Hurry Up and Wait

Our OT evaluation yesterday was something of a mixed bag. It took two hours. The vast majority of that was mostly the OT asking questions and listening to my answers. We filled out one test instrument that was a parent questionnaire designed to give a "sensory profile".

We did very little hands-on work with Ava. She did teach me how to test Ava's gag reflex. That went startlingly well actually. As it turns out, Ava's gag reflex is not overly sensitive. Ava was very, very anti-social. Perhaps if Ava had been more receptive, the evaluation would have been more hands-on.

The OT observed me giving Ava lunch. She requested that I serve Ava one thing I know she likes (grapes) and one thing that she doesn't love, but she might occasionally eat (egg). Now, Ava used to eat egg when she was littler. I haven't gotten her to eat it in months. Today, she ate it with very little prompting. Why do they always do that?

And now I just wait for the results of the evaluation. It feels odd. I think somehow I thought this evaluation would provide a lot of answers and I hadn't stopped to think about the fact that I wouldn't get them right away. Silly of me. I used to do nothing but speech evaluations and so I know that tests have to be scored before the results are given. And so the next wait begins.

_______________________

In other news, we're now trying liquid oral antibiotics for the mystery ailment that's been upsetting the kittens' tummies for over three weeks now. I will be trying the first doses tonight (two different kinds). Somehow I'm not expecting this to go well at all.

All Set for OT Evaluation

Our OT evaluation is scheduled for today. My mom (who just retired last week - Congratulations Mom!) is going to watch Michael. As much as I love Michael, he is a rather overwhelming presence when around. I need to be able to focus on Ava and the occupational therapist and on answering her questions rather than on trying to keep Michael quiet and out of the way.

In one way, I am excited. I know speech pathology. I know Apraxia. Those areas are familiar and comfortable. I know very little about occupational therapy and I am excited professionally about getting to watch an occupational therapist at work. Even as a mother I am excited. Ava will finally be getting an assessment and hopefully some help to address some of her other needs. I always had some idea of how to address her speech issues, but I don't know how to help her with her sensory ones. So I am excited to be getting some help for her in that area.

When the OT called to set up a time for her evaluation we chatted for a few minutes. One of the things she asked me was if I thought Ava had a particularly sensitive gag reflex. (She asked the question in the context of her food pickiness.) I told her I hadn't really observed Ava gagging while eating because she won't even try things she thinks she won't like. So, the OT said, "Do you think she'll let me check her gag reflex?" Hahahahahahaha. Oh my. What I said, very politely, was, "We can try." What I thought was, "Hell, no!" So, I think we'll be looking at a very... interesting hour later today.

Card Sets Stage One Complete

All of the card sets for the early emerging consonants have now been posted. You can find links to all of them here. (In case you were wondering, there is no final /h/ set because the /h/ sound does not actually occur in the final position of words in English.) I spent a lot of time working on these sets and I'm pretty happy with the final product. I'd love to get some feedback from any of you who are using them. Also, please let me know if you find any typos or errors so I can get those corrected.

I am actually working on a book of therapy materials that expands on these basic card sets. I'm expanding the backs of the cards with symbols so the cards can be mixed together and easily resorted back into sets by phoneme, position, or vowel and with symbols for sorting into phonological processes. The book will also include simple two-syllable words for each phoneme and phrase/sentence level cards for each phoneme as well. There will also be games (board game, bingo, etc) for each set of words. I am still at least 4-6 weeks from having a rough draft done, but when I do finish the rough draft I would like to get a couple of SLP's lined up to do some proofreading and product testing. If you are interested, send me an email at testyyettrying(at)gmail(dot)com.

So, for now, I have no more free sets in the works. Once I get this first book up and running, I plan to start working on free sets for the mid-emerging sounds (f, v, k, g, s, z, w, y), but that is several months away.

Initial H: Free Speech Therapy Articulation Picture Cards

Description

These articulation picture card sets are designed to be more comprehensive than the typical sets you might find elsewhere. The target audience for these sets are young children or children with more severe speech delays that need intensive practice with sounds at a one-syllable level or simple two-syllable level. No blends or vocalic /r/ sounds are included in these sets. (Scroll down to preview sets.)

Key Features

• Initial and Final sets include 30 one-syllable words that begin or end with the target sound.
• The words are simple and are easily understood by or easily taught to young children.
• Combines the target sound with all possible vowel sounds at least once.
• Words are sorted by difficulty level for an easy progression from easy to hard.
• Describes the progression from most intense prompts to least intense.
• Provides a simple carrier phrase for every word.
• A gestural prompt for the target sound is explained.
• A list of therapy activities is included.
• Includes 30 therapy cards with the target word and a picture on the front,
  and the difficulty level and the carrier phrase printed on the back.

Permissions

I give permission to copy, print, or distribute these card sets provided that:

1. Each copy makes clear that I am the document's author.
2. No copies are altered without my express consent.
3. No one makes a profit from these copies.
4. Electronic copies contain a live link back to my original and print copies not for merely personal use contain the URL of my original.

Looking for Feedback

I would love to hear back from anyone who uses the word sets. Let me know if there is anything you would change. Comment on this page, or send me an email at testyyettrying(at)gmail(dot)com.

Where can I find more?

More sets are on my Free Speech Therapy Articulation Cards page.

Card Sets

To download click on the image to open it full size. Then right click on the image, choose "save as" and save the page to your computer.

Instructions for printing and using the cards are included in the set.

The Weekly Review: Week 21

Blog Post that Made Me Think

Chris at RudeCactus.com wrote a post about how much and what kind of information people post about themselves online. He also poses a hypothetical question about online posting behavior. I've wrestled with this issue myself. When I decided to blog about the personal topics of my family and my daughter's Apraxia I decided to use pseudonyms. Dala, Ava, Michael, and all of the other names you see on the blog are pseudonyms. It was just a step that made me slightly more comfortable posting about our personal life on the internet. I am also constantly making judgements about which anecdotes are appropriate for public consumption and which are more private. My husband and I have decided that we are only comfortable posting pictures of the children in which their faces cannot be seen. When I am unsure if my husband will be comfortable about a certain posting topic or picture, I check with him first. I'm sure everyone draws the line between what they're willing to put online and what they aren't differently, but I hope that everyone thinks about it a little.

Weekly Weather Observation

Well, it will hardly come as a surprise that the weather has been extremely hot around here. Reading the news, that statement applies to nearly every area of the US. The thing is, I find myself thinking that I am grateful for that heat to some extent, because it means that winter is not near. I'm originally from New Orleans, LA and still travel there at least once a year. Hot is familiar. Winters that are cold with snow, ice, sleet, and salt all over the roads still feel fundamentally unfamiliar even though I've been living with them for well over half my life. I remember growing up thinking that a jacket was a "winter coat". So, even when it is so hot that I don't take the children outside to play, I'm still glad that I can leave the house without bundling everyone into coats and hats and that I still have daylight at 7:30 pm.

The Weekly Michael

Oh my the volume control has become skewed. All of a sudden Michael seems to be extremely loud all the time as his default volume. I wouldn't say he's quite shouting, but almost. He seems to think that talking at a very high volume is a perfectly normal thing to do. And he's so earnest when he's talking. He really just wants you to hear the VERY IMPORTANT THING he has to share. I hate to interrupt that earnestness with the rather mundane request to "tell me quietly please," but I am starting to feel assualted. It is exhausting, somehow, to be shouted at all day long by an earnest three year old. I suppose my next campaign will need to be constant reminders to use an inside voice.

Ava this Week:

In the beginning I didn't have a name because Ava couldn't talk. That was hard and so when "Mama" came I was so excited. I love "Mama." If I could choose what to be called forever, that would be it. Then, a few weeks ago, Ava switched to "Mommy" completely on her own. I noticed, of course, but I didn't draw particular attention to the switch hoping it would pass and that she'd return to "Mama" at some point in the future.

This week, she has suddenly started calling me "Maw-Maw". Seriously?!? "Maw-Maw?" It makes me feel like an 80 year old grandmother. Definitly not my first choice. Ok. It also makes me giggle a little inside because it is pretty funny. Again, I'm trying not to draw her attention to the shift hoping this too shall pass.

The Weekly Kittens:

The kittens have been sleeping with us. In the beginning it was because we needed to keep them separated from our older cat until everyone adjusted and our bedroom was the most convenient place to accomplish that. Now, we just like it. Every so often, in the middle of the night I will be startled out of sleep by a kitten grooming the tip of my nose. I'm not sure which kitten it is, because it is dark, I'm sleepy, and I can't see without my glasses on anyway, but someone likes to groom my nose in the middle of the night. If you've never been licked by a cat, their tongue is like sandpaper. As cute and sweet as it is to be groomed by a kitten, being awoken by sandpaper rubbing across the tip of your nose in the middle of the night is not the best way to wake up. I adore them anyway.

Parenting Slump

I've been in a parenting slump for the past couple of weeks. Don't misunderstand me. My children are loved. They have food to eat, clean clothes and bodies, a roof over their heads, and toys to play with. They get tickled and listen to stories and songs before nap and bedtime. We've been on family outings recently and we have two new kittens that are a joy to have around.

And yet I just haven't been myself. I've been tired and cranky. I'm depending on television a little more than I'd like and I'm more disengaged than usual. I'm letting perfectly normal child behavior irritate me disproportionately. I am building fewer "special activities" (art project, silly dances, special games that are usually put away) into our days at home.

I am aware of the shift and I know that I want to make a change, but I haven't quite figured out how to yet. I'm not sure what the underlying problem is. It could simply be fatigue. I adore the kittens, but they do cause interrupted sleep on a nightly basis. I can start by trying to get more sleep, eat better and perhaps add in a little exercise. Those things certainly can't hurt. Maybe we just need a change in routine. Shift our daily activities around and try to plan some fun things during the day. The busier we are with some fun activities we all enjoy, the less time that is left over for irritating each other.

If anyone has some suggestions for some fun indoor activities (it is just too hot outside for much outside time), please share some ideas.

Thanks!

NutriiVeda - Four Month (and final) Update

I haven't done a NutriiVeda update in quite some time. Before I give my final thoughts on the supplement, here's some basic information about how we used it. We never used a full two scoops a day, as recommended. The most we ever managed was about 1 1/2 scoops a day. For the first two months or so I was pretty consistent about getting that amount into Ava on a daily basis. After that we used the product fairly sporadically.

When we first started using the product I thought I saw an improvement in Ava's speech. I thought she was talking more often in longer utterances. Looking back, I'd say that the improvement was likely due to a developmental spurt or due to the speech therapy services she was receiving.

When we went on a family visit for about a week and Ava did not take the supplement I noticed no change in her speech and language. When we came home and began taking the supplement again I still noticed no change. After that, our use of NutriiVeda became more sporadic and I didn't put the same effort into getting it into her daily.

Now, Ava also has some suspected sensory issues. We haven't had our OT eval yet. One of the ways this effects her is to make her an extremely picky eater. I like the nutritional profile of the NutriiVeda as a meal replacement. It is high in protein and low in sugar. Several times a week I mix it into some yogurt and I feel good about giving it to her for purely nutritional reasons.

We are still buying the product. The company will let you call and delay the autoship for a month. We do that every other month. So, we're buying the product every other month instead of every month and we're doing that for nutritional reasons rather than because we feel it has had a significant impact on Ava's speech.

After having tried it, with high hopes, this is my final opinion:

If you can afford it, and want to try it, go ahead and try it. Many parents have reported that it works for their child and you can't know if it will help you unless you try it. However, unless the results are dramatic and you are positive that the product helped improve your child's speech, your money would be better spent on additional speech therapy or perhaps some speech therapy products to help you with home practice.

Children's Picture Book Review - Goodnight, Goodnight Construction Site

I wanted to share this picture book with you. Goodnight, Goodnight, Construction Site written by Sherri Duskey Rinker and illustrated by Tom Lichtenheld is a wonderful read. The gentle rhymes tell a delightful bedtime story. The story takes you through the last job of the day for Crane Truck, Cement Mixer, Dump Truck, Bulldozer, and Excavator and then puts each truck to sleep. The illustrations are beautiful and the details in the pictures provide discussion material independent from the story. Both my three year old son and my two year old daughter love this book and join me in whispering, "Goodnight" to each truck in turn. This book is a treasure.

Weekend Update

We had an extremely busy weekend around here. Friday night we went to a local children's museum. As it turned out, we spent the entire evening in their courtyard first in the sand pit, then playing with the little stream and boats, and finally playing with the huge set of foam building blocks they have outside. Some of the blocks were as big as the children. We got home past bedtime, but it was completely worth it.

As is perfectly normal for our children, they did not sleep in even a little because they were up late and so Saturday morning began before 7am. We spent the entire morning in our own backyard. We played in the water and on the playset. My husband continued to work on the deck. He's about 60% done laying the floorboards. After afternoon nap we went to the grocery store. So, an at-home day, but it felt busy anyway.

Sunday morning we rushed out of the house so we could get to the zoo by their opening time of 8am. Entrance to our zoo is free, but between 8am and 9am many of the pay attractions are free as well. We rode the carousel three times in a row which was lovely. We could have gotten into the children's zoo section for free during that hour as well, but we didn't make it. The zoo train didn't start running until 9am, so we wandered a bit. We saw the penguins and bears and went into the bird house. This was really our first visit to the zoo where the children actually seemed interested in the animals. Usually it is just like a big park to them. After the zoo we went to lunch and then back home for afternoon nap.

Sunday evening we drove 45 minutes to a small frozen custard store that occasionally has live bands. Everyone brings lawn or camping chairs and sits in the parking lot listening to the band and eating frozen custard. This week was a Cajun band and we all had a good time. My parents came with us and a friend of the family met us there. The children danced in the parking lot entertaining everyone around them. We got home past bedtime again.

As I am essentially a homebody, I found the whole weekend to be a bit exhausting and I'm quite looking forward to spending all of Monday at home. At the same time, I loved the family time and outings. Building memories. As always, I wish I had taken more pictures.

__________________________

On a completely different note, Sunday was my parents' 40th wedding anniversary. I love them both and I'm looking forward to helping them celebrate many more anniversaries.

__________________________

On another completely different note, I know I have several comments and at least one email to respond to. I love comments and want to respond to them all. Thank you for writing them. As soon as I get a chance to catch my breath and the children give me some uninterrupted time I will respond to all of you.

Final N: Free Speech Therapy Articulation Picture Cards

Description

These articulation picture card sets are designed to be more comprehensive than the typical sets you might find elsewhere. The target audience for these sets are young children or children with more severe speech delays that need intensive practice with sounds at a one-syllable level or simple two-syllable level. No blends or vocalic /r/ sounds are included in these sets. (Scroll down to preview sets.)

Key Features

• Initial and Final sets include 30 one-syllable words that begin or end with the target sound.
• The words are simple and are easily understood by or easily taught to young children.
• Combines the target sound with all possible vowel sounds at least once.
• Words are sorted by difficulty level for an easy progression from easy to hard.
• Describes the progression from most intense prompts to least intense.
• Provides a simple carrier phrase for every word.
• A gestural prompt for the target sound is explained.
• A list of therapy activities is included.
• Includes 30 therapy cards with the target word and a picture on the front,
  and the difficulty level and the carrier phrase printed on the back.

Permissions

I give permission to copy, print, or distribute these card sets provided that:

1. Each copy makes clear that I am the document's author.
2. No copies are altered without my express consent.
3. No one makes a profit from these copies.
4. Electronic copies contain a live link back to my original and print copies not for merely personal use contain the URL of my original.

Looking for Feedback

I would love to hear back from anyone who uses the word sets. Let me know if there is anything you would change. Comment on this page, or send me an email at testyyettrying(at)gmail(dot)com.

Where can I find more?

More sets are on my Free Speech Therapy Articulation Cards page.

Card Sets

To download click on the image to open it full size. Then right click on the image, choose "save as" and save the page to your computer.

Instructions for printing and using the cards are included in the set.

Initial N: Free Speech Therapy Articulation Picture Cards

Description

These articulation picture card sets are designed to be more comprehensive than the typical sets you might find elsewhere. The target audience for these sets are young children or children with more severe speech delays that need intensive practice with sounds at a one-syllable level or simple two-syllable level. No blends or vocalic /r/ sounds are included in these sets. (Scroll down to preview sets.)

Key Features

• Initial and Final sets include 30 one-syllable words that begin or end with the target sound.
• The words are simple and are easily understood by or easily taught to young children.
• Combines the target sound with all possible vowel sounds at least once.
• Words are sorted by difficulty level for an easy progression from easy to hard.
• Describes the progression from most intense prompts to least intense.
• Provides a simple carrier phrase for every word.
• A gestural prompt for the target sound is explained.
• A list of therapy activities is included.
• Includes 30 therapy cards with the target word and a picture on the front,
  and the difficulty level and the carrier phrase printed on the back.

Permissions

I give permission to copy, print, or distribute these card sets provided that:

1. Each copy makes clear that I am the document's author.
2. No copies are altered without my express consent.
3. No one makes a profit from these copies.
4. Electronic copies contain a live link back to my original and print copies not for merely personal use contain the URL of my original.

Looking for Feedback

I would love to hear back from anyone who uses the word sets. Let me know if there is anything you would change. Comment on this page, or send me an email at testyyettrying(at)gmail(dot)com.

Where can I find more?

More sets are on my Free Speech Therapy Articulation Cards page.

Card Sets

To download click on the image to open it full size. Then right click on the image, choose "save as" and save the page to your computer.

Instructions for printing and using the cards are included in the set.

The Weekly Review: Week Twenty

Great Blog Post this Week

Mayim Bialik writes about discovering that her son is color blind. I found reading the post valuable not so much because of the story of her discovery (although I liked that too), but rather because of her description of the parenting moment and the lessons she took away from the experience.

The Weekly Parenting Technique I Said I'd Never Use, But Did

Michael has been whining incessantly lately. Well, at least it seems that way. It started before he was sick last week, but then last week I gave in to the whining a lot because he was so pitiful and this week it has been so much worse. I tried not responding to the whining at all. I tried calmly replying, "I can't understand you when you talk that way." Neither technique worked.

Finally I began whining back. I didn't do it in anger or frustration or from a desire to make fun of him. I was just desperate. I told him calmly that I didn't like his whining voice. It was not a nice way to ask for things. I told him that from now on, whenever he whined at me I was going to whine back. And then I did. When he whines at me, I reply, "I can't understand you when you talk that way to me." And I do it in an incredibly exaggerated annoying whiny voice. He immediately cues in to the problem and makes a visible effort to reign in his own whining. The technique gets his attention and works every time (so far). So, even though I don't prefer the whole if-your-child-hits-you-hit-them-back method of parenting in general, in this case, whining back at him seems to be working when nothing else did.

The Weekly Ava

Periodically this week when we are sitting on the floor playing in the playroom Ava will ask me to lie down. After I lie down on my back she climbs on top of me, chest to chest, settles her head on my shoulder, and hugs me. Those are treasured moments for me. A second later, she's up and running again.

The Weekly Michael

"She likes me." Michael said that, in amazement and wonder when one of the kittens came to him for some attention. I am so enjoying watching the kittens get to know the children and vice versa.

Weekly Moment When I Realized My Children Are Older and It Is Wonderful

I took Michael to his second ever dentist appointment this week. For his first ever dentist appointment my husband took off work and watched Ava while I took Michael. This time I dragged both children by myself. Everyone was wonderful. Ava sat in a chair while Michael got his teeth cleaned. They were both adorable and impressed everyone there. The entire experience was easy and fun. Both children got balloons and small toys and new toothbrushes. Perhaps we'll even get Ava to participate next time...

Do you think we'll look back...?

Do you think we'll look back ten years from now and wish we could tell our past selves to relax? Tell that past self that it really will all be ok?

Even now, only six months after our first official evaluation, I wish I could go back to the me that was sitting in front of the computer writing that first post while wiping tears away that things will get better soon. The worst of my fears on that day are not going to come true. Ava can talk. She does not have severe apraxia and we're seeing relatively quick progress. The intensity of those first emotions does fade. Life has moved forward and we have found a new equillibrium.

We are raising a daughter for whom talking is difficult rather than a natural miracle like it is for the rest of us. She needs help and practice to learn to talk and that process will be measured in years rather than in months. I've accepted that. It is simply our new reality. Our lives are so complex and are made up of so many events that the speech issue is really only one small part of the whole. And the whole picture of our lives is a good one. I really do believe that in my heart.

Then there are the fears that creep in late at night, or after a particularly difficult day. At those time I wonder if I'll look back at the day I wrote this post and wish I could tell her that there are unanticipated struggles ahead and that I need to be more vigilant.

Initially, I was nothing but grateful over the extra OT services Ava will be receiving. As it sinks in that she is receiving those services because experienced professionals believe that there is a whole additional area of concern I had previously missed, I find myself struggling again to adjust.

I can wrestle with all these thoughts endlessly, but the bottom line is that Ava is always the same. She is my daughter. She loves me and I love her. A new opinion, service, or diagnosis does not change who she is. Like all other children she needs love, space, encouragement and excellent teachers to help her learn and grow into the best person she can be. I will continue to provide her with those things to the best of my ability and let the future take care of itself.

Our First, and Only, 6-Month IFSP Meeting

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

As it turns out, I didn't need to worry quite so much about that. I was careful to stay focued on her needs rather than her successes, but I did not exaggerate her needs. The main ones I see right now (in no particular order) are:

• The more stress she's under, the more difficulty she has communicating. So, when she's upset or hurt, that is when she tends to lose her words. Those moments are exactly the ones in which you need for her to communicate the most.
• Although Ava is making many communication attempts at home, she is reluctant or unable to communicate at school with her teachers and peers. At school she'd often rather go without than try to tell someone what she needs. At school she doesn't even try to talk to the other children in the classroom. That situation just breaks my heart and I desperately want to see improvement there.
• As an SLP, I continue to recognize the comprehensiveness of the speech delay in terms of intelligibility, but early intervention won't really write goals for specific speech sounds or intelligibility issues because there is such a wide range of normal at this age. That doesn't make it less valid, just something out of the scope of early intervention apparently.

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

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

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

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

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

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

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

Thoughts about IFSP Meetings

In order to qualify for services, children need to meet specific criteria. That's necessary. I get that. No one wants to provide therapy to children who don't really need it, and we can't afford to treat everyone who is even a little delayed, so you set a criterion and treat the children who need it the most. It is practical and theoretically fair if the same criteria are applied to everyone.

However, when the system is set up in this way it causes stress and tension. Parents want therapy for their children and are nervous about qualifying. When the time comes for a new meeting, the parents are hesitant to celebrate their child's successes because they are afraid they may no longer qualify for services that are still very much needed.

So, instead, you focus on all of the areas in which your child still struggles. It makes the meetings more than a little depressing. And although early intervention can be a wonderful experience and resource for families (it is for us), the time frame for early intervention ends so early. Ava will have been in the early intervention program for only a little over a year and then she will age out.

Then you have to start the whole process over again with your local school district and their criteria are even harsher. At yesterday's IFSP meeting, our service coordinator mentioned that next month we will need to hold a transition meeting. The purpose of that meeting, as I understand it, is to introduce us to the school district people that will be handling evaluating Ava to see if she qualifies for their services when she turns three.

And so time, and the special education processess, marches on.

(more on how our IFSP meeting went tomorrow)

Nervous

Later today is our first IFSP six month review meeting. I will be there along with Ava's therapist and our service coordinator. I'm not really sure what to expect and that always makes me a bit nervous. I think the purpose of the meeting is just to check in and see if Ava is making progress towards her goals and make changes if necessary.

Ava has done so well in her first six months of therapy. It is hard to believe six months has gone by already. Ava has gone from being a practically non-verbal child who couldn't imitate and had only three consonants and a handful of vowels to a child who is chattering non-stop at home. We can't understand her all the time of course. She is particularly difficult to understand when the sentences are longer or when she's talking about something out of context. But what amazing progress in such a short time.

But here's the twist. I'm afraid to say so. Somehow, I'm afraid that if I talk about how proud of her I am, and what a wonderful job her therapist has done that they will conclude she no longer qualifies for services and take that away from us.

So I think I'll squash my usual nature and try not to talk much at the meeting. I'll try to listen and only respond when necessary and walk carefully. Perhaps I am worrying without cause, but better safe than sorry.

When I get a chance, I'll let you know how the meeting went.

Final M: Free Speech Therapy Articulation Picture Cards

Description

These articulation picture card sets are designed to be more comprehensive than the typical sets you might find elsewhere. The target audience for these sets are young children or children with more severe speech delays that need intensive practice with sounds at a one-syllable level or simple two-syllable level. No blends or vocalic /r/ sounds are included in these sets. (Scroll down to preview sets.)

Key Features

• Initial and Final sets include 30 one-syllable words that begin or end with the target sound.
• The words are simple and are easily understood by or easily taught to young children.
• Combines the target sound with all possible vowel sounds at least once.
• Words are sorted by difficulty level for an easy progression from easy to hard.
• Describes the progression from most intense prompts to least intense.
• Provides a simple carrier phrase for every word.
• A gestural prompt for the target sound is explained.
• A list of therapy activities is included.
• Includes 30 therapy cards with the target word and a picture on the front,
  and the difficulty level and the carrier phrase printed on the back.

Permissions

I give permission to copy, print, or distribute these card sets provided that:

1. Each copy makes clear that I am the document's author.
2. No copies are altered without my express consent.
3. No one makes a profit from these copies.
4. Electronic copies contain a live link back to my original and print copies not for merely personal use contain the URL of my original.

Looking for Feedback

I would love to hear back from anyone who uses the word sets. Let me know if there is anything you would change. Comment on this page, or send me an email at testyyettrying(at)gmail(dot)com.

Where can I find more?

More sets are on my Free Speech Therapy Articulation Cards page.

Card Sets

To download click on the image to open it full size. Then right click on the image, choose "save as" and save the page to your computer.

Instructions for printing and using the cards are included in the set.

Initial M: Free Speech Therapy Articulation Picture Cards

Description

These articulation picture card sets are designed to be more comprehensive than the typical sets you might find elsewhere. The target audience for these sets are young children or children with more severe speech delays that need intensive practice with sounds at a one-syllable level or simple two-syllable level. No blends or vocalic /r/ sounds are included in these sets. (Scroll down to preview sets.)

Key Features

• Initial and Final sets include 30 one-syllable words that begin or end with the target sound.
• The words are simple and are easily understood by or easily taught to young children.
• Combines the target sound with all possible vowel sounds at least once.
• Words are sorted by difficulty level for an easy progression from easy to hard.
• Describes the progression from most intense prompts to least intense.
• Provides a simple carrier phrase for every word.
• A gestural prompt for the target sound is explained.
• A list of therapy activities is included.
• Includes 30 therapy cards with the target word and a picture on the front,
  and the difficulty level and the carrier phrase printed on the back.

Permissions

I give permission to copy, print, or distribute these card sets provided that:

1. Each copy makes clear that I am the document's author.
2. No copies are altered without my express consent.
3. No one makes a profit from these copies.
4. Electronic copies contain a live link back to my original and print copies not for merely personal use contain the URL of my original.

Looking for Feedback

I would love to hear back from anyone who uses the word sets. Let me know if there is anything you would change. Comment on this page, or send me an email at testyyettrying(at)gmail(dot)com.

Where can I find more?

More sets are on my Free Speech Therapy Articulation Cards page.

Card Sets

To download click on the image to open it full size. Then right click on the image, choose "save as" and save the page to your computer.

Instructions for printing and using the cards are included in the set.

The Weekly Review: Week Nineteen

This week the Weekly Review will appear in a slightly different format.

List of Notable Events this Week (in order of occurrence)

• My wonderful parents took both children overnight from Saturday morning through Sunday afternoon. It was bliss.
• My husband and I celebrated by accomplishing one of the items on our "We will do this at some point in our lifetime" list. We adopted two kittens from the same litter and brought them home.
• Michael caught a cold.
• The kittens spent four hours lost in my own house. It turns out they were stuck behind the washer and dryer.
• Michael's cold turned croupy.
• (Warning: Slight icky factor ahead.) One of the kittens developed bloody diarreah. Mental note to call vet and shelter in the morning. Decide to quarantine kittens until further notice.
• Michael woke up much worse. Called pediatrician. Spent 4 hours at hospital with two young children to confirm original diagnosis of croup. Went home with no new information and no new treatment plan. (Instead of dealing with sick kitten.)
• Noticed that kitten's problem is intermittent, but still present. Called shelter and vet to begin working on the issue. Waiting for vet appointment later today.

Minor (I hope) Health Crisis - Update

We arrived for our appointment 10 minutes early. We were seen relatively quickly, probably no more than 10-15 minutes past our appointment time. Michael's temperature was normal and his oxygen levels were fine. Of course, his temp was down because I gave him acetaminophen this morning and it hadn't worn off yet.

Our pediatrician came in and agreed that Michael sounded croupy but was obviously bothered by the fact that he got a fever first and the croup second. Apparently that's not the usual order of operations. So she did order that chest x-ray. She also added in an upper airway x-ray too. She didn't tell me this at the time, but she was worried he had some kind of abscess in his upper airway.

Now, our pediatrician's office is in a building attached to a hospital so we just went down an elevator and traveled a long corridor to radiology. We sat in a waiting room and waited our turn to give them our order papers and then sat back down to wait for the x-rays. The children were so good. First we used the coloring books and markers. Then we used the paper and stickers. Then we used the popsicle sticks and fuzzy yarn to make (Hmm, can't think of what they're called...little diamond shaped things...very pretty....off on an internet search to find name...really? That's what they're called?) God's Eyes. Then I pulled out a book and we did nursery rhymes and songs. Now the natives were really restless so my husband pulled out the iPad and let them watch a little television.

I wasn't really paying attention to the time because I was so focused on keeping the children entertained, but my husband tells me an hour and a half passed by. Then someone came in and said, "There you are, you're supposed to be in the other waiting room. We've been looking for you guys." Seriously!!!!! Turns out the other waiting room was a 5 second walk down the hall. They couldn't have checked the front waiting room a little sooner?

So, we go down to the other waiting room and wait some more. Finally it is Michael's turn. He was a trooper. By now it was past his usual nap time. He's sick and hungry and his fever had returned so his patience and bravery were a little low. He got through the first two (front and side of chest) like a champion following all the directions and in a fairly good mood, but by the time they did the second two (back? and side of the neck) his patience was a little low for the constant directions to lift his chin just a little more. We got through though. Then we had to wait to make sure they all came out well. Ten minutes later we needed to go back for another chest x-ray.

Finally we headed back up to the pediatrician's office where we waited 15-20 more minutes to see our pediatrician again. They told us that they had to call down to radiology to ask about us and that was the only reason they came looking for us. Wow.

So, after all of this..... The x-rays showed he has croup. Which we already knew. It only took 4 hours at the hospital with two children under the age of four to confirm. Sigh.

The children were so exhausted. By the time we got home it was two hours past their usual nap time. They did well though. I'm proud of them. And I'm thankful that my husband left work and came to help with Ava while I focused on Michael. And I suppose I am also grateful that it is nothing worse.

End of story.