Perfection

I had this game when I was little and I grabbed it during the holidays for the kids. Then I forgot about it in the closet for four months. I pulled it out a few days ago to pass some time on a rainy morning. The children loved it. The funny part is how they play the game. They set the timer but stop the timer from running while they work together to fill in all the pieces. (Sometimes they work together nicely, sometimes lots of mediation from Mama is necessary to keep the peace.) Then they push the start button and run around excitedly shrieking until the timer finally goes off and the pieces pop out. Then they rush back over to the game to start all over again.

NutriiVeda for Childhood Apraxia of Speech: Information and Resources

What is NutriiVeda?

NutriiVeda is a powdered beverage being marketed primarily as a meal replacement shake to aid weight loss. You mix the powder into water, milk, or a smoothie. Nutriiveda has a proprietary blend of 7 Ayurvedic botanicals, 22 vitamins and minerals, high quality protein, soluble fiber, and essential amino acids. Each serving contains 153 calories, 3 grams of fiber, 20 grams of protein, 100% of many vitamins and minerals, and only 5 grams of sugar. It is available in chocolate and vanilla.

What does NutriiVeda have to do with Childhood Apraxia of Speech?

In December of 2009, parents of children with Childhood Apraxia of Speech began to try NutriiVeda with their children. Anecdotal reports began to surface of significant improvements in quantity and quality of speech production. The Cherab Foundation, a non-profit foundation trying to help families cope with their children’s communication impairments, began looking into NutriiVeda. They set up a sister site, Pursuit of Research to investigate the effect of taking NutriiVeda on children with communication impairments.

Here are a few web pages that discuss NutriiVeda and Childhood Apraxia.

• NutriiVeda Pursuit History: This article discusses the history of using NutriiVeda with children with apraxia and gives a detailed testimonial.
• Theories Based in Science to Support Whole Food Therapy for Autism, Apraxia, Traumatic Brain Injury, Seizure Disorders: This article discusses theories about why the ingredients in NutriiVeda may help children with apraxia and other special needs.
• Anecdotal SLP Children NutriiVeda Testimonials: This is essentially a long list of testimonials from parents of children with special needs who have seen improvement using NutriiVeda.

NutriiVeda for Childhood Apraxia: Review of Initial Product Purchase and First Impressions

I purchased a one month supply (at 2 scoops/day) of NutriiVeda from the Pursuit of Research website. I found it to be cheaper there than on other sites where it was being sold as a weight-loss product. When I read my confirmation email I was surprised to learn that when I made my purchase I had actually signed up for a monthly automatic shipment program. That was not clear to me during the checkout process. However, the number to call and cancel was clearly listed in the confirmation email and their customer service was excellent when I called.

The product was well packaged in an attractive box and arrived promptly. The individual containers are attractive and the product appeared to be in good condition. I’m using the product with my two year old daughter who has suspected Childhood Apraxia of Speech. I found that if I mix about half to 2/3 scoop (vanilla flavor) in with 4 ounces of yogurt, my daughter will eat it with no problem. Depending on how often she eats yogurt in a day she’ll get anywhere from half a scoop of NutriiVeda a day to two scoops per day. We’ve been using the product for about a week. At only one week, I cannot claim that I see clear signs of improvement in her speech that I definitely attribute to use of the NutriiVeda product. However, we haven’t been using it very long. I will update in the future. The product has a nice side benefit of adding a nutritional boost to the diet of a very picky two year old, so in that way it is a win either way.

Two-week Update: About two weeks into using NutriiVeda (average of one scoop daily) I feel like I am seeing definite improvement. We are hearing a lot more talking. She's even attempting to sing. She is listening to her own speech and self-correcting which we had never seen her do before. Could it be coincidence? Of course. Until someone completes a double-blind scientific study we won't have hard evidence. For now all we have is parent report. I'm reporting that I feel like I'm seeing improvements that I wasn't seeing before starting to give her NutriiVeda.

Six-week Update: At about six weeks after starting to supplement Ava with NutriiVeda we are giving her about 1.5 scoops a day on average. I believe that she is speaking much more often, her sentences are longer, and she is trying to string several sentences together to tell a single story. She has also learned a new sound (/f/) and some other new sounds are starting to emerge. She is occasionally putting a consonant at the end of some of her words (the /p/ at the end of "up" for example). All of this is new. As before, there is certainly no proof that these improvements are due to the NutriiVeda and wouldn't be happening anyway, but the coincidence is interesting and I'm not complaining. We will be continuing to use NutriiVeda in our household.

Are there other supplements that might help with Childhood Apraxia of Speech?

There is some evidence that supplementation with Omega-3 fatty acids can be helpful for children with Childhood Apraxia of Speech. You can read my Information and Resources page on Omega-3 fish oil supplementation for Childhood Apraxia of Speech here.

Omega-3 Fish Oil for Childhood Apraxia of Speech: Information and Resources

What are Omega-3 fatty acids?

Omega-3 fatty acids are molecules that are necessary for human health but cannot be produced by our bodies. They have to be obtained through our food. They are most commonly found in fish and some nuts. Omega-3 fatty acids are essential to brain function and play an important role in growth and development. There are several types of Omega-3 fatty acids, but most research indicates that EPA and DHA have better established health benefits and these types are found in fish oil rather than in nut oils.

Here are a couple of web pages that discuss the general health benefits of Omega 3 fatty acids.

• Omega-3 fatty acids: This article defines Omega-3 fatty acids, discusses their health benefits, gives some dosing guidelines, and discusses precautions and interactions.
• Omega-3 Fatty Acids: Fact Sheet: This WebMD article discusses the basics, benefits, types, food sources, and supplements.

What does Omega-3 Fish Oil supplementation have to do with Childhood Apraxia of Speech?

Many parents of children with Childhood Apraxia of Speech first encounter the idea of supplementing with Omega-3 fatty acids in The Late Talker book. That book devotes an entire chapter to the topic. Most of the evidence is anecdotal. Some families have seen dramatic improvement after a plateau when adding Omega-3 fish oil supplementation was the only change. Given that there is evidence of general health benefits, few drawbacks, and the possibility of helping a child communicate better, many parents choose to try it.

There is some preliminary scientific evidence that Omega-3 supplementation does help with related disorders like dyspraxia (neurological motor planning disorder of the limbs) and autism.

Here are a few resources that discuss Omega-3 supplementation and Childhood Apraxia (or related conditions).

• Dyslexia, Dyspraxia and ADHD – Can Nutrition Help?: This article is in .pdf form. It nicely summarizes some of the actual research out there on fish oil supplementation and disorders. Note that none of these studies are actually about children with Childhood Apraxia of Speech. These are studies with related disorders including dyspraxia.
• Therapeutic Use of Fish Oil for Apraxia, Autism and Other Communication Impairments: This article is structured like a FAQ covering topics like dosage, brand, and tips for getting your child to take the supplement among other topics.
• Syndrome of Allergy, Apraxia, and Malabsorption: Characterization of a Neurodevelopmental Phenotype that Responds to Omega 3 and Vitamin E Supplementation: This is a research article published in the Journal of Alternative Therapies in 2009 (also a .pdf). This study was conducted with children diagnosed with Childhood Apraxia of Speech. However, this research study did not have a control group, so although as a parent I am encouraged and interested, as an SLP I am still not convinced.
• Scientists Characterizes New Syndrome of Allergy, Apraxia, Malabsorption : This is a science news article about the Journal of Alternative Therapies study. It summarizes and discusses the results of the study.
• The Omega Wave This is a pretty interesting BBC news article on fish oil supplementation and learning disabilities, but it is just a news article, not a research article.

Omega-3 Fish Oil Supplementation for Childhood Apraxia of Speech: Review of Product Purchase and Impressions

After carefully reading the chapter in the The Late Talker book and all of the articles referenced above we decided to purchase the Nordic Naturals Ultimate Omega Liquid. The Nordic Naturals brand has a great reputation for quality and we wanted the product in the most concentrated form possible given that we weren’t sure how well our two year old daughter would take it. This product also has a blend of the different types of Omega-3 fatty acids and we wanted that as well in order to get the closest possible approximation to the therapeutic doses described in the book and articles.

The product is lemon flavored and does not smell or taste fishy at all. I have been very pleased with the quality of the product. I suppose you could try to give it to your child straight off a spoon or medicine dosing cup, but we’ve never tried that. If the product starts to smell or taste fishy, it has spoiled. After doing some research, we decided to store our bottle in the freezer to extend its shelf life.

We mix the Omega-3 supplement in with about two ounces of yogurt. At first we bought lemon yogurt, but when we ran out we tried random flavors and they all seem to work. We’ve also mixed it in with yogurt drinks and that has worked as well. I simply use a medicine dispenser I borrowed from an infant ibuprofen bottle to measure the right dosage and then squirt it into the yogurt. Stir and serve.

Is Omega-3 Supplementation working to help our daughter’s Childhood Apraxia of Speech?

To be honest, I cannot tell if the Omega-3 supplementation is helping for us. We started the supplementation and intensive therapy in the same week so it is impossible to tell if the improvement we have seen is due to the Omega-3 supplement, the therapy, or a combination of both. I can say that I have not really noticed any kind of regression when we miss her nightly dose several nights in a row for some reason. However, given the general health benefits and the possibility that it is helping in a subtle way I am certainly not going to stop using the product.

Are there other supplements that might help with Childhood Apraxia of Speech?

Many parents are anecdotally reporting improvement in their child's speech when using a meal replacement supplement called NutriiVeda. You can read my Information and Resources page on NutriiVeda for Childhood Apraxia of Speech here.

Testy Yet Trying: Childhood Apraxia of Speech Reference Posts

I am going to be working on something new over the next few days (or couple of weeks). I am going to re-work and add to some of my Childhood Apraxia reference articles and put them all in one place so they can be accessed easily. If you notice, there is a new link at the top of the page (or depending on when you’re reading this – there will be soon) to the reference posts.

I’ll be adding new ones as I finish polishing them. If you have a post that you would like to see added to the new page sooner rather than later, just leave a comment and I’ll put it at the beginning of my list of posts to work on. Please comment. I’d love to hear which posts you have found to be most useful.

As I finish each article, I will also post them on the main page so you can see the new content. I just wanted to let you know what was going on so you wouldn’t be confused by the return of some of these topics. I’m starting with the two supplementation posts: Omega-3 Fish Oils and Nutriiveda.

Therapy Progress - Steady Progress and Subtle Change

I was looking back at all of Ava’s progress reports and I realized that her progress has been very steady. Every 3 weeks or so, significant progress has been made. Here’s a quick summary.

• Beginning of January – Ava had only three “words” and very few consonants and vowels.  She couldn’t imitate.  She was starting to use gestures instead of even trying to communicate verbally.  We began therapy and Omega 3 supplementation in January.
• End of January -  At this point Ava would imitate when bribed with food.  She had learned several new consonant sounds and was using 15-20 words spontaneously.
• Middle of February - Ava was spontaneously trying to label things.  She had started two syllable words like “nanuh” for banana and “baby”.  She was making further progress on consonants and some progress on vowels.
• First Week of March - She started putting two words together make short phrases and sentences.  It was a huge step.  We were getting 3-4 syllables strung together at a time.  
• End of March -  Ava was continuing to practice multi-word utterances.  She was using them more frequently and would often use three word sentences.  Occasionally we would even hear a four word sentence.  We started using Nutriiveda.

 

At the moment, we’re trying to add a little clarity to Ava’s words.  Before, her words had no final consonants (“ha” for hat) and no medial consonants (“pu-ee” for puppy).  We’re using gestural cues to help her add those back in.  It’s working.  She’s occasionally doing it spontaneously (she’ll add the /t/ in the middle of turtle), but most of the time we have to remind her (using the cues).  When she’s imitating I’d say she’s successful about half the time.  It depends on the sound.  She does a great job with /t/ and /p/, but /d/, /b/, /n/ and /m/ are harder.  She doesn’t have /k/, /g/, /f/, or /v/ at all, so we aren’t even trying with those. 

All of these things are very concrete.  These are the kinds of things that speech pathologists choose as goals and can collect data on to track change.  I talk about this kind of progress because I am a speech pathologist and these changes make sense to me.  I’m proud of them.

There has also been a more subtle kind of change.  This is the change that my husband and parents notice.  It’s less about specific sounds, utterance length, and data and more about Ava as a person.  There’s been a change in her confidence.  She’s talking more.  She’s talking when she’s by herself in another room.  She’s chattering away in the back seat of the car.  She’s trying to sing, laugh, and make jokes.  She has conversations with her parents, grandparents, and brother.  She is no longer the baby who had to grab my hand and drag me to the refrigerator, pound on the door to get me to open it, and point to ask me for milk.  Now she can just ask, “Mi pea!” (Milk, please!)   It’s been a wonderful change to watch.

How do you measure progress in your little ones?

Nightmares and Dreams

I rarely remember my dreams, but I had what I consider to be the worst nightmare of my life recently.  The nightmare started out well, as they usually do.  Michael and I were in some kind of store having a great time together.  The shelves in this store were made out of a really lightweight plastic, and when a spot was empty on the shelf you could see through to the next aisle over.  Michael was on one side of the shelf and I was on the other and we were playing peek-a-boo.  We were both having a blast.  Then he started trying to climb through the hole to get to me and the entire shelf and all its contents began to fall towards him.  I tried to catch the shelf to prevent it from falling but I couldn’t hold it up.  That shelf and the next three shelves all toppled over like dominos burying Michael underneath. 

My first response in the dream was embarrassment – not worry.  The shelves were so lightweight I really thought he was ok under there and I was more embarrassed that we had made such a huge mess in the store and attracted so much attention.  Then I started frantically trying to dig him out.  When I found him, he was mostly limp and dazed.  He was confused and murmuring, “Mama” over and over again.  Then, in a flash, in the way of dreams I suddenly knew that this was very bad.  I cradled him in my arms sobbing.  I knew he was going to die.  Then I woke up.  My face was covered in tears and my heart was racing.  I felt sick.  Seriously, it was the worst nightmare of my life. 

As a contrast, I also recently remembered a good dream.  In high school I lived in Pennsylvania in a home with a pretty unique architecture.  For example, this house had two kitchens – one on each end.  It also had two bathrooms side by side.  The elderly couple who owned the house before us apparently liked to keep things separate and converted a screened in porch to an extra kitchen and one large bathroom into two small ones. 

In my dream my family as it is now (my husband and I, and Michael and Ava) were living in the PA house.  I was in the extra kitchen and found a previously undiscovered cabinet full of old toys.  The kids were elated.  As I pulled the toys from the cabinet I found a hidden door and tunnel.  We crawled into the tunnel and found a passageway that ended in a secret playroom and nursery.  The playroom was full of really cool 60s era toys and the nursery was kind of like the one in Peter Pan.   It was a bedroom for two decorated beautifully with two twin beds, small dressers, lamps, mobiles, a rocking horse, etc. 

As I describe it, the dream sounds pretty mundane and unremarkable, but it felt like adventure, discovery, and treasure all rolled into one and left me feeling happy.  Well, I was happy until I found out that I was awoken by my husband calling for assistance because Michael had thrown up.  Isn’t life with young children always like that?

Gestural Prompts for Apraxia – Therapy Techniques

Using hand signals (sometimes referred to as gestural prompts or visual cues) paired with specific speech sounds has been very successful at helping children with apraxia learn and use those sounds. Every professional book I have read about apraxia has a section on this technique. Every speech pathologist I’ve been working with uses gestural cues. It has worked exceptionally well with Ava. I’m going to explain the therapy technique, give you a specific example of how we’re using the technique with Ava right now, and then give you descriptions of several of the prompts we’re using right now.

Using hand signals is very simple actually. You just make sure your child is actually watching you, and then use the signal as you say the word. For example, right now we’re trying to get Ava to use the /t/ sound at the ends of words. She’ll say “ha” instead of “hat.” I will repeat the word emphasizing the /t/ sound at the end and at the same time I make the hand signal for /t/ (tapping the index finger on your upper lip right under the nose). The visual cue in addition to the auditory cue really seems to help her focus on that missing sound. Almost all the time now, she’ll then repeat the word adding the missing sound. She often uses the gestural cue herself when she repeats the word correctly. We’re also using the technique in the middle of words. Ava will say “tu uh” for “turtle”. If I use the hand signal for /t/ while emphasizing the /t/ sound that should be in the middle of the word, she will repeat, “tu tuh.” She still can’t make the /r/ or /l/ sound in that word, but she can add the /t/ in the middle.

These are the gestures we are using as our hand signals. You can use a different signal, it just needs to be consistent.

• T - tap the index finger on the upper lip right under the nose
• D - tap the index finger on the lower lip above the middle of the chin
• P - close your fist and pop it open (into a "5" position)
• B - use the ASL sign for /b/ and tap the hand gently against the side of your chin
• M - gently pretend to pinch both lips closed together with your index finger and thumb
• N - push index finger against one side of your nose as if you're trying to close one nostril
• SH - finger across your lips like you're shushing a child

There are more. You can find a hand signal (or make one up) for any sound you might be working on. Here is a link to a great video of a woman demonstrating a hand signal for almost every sound. Some of her signals are different from what I described above and that’s ok. You can use any signal you’re comfortable with as long as that symbol is consistent. Also, don't feel like you need to learn all of these at once. Pick one or two to start with and if that goes well you can always learn more. Be sure to choose a sound that your child is currently working on and check with your SLP. She or he may already be using a hand signal for that sound.

Other than tapping, this is the technique that has been the most successful with Ava. I highly recommend it.

Two and Three

Michael and Ava are only 15 and a half months apart in age. So, when Ava was born, Michael was a very young one. Parenting a one year old and a baby was… challenging. We got very little sleep. Michael didn’t understand that sometimes Mama and Daddy needed to tend to Ava, and Ava certainly didn’t understand that sometimes Mama and Daddy needed to tend to Michael. Everyone was in cloth diapers. We changed lots of diapers and washed lots of diapers. There was lots of crying. It was just a rough time. The learning curve for jumping from one baby to two was very steep.

Fast forward a year. Now the children are one and two. They’re both mobile, but not particularly steady on their feet. They’re still both in cloth diapers. Only one of them is talking. This was worrisome. They’re old enough to both want the same toy at the same time. Going out was a challenge because they were both at ages where they had to be closely supervised to make sure they didn’t tumble down a small step, or fall into the creek, or try to climb something they couldn’t get back down from. Again, challenging.

Now we’re at two and three. This stage is nice. They’re both out of diapers (except when asleep). They both talk (yea!). They’re both relatively steady on their feet. I no longer feel like they must be wearing long pants when they’re walking on the sidewalk to prevent bloody knees. They can feed themselves at the table. They can climb up and down most play structures successfully. They can both get up and down the stairs safely. Almost all the baby gates are down. Even the one at the top of the stairs is rarely used. They’re playing with each other. They’re having conversations with each other. I am starting to remember why I wanted my kids to be so close together. I wanted them to be playmates and friends. That is starting now and I like it. I’m beginning to feel less like I’m drowning and more like I’m taking control.

I expect things will only get better from here. Well, better until they’re both pre-teens and teenagers at the same time. That will be a whole new challenge that is thankfully still very far away.

The Weekly Review: Week Four

Viral Video of the Week: At least three of my "friends" posted a link to this video on facebook. There were news articles about it. I'm sure you've probably already seen it. This is a youtube video a mother posted of her 17 month old twin boys having a babbling conversation in the kitchen. Everyone loves this video. It's adorable. It makes people laugh. My reaction was different. It made me sad and jealous and I'm proud of neither emotion. It just really emphasized for me that I never had that in my household with either of my babies. They did not babble normally (ok, at all really). It wasn't until I saw this video that I realized exactly what I'd missed out on.

Sibling Moment of the Week There are so many little conversations to choose from. Yesterday we came in from playing outside and Michael told Ava, rather bossily, to take her shoes off. She said, "O-tay Mai-Mai," and proceeded to take her shoes off. It was cute.

Michael’s Surprise Accomplishment of the Week: I picked Michael up from school and gathered the art projects they were sending home. There was a page that was pretty much all orange scribbles (a map he tells me). In the upper left hand corner of the page he had written his name. It wasn't perfect, by any means. I could recognize the first two letters, and the last one, and the ones in between were just scribbles, but it was instantly recognizable. He had done it completely on his own. His teachers hadn't helped him. I haven't been working with him on writing his name. It just came out of nowhere. I was very impressed.

Ava’s Song of the Week: Ava will cradle a baby squinkie in her hand and sing Rock-A-Bye Baby to it. Well, she sings something like, "Ra a baba" over and over, but still. It's adorable.

Project of the Week: Our library system will let you log in online and place books on hold. They send you an email when the books are ready at your local branch. Then all you have to do is drive there, pick them up off the shelf, and check them out. I spent an hour choosing board books for Ava and juvenile fiction for Michael. I threw in a couple of CDs (Raffi and Tom Chapin) and DVDs (Handy Manny) for fun. Today I picked them up. New books and entertainment for free. I'm going to try to do it once a week. Kudos to our county library system.

Conversations

Michael and Ava are starting to have actual conversations. He’ll say something to her, she’ll reply, he’ll respond, etc. They aren’t long, or complex, but there’s actual turn taking going on. I love it.

Here’s a conversation I listened to as I pushed them on the swing today. We have a tire swing that is square rather than round. They like it because they can sit on it together. (Obviously the tire isn’t real, it’s plastic but still fun.) Michael told Ava the tire was square. Ava said, “Circle.” Michael replied, “No, it’s a square.” Ava insisted, “Circle!” Michael explained, “No, it’s a square Ava! See, it has corners. And see the straight parts? It’s a square.” Without even considering his argument, Ava simply replied, “Circle.” At that point they got distracted with something else.

I loved overhearing the conversation. I also thought Michael did a pretty good job of identifying the key differences between a square and a circle. I was pretty impressed.

What did we do with a huge pile of mulch?

Our yard is a soggy mess for days after each rain. Last spring we invested in a backyard playset for the kids. We got it for a very reasonable price at Sams and built it ourselves in the only spot in the yard that was flat enough for it. It turned out that the absolute soggiest place in the entire yard, the spot that takes days and days to dry out after every rain, is directly under the swings. We put up with it for a season, but now that the kids are a little older and able to use the playset a bit more independently (yea!) I didn’t want us held back by the constant mud. (As a quick aside, last year Ava could climb up but not down. She would climb to the highest level and then wail for me to come get her. Not so much fun for Mama.)

What I would love would be to have a landscaping company come in and install a patio and a drainage system for the yard. That's just a dream though. Instead, we decided to order $100 of high quality playground mulch from a great local company that delivers for free. They dumped the pile in our driveway.

My parents came over for the evening. When we all started the project the kids were very excited. They used buckets and sand table shovels to help fill the wheelbarrow. When it was full one or the other would ride on top around the side yard and into the back to be dumped out along with the mulch. They loved it. Several times Michael took his huge Tonka dump truck and pushed it to the driveway to have Daddy or Grandpa fill it with a shovel. He’d then push it all the way back and dump it on the pile below the playset that I was raking into shape. When the kids got bored with helping, my mom took over their entertainment while my dad and husband continued to fill the wheelbarrow and push it around back to dump wherever I directed them to go next. I did all the raking.

It took about two hours of labor from three adults, but the result looks great. All of the mud from yesterday’s rain is completely covered up. And the whole project was done for a reasonable cost. I think it looks great and I’m quite pleased with how it turned out. I’m calling it a success.

Tot Clock = More Sleep

I wanted to write a review of a product that I love. As I’ve mentioned before, my children are early risers. Michael rarely sleeps past 6:30 in the morning and Ava has never learned to go back to sleep after the sun rises. Right now, after the time change that’s about 6:15, but by the middle of the summer it tends to be in the early 5:00 hour.

Meet the Tot Clock

I decided to try a Tot Clock with Michael. This product is wonderful. Fundamentally it has a clock face that changes colors. It’s standard color is yellow. That’s the “awake color”. You then set a bedtime and a wake-up time. For us, bedtime is 7:40 pm and wake-up time is 7:00 am. At bedtime the clock face turns blue and it stays blue until the time you’ve set as the wake-up time. Then it turns yellow again. Michael knows that he can’t leave his room or call for us until the light turns yellow. It has a nap timer too. So I’ve set his nap timer for an hour and a half. I push a button to turn it on (and turn the light blue) when I leave his room. If he wakes up before the hour and a half he knows he has to wait until the light turns yellow before nap time is over. It has worked beautifully. I love this clock. Michael never calls for us before 7am any more.

There was a flaw in my plan to get more sleep though. It didn’t really do me any good to keep Michael in his room until 7am when Ava was still waking up at 6:15. So I decided to try a Tot Clock for her too. She’s a little young for it, but she loved Michael’s clock and seemed to get the concept. But when I went to order the second Tot Clock for Ava they were out of stock and wouldn’t be getting more in until May.

I didn’t want to wait that long so I tried a similar product I found on Amazon. I hated it. It was difficult to set and didn’t have nearly as many features. Most importantly, it didn’t have a nap feature. Ava was completely confused by the fact that her light didn’t turn green (this clock’s default color was green) letting her know nap time was over. Then I got an email that Tot Clock had some used clocks in stock. I ordered one immediately. Ava was delighted to have one just like her brother’s clock and I shipped the other one back to Amazon. Actually, there is one difference between Ava's clock and Michael's clock. Michael's clock has the standard face plate: the moon and stars. We ordered one with butterflies and flowers for Ava because I knew she would like it and it would make this clock "hers". The company has a ton of optional face plates to choose from.

So now we have two Tot Clocks. They’re working perfectly. We now set our alarm for 6:50 so that we can wake up and pull on clothes before the kids start calling, “Mama, Dada, my clock is yellow!” at 7am. Sure, 45 minutes of extra sleep doesn't sound like all that much, but remember that before now Ava rose with the sun. In the middle of the summer I'm hoping this clock will be getting me almost two hours of extra sleep every day. Besides, the predictability is nice.

I also think it is helping Ava learn to go back to sleep after surfacing. I’ll hear her wake up and fuss a little, but then she’ll fall back asleep for a while. She rarely did that before the clock.

It has a ton of features we’re not using. It will tell a bedtime story, play music and white noise, and function as an alarm clock (who on earth would actually want to wake their toddler up in the morning on purpose?). It has a built in time-out timer (turns red) and activity timer (turns green). If any of this sounds interesting to you check it out. I highly recommend it.

(One drawback: the blue night-time setting is very bright in a small room even on its dimmest setting. You can turn the night-time light off all together, but Ava protested that option. We've ended up turning the clock away from her bed at night and partially covering it with a baby blanket to reduce the extra light in her room.)

Selling baby things - or not?

I decided to bring in a little extra money and declutter the house and garage at the same time. This seems like the perfect time to do a little craigslisting and maybe pay for a month of therapy.

First I decided to list the double stroller. I truly don’t remember the last time we used it. I wrote an amazing, detailed ad for craigslist. I spent at least half an hour working on the ad. In the process of writing the ad I remembered exactly how cool our double stroller is. And I remembered that spring and summer are right around the corner. I started to think about how I could take the kids on long walks, carry all the drinks and snacks in the stroller, and then push them when they were too tired to walk home. So I didn’t post the ad for the stroller on craigslist after all. I did save the ad though. It will be all ready when I am finally prepared to let the stroller go.

Then I decided to list the cloth diapers. We used Fuzzi Bunz cloth diapers with both kids. Now they are pretty much both potty trained. We haven’t used a cloth diaper in months. We use 4 pull-ups a day – two at nap time and two overnight. So, I pulled out all the cloth diaper stuff, sorted it and separated it into three lots of 8 diapers each. I took pictures. I wrote the ad. Then I started remembering how nice cloth diapers are and how expensive the pull-ups are. Ava walked by and desperately wanted to put on a pink one. I started talking to my husband about how perhaps we should start using cloth again for naps. Well, I did list one of the lots of diapers, but at the moment I’m hanging on to the other two. Still deciding. Money is tight right now and pull-ups aren’t cheap. Perhaps I should switch back to cloth for naps.

I still have some wraps I used when the babies are little that I haven’t listed yet, and even I can’t think of a way to use them with a two and three year old so I’m hoping I’ll get those successfully listed without changing my mind. And there’s the single stroller and matching pumpkin seat/carseat base. Again, not much use for those any more. But so far, this project isn’t exactly leading where I’d hoped.

Nutriiveda – First Thoughts and Impressions (and a little extra information)

Ok. First item of business. They are a little sneaky. Not a lot sneaky, but a little. Let me explain. Apparently, when you order your $80.00, 2 can package you are actually approving an autoship program. They do make that very clear in their confirmation email, but a lot of people don’t read those confirmation emails. So, if you do nothing, they will continue to charge your credit card and send you another shipment each month. They include the number to call to change that right in their email though so the issue is easy to fix. I just figured I’d give you fair warning.

Second small issue. The checkout process told me there would be a $7.95 shipping and handling fee. Ok. I was expecting that. It did not warn me that my state was one of the states where they also need to charge tax. So my total was $95.14 instead of the $87.95 I was expecting.

You receive two cans that have 15, 2-scoop servings each. The serving they recommend therapeutically for children is 2 scoops a day, so you’re talking a 30 day supply. That’s essentially an extra $100 dollars a month. This is not an inexpensive experiment by any means.

I did call their number. They answered with no wait and the person I spoke with was polite and helpful. She explained where the extra charge came from (taxes) and told me that if I wanted to postpone a shipment (or cancel the autoship entirely) I just needed to call at least three days before my scheduled ship date. I decided not to postpone just yet. I want to see how things go over the next three weeks or so. If I want to continue, and we’re successful at getting 2 scoops into Ava per day we’d need a monthly supply.

They also have a rewards program. They give you 10% of your product order in “Loyalty Rewards Dollars”. So for each shipment you earn 8 reward dollars. When you have enough to cover an entire order you can redeem them for a “free” product. So, essentially, it’s buy 10 and get the next one free (not counting shipping and tax). You only earn the rewards if you stay enrolled in the autoship program. So, it isn’t exactly an overwhelming deal, but if you do end up deciding you want to try it long term, there’s a bonus coming down the line. Oh, and you have to call to redeem them. They won’t do it automatically.

So, the product is nicely packaged and arrived promptly. I ordered it at 9pm on the 27th and it arrived in the mail on the 31st. They recommend you start with one scoop a day and work your way up to two. I was mixing up Ava’s yogurt/Omega-3 supplement nightly “treat” anyway, so I thought I’d just mix it in. After opening the container and looking at the size of the scoop I actually only added about 1/3 scoop to the yogurt (about half a container of yogurt). It took a couple of minutes of stirring before I felt like it had blended well. It takes some time for the mix to actually dissolve. She ate it just like she normally does. I couldn’t tell that she even noticed it was different. Michael actually had some mixed into his yogurt as well and didn’t seem to notice.

The next morning I mixed in half a scoop with about 4 ounces of yogurt and again, Ava didn’t seem to notice. So getting it into her doesn’t seem like it will be a problem. At least not when mixed in at those ratios. Ava only has yogurt twice a day though and I haven’t tried mixing a whole scoop in yet. I’m not sure that it would still be unnoticeable at that amount. We’ll see.

Now I just have to wait and see if I feel like it’s making a $100/month difference for her. We’ll see.

As an aside, I tried it myself. I mixed two scoops in to about 11 ounces of non-fat milk. This is the recommended amount for an adult meal replacement shake. Now, admittedly, I’m a picky eater. Truly. I am. But I only managed to drink about half of it and poured the rest down the sink. I didn’t like it. I wanted to. I really did. But, at least in milk, I felt it had a really chalky aftertaste. If I can think of something else to mix it with perhaps I’ll try it again. (I don’t like yogurt, so that’s out.) So that was my opinion. Then again, for our purposes, my opinion doesn’t matter. Ava needs to eat it and she will when it is mixed into yogurt.

Bottom Line(s):
Ava ate it without noticing when mixed in with yogurt. She’ll even eat both the Omega-3 supplement and the Nutriiveda supplement mixed in at the same time.

Their shipping is prompt and their customer service is polite and helpful.

Remember to cancel the autoship if you don't want it.

I personally think it tastes awful. (We’re using vanilla.)

Time will tell about whether it seems to help therapeutically for us.

Oh, and as a bonus, I found a more detailed web page testimonial on Nutriiveda for Apraxia.

A B C

I’m working on making my own alphabet border as a decoration for our playroom. I thought it would brighten the room a little. Michael knows his letters and is working on his letter/sound correspondences. This project is a good way to talk about that a little. I’m trying to choose a picture (or pictures) for each letter that is appealing to my kids. If the letter corresponds to one sound in some words and another sound in other words I’m trying to represent both sounds on the border. So, A has both acorn and apple and C has both cow and city. I’ll post more pictures as I get more of the border done.

The Weekly Review: Week Three

Blog Post I Enjoyed Most: Robert Rummel-Hudson is a father of a daughter with polymicrogyria (a rare neurological disorder) which effects speech in addition to many other things. He has written a book about his journey with his daughter, Schuyler. He also writes a blog and I particularly enjoyed his most recent post. This particular post has little to do with Schuyler but much to do with frustration. I also enjoyed the Office Space reference.

Interesting Apraxia Article: Here is an article I found on the Apraxia-Kids website about trying to get insurance coverage. I’m just starting to seriously research this topic so I’m sharing one of my first finds. I intend to do a full post on this when I get a little further in the process.

Ava’s new favorite phrase: I love this one. This week she’s started saying, “O-tay (okay) Mama.” I’ll say, “Let’s go put your shoes on.” and she’ll reply, “O-tay Mama.” It really is adorable. She says it in the cutest way and it’s a nice contrast from last week’s constant “no.” We still hear lots of “no,” but at least we’re hearing some agreeableness too.

Ava's second new favorite phrase: I don't love this one quite as much. "Na (not) Dada. Mama." This is repeated several times in urgent succession any time my husband attempts to help with Ava's care. I have mentioned the Mama stage she's going through?

Michael's Phrase of the Week: "Daddy, will you come play with me?" This request has been constant this week whenever my husband is home. I'll admit to a little bit of quiet amusement every time I hear it. Ava has been going through that Mama phase. I enjoy seeing the tables turned a little with Michael.

Favorite Project of the Week: My favorite this week was definitely the eye dropper art with the kids. It was a lot of fun.

Poll #2 results

Only 5 people responded to March's poll question. The question was: How old is your child with CAS? One person has a child under two years of age. One person has a two year old. The other three people who answered have a child who is three years old. No one answered four years or older.

Click in the sidebar to answer this month’s question.

Insurance Coverage - So Intimidating

It’s incredibly depressing. I looked up whether speech therapy is covered by our insurance policy. Essentially the answer is not unless your child has speech and then loses it due to head injury or stroke. They don’t cover developmental delays.

My understanding after doing a bit of research is that I can appeal that. I can argue that Ava does not have a developmental delay. A developmental delay implies that if left alone, she’ll eventually catch up on her own. That is definitely not the case. Ava has a neurological speech disorder. She will only catch up if she has intensive, specific types of therapy.

I’ve read that if you make the right kind of appeals with the appropriate insurance diagnostic codes (neurological disorder, lack of muscle coordination problem, etc.) and you have a lot of persistence and luck you can get some insurance coverage. To be honest, I read a little bit about the process, I get discouraged, and I promise myself I’ll look at it again next week. Well, that was three months ago.

This therapy stuff is expensive and it is putting a significant strain on our family’s budget. I’m already having to fight balancing budget needs with Ava’s need for intensive therapy. I think to myself, “Does she really need to see Ms. E twice a week, or would once a week be enough?” The real answer is that she definitely needs twice a week. Three times would be even better. I hate letting money dictate my decisions about what is best for my daughter, but that is a practical reality.

Having some insurance coverage would make a huge difference, but I don’t know where to start. I’m paying two different therapists out of pocket. Neither therapist submits to insurance for you. I don’t even know how to do it myself. I guess I need to find out. I understand that the appeals process can take months, so I suppose I should get started soon.

The endless cycle of feeding

I thought the feeling that you barely finished feeding your child before it’s time to start again would be forever gone after breastfeeding. Not so much.

To be completely honest, I am not a kitchen person. I don’t have a history of enjoying cooking. I have no significant experience or skills or natural inclination to cook. To some extent, necessity is the mother of invention. I am interested in feeding my children healthy food. I made baby food when they were little. Michael ate pretty much everything. Ava not so much. I actually stopped making baby food and switched to finger foods pretty quickly because she just didn’t seem to like the baby food and it was a lot of work.

Now that they’re at the toddler / preschool stage I find myself in a serious rut. For breakfast they eat a banana, baby yogurt (whole fat, supplemented with iron) with some multi-grain baby cereal mixed in, or a relatively healthy cereal (Cheerios, Mini-Wheats, Kashi) dry. This is pretty much every day. Lunch is fish sticks and sweet potato fries, peanut butter crackers and carrots and grapes, and whole grain pasta with peas and parmesan. I’m having trouble thinking of more. Dinner is often some kind of pasta: spaghetti and salad or cheese tortellini and broccoli. If my husband takes over it might be pot roast or chicken from a crock pot. We tried hamburger helper. The kids won’t eat it so that was kind of a fail. Not really a nutritional win anyway.

There must be more simple, picky toddler friendly, quick meal ideas out there right? I came across a website devoted to healthy meals for small children. We found some ideas we like and were inspired to try for a very simple goal. We want to make one week of meals that we can regularly prepare here at home that minimize dependence on pre-packaged material, have some variety in all the food groups, and that the whole family will eat. (Ok. We had to give Ava a pass on three of the dinners. It just wasn’t possible. She'll eat leftovers or just the sides on those nights.) Just one week’s worth of meals. I’m willing to eat the same thing week after week. That’s what I’m doing now anyway really. Maybe we can eventually build up to a Week A and Week B plan, but let’s start small.

Here’s the current rough draft of the meal plan. We’re starting this week. Wish me luck. Tuesday and Thursday have no lunch because they eat at school. Friday’s lunch has a question mark because we usually meet my husband at work and all eat Chick-Fil-A for lunch on Fridays. The arrows to the right on Tuesday/Thursday/Saturday breakfasts indicate planning to eat leftovers from the day before.

So, does anyone have other suggestions? What are your “go to” meals? I could really, really use the help.

Fine Motor Activity - One

I came across this webpage on handwriting. The entire site has been fun to browse. I don’t even remember how I ended up at the site, but I'm glad I found it. The page has a great list of fun fine motor activities. Since I’m looking for fine motor activities to do with Michael, and fun activities to do with the children in general, I was pretty excited.

I decided to do the eye dropper art. I gathered eye droppers (something I had gotten months ago for art projects and never used), paper towels, cookie trays, food coloring, a cup of water, and ice cube trays before I called the kids over to the kitchen table. (Please excuse the blurriness of the picture. I didn't realize it was so bad, but at least it gives you an idea of what the prep looked like.)

I did a sanity check and decided propping the eye droppers in ice cube trays wouldn’t work and switched them out for empty baby food jars: two for Michael, two for Ava, and two for me. I brought the kids in and we talked about how water is clear but when we add the food coloring to it we can make it pretty colors. I let them choose the colors to make. Ava chose pink and green. Michael chose pink and yellow. I chose purple and blue. They loved watching the food coloring drop into the water and combine as we swirled.

Then I stuck an eye dropper in each jar and let them start. I quickly realized neither child knew how to use an eye dropper. Michael picked it up pretty quickly. Ava took a little more time but eventually got it. Michael didn’t have the patience (or fine motor control) to do only one drop at a time even when I encouraged him and showed him with my picture that you could do things like make flowers using one drop at a time.

He did stay engaged in the activity for nearly twenty minutes though which is a major accomplishment. Usually he’ll only do an art activity for a few minutes before getting bored/frustrated and wanting to quit. Ava loved it too. She actually remained at the table another ten minutes or so after Michael left to do another one.

I think the finished products are rather pretty. Mine is the one that looks vaguely like flowers. Ava’s are the small ones and Michael’s is the other large one.

I’m going to do this project again. We all enjoyed it and it’s good fine motor practice. Perhaps if I demonstrate how to make a train track or road or something like that he’ll be motivated to fine tune a little more?