fine Motor Skills was an activity where the kids got to put their hands in the glue to stick fish, crabs, and sharks in the sea (a big poster hanging on the wall) and then finger painting their sea creatures. Although John wanted his hands in the glue and the paint, he was more interested in going to the "ba-oom to wah ans" (bathroom to wash hands).

Washing his hands has become a big thing these days because John is close to being completely potty trained!!!! He decided that Katie wore underwear and so should he, so he refused to wear pullups and diapers. Two potty accidents taught him to tell us he needed to use the bathroom and from there, we've progressed quite nicely. Even now if he starts to have an accident, he can stop it and tell me he's going to have an "acdent", while grabbing his crouch! He has 4 stickers this week for pooping on the potty seat. Now, this is very rare for a child with John's issues to be potty trained. It was something I wasn't ready for, but John made sure this was something he learned. Again, an example of his 'scattered level of skills'.

I digress, back to Monday and the "bad day". Work time was especially hard. He didn't want to look at the teacher and she was having to constantly remind him to "check his eyes". With his eye contact issues, they have him make sure that he tells the person what he wants by looking at them. So, if he wants the school bus to "go", he has to say "go" by looking at the person that will push it to him. Some days this is easy and some days this is hard. Monday was hard.

After school, we went home for lunch and a nap so we could go to speech class. Our next door neighbor came over to babysit Katie and she brought movies. John didn't want to go to speech class anymore. Leaving was a battle. Once we got to class with Tonyia, we started the eye contact battle again. He did everything he could not to look at her ---turned around, closed his eyes, put his head down, yawned a lot, kept pointing out the clock, etc. She worked him hard for the first 25 minutes, but she told me we were going to stop because she thought he needed to move around. We went into the START gym and he played in the ball pit and swung on the swing. He didn't want to do much in the gym either. He kept pointing out the clock.

After speech, we went to the second session of Neurofeedback. Well, John didn't want them to hook up the EEG monitor. He cried, squirmed, kicked, and got very upset. I told them that I was taking him home. It was a bad day and forcing him to do it would have been torture for him and me. So, we went in the elevator to go down to the first floor.

We got stuck in the elevator for 25 minutes! We were going from the second to the first floor. It got stuck between floors. Before we got in the elevator John was crying. Getting stuck was the best thing that happened to him all day. I had apple juice with us and he drank that, danced around, pushed buttons, and kept squealing in delight, "elvater!" The best part was when the firemen let us out and showed him the fire truck.

The family then went to get dinner at Rubio's, where Katie vomited in the trash can outside before we ate. She continued with the flu all night long.

Monday was a bad day.

Autism

I thought I'd take the time in today's blog to concentrate on Autism, the diagnosis John has received.

Autism (defined here by regional center) is a developmental disorder defined as a syndrome causing significant and sustained impairment in social interaction and communication, with restricted and stereotypic patterns of interests, behavior, and activities which appear before age three. Since Autism is a syndrome, all people who have the disorder will not have all of the different behaviors associated with the disorder. Autism is a lifelong disability.

Children with autism are slow developing self-care, communication, social or learning skills. These skills are often uneven, having good skills in one area and poor skills in another. The person will have limitations in understanding words and ideas, and may be inappropriate responses in sight, hearing, touch, pain or balance. Relationships with people and objects may be abnormal.


Here are a list of behaviors that are Characteristic of Autistic Children: (though a child may not show all of these, showing a significant amount of them could lead to a diagnosis of an Autistic Disorder)

• Difficulty expressing needs; severe language deficits
• difficulty mixing with other children (parallel play)
  
• Repeats words or phrases in place of normal responsive language
• Acts deaf at times. Tests in normal range of hearing, but not always responsive to verbal cues (doesn't respond to name when called, for example)
• Resists learning
• No fear or danger
• Resists change in routine
• Indicates needs through gesture (may lead adult by the hand, instead of pointing)
• inappropriate laughing
• resists cuddling
• physical over activity
• avoids eye contact
• inappropriate attachment to objects
• spins objects
• sustained odd play
• standoffish manner
• uneven gross/fine motor skills
• laugh, cries, or shows distress for no apparent reason
• unresponsive to normal teaching methods

John's Autistic Characteristics
I took John in for a speech delay, but had also noticed these things:

• would make eye contact for only brief periods of time - nothing sustained
• Abnormal behavior of touch (wanting his hands in my mouth or armpits all the time)
• Difficult time with pointing out objects
• Communication issues (would lead my hand to what he wanted)
• Scattered skills (on a development chart he would have some advanced skills and lack basic skills like stacking blocks)
• Didn't always respond to his name when called
• always in constant movement

I did not notice: problems with cuddling, social skills, interacting with other kids (although he did not have a lot of opportunity), spinning objects, odd play, inappropriate laughing, attachments to objects, etc.

Characteristics seen in his evaluation

• tip toe walk
• "W" sit on the floor
• did not respond to his name
• reduced eye contact
• low joint attention (ability to point or look at an object one is directed to)
• Could representational play (imaginary play -- pick up a phone and say hello)
• short attention span
• Difficulty with imitation (this one surprised me because at home,he imitates everything Katie does)
• Could hold crayon appropriately
• Completed peg board quickly in only 25 seconds
• Could retrieve hidden toys quickly
• Easily distracted
• Could follow directions in imaginary play (feed the baby, put the baby to bed)
• needed to be reminded to "watch where he was going"
• words used were not recognizable
• Difficulty in sensory processing
• preference for mother
• engaged in non-functional activity (turning lights on and off repeatedly)

The areas of concern were:
Social Skills : Tested at a 10-17 month level (he was 30 months the day of the test)
Language Skills: tested at a 6-9 month level
Problem Solving: tested at a 21 month level

An "area of concern" is determined when a child tests at 1/3 his age in any category. He was 30 months old when he was tested. Any category where he tested at 20 months or lower was labeled an "area of concern".

The pattern of development shows "at risk" behaviors for an Autistic Disorder. At this time, he has not been "officially" diagnosed with Autism. The pattern meets the criteria for an Autistic Spectrum Disorder. Early Intervention was recommended, as well as a re-test when John is 4 or 5. We are also going to be seeing an Autistic Specialist in October for a second opinion.

Early Intervention

John success thus far is not just because he is getting a little attention; it is because of an intense early intervention program. Although the therapy is play-based, it is structured. Goals are set and the play is used to help meet those goals.

Early Intervention is an educational program that is designed to help children with special needs that are under 3 years of age --- too young to enter the public school system's special education. During this critical time of development, children who are offered assistance through intense educational programs may not need any label once they hit school age. The goal is to address any needs the child has so that they will not need them later. Kids are like sponges and they are still developing at this age.

Many people miss the opportunity to seek early intervention. When a child gets a label under the age of 3, it will not remain on their permanent record. The label only gives them help and assistance from state funded programs. The label often scares families away.

Here are reasons why some people avoid early intervention and my reasons why you shouldn't:

Avoiding & ignoring the label
You don't do your child any favors by pretending the condition doesn't exist

Other Family Members Disagree
Other family members convince you there is really nothing wrong. As a parent, you spend the most time with your child. If there is something in your gut that tells you something is wrong, then there probably is.

They think that their child is too young to really tell and he'll catch up by 5 yrs. old
You can't go backwards. Early Intervention only works if you catch problems before the age of 3. Maybe he would have started talking on his own, but you'll never know. If you take a pass on the early intervention, you may be making it harder down the road. It can only HELP your child. If he never needed it to begin with, it will only help him get ahead.

They find other excuses to explain away the developmental delay
"My child is a boy. Boys always talk later than girls"
"My child is a second child. We don't always have time to spend with him. We just need to give him some attention"
"His daycare doesn't stimulate him enough. We're researching other schools to put him in"

They think kids need to play and have fun---that there is plenty of time for school
This therapy is fun. It is play. Kids love the structure, love the singing, love the games, and learn from it all. It strengthens the skills they are supposed to be developing before they enter school. They can only benefit from it.

Early Intervention is the best thing that happened to my family.

Neurofeedback

At a silent auction, my mom bid on a package at Neurofeedback Centers for Success. She gave me the package for John, which consisted of an evaluation and 10 sessions.

From their website:

What is Neurofeedback?

Neurofeedback exercises the mind and strengthens healthy brain function with visual and auditory rewards. At the Neurofeedback Centers for Success a staff of specially trained clinicians administer non-invasive neurofeedback brain training that eases stress and enhances cognitive performance.

Neurofeedback is an exercise for the brain that can be compared to a workout at the gym. It improves the brain’s ability to self-regulate and encourages greater control over functions including concentration and mood. Sometimes our nervous systems interfere with self-regulation with the result being headaches, panic attacks, extreme anger, etc. Strengthening the brain’s self-regulation is a drug free method of overcoming these interferences.

Yesterday, my husband, Bill and I, took John for the evaluation and first session. We were a bit apprehensive before arriving. Once we got there, John sat in front of a computer monitor that had imagery that was similar to a "PacMan" video game. The "pacman" rotated in a square formation, moving into the center, eating a series of small yellow dots and then larger red ones. John would giggle when the "pacman" ate the red bubbles. It made a funny noise and he thought it was great. They soon gave him a stuffed lion that was attached to the computer and would vibrate when the 'pacman' ate the red bubbles. John thought this was cool.

While he was watching the video game, he was hooked up through an EEG, which measured his brain waves. We could see them on the monitor next to the video game. We could see through the visual images of his brain that he was more often than not in the "drowsy" level of brain activity. His constant movement was his brain's way of attempting to keep himself awake. Every movement he made, showed1 that he "overused" his energy, sending him over to the "overaroused" section of brain activity. The technician would set levels that John needed to maintain. When his brain activity went out of these levels, the video game would stop, encouraging his brain to come back within the set levels and then the game would continue.

It was actually very interesting to watch. John sat attentive to the game for 1 hour! He got fidgety, asked to go to the bathroom once (which we proceeded to stop the session and take him), needed food for more energy, and became tired at times. About five minutes before it was to end, he told us he was "all done". Watching him over the last few weeks, I would have told you that "all done" would have come much sooner than it did. It was very interesting watching how he responded.

The technician then told us to monitor him, for the next few days to see how he responds to the feedback and brain exercise. So, I took notes.

Here were our observations for the first day:

• We got in the car and he slept for 15 minutes on the way home
• He got home and ate lunch
• He then went and laid down with Bill and slept deeply for 2 hours!
• He was alert and in a good mood for the rest of the afternoon and evening
• We visited my grandpa at the hospital, where he got fidgeting and Bill needed to take him for a walk
  
• We went out to dinner, where he sat and ate a good meal
• Bedtime routine seemed normal, getting out of bed a few times before falling asleep
• About 2 hours after he fell asleep, he woke up crying for what seemed like no reason
• I couldn't console him in his bedroom, so I rocked him back to sleep
• He then stayed down for the night

The only significant change that I noticed was the two hour nap. He typically naps for about an hour. The nap did make him more alert and happy for the afternoon. Dinner out did seem pleasant and Bill did not need to take him outside at all during the meal. Waking up after going to sleep doesn't happen much anymore, so that stood out too.

The package we received includes 10 sessions. The company states that to make the brain training permanent, they recommend 50 sessions. This week, John will have 3 sessions. I don't know if we will want to continue it past the 10 free ones we get or not. Even if we did, the cost is significant.

At this point, I'm intrigued by it, but I don't know how I feel about it beyond that. My pediatrician says that the medical field doesn't stand by or against the feedback, but said that a lot of people "swear by it". We'll have to see. If John could train his brain to self regulate, I do believe many of his symptoms would disappear. But can this kind of feedback truly train our brains?

Sensory Integration Disorder

Through an Occupation Therapy screening, I have learned John needs an evaluation for Sensory Integration. Sensory integration is an innate neurobiological process and refers to the integration and interpretation of sensory stimulation from the environment by the brain. In contrast, sensory integrative dysfunction is a disorder in which sensory input is not integrated or organized appropriately in the brain and may produce varying degrees of problems in development, information processing, and behavior

I was told to read a book called, "The Out-of-Sync Child" by Carol Stock Kranowitz. I can't put it down. Right now, I'm about 150 pages into the book. I feel like I am reading a book that was written about my son.

The book has checklists that parents can use to determine if their child has a Sensory Integration dysfunction and what kind it may be. I have learned that John is a Sensory Seeker. He craves movement, loves being upside down, bumps into couches for sensory stimulation, loves spinning, oftentimes not getting dizzy, can't get enough of tactile stimulation (through the hands), etc.

John has always wanted his hands in my armpits. He would put them there when trying to fall asleep, when I'd carry him in the grocery store, standing in church---everywhere and any time. I thought it was weird and annoying, but didn't think much more of it. He touches to a point of annoyance, even when the touch isn't wanted. He always has his hands on my face or trying to put them in my mouth. If I'm talking to other people and my attention is diverted away from him, he often grabs at the collars of my shirt, trying to put his hands down the front of my blouse or up the sleeves.

John is always mouthing/teething objects. He doesn't put play dough or glue in his mouth, but he does chew on shirt collars, toys, blocks, bottles, the car seatbelt ---anything that can be chewed on. His shirt is often wet and if he can't find anything else, his fingers go in his mouth. He never was a thumb sucker and his pacifier was given up at 6 months old. But, he has always chewed on toys and clothes.

He loves his teeth brushed. He has always been obsessed with toothbrushes and helping my husband and I brush our teeth. We used to joke that he was going to be a dentist. Recently, we bought him an electric toothbrush, which has helped him with his poor muscle tone in his mouth.

Low muscle tone is one of John's problems. I never realized this, as I always thought of him as strong. But, muscle tone is not a measure of strength. It is the amount of tension our muscles have at rest. Normal muscle tone would reflect muscles that are "ready to move" or react when we need them to. Low muscle tone means that they are more at rest than they should be.

John's low muscle tone in his mouth accounts for his speech delay and inability to make his mouth move in certain ways to make certain sounds. It makes it difficult to blow bubbles. Ways of increasing muscle tone of the mouth includes sucking a milkshake through a straw, blowing bubbles, etc.

Low muscle tone would also account for the inability to stack blocks. Stacking blocks in a high tower requires the hand to 'release' the block. The muscle used to release is different than the muscle used to grasp. Ways of increasing muscle tone of the hands is to squeeze a wet sponge and release it. Different size sponges increase the level of difficulty of squeezing to help build the squeeze and release muscles.

John loves tactile sensations. Many kids do, but children who are sensory seekers can't get enough of it. The brain doesn't recognize that it has received enough stimulation because the nervous system is "out of whack". These kind of children want "more more more". The opposite, but still sensory dysfunctional on the other extreme, would be the child who can't stand touch, who withdraws from it (or any other sense for that matter --- covers ears during fireworks, high pitch noises, doesn't like crowds). Each sense has sensory seekers and avoiders, as well as those that don't show one way or another. A "normal" sensory integration child would be able to adapt to the environment as different senses pick up different things. It's what tells us that there is danger or fun in what is around us. Kids with this dysfunction don't know how to interpret this sensory information and it throws their whole day off.

For John, he needs "more more more". His brain is using its energy inefficiently, which accounts for his lack of attention. Everything is full force and outside the level his brain should function at. Calming him down is difficult. When he sleeps, he's not at full rest. He inefficiently does everything around him.

I tested this theory, doing a sensory activity for the tactile sense. I put both my kids in a bathtub with shaving cream. I told them we were going to finger paint in shaving cream. I squirted it all over the bathtub and let them at it. Katie rubbed her hands and arms in it for a few minutes and then washed it off, proceeding to draw letters and pictures around the tub. John, on the other hand, took huge clumps of it, clapped it together, watched it fly around the bathroom and giggled. He then sat in the tub and put his feet up on the sides, rubbing them in the shaving cream, giggling. After that, he stood up and grabbed a bunch and began lathering himself in it. He rubbed it on his stomach and then continued to put more and more on. He then slapped it and watched it float and fly off his body. Once it was gone, he wanted more. I obliged and it started all over again. When it was all over, he transitioned fine to the next activity, but talked about the 'shvn crm' all night long. Now, every time he sees the bathtub, he wants the 'shvn crm'. I'm just happy he's saying "shvn crm"!

Bringing the Work to the Home

Casa Colina Children's Services' work sessions inspired me to go shopping and bring it into the home. Here is where the title of my blog, Proactive Parenting comes from. By bringing the early intervention into the home, I am able to increase his progress and reinforce what the therapists are teaching in the classroom. Any educator will tell you that if parents reinforce their work in the home, the success rate increases.

I found a plastic bin and began collecting things around the house I could use and created a "work" bin. I went shopping at a local teacher's educational store and found many of the same tools the therapists were using during John's work sessions. I was creating this for both of my kids. Each one would get some time each day to do "work". These toys and educational activities would only be available to John and Katie when we had one-on-one work time.

Katie just turned 4 and has been in preschool two days a week since January. She is a very advanced child, who began reading at age 3, has a photo graphic memory, and began talking at 10 months old. She is very polite, a mature talker, and always demands attention wherever she is. She is a little performer, reciting books she has memorized, movie lines she loves, and dances in circles. She has a hard time waiting for the buzzer to go off when it's John's work time so her work time can begin. She loves for me to create 'new work' for her each time we sit down.

John loves work time at home and is always trying to find where I have put the bin. He is always excited when I announce work time. He also reacts the same way he does in the classroom --- he is ready to clean up and is "all done" pretty quickly after an activity starts. He also yawns about 10 minutes into a session.

My bin includes:

• Colored plastic teddy bears; 6 colors
• Colored rubber vehicles; 6 colors, 6 vehicles
• Colored rubber animals; 6 colors, 6 animals, 2 sizes
• 6 colored bowls for sorting objects
• Colored plastic frogs with holes for stringing together; 6 colors, 3 sizes
• 3 wooden puzzles; alphabet, numbers, animals
• 4 books - shapes, first words, colors, animals
• Bubbles
• Flash Cards - Nouns, Action Verbs, Adjectives, Things at School, Things in a Child's Day
• Wooden Blocks
• Plastic Shapes - geometric patterns
• Mr. Potato Head
• Play Dough

What is great about these things is that I am able to structure the "work" to the level of the child, using these toys for a variety of levels. Both Katie and John can benefit from the "work" I create using the same tools. For example, John may be string frogs to work on fine motor skills, but Katie is stringing them in a pattern I create for her.

I set the timer for each child so there is a specified length for our work. The added structure helps all of us organize our brains. Remember, although we call it work time, it is play therapy. It's just playing with our kids, using a little bit of structure in how you play. Each child is going to be different in their goals and how much structure they need, but the idea is the same.

Sample Activities:

• Place 6 colored bowls on the table or floor in front of John
• Hold up 2 colored bears
• Ask him to pick the RED one and place it in the RED bowl
• If he chooses wrong one, don't let him grab it, remind him of instruction
  
• Hand John 4 bears
• Ask him to put them in the matching bowl
• Hand John 4 bears
• Ask him to hand me ONE bear (understanding the concept of one or two)
• make sure you wait to see if he is really handing you one bear or if he is handing them to you one at a time -- it's a different concept and he needs to distinguish the difference
• Show John a vehicle (for example Purple Airplane, Red Boat, Yellow Car, Green Train, Orange Fire Truck, or Blue School Bus)
  
• Ask him what it is
• Ask him what sound it makes or what it does; have him demonstrate
  
• Ask him what color it is
• Ask him to place it in the matching bowl
• Have him count how many vehicles are in each color before he puts it away
• Have him pick out one of each color or two of each color and hand to you
• Take out a Wooden Puzzle of Farm Animals
• Show John the puzzle and ask him to take out the Cow and hand to you
• when he does, make the animal sound
• After all the pieces are out, show John 2 animals, ask for him to find the one that oinks and put it in the puzzle
• Show John 2 more, ask him to take the Horse
  
• When he puts it in the puzzle, ask him to make the horse sound
• Have him say "Horse"
• Use bubbles or other reward to encourage child to finish a task.
  
• "If you finish the puzzle, we'll play with bubbles"
  

These are sample activities that teach concepts through play. Some children naturally learn these concepts through normal playing and interaction, as my daughter, Katie did in her early development. Early Intervention therapy is using play, with certain structure, to help develop these skills in at risk toddlers. I am not a therapist. I have not conducted research or done test groups. I'm a mother.

I've watched John in only 6 weeks increase his attention, language, and behavior. He knew his shapes, colors and animals prior to starting the class. He knew how to count to 20 and backwards from 10. But, he was impulsive, which made him unable to correctly match colors and shapes with consistency or on demand. Now, my family, as well as his therapists, are able to say he really does know these things. We are seeing him correctly answer with consistency, as well as consciously slow himself down to 'think' about the answer.

We have a long way to go, but I am convinced that early intervention is the best solution for 'at risk' toddlers. It is the best thing that has happened to us. When people hear about John's diagnosis, I often get "oh, I'm sorry". In response, I say "NO, it really is the best thing that they could have told us".

I encourage anyone who has that gut reaction that something isn't right to get help now. The earlier the intervention can happen the better. Children are sponges. Their brains are still developing. If you can get in and correct the delayed development, your child will be better off for it. Your life can get better. Your life will get better. The worst thing a parent can do is ignore that there is a problem. You can do something. Be proactive and embrace what you can do.

Casa Colina: Early Start Pre-School & Speech Therapy

One of the first forms of early intervention that John received was an Early Start Pre-School class at Casa Colina in Pomona, California. The Early Start class is focused on developing the goal areas of gross motor, fine motor, sensory, communication, cognition, socialization/play and self-help. Children work individually and in groups with their parents and child therapy instructors as they rotate through a series of activity centers.

John attends the class two times a week for 2-and-a-half hours each time. Upon arriving, John must find his picture and place it on his schedule. After completion of each activity, he is instructed to "check his schedule". Using a laminated paper with a check mark on the front and piece of velcro on the back, John takes it to his schedule hanging on a wall. He places the 'check' next to the first activity, which is dipicted in a photo. The first activity is to 'wash hands'. John takes the photo to the sink, places it in a folder and proceeds to wash his hands. He is given a second 'check' to take to his schedule.

The next photo announces that its "circle time". John takes the photo and finds a square to sit on with the other children. He hands the photo to the teacher, announcing that he is ready for "Circle Time". The teacher shows the children a board that has pictures that represent different songs they can sing. Each child, in turn, chooses the song that everyone will sing. A picture of raindrops represents the first verse of the song "if all the raindrops". After the group sings the song, the child who picked the song is given a "prop" for that song. A rain stick is given for "If All the Raindrops". The child watches it fall and then is instructed to turn it over and watch again. They then must hand it over to the next child sitting next to them. After the prop makes it's way around the circle, the next child picks the song they want. John's favorites are "Boom Boom Ain't It Great to Be", where he can play the beat on the drum, "Wheels on the Bus", and "If All the Raindrops". He doesn't sing much at school, which is surprising because he does at home, but he loves the pantomime gestures and passing each of the props.

The schedule order is then different for each child, but each will have time outside on the playground, project time at the table, imaginary play, work time, and gross motor skills activities.

We have learned, through Outside time, that John loves the swing. He could swing for the whole 20 minutes. I started going through counting and alphabet games while we swing. He loves to talk and verbalize while swinging. (more on this in a later blog).

I have never let John play with glue or scissors up to this point because I just felt that he wasn't ready. Well, a kid is never going to learn if you don't teach him! So, he's learning to cut with scissors and squeeze out the glue. He loves the glue and the first week called it "gluke", but has already corrected himself and says it just right! Already, he has made a shaker, 2 caterpillars, a texture book, and a flag. He wanted to glue paper with the glue side up, but he learned quickly that his hands get messy that way and paper won't stick.

He has a 20-minute one-on-one work session where individual goals are set and then worked on to meet. John sorts colors and shapes, does animal puzzles, strings beads, blows bubbles, plays with Mr. Potato Head, and various other activities to strengthen his skills in each of the developmental areas. How they play with him is the key to his success' thus far. John came in to this program very impulsive. If a teacher held two objects, one in each hand, asking for him to pick the red one, John would reach for both without listening to her directions. By the second session, they had him waiting, looking at each one and then choosing. His first reaction is definitely impulsive, but slowing him down is the key. He has a very busy brain, which is easily distracted. He learned the "clean up" song really fast and he says and signs "all done" pretty quickly after starting a task. The therapists are really good at making him do it "one more time" and "we will be all done". I think he enjoys cleaning up and finishing more than anything else, but he is learning so much.

In addition to his early start classes, he attends 2 hours of speech therapy a week. Speech therapy is play based therapy that works on his language skills. They use a reward system (for John it's bubbles) to get him to say his words. They play with cars, Play Dough, flash cards, balls, etc. while concentrating on his verbal skills. John loves coming to "school", but speech therapy wears him out. About 30 minutes into a session, John becomes distracted and begins to look around and "space out". This is the most important time to keep going --trying to increase his attention span.

We've been in the program for 6 weeks and he has improved so much! I can't believe the changes we have seen both at home and in the classroom. He tested at a 6-9 month age level for language 2 months ago. Last week, they told me his language has already gone up to 17-18 months age range.

Things we've noticed:

• He sits during circle time
• John never sits still and the first day, I chased him around the room, leading him back to his square and having to hold him in my lap
• By the third class, I was able to sit behind him
• He has poor posture, which I never noticed before because he would never sit still; he sits leaning back on his hands or slumped over his knees
• His language is controlled
• There is intent behind his words; he communicates to have needs met
• "all done" and "more" have helped us understand when he is ready to do something
• he points to objects and tells us what they are
• He is engaging
• The inability to engage, which he showed during his Regional Center testing, is one huge part of the Autism diagnosis
• He is able to follow direction
• He is able to get my attention and tell me about an object or what he wants
• There is a 'give' and 'take' in play with him
• His attention is increasing
• Work wears him out
• John yawns about 10 minutes into every work session
  
• John gets tired after school
• John tends to have melt downs when he is tired

Goals we are working on:

• Building towers with blocks
• Increase attention
• Completing tasks
• Articulation in Speech
• Jumping from 2 feet
• Decrease impulsiveness
• Stringing multiple beads
• Blowing bubbles

This has been the best experience so far. I can't believe his progress in the little time he's been attending Casa Colina. I can't wait to see what the next few months brings us.

John's Diagnosis

The motivation for writing this blog is my son, John. He will be 3 in November. Two months ago, he was diagnosed by Regional Center with an Autistic Disorder. His "at risk" behaviors has led them to recommending an early intervention program.

I took him in for an evaluation due to a speech delay. By 2 years old, he hadn't turned his baby babble into understandable words. He had only 2 words that were close to the correct pronunciation -- and those were not "mommy" and "daddy". He could say 'mulk' for "milk" and "butter"!!! Mommy was "baugh-in". He just couldn't move his mouth the right way to get words out. He had created his own language for things and couldn't figure out why we couldn't understand him. Temper tantrums came from frustration and life was very difficult for all of us.

John was a high maintenance baby. He is and always has been "on the go". He is in constant movement, rarely at rest, often irritable, had times when he cry inconsolably, and had poor sleep habits. From the time he was born, he was waking up 5-8 times a night. Every 45 minutes to an hour, he was usually waking up. I nursed him until ten months old and went straight to a sippy cup with milk, skipping the bottle. The milk became a security blanket for him. He'd ask for milk all the time, sometimes foregoing meals to drink milk. If he was tired, upset, or hungry, he wanted milk, and I gave it to him. By 2 years old, he was drinking between 24-36 ounces of milk a day! I had suspected milk allergies and was switching to lactose free and lowering his quantities daily. When he was tested at Regional Center and we were given the diagnosis of Autism, I decided to pull him off of milk completely. That night, we got our first full night of sleep! From that night on, he slept through the night. Life was about to change! His ability to function during the day increased with sleep. I got sleep, which helped me function better in the day!

Regional Center's findings surprised me at first, but I wanted to help John. My mind was all over the place. If I need to place a label on my child to get him help, then there will be a label on him. But, what other effects do labels have on our kids? At what point do we ask ourselves, “slightly autistic or typical boy behavior?” Is Autism the buzz word for the next 5 years? Are kids that don’t fit into a box labeled “autistic”? But, at the same time, we need to get our kids help if they need it. How do we tell if the clinical stuff is right?

The answer is simple. Be a mother. Be there for your child. Know your child. Be cautious, but listen. Fight your child’s battles. Fight for your child. Do everything you can do that helps your child. Not all advice is worth taking. Weed it out. Find out what works for your family and your child’s needs. Pray for your child. Pray with your child. I’m just starting this journey, but to ignore that journey would not benefit John. I'm going to be a pro-active parent and get John the help he needs.