Mama's Learning

Geesh, the past week I feel like I've been in school again. I finished VCU's course that had good initial information, and now I've completed an Autism Internet Module on PRT--the therapy we want for Bug. It is so wonderful to be able to access so much information online, even if it does take a bit of hunting to find what I need. I still want to complete the course that's offered online through Michigan, so I guess that's up next. And, one of my friends gave me a book filled with learning activities for three year olds, so I've got some good ideas for what I want to do with the kiddos this fall.

We did get more info on the Medicaid waiver and well, we just don't know if we'd qualify or not. We are making some progress with Adam's work, they're looking into covering ABA, so prayers would be MUCH appreciated. It would be such a blessing and a relief for us to be able to just go through insurance and we would have a lot more options than what we do now.

I also got in touch with the clinic at Virginia Tech and it looks like we will be doing PRT training in late October or early November. They're not quite sure how it'll work, I guess they have a lot of interest so it might be a group training. We'll see I guess. The good thing is that we're guaranteed a spot, so we just have to sit tight for a while.

Final Mama note: I'm going to start working to get things a little bit more organized and put up a list of sites, books, etc, that we've found helpful so far. I figure that even if it helps one person out, it would be worth it.

Alright, Bug stuff:

Speech: Bug is working so well with Kathy. They're doing a lot with verbs and talking about what people/things are "doing". I guess Bug's favorite activity is looking at flashcards that have pictures of actions on them. Bug really likes the ones that involve slides and swings, so Kathy saves those for last as a reward for doing the other ones. It's always so cool to hear him say full sentences like "He is swinging" :D

At home, we are having some confusion with "you" versus "I"--Bug will often say "You want ____" when he wants something (because when he says "I want ___" we respond "You want ____"). Pronouns are often tough for ASD kids, so we're working to reinforce the "I" again.

We are also doing a bit of potty training, pretty much on Bug's terms. It seems like in late afternoon, Bug is done with diapers and sometimes even requests undies, so we're giving it a slow go. So far we've had one accidental success and a lot of wet undies. We'll get there. I'm glad at least that he's interested and pretty compliant about heading to the bathroom. We just need to work on him relaxing enough and sitting long enough to be successful. I'm struggling to find rewards or reinforcers that work for him. He does like playing Angry Birds on my phone but it doesn't seem to be a strong enough reward for him. So I guess I have to do some brainstorming.

I've also tried a bit of prewriting with Bug. I filled a cake pan with a little bit of salt and let Bug put his fingers in it. He seems very into exploring it and getting it everywhere, so I've been trying to get him to try doing single strokes. We need some work, but I'm glad that he's interested in it.

 I also put together a very mini-sandbox (out of a small under-the-bed tote) and both boys really love playing in the sand. And dumping it all over our driveway. Sillies.

In OT, Bug tried a lot of new things this week! He bounced on an innertube, played with cars on a ramp, rode a scooter and even pedaled a trike a little bit! He didn't do as much swinging as he had been, which was kind of surprising. Once again, he enjoyed the "motorcycle" swing and going down the slide backwards. He does seem to be "done" with OT usually around the half hour to 45 minute mark, and tends to be more resistant towards Geri's activities, but we've been coaching him through. I do have a hard time because I never know exactly how involved I should get, but I always try to praise him and encourage him when he looks towards me.

I'm hoping that we can start incorporating some PRT during our day-to-day activities and slowly start building everybody up to a couple chunks of "work" time each day. For all of us, it'll be an adjustment as we learn new habits and skills. I just have to be persistent and keep trying even if we hit bumps.

He just cracks me up. So excited about the camera flash!

Great Week!

Bug has just been on a roll this week!

Speech: Laura has Bug working hard and he is doing a great job meeting her challenges! Today he actually requested a specific book from her. He does this more frequently at home now, but it's good to see he's willing to work with others on it too. They're still working on the difference between "I want" and "I like" but he's at least doing full sentences, which is great.

At home I've been noticing (especially today) how far Bug has come. We hear lots of full sentences and he responds fairly quickly to familiar requests ("Get your shoes." "Can you pick ____ up?" etc). Today he and I were in my bed and he asked for his blanket. I said "Your blanket is in your room." and he climbed down, got it, and came back. This sounds so trivial, but he used to just say "blan, blan" and if we said where it was he'd say "get, get". It is so rewarding to see such strong progress from him!

OT: We had a really good OT session yesterday. Bug immediately went for the tent swing, and cooperated with Geri to get his shoes and socks off before getting in. She initially wanted to only do about 15-20 minutes in the swing, but his "M'Gewi, I...I want swing please" got him a full 30 minutes. She then got him to complete a few small tasks and rewarded him with swinging. Nothing extraordinary, but it was a good start and a good way to show him that he'll get what he wants (swinging) if he does a little work for her. This is basically the same system Laura uses in speech.

We also have done the headphones/listening therapy with him. He seems ok with the concept, but won't keep the headphones on for more than a minute (and that's pushing it). I've been trying different places (driving, at the grocery store) and different activities with him to try and distract him while he's wearing them. The most successful is to do something tactile with him like play with cars or put lotion on him. We've kind of dropped it the last few days so I'll have to pick it back up again.

I've also made some headway with lining up therapy for him. The ABA clinic I contacted called me back and is going to check with our insurance to see if there's a way for us to get at least some of it covered. The out-of-pocket costs are just too high for us--I would need to get a full time job to cover therapy and childcare while I was working, and even then I don't know that would be enough. I did contact a clinic that runs through Virginia Tech too, they do an intensive parent training clinic on ABA techniques. It would be quite a hike, but I'm hoping there would be a way to accommodate us.

I also got a hold of the Early Childhood coordinator to get a child study set up for Bug. This would be the first step in determining what services we could get through the school system and getting an IEP. So at some point this summer we'll have the child study done.

I did talk to our pediatrician and he recommended that we do the genetic testing. The two main benefits for us would be knowing if it's a genetic issue that would potentially affect our other child (or children, at some point, maybe) and also if it's attributed to a syndrome we'd have a better idea of what to expect in the future (future issues that might come up, or how much progress we'd be able to make). I'm not in a huge rush to line up the appointment, but I should probably put in a call.

The other big thing for us: POTTY TRAINING. As the Bug would say "Oh-me smokes" (Holy smokes). I can't believe we're attempting it, but we are. This is a three day weekend for us, so I figured we'd give it a hard push. So far, I'm very please. Bug seems to be ok with (not super thrilled about) wearing underwear, which is a big relief. He was initially COMPLETELY resistant to sitting on the toilet, but I've been able to break it down into smaller steps to ease him into it and that made for fast progress. I'm going to detail this out, mostly if another parent stumbles across it.
We are not using a small potty for two reasons: 1) Bug is really so big I don't think he really fits on a little potty very well and 2) It would add another step/transition that I'd like to just avoid. **Note, if you don't care about the actual process, skip the blue text below**

We're doing a 10 minute cycle--every 10 minutes I take him to the bathroom. It's exhausting, but apparently successful with autistic kids. You praise them if they're dry, reward them if they "go" and sternly tell them that they need to go in the potty if they're wet. So he's great about heading up to the bathroom, turning the light on and getting out of his pants. After that, things broke down almost completely. He wouldn't use the step stool to sit on the toilet. So for a few tries, I had him step on the stool (with help) just in the middle of the floor, not near anything. Then when he felt comfortable with that, I started moving the stool closer and closer to the toilet. Typically it seemed like it took about 2 cycles to get used to each baby step. Then we worked on sitting him on the closed toilet. Then things broke down again when we tried with the lid up. Bug is super uncomfortable about this and really tenses up. I tried to push the issue but he really was bothered so after speech we just laid off. I bought a potty stool off Amazon. We have a little seat that goes over the normal one, but he is not ok with that either.

I figured we'd just give it a rest until we get that thing. I thought the handles would be nice for him to hold onto.  So naturally, twice this afternoon he's ASKED to go potty and has sat briefly on the normal seat. :P He is still quite nervous about it and I have to keep my hands around him so I can't show him that he can kind of prop himself up. He seems ok sitting for a while. I put a basket of books and a couple toys in the bathroom for him to look at. He is good about flushing and washing hands, so we've got a solid take on the process at least. We decided that we're going to slow down a bit and take him every half hour just so we can keep the process fresh and make some progress on being ok on a regular seat (seeing as he'll have to go potty at therapy and playgrounds and possibly school). Once we get the potty stool then we'll be more intensive again.

I'm super proud of how well he's handled it so far. No meltdowns, super cooperative for the most part. He understands at least that "potty" means go to the bathroom and sit on the toilet. Hopefully it won't be a stretch to pee and poop. I have a few worries about the actual training part too, but I'm trying not to get too far ahead of myself. First we have to be ok sitting on the toilet.

I am grateful that we've had all the evaluations because it's given me a better idea of what Bug gets hung up on. One of his biggest weaknesses is motor planning: He doesn't always know how to move his body the way it should move. We saw this in OT and I see it regularly at the park: Bug will climb up a ladder to a slide, or an open climber and freeze because he doesn't know how to get his feet out from under him to sit at the top of the slide, or he's at an angle on the climber that he'd be more bear-crawling than climbing and he can't figure out how. It's kind of a coordination thing.

Today in the bathroom, we worked on stepping on the stool not near anything so he could focus on that and get the feel of how to do that. Then we worked on turning around on the stool (ie, stepping up facing the toilet, then turning to face me). Then lowering him onto the toilet seat. It didn't take long at all for him to realize, ok, I can do this, this isn't so different from what I do normally. I've learned that this is what it's going to take sometimes. And it's a little baffling that sitting on a toilet is stressful but kneeling on the couch arm and leaning over a gap to danging his torso in the trampoline is not a big deal at all. :P But it is what it is, and we'll help him figure it out all the same.