Friday, September 30, 2011

How to properly ring in the change of seasons...

In our house, it wouldn't be fall unless we pick up a child from school with a 102.5 degree fever, wheezing, and the croup. Please, oh please let this pass quickly, relatively painlessly, and without a trip to the emergency room. And while I'm wishing, it would be awfully nice to not pass the illness around through all members of the family including the grandparents this time.

The first illness award this year goes to Ava. It is interesting though. The last time Ava was sick, last spring, she couldn't really communicate about it. This time, just as the 4 hour dose of acetaminophen was wearing off she came to me and said, "Mama, my mouth hurts." As pitiful as that was, I was grateful that she finally has the words to tell me.

The Weekly Review: Week 28

The weekly review will look a little different this week just because I feel like changing things up a little. This time you get what comes floating off the top of my head. :-)

The Weekly Annoyance:

Facebook changed everything around again and I'm not particularly fond of this newest version.

The Weekly Indulgence:

I'm watching fall television pilots over the internet. I very rarely have the time to watch tv anymore, but prior to having children I loved checking out all the new shows each fall. Now we don't even subscribe to television. I do have a hulu plus account and lots of the networks make their newest shows available on their website and so I have spent way too much time this week checking out some new shows that I enjoyed and several I thought were pretty awful. Still, I had fun and isn't that what's really important for leisure time?

The Weekly Admission:

Someone, who shall remain nameless, had their school pictures come in this week. I admit it. I snickered. If you could just see the facial expression involved you'd snicker too. How can it be so cute, and yet so funny at the same time?

Weekly Coolest Toy Ever:

We found Michael's birthday present. It is two months early, but I stumbled upon it on Amazon and it was just so perfect. Apparently Lego has a whole separate educational line. Who knew? I certainly didn't. In that line they have a Duplo set called tech machines. This is a set designed around the concepts of air, land, water, and space. The set comes with lesson plans for a teacher. The thing that is unique about it is that there are screws built into the duplo blocks. So when you assemble the vehicles, you lock each piece together so that they can actually be played with without falling apart. I think Michael is going to love it. It's a shame I have to hide it for the next two months.

Thursday, September 29, 2011

Dawn of a New Era

And so begins sibling sneakiness...

Part 1:
The children were playing "sleepover" upstairs. I heard thudding feet coming down the stairs and I overheard Michael say, "We need to go to the basement without Mama seeing us." He says this five feet away from me at full volume of course. He's just old enough to start being sneaky, but still unsophisticated enough to think that if he can't see me, I can't hear him. Ava echoed, "without Mama seeing us". I actually thought it was all pretty funny and kept my back to them as they "snuck" around the corner to the basement stairs. I managed to not laugh out loud as Michael pulled Ava away rather loudly when she almost came the wrong way (towards me).

Part 2:
I put the children down for nap. Michael first, and Ava second. I close their doors during nap. Michael's door has one of those child protection devices on the inside doorknob to keep him from wandering when he should be sleeping, but Ava's does not because until recently she didn't wander.

I came downstairs and began to settle. I love naptime. I love the quiet and the moments that are completely mine. Then I heard feet coming down the stairs. And giggling. And shushing. Michael said, this time whispering (loudly), "Shhhh! She'll hear us!" Apparently Ava had left her room and let Michael out of his and the two decided to go exploring. I deliberately shifted in my chair making it creak. Michael said, "Quick, she's coming!" and then I heard thudding feet heading back upstairs.

I waited a few moments to give them time to get back upstairs. Children who were experienced at this game would have each gone to their separate rooms and pretended to be asleep. My little ones both headed to Michael's room and were playing when I got up the stairs. I escorted them both back to their beds and reminded them that naptime isn't playtime. I actually sat in a chair in Ava's room for the five minutes it took her to fall asleep when she stayed still for that long. Then I slipped back downstairs for a second time.

Wednesday, September 28, 2011

Speech Sample - Suspected Childhood Apraxia of Speech - 25 months

This is a bit of a therapy session I was doing with Ava on 4-4-11. We were using a few of the Kaufman Cards. She had just turned 25 months old.

In the previous sample, Ava used the following consonants: /b, d, t, m, n, w, j/. All but one of those (mama) were used in one-syllable CV words.

In this sample Ava produces five different two-syllable words. Four of them were imitated correctly and one was imitated incorrectly, but still with a two-syllable non-reduplicated word. She uses /b, d t, p, m, n, h/ in this sample. She has added the /p/ and /h/ syllables in the six weeks since the last sample. She has also moved from productions that were primarily the CV syllable shape to productions that are C1V1C2V2 in syllable shape which is much more complex.

Tuesday, September 27, 2011

Rear-Facing Car Seats Revisited

Almost four months ago I wrote a post about reading a NYT article on the American Academy of Pediatrics recommendation to keep children rear-facing until at least two years of age or until they reach the rear-facing weight limits of their seats.

Then, and now, both of my children are still rear-facing in their seats. Ava is in a seat with a rear-facing weight limit of 35 pounds and weighs about 32 pounds. Michael is in a seat with a rear-facing weight limit of 40 pounds and weighs about 36 pounds. Michael is almost four years old. He never complains about being rear-facing. He's starting to get a bit cramped. I have to shuffle legs around to get him buckled in, but once he's settled he is perfectly comfortable.

The Washington Post just did an article on the topic. Again, the information that stands out in my mind is that "children younger than 2 were 75 percent more likely to die or be seriously injured when facing forward." The article explains that rear-facing is safer because small children have relatively heavy heads and weak necks and spines. When forward facing during a crash the heads can snap forward with so much force that necks break, spinal cords are injured, and brain injury can result. When rear-facing, the seat supports the head and neck and distributes the force of the crash more evenly.

Given the safety reasons for keeping them rear-facing, we have decided to continue as long as possible. With our current seats we can keep them both rear-facing for several more months. But as soon as either child outgrows theirs we will have two choices. We can turn one of them around and keep one rear-facing with the current seats. Or, we can buy a new Radian. That will buy us an extra five pounds. At this age, that is a lot. It could well keep both of them rear-facing another year.

Is the extra time rear-facing worth buying another very expensive carseat that we don't really need? That is the question I'm wrestling with. I'll probably just postpone deciding until the last minute.

Monday, September 26, 2011

Wilbarger Deep Pressure and Proprioceptive Technique (Brushing Technique)

I have to admit, when our OT first introduced the "brushing technique" to us I thought it seemed a bit questionable. And yet I think it is working wonders.

First, some background. Ava seems to have a fair amount of tactile defensiveness. Prior to beginning occupational therapy she hated tags in her clothes. She never allowed me to fix her hair with barrettes or hair bands. She barely tolerated brushing her hair. For months, brushing her teeth involved pinning her down and brushing them as she screamed. She panicked every time she needed a band-aid. She is an extremely picky eater and her pickiness seems to be related to food texture. She doesn't like to get her hands messy and even as a very young toddler taught herself to use utensils rather than have to touch her food. Art activities were only tolerated when a paint brush or some other tool kept the paint from her hands.

Several weeks ago our occupational therapist gave me a surgical brush and showed me the brushing/deep pressure technique. At first it felt awkward and I was self conscious. Ava was a bit intolerant at first as well. After only a few sessions it became something we both enjoy. I tell her it is time for brushing and she hops right into my lap.

Now, you are supposed to do the technique every 90 minutes to 2 hours all day long. We don't. We do the technique twice a day before nap and before bedtime. I am going to try to incorporate it right after morning dressing as well. However, even with a twice a day schedule I have noticed changes.

Ava now lets me fix her hair. She is more tolerant of a wide variety of clothing situations. She is more adventurous with touching art materials, sticky foods, and muddy or dirty things. She's allowing band-aids without much of a fight. For Ava, the brushing technique has worked wonders.

She's also having a bit of a speech and language and social developmental spurt and I'm not sure that is all coincidence. I think that she's feeling more comfortable in her own skin and less overstimulated by her environment. That translates into more mental resources left over for communication.

So what is the Wilbarger Deep Pressure and Proprioceptive Technique?

This technique of brushing the skin and joint compressions was developed by Dr. Patricia Wilbarger, an occupational therapist and clinical psychologist with 30 years of experience working with children with sensory processing issues. The technique involves running a soft surgical brush (it reminds me of the brush the hospital uses to clean newborn babies) over the arms and hands, back, and legs and feet of the child with a firm pressure. The brushing is followed by a sequence of gentle joint compressions of the fingers, elbows, shoulders, hips, knees, ankles, and spine. The entire process takes only minutes and is often soothing and enjoyable for both parent and child.

Here is a link to a youtube video of an OT using the brushing technique with a young toddler. The video is pretty different than the way we do it. Our way separates the brushing from the joint compressions and is smoother, slower, and more relaxing.

Instructions for the Wilbarger Deep Pressure and Proprioceptive Technique (brushing technique)

Before I explain how we do the technique I should say that this is just the way that we do it as shown to us by our particular occupational therapist for our child. The technique may vary in other situations. Also, I highly recommend that you only perform this technique after being shown how to do it by a certified occupational therapist (which I am not).

Use a soft surgical brush. Use pressure firm enough that the bristles on the brush bend. You may do the technique through clothes. My daughter often seems to be a little hot and sweaty and the technique seems to be easier to administer through clothing. Never brush the tummy or face.

We sing a song as we do the technique. At first I would modify the "This is the way we wash our hands, wash our hands, wash our hands. This is the way we wash our hands so early in the morning." song. The first verse would be, "This is the way we brush our arm, brush our arm, brush our arm. This is the way we brush our arm, brush our arm with Mommy." (and so on for each body part). Now I just sing the numbers 1-10 to the melody of a lullaby. It is soothing and peaceful and helps us keep a calming rhythm during the entire technique.

Sit down with crossed legs and invite your child to sit in your lap. Their back is towards you. Begin on whichever side of the body is most comfortable with you. We begin on the right. With a firm pressure, stroke up and down the full length of each body part in the sequence described from 3-10 times (as many as your child will tolerate) moving smoothly from one section of the body to the next.

  1. Right arm and hand. (Both sides.)
  2. Back. (Have child lean forward so you have room.)
  3. Left arm and hand. (Both sides.)
  4. Left leg and foot. (Both sides.)
  5. Right leg and foot. (Both sides.)

Joint Compressions
You've now worked your way around the body in a circle with the brushing. Set the brush down and move right into the joint compressions. These are difficult to describe in text, which is why it is so important to have an OT demonstrate the technique for you. I will try.

  1. Right elbow. Bend elbow 90 degrees supporting elbow from bottom with left hand and holding the wrist with your right. Gently push elbow down into your left hand 10 times.
  2. Right shoulder. Straighten child's arm. Place left hand on top of shoulder still holding wrist with your right hand. Hold arm away from body and push straightened arm towards the shoulder 10 times.
  3. Right hand's fingers and thumb. Gently squeeze each finger and thumb between your thumb and finger (one at a time) starting at the base of the finger and sliding towards the tip. Do this once per finger.
  4. Left elbow. Same technique as before.
  5. Left shoulder. Same technique as before.
  6. Left hand's fingers and thumb. Same technique as before.
  7. Left hip. Cradle the left hip from the bottom with your left hand. This is kind of like having your child sit on your left hand with the left side of their bottom. With their leg bent bring their leg towards their tummy almost like they are going to hug their legs. Place your right hand on their left knee and press down toward their hip 10 times.
  8. Right hip. Same technique as before.
  9. Knees and ankles. With the child still in your lap place both feet firmly on the floor with their legs bent at a 90 degree angle. Place your hands on top of their knees and gently press down towards the floor 10 times.
  10. Back. Set them down on the floor right in front of you and have them cross their legs and sit up straight. Place one hand on their chest and the other on their back and press gently towards the floor 10 times.

Ava just melts into my arms by the end. It is a really peaceful time where we are completely focused on each other and we both enjoy it. The trick is to find the time in a busy day to work it into your routine.

Sunday, September 25, 2011

Amazing Things Do Happen

Eight months ago we were a household with two cats. Peanut was mine from before we got married and Cleo was my husband's cat from before we got married. Cleo was a one-man cat. It took me years, I kid you not, to get her to let me pet her. But she adored my husband and the feeling was mutual. He had brought her home from a local animal shelter when she was tiny.

Over six months ago Cleo slipped out of the door and was lost. We searched the neighborhood, let the neighbors know she was missing, posted a few signs, and brought a flyer to the local vet's office to join a sadly crowded bulletin board of similar flyers. We knew the fact that she was people shy was not going to help a lost kitty.

The date on the flyer is the date the vet's office intended to pull it down. They will typically only leave the flyers up for six weeks or so. They called us and asked if we had found her and we asked them to please leave it up.

As days, then weeks, then months passed by we gave up hope. When Michael asked what had happened to Cleo we told him that she had accidentally slipped out the door and got lost. She couldn't find her way home, but another family found her and was taking good care of her for us. We didn't really believe it though.

Several months later we decided to get kittens. Peanut was lonely and too old to want to be involved with the kids much. The kids were starting to get interested in pets. We got the kittens from the same animal shelter my husband had brought Cleo home from all those years ago. When I took the kittens to the vet I saw the flyer and almost told them to take it down, but I didn't.

A few days ago Michael said, "I love our kittens! I hope they never, never slip out the door Mama." He hadn't forgotten Cleo.

Yesterday, out of the blue, we got a call. Someone had Cleo. Apparently she had found her way two subdivisions over. A man who we are told looks something like my husband, saw a stray kitty and slowly began to win her over. They fed her and took care of her as best they could, but they traveled a lot and weren't interested in adopting an indoor cat. They began to think that she had been an indoor pet and after several months found a home for her with a neighbor of theirs. That woman took her cat to our local vet for her annual checkup yesterday and saw our flyer. She called us and Cleo came home that day.

She's so happy to be home. We are happy to have her. Right now she's sequestered in our bedroom just getting used to being home again before we introduce her to two preschoolers who are 6 months older than she remembers and two kittens that weren't here before.

We got her back. After being missing for more than six months, we got her back. It is absolutely amazing.

Saturday, September 24, 2011

Speech Sample - Suspected Childhood Apraxia of Speech - 23 months

This is an audio clip from a video we took on 2-12-2011. Ava is 23 months old. At this point Ava was about six weeks into receiving speech services. Ava and I were laying on the floor and she was making some observations about the striped shirt I was wearing.

In the last audio sample, four weeks prior to this one, Ava produced 10 utterances in a little under a minute. Those utterances included four different words. She used one consonant (/d/) and three vowels (/Ɛ/, /Λ/, /OƱ/).

Here is the new sample:

In this audio sample Ava's utterances are:
"brown" /baƱ/
"brown" /baƱ/
"black" /bæ/
"brown" /baƱ/
"white" /wæ/
"two" /tu/
"there" /dæ/
""black" /bæ/
"more" /mɔ/
"no, no" /noƱ noƱ/
"yeah" /jæ/
"no, mama" /noƱ mama/
"no" /noƱ/

That's 13 utterances total in just over a minute. Two of them are two-word utterances. Nine different words are used. She went from using one consonant to using seven. In the last sample she used three vowel sounds and in this one she uses six vowel sounds. In four weeks, Ava made huge strides in her speech.

Friday, September 23, 2011

The Weekly Review: Week 28

Blog Post that Gave Me an Idea:

I need to do this project for a meal plan board. Several months ago my husband and I finally felt that our family life was pulling together enough to stop planning meals five minutes before we needed to start cooking (and then often going out to dinner because we didn't have ideas/groceries). It has actually been great. Our food budget was reduced by at least a third and as long as we've actually done the meal plan and made the trip to the grocery store we always know what dinner will be. My current sophisticated method of accomplishing this task looks like this:

The meal plan board would be a beautiful upgrade.

Ava this Week:

Ava started going to school two mornings a week when she was 18 months old. She cried at drop off every time. They always tell you that after a few days, or weeks, or months it will stop. It didn't. I was told that she was fine within five minutes of me dropping her off, and I believe that. That knowledge didn't make leaving my crying child any easier. I learned to just make the transition short and quick. Lingering only prolonged things. It has been this way for over a year.

It started last week, but was perfect this week. (I hope I'm not jinxing things by saying this out loud.) Ava has been perfect at drop off. She's excited to enter her classroom. She immediately goes over to her teacher or joins the other children at their activity. I have to get her attention to give her a kiss and tell her goodbye. It is beautiful every time and I feel relief and gratitude for the change.

I really do think the combination of occupation and speech therapy is beginning to pay off. Ava is more comfortable in her classroom and more confident about her ability to communicate and participate. And that translates into less anxiety about being dropped off. It is wonderful.

The Weekly Michael:

Michael loves company. He likes to communicate and interact with other people most of the time. A few weeks ago he was constantly seeking out my company or his Daddy's company. "Come play with me" was a common refrain. Over the past couple of weeks we have started to see a shift. He's asking Ava to come play with him. When she is in the mood to join him, they disappear for 20 or 30 minutes at a time to their bedrooms or the basement playroom. I love watching their bond as playmates begin to deepen.

On the other hand, Ava is still kind of a Mama girl. Often she doesn't want to leave me. Or she'll play with Michael for a while and then wander away from him to come check in on me. And I'll hear Michael calling after her, "Ava, come play with me!"

Kitten Update:

The kittens are hitting adolescence. They are climbing curtains, tipping over laundry baskets and getting stuck in boxes. They are also still adorable and cuddly with us and each other. Black and white Sophie is amazingly tolerant with the children letting them carry her around and pet her in their rather clumsy way. Grace (all black) comes out in quiet moments and snuggles the adults making sure we get some kitten love too. They are now four and a half months old and have been with us for over half their life. Here's a picture of the two of them in a quiet moment.

Weekly Random Question:

Do you ever find yourself debating what's more important: transferring leftovers into a smaller dish so they'll take up less space in the fridge vs. the fact that doing so will create an extra dirty dish to take up space in the dishwasher?

Thursday, September 22, 2011

Speech Sample - Suspected Childhood Apraxia of Speech - 22 months

This is an audio clip from a video we took on 1-15-2011. Ava is 22 months old. At this point she had been evaluated by early intervention and had begun seeing a private SLP twice a week for 30 minutes. I was not yet working with her in any structured way and we had not begun receiving services from early intervention yet.

Ava was laying on a blanket and I put my head beside her. She was quite offended that I was trying to share her blanket and was trying to persuade me to move off. She keeps pointing to a spot off of the blanket and telling me to move "there" while I keep pointing to a spot on the blanket and insisting that I stay. After quite a bit of back and forth I tell her I'll get off if she says "please" (we had taught her the sign for please and I'm actually asking her to use the sign). She uses the sign and I move.

During this interaction I am focusing on getting as many conversational turns in as possible without frustrating her. I've made the situation into a game where she is vocalizing over and over for me. In this one minute interaction I get 10 utterances and a sign. There -may- have even been one two-word utterance of "No, there!", but I can't swear that she really intended two words of if her Daddy and I were reading too much into that one.

As you can see she had made significant progress in a month. In the first video and audio sample Ava was mostly saying "there" over and over. In this audio clip you hear "there"(deh) "no"(oh) "yeah"(eh-uh) and "uh-oh". That's three vowels and one consonant. Still, it is four distinct utterances.

Wednesday, September 21, 2011

Speech Sample - Suspected Childhood Apraxia of Speech - 21 months

I decided to go back into the family video archive and try to pull some audio files that are representative of Ava's speech at different points in time. I've already posted something recent and a video from November of 2010 when Ava was 21 months old.

Here's something from about three weeks later (12-19-2010). Ava has found something interesting on the floor. It looks like a sticker of an eye that has fallen off of something and she is pointing to it and "talking" to her Daddy about it.

This was taken about two weeks before she was evaluated by early intervention, about four weeks before a private SLP and I began speech therapy, and about six weeks before she began receiving speech services through early intervention.

It was however, after I had accepted that there was a significant delay and that I needed to schedule evaluations. I began to consciously try to encourage more vocalizations and one method of doing that is to "echo" back what you hear from your child. You hear my husband doing that with Ava during this clip.

Keep in mind that she is almost two years old here.

Tuesday, September 20, 2011

They Called

Our diagnostic evaluation is officially scheduled. December 15. I spoke with the coordinator of the diagnostic team that will be evaluating Ava. They'll be sending someone out to her school the week before her evaluation to observe her and then we are supposed to allocate all morning starting at 9am for the actual evaluation.

I was nervous as soon as the person on the other end of the line identified herself, so my initial impressions probably aren't super accurate, but I didn't get a great vibe. I can't even quite pinpoint why exactly. I just got the feeling somehow that she already didn't think Ava will qualify.

My thoughts scatter in so many different directions when I think about the evaluation and they're all contradictory. First, I feel I'm embarrassed because I might be wasting their time - Ava probably isn't severe enough any more to continue to qualify for services. The next moment, I'm scared that I'll get that same terrible feeling I've gotten after her initial evaluation and after her formal articulation test. The one that sinks down to the pit of my stomach when I realize how far behind her peers she still is. I worry that she'll do too well and then I feel guilty that I can possibly want her to do poorly. What kind of thought is that for a mother?

I need to just relax. The evaluation is almost three months away. It doesn't do anyone any good to spend those three months obsessing over what may or may not happen. And ultimately, whatever happens, it will be fine. Everything will work out.

It is so easy to dispense such advice, even in my own mind. Now to just follow that good advice...

Monday, September 19, 2011

Movie Night

We have recently started movie night in our household. Once a week or so, we pick a small-child friendly movie. We sit in the dark with a special treat (last night: Necco wafers) and watch the movie - all four of us together. The children are pretty sensitive and during any tense moments we often end up cuddling both children and reassuring them that it will be all right. We tell them that we do not, in fact, have to "quit" the movie.

Our first movie night a couple of weeks ago was the Curious George movie. I thought it was wonderful. It was relatively conflict free and the only part that devastated the children involved animal control briefly taking George away. Last night we watched Ponyo. While the plot was not perfect, it enchanted the children and was interesting for the adults. Definitely a success.

One of the best parts of movie nights has been watching how magical it is for the children. You can just see the wonder of the storytelling in their exclamations and the way they sit on the edge of their seats. I adore watching Ava hop up during the credits and dance to the final song.

Does anyone have any other suggestions for low conflict movies? Traditional Disney movies haven't worked well. My kids are still too little/sensitive for traditional Disney villains. I even unsuccessfully tried Finding Nemo the other day. I could really use some fresh ideas.

Saturday, September 17, 2011

The Things I Struggle to Resist

Everyone has their thing. Some people are into cars. Other people are into their houses and decorating or cleaning them. Some people are into clothes or accessories. Some people love crafts. Some people enjoy hobbies and tools. That thing... your thing... is difficult to resist even when buying another item is an indulgence you really should resist. All of the other things are easy to resist, because you just aren't that into them.

For me, cars are just a way to get around. I don't much care what kind of car it is or how it is decorated or cleaned. I love our home, but home decorating and cleaning isn't really my strong point (just being honest here). Clothes are just something to wear. I want to be warm and to feel marginally attractive, but as long as I have two decent pairs of jeans and enough t-shirts, socks, and underwear to make it until the next wash day that's enough for me. Occasionally I will get into a craft of some kind (crosstitch, cricut, many educationally related craft projects), but those are usually relatively short lived.

My weaknesses are books (for myself and for the children). When I am going through a book phase I do the bare minimum on the blog and eat, breathe, and sleep books every moment I am not engaged in child care. The instant download of a new kindle book to my iPhone is dangerous and I will absorb one or two series (3-8 books) in a week. Fortunately, at that point, sanity returns and I put books aside for a while.

The library gets me through the summer months, but Scholastic book orders are dangerous to me during the school year. I have to struggle to get my monthly wish list for the kids down from $60 to a slightly more reasonable $20-$30.

And so that is why it surprised me that I fell in love with a jacket of all things at the mall this weekend. My parents had both children overnight (happiness and joy and much thanks). My husband and I went out for dinner and then headed to the mall to sit in a bookstore and enjoy some leisurely quiet time in public. I got distracted from our main goal (of some peaceful time) by a need to replace the jeans I had literally worn until they had holes in them. While shopping for jeans I discovered this amazing jacket. It was light and compact and fit me beautifully. The cuffs fell right at my wrist and the neck fit perfectly without being too long or short when zipped all the way up. And it was so warm. It was stuffed with goose down.

And I had been wanting a jacket. I only have a winter coat, but no jacket. For the past several years during a fall trip to a park, the rest of the family would pull on jackets and I'd struggle into a bulky long winter coat. Of course, this beautiful, warm, lightweight, perfectly fitting jacket was prohibitively expensive and so I reluctantly put it back on the rack. I went and found some jeans. I insisted that we pop back in and drool on the jacket some more on the way to the bookstore but then I put it out of mind.

As I sat in the bookstore browsing books on homeschooling (a story for another day) I vaguely noticed that my husband disappeared for a while and then came back. On our way out I asked him to grab my sweater from the bag the new jeans were in because the night was chilly. He reached in and pulled out the jacket. He has gone back and bought it for me while I was completely distracted at the bookstore.

And so, for once, I find myself in the odd position of being incredibly excited about having some new clothes. (And very thankful to both my parents for watching our children and my husband for being so thoughtful.)

So what is it that you struggle to resist? :-)

Scholastic Teacher Express eBook Dollar Sale - Code for $10 free

Scholastic has a Teacher Express store where you can buy teacher's resource books in eBook format. The books usually range from $5 to $25 dollars each. They have books targeted to preschool all the way to books targeting high school. They cover a wide variety of subject areas as well.

Through September 20, 2011 they have 849 of their eBooks on sale for $1 each. I think it will combine with the coupon code 10THANKS for $10 off your order. You can actually choose $10 books for free without entering any payment information at all and immediately download the books in pdf format. You do need to create an account with them.

I haven't actually placed my order yet, but I have 45 books in my cart so far. I may need to narrow that list down a bit before actually placing my order. They seem to do this sale once a year. Last year I bought 20 or so books and have enjoyed them.

Friday, September 16, 2011

The Weekly Review: Week 27

Post I Found Visually Amazing

I came across 21 Images You Won't Believe Aren't Photoshopped at I loved the images and the true stories behind them. They really are extraordinary pictures of some amazing things.

Sibling Moment of the Week:

Typical school mornings involve getting the children dressed and fed in pretty quick succession. They tend to be underfoot the entire time we're getting ready. Then we drive first Ava, and then Michael to school. Yesterday morning I went downstairs to make some oatmeal for breakfast. I didn't really pay attention to the relatively leisurely time I was having making breakfast until I realized half an hour had passed, the oatmeal was cooked and had cooled and there were no children attached at my hip. I eventually found them together in Michael's closet with some toys and flashlights playing sleepover. I do love the joys of independent sibling play.

Ava Names a New Kitty:

Ava has her mama kitty and her baby kitty. She has recently discovered Hello Kitty. She likes Hello Kitty bandaids and a Hello Kitty shirt she was gifted as a beloved hand-me-down. I noticed though, that she calls Hello Kitty, "Hello." When choosing a bandaid she requests "Hello." When picking which shirt to wear, she wants the one with "Hello" on it. It is difficult to figure out how to explain to my 2 1/2 year old that the character's name is "Hello Kitty" and not simply "Hello." It sure is cute though. Too bad we had to ban the bandaids. As it turns out, her skin reacts to the adhesive with huge red welts.

The Weekly Michael

Michael read the first Bob book to me tonight. I am so proud. He's been spelling for a while now. If I help him sound out the individual phonemes he can instantly tell me the letters that go with the sounds. Every time he's on the computer playing with the paint program he switches into font mode and tries to spell something. A few days ago he ran in the kitchen saying, "Mama, come see! I made zoozoozoo!" Sure enough, he had typed in exactly that.

At the easel today he wanted to write boom. I asked him what it started with. He said, "B." And then he attempted to write a "B". Then I told him that two letters together make the "oo" sound and asked him if he knew what two letters do that. He responded "O" "O" and proceeded to add two Os to his word. Finally he put the "M" on as well. I am amazed at how good he is at this stuff. (Of course, "boom" looks more like "doom", but he tried.

Projects of the Week:

  1. I figured out how to add both audio and video to the site.
  2. I completed two hours of continuing education credit. Both hours were on Childhood Apraxia of Speech topics.
  3. I created a short screening tool for my own use with the kids that tests each phoneme in initial and final position using only 22 CVC words and administered the screening to both children. I am using the results of the screenings to decide what to work on next.

Thursday, September 15, 2011

Wishing for Another Year (Upcoming Evaluation Anxiety)

In quiet moments I am beginning to experience a sense of unease about upcoming changes. In five and a half months Ava will age out of early intervention. Before then she will be evaluated by our local school district to determine if she will continue to qualify for services.

Things are going so well right now. Ava has been making steady progress in speech. We finally identified a need for OT and are just now beginning to receive those services as well. The combination of speech and occupational therapy services is powerful and she is making progress.

I am both profoundly grateful for that progress and somewhat fearful of it at the same time. I am happy that Ava's ability to communicate is improving and her frustration is decreasing. I am happy that she's making progress towards her feeding goals. I am delighted to see her become a bit bolder with sensory exploration and a little less overwhelmed in environments that used to be overstimulating for her. At the same time, I am afraid that she will have made just enough progress that she will not qualify for services at the next level.

I feel like we are standing before a diverging path. One path takes us down a road where we can continue intense intervention through these early years and maybe, just maybe find ourselves in a place where she no longer needs extra help later on. I desperately want that path for her.

The other path involves being denied services. We will try to provide her with as many services as possible without help from the school district but it won't be the same. I worry that the second path will involve less intense intervention that results ultimately in her needing extra help for a much longer period of time.

I know it isn't that simple. I know there are always options even if they aren't the ones I want most. I just feel like this transition from the early intervention program happens so quickly. Many children are just settling into a program of services when they "age out" and have to go through another round of testing. Then, even if they do qualify, they go through another round of getting to know new therapists when the old ones were working perfectly well to begin with.

I find myself wishing that early intervention went just a year longer. Of course, I'm sure I'd still dread the transition even then, but at least she would have had the same set of therapists for 18 months rather than for 6 months by then.

Wednesday, September 14, 2011

It Was An Innocent Idea - Honest

I decided to recreate the success of the shaving cream in the water table day. Except this time I thought it would be fun to bring the water table up to the increasingly complete deck. I just thought the kids would enjoy the change of scenery and I knew I would love to sit on my swing while watching them instead of perched in a lawn chair in the yard down below batting away gnats. Also, for another change of pace, I decided to try cool whip (or some generic brand that was cheaper) instead of shaving cream.

First, let me say that the children did have a wonderful time. From their perspective, an hour flew by in absolute bliss as they flung first cool whip, and then water all over most of the deck. However... I don't think I completely understood how difficult it would be to remove cool whip from the wood after it had been sitting there a while. I innocently assumed that it would spray away easily with the hose. It took a bit more effort than that. Let's just say that my husband wasn't delighted with the experiment when he heard about it that evening.

As much fun as the children had with the activity, I found it interesting that they were much less bold without a friend over to model playing in it with her hands. They mostly used spoons and other various kitchen implements to play in the cool whip. They also ran over to the hose to rinse their hands and bodies off frequently. Baby steps I suppose. I need to invite friends over for these sensory activities more often.

Tuesday, September 13, 2011

Speedy Progress Right Off a Cliff

So Ava continues to do well with her feeding hierarchy. She's pretty much just accepted that she has to take a bite of the food she doesn't like in order to receive more of the food she wants.

Her technique so far has been to pop that food in her mouth and let it sit front and center on her tongue as if I had put something horrendously nasty in there. She grabs her milk and swallows it down as if it were a pill-tasting it as little as possible. In the name of substantial progress, I was letting the fact that she was treating perfectly yummy food like dirt go.

Well, yesterday morning, in the middle of our weekly OT session I had set her plate up with small pieces of sausage. They were the size of large blueberries. A bowl of cheerios to use as a reward had been set to the side. She asked for cheerios. I told her she'd need to eat a small bite of sausage first and I stepped away from the table to grab a knife. Usually I cut a tiny sliver off the larger piece of sausage for her to try.

Well, when my back was turned she popped the entire piece of sausage in her mouth and tried to swallow it whole by gulping several large gulps of milk. I turned around to see her choking back up all the milk and finally (thankfully) the piece of sausage too right back into her lap.

I calmed her down, cleaned her up, and told her I was proud of her for trying such a big piece. I then tried to explain that we can't swallow such big pieces without chewing them first. I'm pretty sure she didn't really get it.

So now we're working on teaching her to put food in the side of her mouth and to chew it up in an exaggerated way. We're teaching the technique with foods she likes first. Once she's really good at it, I'll have to insist she actually chew the things she doesn't like before swallowing them and getting a reward.

I'm pretty sure that this next step forward is going to be a big struggle.

Monday, September 12, 2011

Is it that I don't remember?

I had the privilege of holding a three week old little girl last night. As she snuggled in my arms I watched all of the fleeting facial expressions and listened to the grunts and snuffles and sighs. It was so sweet.

I don't remember my babies being so expressive so young. To be honest I don't remember them being so expressive even much older. Is it that I just don't remember? Is it that I was too sleep-deprived and stressed to notice? Or does the apraxia start to show so early if you know what to watch for? Do the problems with motor-planning show up even as tiny infants? Apraxia is neurological in origin. Presumably it is there from birth. How does it impact their infancy and our introduction to motherhood?

Sunday, September 11, 2011

Nine Months Ago

After listening to Ava sing the Itsy Bitsy Butterfly, I found myself trying hard to remember what she was like before.

Ava - 21 months old - Childhood Apraxia of Speech before therapy

At 21 months of age, you want most typically developing children to have a spoken vocabulary of at least 10-24 words. By 24 months of age you want to see 50 spoken words and some two-word combinations. You also expect those words to contain almost all vowel sounds and a wide variety of consonants. You would expect a typical history of cooing, laughing, smiling, and babbling as an infant.

Ava did not have a typical history of cooing, laughing, smiling, and babbling as an infant. At 21 months she used no more than 4 different vowel sounds and 3-4 consonant sounds. Her spoken vocabulary at that time is well represented in this video I took one day (11-30-2010 to be exact) while we were reading a story before bed. She had about three words: "de" (that or there), "uh" (used in a variety of ways for emphasis), and "oh no".

I remember taking this video. It was after I had finally accepted that there was a problem and I needed to pursue getting Ava evaluated. I took the video thinking it might be helpful to show it to someone because I knew she often wouldn't "talk" at all in front of strangers. As it turned out, I never used the video for that purpose, but I wanted to share it now. It is a good representation of what Ava's expressive language looked like before we started intervention.

Saturday, September 10, 2011

Who wins?

She wins
I knew it was too quiet...

I win
Finally, I get something in the girl's hair! And she's happy about it. And she wears it to school!

Friday, September 9, 2011

My Favorite Toddler Jeans

I have favorite winter toddler jeans (for the children). We've been using them for Michael two years in a row now. They are usually $25, but they are on sale at Old Navy's website this weekend for $15. They also have a coupon code that stacks that brings the price down to $12.75 if you're spending less than $100 or to $12 if you're spending over $100.

They have adjustable waistbands and wear incredibly well. They're cozy and warm. They have three colors for boys and three for girls. We picked up 4 pairs for each child. Two for this winter and two a size up for the winter after that. The deal was just too good to pass up.

They also have lots of other baby/toddler items on sale too and most of those stack with the discount code as well (ONSAVEBIG).

I know this is a departure from my usual type of post, but I wanted to make a public service announcement in case any of you are looking to pick up some fall/winter clothes at a good price.

The Weekly Review: Week 26

Weekly Blog

I discovered a new blog: The Long and Winding Journey. I don't remember exactly how I stumbled upon it. It is sad and fills me with a desire to turn back the clock and change one moment in time for this family. At the same time, this mother's blog about her precious daughter is a chronicle of strength and hope. Reading it brings some perspective, balance and wisdom to my own life. My prayers are with their family as they journey through their life.

Michael's Moment

We often serve banana pancakes for breakfast. To increase their nutritional value a bit and help breakfast stick with the children, we sandwich some peanut butter between two layers. Some days they get a whole circle, and some days when we're running low they only get semicircles. Occasionally, when only one pancake is left and both children want a little more, they get quarter circles.

Yesterday morning, Michael had an entire circle (two full pancakes with peanut butter in between). On a whim I asked him how many semicircles were in a whole circle. He answered two without a pause. I thought that was pretty smart, so I decided to ask a couple of follow up questions. I asked him how many quarter circles were in a semicircle. He thought for a brief moment and answered correctly, "two." Finally I asked him how many quarter circles were in a whole circle. After a short pause he replied, "four." I was so impressed. Here we are laying the foundation for fractions at breakfast.

Ava this Week:

One moment Ava is full of snuggles, sweetness, songs and giggles and my heart melts. I wrap my arms around her, smell her hair, and savor the moment. Mentally I try to bottle it up and save it for the time in the future when she no longer wants my arms wrapped around her all the time.

At least three separate times this week, as I enjoyed a few moments of quiet conversation with my husband wrapped in a mutual hug, Ava glanced up from whatever she was doing and rushed over to us. At that point she would squeeze herself in between us prying us apart and look up at me expectantly waiting to be picked up. It cracks me up every time. It cannot be coincidence.

And then there are the frequent moments when Ava pushes me away because she insists that she do something, "on my own." This girl has an independent streak a mile wide.

Thursday, September 8, 2011

Therapy and Hierarchies of Difficulty

In general, therapy consists of breaking complicated tasks down into a hierarchy of components and then working on those components from easiest to hardest. So in speech therapy we start with sounds in isolation, then at the syllable level, then at the beginning, middle, and ends of words, then in phrases, then in sentences, and finally in conversation.

In OT we've been working on getting Ava to try new foods. Prior to OT, the only options I could think of were to try to make her try a bite (ha, ha) or to just put it on her plate and hope that eventually she'd try it if she were hungry enough and if everyone else around her was trying it. Well, nothing was working. She was never hungry enough to try something out of her comfort zone. She didn't respond to playing (let's play airplane type activities). She didn't respond to comments that her brother was doing a good job trying it. She didn't even respond to bribery (eat just a little and I'll give you a treat).

Our OT introduced a hierarchy for getting Ava to try new foods. I never would have thought of it on my own, but it is working.

The lowest level is just getting her to touch the food. I used tricks like asking her to test if it is too hot for me while pretending to be busy pouring a drink so I couldn't do it myself. I wasn't asking her to eat it yet - just to touch it.

The next step was to get her to just give it a kiss. She didn't have to eat it, just kiss it. Now this required a combination with bribery. We needed to fill her plate with something she didn't like and something she did like. She didn't get more of the food she did like until she gave the other food a kiss. This step took a little longer, but eventually she realized that giving food a kiss was not a big deal.

The next step was to give the food a little lick (if it is solid - this would't work with a pudding or anything like that). So when she wouldn't eat sausage, I could put a piece on a fork and she'd lick it. Again, we have to bribe her to do it for a second serving of something she likes.

The next step is to eat some of the new food. Sometimes we cut it into a very, very tiny taste and put it on a fork for her. She'll put it in her mouth and wash it down with a big gulp of milk. She doesn't actually chew it, but still it is a big step in the right direction.

Other times we use a food mill. You can put food in it and the children can help grind it up by turning the handle. We tell them they're making "magic" food. Then she can try a small taste of the magic food before she gets to eat something else.

A month ago Ava would absolutely refuse to touch or even consider trying anything outside her comfort zone. She honestly preferred to go hungry. She rarely ate more than 1 out of 3 things on her plate. A month ago our OT introduced the hierarchy (touch, kiss, lick, tiny taste, regular bite...) to us. Now I can get Ava to at least taste a tiny amount of a new food at least 80% of the time. It is a huge change and I'm so proud of her. It's amazing what a little knowledge and some new strategies can do for a situation that seemed impossible to change.

Wednesday, September 7, 2011

Itsy Bitsy Butterfly

I asked Ava to sing to me the other day. We were sitting on the mostly finished deck in our swing. Using the front facing camera on my iPhone I managed to capture quite the concert. First I got her version of the ABC song twice. Then I asked for the Itsy Bitsy Spider, then Row, Row, Row Your Boat, and finally Hush Little Baby. It was so adorable.

Here is a small audio clip from the concert. (Yea! I finally figured out how to post audio!) She decided to sing the Itsy Bitsy Spider as the Itsy Bitsy Butterfly instead as she explains at the end.

Tuesday, September 6, 2011

Outdoor Sensory Table Ideas?

We have both a sand table and a water table. The sand table is useful year round, but the water table is pretty much a hot weather only attraction. I would like to use it during the fall/winter as an outdoor sensory table on the deck.

I'm just not sure what to fill it with. We don't need two sand tables. It needs to be something dry so that they can play in it with winter coats/gloves on if that's necessary. It also needs to be able to withstand some humidity without getting icky given that I'd like to leave it outside. Also, it needs to be something that is either big enough to easily retrieve and put back in the bin or environmentally friendly so that when it falls off the deck into the grass it won't mess with the grass or lawnmower in the summer (so no rocks or gravel).

I've considered rice, feed corn, dried beans, uncooked pasta, etc., but I'm worried that they wouldn't stand up well outdoors. I've searched a bit online, and the only idea that looks even vaguely workable is those decorative glass gems. If I can find them bulk and reasonably priced, they would be fun to dig in and pour, and large enough to just pick the ones that fall out back off the deck and dump them back in. On the other hand, the ones that escape will simply be glass hanging out in the back yard and that doesn't seem wise. I also don't know if they'll get chipped if played with roughly and then be sharp and dangerous to little fingers.

Does anyone have thoughts about the glass gem idea or any other suggestions?

Monday, September 5, 2011

A Deck Takes Shape

So the deck is not finished yet. See the following photographic evidence.

Note strategically placed bin to prevent accidental 8 foot plummet.

Stepping into and out of the dining room is a bit interesting.

Getting to the stairs requires bravery and acrobatics.

The stair rails are currently non-existent.

And yet, huge finished sections are breathtakingly beautiful.

My husband is amazing.

Sunday, September 4, 2011

A Flurry of Activities

We had a friend over for a playdate Wednesday and I decided to fill our water table with shaving cream (outdoors). The children had a blast. The modeling of a typically developing peer is so powerful. They had their hands in it and were covering the glass of the french doors with it. When our guest began painting her arms and legs with it we decided to strip them down to their underwear. Before all was done, our guest looked like a snowman front and back and Ava had covered her entire belly and most of her legs. It was wonderful. Two weeks ago we had to persuade her to touch the shaving cream with a fingertip. All the credit goes to the great modeling of her friend.


They came back for a bonus visit yesterday and my bright idea this time was to redo the pudding activity, but this time in an empty bathtub for more exposure and easier cleanup. We put the two girls in the bathtub with a bowl full of pudding I had colored with green paint and told them to have fun painting. I gave them paintbrushes because I was hoping that there would be no way Ava could avoid getting covered in at least a little of the pudding even with the paintbrushes to help get her started. Well, they quickly ran out of pudding and I grabbed some washable fingerpaint and we just continued the fun. Every time the walls filled with paint I would simply shower them off and the girls would begin again. They were in there at least an hour. It was great.


We had an old baby gate. It was the huge kind you can use to make a play yard. Or, in our case, to protect the little ones from a huge brick fireplace. We're no longer using the gate. I set the gate up in play yard formation and used some old blanket and baby wraps to make a tent, or cave. The kids loved it until they destroyed it. Here's a picture I managed to take before the destruction.


One last fun activity we did this week was to take some bowls of water, paintbrushes, and ice out on the deck. The children had fun "painting" the wood with the water and just exploring pouring water and playing with ice cubes. We were out there for at least an hour two separate times this week. We went through three huge bowls of ice cubes each time, but it was completely worth it.

Saturday, September 3, 2011

I Concur

Last week when my cousin was in town we were taking the children to meet my husband at work for lunch. We were all going out to Chick-fil-a. I overheard a conversation between my cousin and Michael that cracked me up.

Michael: We're going to Chick-fil-a!
My cousin: I love Chick-fil-a! What do you like to eat there?
Michael: The chicken.
My cousin: I concur.
Michael: (long pause) They don't have concur at Chick-fil-a.

After much laughter we explained that concur is just a fancy word for agree. Later, as we told Daddy the story, Michael was able to explain to Daddy just what concur really means with no reminder from us. We all used the word concur instead of agree for the rest of the visit.

Friday, September 2, 2011

The Weekly Review: Week 25

Two Favorite Blog Posts of the Week

I enjoyed a post by Swistle about nutritional advice because I've had similar thoughts. And she expresses her thoughts so very eloquently.

I enjoyed another post at All & Sundry because I have a similar Melissa and Doug puzzle box and I knew exactly how the post was going to end. I sympathize.

Siblingness of the Week:

The children are ramping up both their sweet togetherness sibling moments and their shouting/pushing style sibling moments at the same time. It seems we get more of both. They are talking to each other instead of us more and more. Ava will ask Michael for help when she's having trouble with the computer or if she needs someone to turn on the water in the bathroom so she can wash her hands (he can reach the faucet, she cannot). I love it.

And then there are the moments that perplex me because they are coming too soon. Michael will repeat an action that irritates Ava simply because it bothers her. Why on earth does a three year old need to irritate his two year old sister just because? Alternately Ava will just push Michael out of her way instead of asking him to move. Or grab a toy from his hands, not because she wants it, but because she feels it is hers. Sigh. Lots of mediation going on in our household now and probably for the next 16 years or so.

I am trying to butt out whenever possible. I am inclined to micromanage and I'm making a concerted effort to just let them be and figure things out on their own.

The Weekly Michael

Michael continues to love his new preschool. I continue to love the fact that he's happy there. He comes home talking about art, and songs, and snack, and activities. Before, when it was a school day he'd protest going. Now he's excited. It is a beautiful thing to watch.

Ava this Week:

Singing. I wish I knew how to post audio samples here so you all could hear her too. She's singing the ABC song and Itsy Bitsy Spider and Row, Row, Row Your Boat. By no means are they perfect, but I think that even a stranger would know what she's trying to sing. Understanding her isn't what is important here though. What makes me so happy about it is that she's finally confident enough to try and capable enough to string many, many syllables together in sequence to a tune.

Thursday, September 1, 2011

Ebooks, Kindle, and Lendle

I don't remember when exactly, but let's guess around a decade ago, someone gave me a palm pilot as a gift. I honestly didn't know what to do with it. I wasn't super impressed with the address book or calendar functions and so it was a rather expensive but unimpressive toy. Then I discovered ebooks.

I was always an avid reader. I would go on vacations with half my suitcase filled with paperbacks. I carried one to every doctor's appointment. I read in the car until the sunlight faded and then continued on with a flashlight until my batteries died. The ebook was an amazing upgrade for me. Suddenly I could carry dozens of books in less space than one paperback. Also, it was backlit and so I could read in the dark. It was wonderful. I never struggled with eye strain, so other than the occasional low battery issue, I never looked back.

Due to issues I won't go into now, I switched from my old ebook format to the Kindle format a couple of years ago. I don't actually own a Kindle. I use a Kindle app on my iPhone. I'm perfectly happy with that. It is smaller than the Kindle device, has backlight capability, and is always with me. I love ebooks. It is by far my preferred format for reading.

I recently stumbled upon a new website that is really great. It is called Lendle. Some Kindle books are lending enabled. The publisher determines if that function is enabled, not Amazon. If the book is lending enabled, you can loan the book to someone else with a Kindle account one time for two weeks. Or, they could loan a book to you for two weeks. The problem is, I don't know anyone else using a Kindle. That's where Lendle comes in.

You set up an account with Lendle and tell it what Kindle books you own. They automatically figure out which of those are lending enabled. (I own 81 Kindle books. Only 16 are lending enabled.) You get a few free borrowing credits just for signing up and entering your book list. Your available loans are entered into a database along with everyone else's. Then you can browse available books and spend a borrowing credit to request a loan. You earn another borrowing credit for every book you loan out. As an added bonus, Lendle gives you a small credit (5-49 cents so far for the five books I have currently loaned out) for each book you loan out. When your account reaches $10 they send you an Amazon gift certificate.

Their catalog is pretty slim because so few books are lending enabled. However, I found one I wanted and requested the loan. It came through within half an hour and then I was reading the book on my phone. It was great. I requested the sequel. Now, that one is taking longer. The lender has two days to actually send you the book and this person is a bit slower. Still, I'm getting to read free books in exchange for loans that were sitting around unused in my Kindle account.

If you have a Kindle account, I highly recommend checking out Lendle.
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