The Weekly Review: Week 26

Weekly Blog

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

Michael's Moment

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

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

Ava this Week:

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

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

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

Therapy and Hierarchies of Difficulty

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

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

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

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

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

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

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

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

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

Itsy Bitsy Butterfly

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

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