Therapy Schedule

Our schedule has finally settled down.  From start to finish, it took about two months from when I started to make phone calls to experts asking if I was worrying too early, to having Ava’s therapy schedule in its current final form.  That’s pretty quick.  I feel lucky.  I’ve read stories from many other parents talking about it taking much longer.  In that time we had Ava evaluated by our state’s early intervention program.  She qualified.  We had our IFSP meeting and a therapist was assigned.  We also found two different private therapists.  We had her hearing evaluated unsuccessfully twice, found out she had fluid in her ears, had surgery to put in PE tubes, and during surgery had a hearing test done to confirm that she can hear. 

So, this is what the complete picture looks like now.  I do focused therapy one-on-one (with no brother around) with Ava at least three days a week for about 30-45 minutes.  My therapy is guided by Ms. J.  Ms. J. is a local therapist who is an expert in apraxia.  She has a private practice but she only sees her private clients two weekends a month.  So Ava works with her for an hour twice a month and then she tells me what to focus on for the next two weeks.  Once a week for an hour we receive services from Ms. A who is our early intervention therapist and a former student of Ms. J (who works at a university).  In addition, Ava gets pulled out of her preschool program twice a week for half an hour by Ms. E., the first local therapist, I contacted. 

Tuesday, Thursday – 30 minutes at school with Ms. E

Friday – 60 minutes at home with Ms. A

Every other Sunday – 60 minutes at private practice office with Ms. J

At least three weekdays / week – 30-45 minutes with mama SLP at home

It’s a bit of a patchwork quilt and in an ideal world I would love a bit more consistency, but it seems to be working so I’m not complaining.  That’s what we’re doing right now.  If you’d like to share, I’d love to know what you guys are doing with your little ones. 

Unlocked

Two months ago, when Ava had barely three words, and yet could understand everything going on around her I could see the frustration building. She had so much she wanted to communicate and it was all locked inside her. In fact, I think it was her frustration that was making her so stubborn about even trying to imitate. She wouldn’t even try. That was why we started by giving her completely new ways to communicate. We used signs and the communication boards and you could just see the light in her eyes. She was so excited to be able to communicate successfully.

We also started working on her speech. I worked with her at home and she was seeing first one (twice a week for half an hour – private therapist), then two (once every two weeks for an hour – local apraxia expert), and now three (once a week for one hour – state early intervention therapist) therapists. Once she experienced the tiniest bit of success, and the praise and attention that went along with it, she began progressing quickly and steadily. She went from simply learning how to and being willing to try to imitate, to imitating single syllables with familiar sounds, to imitating single syllables with new sounds, to repeating multiple syllables with those sounds, to spontaneously trying familiar and new words, and finally to making some two and even three word utterances. The progress in speech alone is wonderful and gratifying.

What is amazing is the personality and confidence explosion that is taking place at the same time. It’s like I’m finally getting to meet my daughter and she’s finally getting to meet the people around her too. Her bond with her family members has intensified exponentially. She and her brother are communicating and playing with each other so much more. She’s trying to sing. She’s engaging in imaginary play. She’s initiating play with other children instead of pushing away every advance another child makes. Today, at her two year pediatrician visit, she went through all of the usual things (being weighed, measured, having her ears examined and her heart listened to, etc.) with a minimum of protest. The last time we went, the doctor and I could barely hear each other over the constant screaming. Today we were able to carry on a conversation without raising our voices at all.

The changes are fairly dramatic and almost all positive. Fine, I probably could do without the loud and gleeful shouts of “no” which she seems to use just because she thinks it’s fun. Seriously, there’s an amused gleam in her eye. She obviously finds it entertaining. But overall I’m delighted to see her personality unlocked and I like the little girl I’m finally getting to know.

Sometimes I just want to be me

In an alternate reality I live in a world where I am completely selfless, well-rested, and perfectly healthy. In that reality, I have the energy and enthusiasm to devote hours of my time to my children. I would play with them, do enrichment activities with them (cooking, art, music, physical play, literacy, etc.), and make sure that Ava and I get at least 30 minutes of direct, targeted therapy time every day.

In this reality, our household has spent more time sick this winter than well. This makes everyone tired and cranky in addition to the actual symptoms of the current illness (stomach bugs, colds, sinus infections, pink eye, etc.). I seem to be operating on a constant sleep deficit which is being exacerbated by Ava’s desire to wake with the sun. In our area, the sun is currently beginning to show up before 6am. And, to be perfectly honest, I am selfish. I want some time to call my own. I want some time separate from my children. I want to read, or blog, or play a game, or do a craft activity, or have a quiet moment where I do absolutely nothing. As a stay at home mother, I am with my children from the moment they wake till the moment they go to sleep all seven days a week. As much as I love them, that is a lot of time to spend with a two year old and a three year old who don’t know the meaning of independent play yet.

Each day, Ava wakes from her afternoon nap at least an hour earlier than her brother. This is supposed to be her therapy time. It’s the perfect time to do it in theory. She’s well rested and with a small snack, well fed. Sometimes I just don’t want to. I’d rather let her watch tv while Michael finishes his nap. This effectively extends my afternoon break from about one hour to about two. But I feel doubly guilty about this desire. First, tv is the root of all evil (ok, not really, but how many articles do we read about how bad tv is for our children?). Second, it’s her THERAPY. It should be non-negotiable. I shouldn’t even be considering letting it go. It doesn’t matter that she’s getting it elsewhere anywhere from three to five times a week. I have the skills to supplement her therapy myself. I should be doing it. Boy do I hate the word “should.” Anyway, sometimes I just want to be mama (and an imperfect one at that), instead of being a therapist.

And that’s my confession of the day.