Playing catch-up

I've been slacking on this blog. Big time. So I'm going to give some brief up-dates of a few things we've been up to.

ISSP
From the ISSP meeting we came up with the following three major goals:
1. To increase expressive vocabulary to 100+ words. To be implemented by family, home therapist (HT), and senior therapist (ST) in the home environment. To be reviewed October 2010.
2. Jesse will navigate his environment using heel-toe pattern. To be implemented by family, HT, and ST in the home and in the community. To be reviewed October 2010.
3. Jesse will understand and follow one and two step commands regarding safety. To be implemented by the family, HT, and ST in the home and in the community. To be reviewed October 2010.

As of now though, I think Jesse has likely already met goal #1. His vocabulary has just exploded. Jesse's SLP has told us that we're not going to be able to keep up with writing down his new words. And it's true! I'm going to try though. Probably tonight at work. I'd like to have a better idea of exactly how many words he does have. I suspect though, that it is around 100 words. Jesse's already come a long way in terms of meeting goal number 3 as well. I can actually hold his hand in parking lots now, whereas I used to have to carry him. He's much more compliant about important things, like holding my hand, and not running off. I'm still cautious, of course, and hold his hand tightly, but it so much better.

I think that the most difficult goal to meet is going to be #2 - dealing with the toe-walking. We have activities and exercises in play to encourage heel-toe walking, but so far, he goes straight back to toe-walking. I'm hopeful, but not convinced, that this goal will be met by October.


Home Therapy

Our HT is working out really well thus far. She's here from 8 am to 12 noon Monday - Friday. Jesse really seems to like her, and she's really patient with him. He's even saying her name. The therapy is going well and Jesse is mastering his programs without much trouble at all. He's working on puzzles, letters, matching, body parts, animal sounds (he knows a ton!!), prepositions, and following instructions.

My only concern with the home therapy, and it's a big one, is that the ST and her mentor seem to be very reluctant to move Jesse's therapy outside. The weather's getting nicer, and I don't want Jesse stuck inside this summer. Yes, his therapy is only in the morning, but Jesse naps for 2-3 hours every afternoon. That leaves little time for getting out and about. So right now I'm trying to come up with ways of doing his home therapy outside the home. I need to do some research on this over the weekend.


Chiropractor

We've decided to start taking Jesse to the same chiropractic clinic Steve and I use. One of the chiropractors there works with kids with developmental issues. She's trained in Brain Gym. We had our first appointment yesterday. She did a physical assessment and asked me lots of questions about Jesse and his development. It was interesting to say the least. She does think that she can help with the toe-walking and the w-sitting. She wants to do some craniosacral work, and possibly do some adjustments as well. She assured us that adjustments in kids are nothing like adjustments in adults. I was very happy with how calm and respectful she was. She told Jesse everything she was going to do, and adjusted her assessment and treatment to suit Jesse's desire to be up and about and active. Some of what she does seems very strange (which she warned me of!) but I'm not going to discount it unless I see that it's not helping. I can't say that I understand chiropractic care very much, but I do know that it works for me, so I'm willing to give it chance to help Jesse.


And last, but not least, we took Jesse to feed the ducks at the park on May 24th. He had a blast! Here's a video. You can here him asking for "more" bird seed. Don't mind my voice.

Put yer feet up....

...this is gonna be a long one!

Tomorrow is Jesse's Individual Support Services Plan (ISSP) meeting. It'll be here at the house, so I don't have to find a sitter (thank goodness). There will only be a few people in attendance - the Autism Program's social worker, Jesse's senior therapist (ST) and her supervisor, and myself. Jesse's SLP can't make it, but she emailed me a progress note. Steve can't make it either, since he's already at his max vacation time this year. He helped me write up our own contribution to the meeting anyways. It's basically just a sheet of paper with the heading "strengths" written on the left and "needs" written on the right. We came up with the following...

Strengths:
-non-verbal communication
-growing vocabulary
-will attempt new words
-imitation
-high energy
-great fine motor and gross motor skills
-likes to be around adults and other children
-transitions easily from one place to another and from one activity to another.

Needs:
-to work on increasing vocabulary and phrases
-to work on decreasing toe walking
-to work on interactive play with other children
-to work on not running away when out in public
-has difficulty breaking certain routines 

Jesse's SLPs progress note also listed some strengths and needs, none of which were a surprise to me. It was very encouraging though, that she seems so pleased with his progress thus far. It will be interesting to hear what his ST and her supervisor have to say at the meeting tomorrow.

I'm also really looking forward to this, because the funding for Jesse's home therapy program will be approved. We'll actually be able to pay whoever (whomever?) we hire to be Jesse's home therapist!

Speaking of which, we have an interview set up for Wednesday night! I'm very nervous about interviewing someone. I've never really done that before, aside from sitters for Jesse. I suppose this shouldn't be that different though. I definitely need to prepare for it though! I also have to go through the rest of the resumes and try to find a few more candidates to interview. I'm thinking 5-6 interviews should be sufficient. I really want to find someone who's high energy, friendly, creative, and dependable.

Also, I figured now would be as good a time as any to share an update on Jesse's vocabulary. It's growing so much! It's very difficult to keep up with now too, since he'll at least try to imitate almost any word you ask him to say.

Imitated/prompted words:
Koko (the daycare owner's dog)
ears
hair
knees
toes
on
out
boots
shoes
go ("doe")
duck
gone ("don")
ball
arm
god
mouse
purse
pee
cheese

Spontaneous Words:
Mom
Da/Dad
Nan
Pop
Josh ("Dosh")
Jesse ("esseez")
Anna ("Nana" - daycare owner's daughter)
no
this
up
nose
baby
hi
bye
juice ("dooce")
bees (refers to nursing)
boo
uh-oh
off
eyes
poop ("doot")
hot
beep
more ("no")
ta-da
night-night
hop
ding-dong ("ning-nong")

Jesse also has a handful of two-word phrases now too, including "bye bees/Mom/Dad/Nan/Pop/Josh," "my baby," "no, Jesse's!" and "uh oh Da!"

It's quite a bit better than the list from March 11th, which was the last time I did this. And so, so much better than the 5 words he was using when we had our first speech therapy appointment with his current SLP on March 8th. That was only 6 weeks ago! His non-verbal communication has also come a long way since then, which is very helpful. He's much better able to communicate with us what he wants (to eat, for example) and when he wants us to play with him.

There's so much more to tell, but it's getting late and we have an early rise tomorrow. Speech therapy is at 8:30 and the ISSP is at 10 am! Hopefully I'll get a chance to update tomorrow.

Just call me Pavlov

 This week Steve and I took the Applied Behavioural Analysis (ABA) Training course that home therapists are required to take to work with kids with autism. It's offered to parents so that we can understand the programs and assist as needed, and also so we can better understand our kids and our interactions with them. It was all very interesting. It's VERY much based on the principles of operant conditioning. The trainers were great, and the other parents and home therapist that attended were fantastic. It actually was a lot of fun, which I hadn't expected. It also helped me to see that this home therapy will actually be fun for Jesse as well. It's meant to be.

I was really surprised too, at how the discussion we had seemed to tie some things together for me. Some things that Jesse does have always been a mystery to me. Like a year ago when he repetitively rolled himself off the couch to fall sideways on the floor. When he repetitively bangs his head, arm, leg, back again the wall or furniture. It's all a sensory issue! It's not seeing, hearing, smelling, touching or tasting. It's proprioception! It's one of the seven senses we have (there's also vestibular), and Jesse seems to just need more of that sensory input!

There were other times though, during the course, that I though how Jesse really doesn't fit the bill. I know there's a huge range of abilities and issues when it comes to an autism diagnosis, but in many ways Jesse is just so NORMAL! For example, they explained that imitation usually has to be taught. Imitation or mimicry is one of the major ways kids learn how to do things or how to act, and it's often (usually?) absent in kids on the spectrum. Well, Jesse mimics EVERYTHING! From chasing around the kids at active play and "falling" when they fall, so mimicking Steve's mannerisms and speech. And there were other things too....I can't recall them all at the moment due to sheer exhaustion, but it really made me doubt, at time, the diagnosis. I guess all we can do it wait and see. His ADOS will be repeated at age 3 and he may or may not come away from it with the diagnosis again.


***edited May 1, 2010 to add: 
The title of this post will tell you how far removed I am from my B.Sc. in Behavioural Neuroscience. I'm only now realizing it should be "Just call me Skinner".