Wednesday, July 27, 2011

Our First, and Only, 6-Month IFSP Meeting

Unlike IEPs, IFSPs are reassessed twice a year. Our 6-month IFSP meeting was held Monday morning. I was nervous going into that meeting. Ava has made great strides and I was a little concerned they would tell me that she didn't qualify for services any more.

As it turns out, I didn't need to worry quite so much about that. I was careful to stay focued on her needs rather than her successes, but I did not exaggerate her needs. The main ones I see right now (in no particular order) are:
  • The more stress she's under, the more difficulty she has communicating. So, when she's upset or hurt, that is when she tends to lose her words. Those moments are exactly the ones in which you need for her to communicate the most.
  • Although Ava is making many communication attempts at home, she is reluctant or unable to communicate at school with her teachers and peers. At school she'd often rather go without than try to tell someone what she needs. At school she doesn't even try to talk to the other children in the classroom. That situation just breaks my heart and I desperately want to see improvement there.
  • As an SLP, I continue to recognize the comprehensiveness of the speech delay in terms of intelligibility, but early intervention won't really write goals for specific speech sounds or intelligibility issues because there is such a wide range of normal at this age. That doesn't make it less valid, just something out of the scope of early intervention apparently.

So, we reviewed her speech progress and discussed her speech needs rewriting her goals and continuing her in speech therapy for an hour a week. If our therapist's schedule permits, she will actually see Ava at school in order to facilitate her communication and speech there. I will obviously continue to work with Ava here at home.

The big story of the IFSP meeting, however, is that we veered off into an entirely new direction. My service coordinator sent me a questionaire ahead of time and one of the questions was about my areas of concern for Ava. Almost on a whim, I wrote in a couple of non-speech items that have been bugging me for a while now. Honestly, I was expecting to bring them up and be reassured that they were within the normal range for kids her age. That's not exactly the way it went.

I've noticed that Ava is really sensitive to noise. The sound of the washer or dryer running will bother her enough while she is watching television in another room for her to leave the tv, run around the corner and down a hallway and shut the door to the laundry room. The flushing of the toilet in a restroom bothers her. Her hands clap over her ears and she recites, "loud, loud, loud" until the sound stops. Her father's electric razer will get the same reaction. We took the kids to their first movie (Winnie the Pooh) and I spent the entire time with my hands over her ears trying to reassure her that it really was all right.

Another issue is her picky eating. It is getting worse and worse and seems to be related to texture. She doesn't like to touch things that are messy and if her hands do get messy she immediately wants a napkin. She doesn't like to be touched or restrained. When other children approach her she gets really upset and reacts almost as if she's been hit. Washing her hair and face is pretty traumatic because she reacts so poorly to the washcloth and tilting her head back.

Well, to make a long story a bit shorter, we've added an hour of occupational therapy to her services. They feel like some OT might make a big difference with her feeding and bathing issues and other sensitivities.

I've never been closely involved with occupational therapy services before and so this will be a whole new area for me. I am hopeful that they can help Ava to be less sensitive and to experience the world a little more comfortably and fully. That would be such a gift to her.

All in all, a useful IFSP meeting. Next up: transition meeting and scheduling our first occupational therapy session.

5 comments:

  1. Funny that you posted this today. I actually just spoke with Brayden's service coordinator today about an OT eval and sensory profile. Our concerns are somewhat similar but also related to some fine motor delays. We had our transition meeting last month, but our first review isn't until October. It has been interesting to see the process. Thanks for sharing your experiences!

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  2. We are also struggling with some OT issues...I'm glad you are going to get to continue Ava's services and get some OT services too. Our developmental specialist recommended the book, "The Out of Sync Child has Fun" as a supplement to OT services. It is a very helpful book so far.

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  3. Leah: Let me know what they say once Brayden has his OT eval. It is interesting how we are all traveling similar paths down this early intervention road.

    Gentle Blue: Thanks for the tip on the book. I've downloaded a free sample chapter to the kindle app on my iPhone and I'll check it out.

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  4. My son Alex has noise sensitivity and texture issues too. He had his last early intervention OT yesterday since he turns 3 tomorrow. He gets really upset with noises. He also cant stand being dirty. His therapist said he basically fails at play-doh because he refuses to even touch the stuff. She said that he's doing really well though so I'm hoping he outgrows the sensitivities since we have no more resources on that.
    He tests on par for his age with cognitive and motor skills.

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  5. It is interesting that many of our little ones with apraxia also have some sensory issues too. I'm a little bit frustrated because I haven't gotten a call yet from my service coordinator to let me know who our OT will be or when to expect services to begin, but I am trying to be patient. It is hard when the time always seems to be ticking closer to that three year old birthday.

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