IFSP Meeting - Ideals vs. Practical Realities

The IFSP meeting went well overall. Everyone was nice. Everyone was well prepared. In fact, the SLP that evaluated Ava had done some preliminary research for me. She had a specific therapist in mind for Ava. This new therapist (Ms. A.) is a person the evaluator thinks would be perfect for Ava because she has a lot of experience and success working with children with apraxia. The evaluator had called Ms. A. to check if she had any openings in her schedule. She does. One. For an hour, once a week on Friday mornings at 8:30 am.

So, I had to choose. They were perfectly willing to write into our IFSP twice weekly sessions for 30 minutes. But then we couldn't work with Ms. A. Or, we can see Ms. A. for the once a week for an hour session.

In an ideal world I could have my first choice therapist see Ava for my first choice therapy schedule. That's not reality though. I decided to try Ms. A. once a week. We can reconvene another IFSP meeting and change to twice a week for 30 minutes later if this isn't working. I made that decision because I'm an SLP and Ava is willing to work with me on other days. I can learn from someone who is experienced in working with little ones with apraxia and do extra sessions in between.

If I wasn't a speech-pathologist, or if Ava refused to work with me I would have made a different choice. Once a week isn't enough to address apraxia. They need practice more often. But because we're getting therapy elsewhere, and I'm working with her too, this choice makes sense for us now.

So that's how the IFSP meeting went. I'll let you know how the first therapy session goes and what I think of Ms. A. once I meet her.

Experimentation

You hear that toddlers and preschoolers can be forces of chaos and destruction. I read a blog post recently by one of my favorite bloggers about her toddler who took a pair of scissors to their sofa and his preschool-aged brother who tried to tape up the evidence. In general my children do not do these things. I have to count my blessings as they come.

However, in the past week Ava has taken a crayon to our basement playroom wall. Crayon over about four feet of one of the beautiful walls in the playroom with the gorgeous murals painstakingly painted by their grandfather and a good family friend over about 5-10 total days of work spread out over a couple of months. This picture is of one small section. I have not yet tried to remove the crayon. I've never needed to before. Do I just take a wet washcloth to it?

Then after two hours of not napping, I went upstairs to fetch Michael and discovered that he had stuffed multiple wads of toilet paper into the bathroom sink drain (which is missing the little drain cap thing that should be there). I did manage to extract them with my good tweezers. Then his father noticed that he had apparently used a hard object to bang a series of dents into the drawer of the nice bedside table in his room.

All children seemed appropriately regretful when the error of their ways was pointed out to them and we’ve had no repeats. Still, where on earth is this coming from?

Speech Therapy Progress

I’ve been doing therapy with Ava about 5 days a week for two and a half weeks now. She’s made a lot of progress. We’ve also been giving her the fish oil supplement for about that same amount of time. Draw conclusions from that information as you will. We’re not an ideal test of which one is helping because we started both together.

Before we started I could not get Ava to imitate at all. She simply would not respond to a request to “Say _____.” Or at least, she’d only very rarely imitate. Now she’s pretty willing to imitate. Ok. I admit it. I’m bribing her with food. With food she’s willing to try most of the time. Without food, at other times of the day, she’s willing to imitate only about half the time.

Before we started Ava was only using three consonant sounds /d/, /m/, and /h/. Now I’ve been able to get her to produce /s/, /n/, /sh/, /t/, /w/, and /b/. That’s a huge difference. She learned them during our sit down therapy sessions, but she’ll use some of those sounds at other times during the day. She’ll use /n/ in “no” when you remind her. She’ll make /s/ as a snake sound just for fun when she’s in the mood. She’ll use /b/ in “book” (without the final /k/) to ask for a book when she wants one. So there’s been a huge change in her number of consonants. I consider this area to be a big win.

No significant progress in vowels. The ones she already had she will still work with. Some of her consonants she can only produce with certain vowels, not others. The vowels she doesn’t have she won’t even try. That child has a will of steel.

Before we started Ava communicated mostly with gestures, grunts, vowels, and a few Consonant/Vowel (CV) productions like /da/ for “ that”, /mo/ for “more”, and /ya/ for “yeah”. Now she’s using words and sign language when she can. She can imitate CVCVs like “mama” and “dada”. She has so many more words (all without their final consonants though). Off the top of my head, she has “more,” “milk,” “no,” “hat,” “hot,” “meow,” “moo,” “book,” “uh oh,” “ow,” “up,” “yeah,” “down,” “out,” and “help.” These are all words she’ll use spontaneously. I’m not even counting the ones she’ll imitate when I’m working with her but she’s not using at other times. I know there are more, but I can’t think of them right now. It’s pretty amazing to find myself in a position where I can’t even list all of the words she’s saying off the top of my head.