The Weekly Review: Week 43

Weekly Main Event

Ava's IEP meeting was held Thursday morning. It went well. She'll be receiving 90 minutes of speech therapy a week beginning on her birthday and 15 minutes of consultative services/month beginning in the fall when she moves from daycare to preschool. It's nice to actually be anticipating the benefits of the transition from early intervention services to services provided by the schools. The program she'll be entering seems to be extremely well designed and well suited to her needs. I am excited and thankful that she'll have the opportunity to participate.

Ava this Week

Completely spontaneously, with very little encouragement or input from us, Ava has begun to night train. She's been potty trained during the day since well before she turned two. She just picked that up when we were training Michael. Over the last week she has begun to wake up in the middle of the night disoriented and somewhat panicked wanting assistance in going to the potty. She takes great pride in trying to keep her nap and nighttime pullups dry.

I am proud of her, of course. Is it terrible to admit that the return to inconsistent and unexpected night time wake-ups is very unpleasant? I wonder how long this will last? When will she learn to just take herself? Or, even better, just be able to hold it until morning?

Even with the inconvenience and disrupted sleep it is still a huge milestone and I'm simultaneously proud of her and amazed at how big she's getting.

The Weekly Michael

Have you ever heard the phrase, "If you don't have anything nice to say, don't say anything at all."?

Let's just say that the combination of my stress level this week and subsequent impatience and Michael becoming a little older and more independent and stretching his wings has been a bit...unfortunate.

I'm desperately trying to be more positive and use more redirection. And I'll just leave it at that.

Ava's Weekly Home Therapy Focus

We're continuing to work on initial and final /k, s, sh, and f/. We're also working on initial /l/.

We chose /k/ months ago because Ava was fronting everything and didn't really have any back sounds at all. We finally have an approximation of /k/, but some nights it comes out flawlessly on every repetition of every word and other nights she substitutes /t/ every time and nothing I try changes that. Ahh, lovely motor planning problem.

We added /s, sh, and f/ recently because Ava wasn't really using any fricatives and she was stimulable for all three. She's doing remarkably well with all of them. /f/ is particularly easy for her and I'm already seeing occasional spontaneous generalization in conversation. /s/ is pretty good and with a gestural cue I can get a good production every time. /sh/ is a bit more difficult, which makes sense given that she has more difficulty with sounds that are produced further back in the mouth. However, with more intensive cueing, she's pretty successful there as well.

We added /l/ because it is a phoneme she uses daily. It is in the name of someone in her life. She really struggled with it for the first few weeks, but this week it has really clicked for her. She seems to enjoy it and is spontaneously using it correctly in conversational speech. It's a thrill for me every time. I love hearing the beautiful /l/ and enjoy watching her pride in making it.

Grace Under Pressure - Not So Much

PSA: Pitiful whiny post ahead. Feel free to not read this one. :-) You have been warned.

This is a rough time of year. I love the holiday season, but it is intense. There are two major holidays in a row and big breaks in the daycare/preschool routine. (Therefore, less breaks for Mama.) We also have our annual trip 12 hours away taking our little ones away from home for 5 days.

This is also the exact same time frame that Ava's special education eligibility evaluation was held. I've also been informed that our IFSP is going to need to be updated even though it will only be in effect for approximately five weeks before she ages out. Our first IEP meeting is scheduled for later today.

Paperwork needs to be filled out to prepare for the IFSP meeting. Paperwork needs to be filled out for the IEP meeting. I scheduled a visit to the special education preschool classroom. I need to set up pediatrician visits. I haven't had enough sleep in weeks. I've been ill at least twice during this time frame. The children have each been ill 2-3 times and my husband and mother have been ill as well.

I'm limping along trying desperately to keep things together and still be a pleasant, cheerful, effective, and efficient mother/wife/therapist/friend/acquaintance, but the cracks are beginning to show. I'm less than patient with the children, Michael in particular, and I'm feeling pretty guilty about that. I had a "thing" with my husband - which never happens. Seriously, we're in sync 98% of the time. It was strange and disorienting to be upset with him. Fortunately we had that patched up in less than 36 hours.

I'm having trouble focusing on tasks that need to be done. My /s/ sets for Ava have been sitting 25% done for almost a week. If I could focus and finish them up I could be using them with her and sharing them with you. But when I do find the time to sit at the computer, my mind rebels and I end up randomly web browsing remembering little when the snippet of free time comes to an end.

The IEP meeting will be done in a few hours. The mostly token IFSP meeting will be done next week. Hopefully, things will settle a little after that and I'll have a chance to regroup. Well, until her birthday. Then everything shifts again. I suppose that's just how life works. This parenting a child with special needs is an endless exercise in flexibility. Someday I'll be an expert in that, right?

First IEP Scheduled

Our first IEP meeting will be tomorrow morning. My original guesses about placement options were incorrect. As it turns out, we are going to be served by a different school district than I expected. Essentially, since Ava is not old enough to be enrolled in the optional preschool program in our home district, they assigned her to the school district her daycare is in.

The district she's being served by is larger than our home district and so is able to offer a special program for speech-only preschool children. Essentially they have intensive 45 minute speech sessions offered from 2-4 times a week. There are no more than 9 children in a class and there are two certified SLPs and one speech assistant. The children are separated into three groups (high, medium, and low) and the program is run according to a Hodson's Cycles Phonological Approach. One target is chosen per week and worked on intensively. Each session begins with auditory bombardment and data is taken daily. Another placement option would be for an SLP to see her individually at daycare. That would probably be once a week for an hour, but I could try for twice a week for 30 minutes each. In this district, word of mouth says that they feel a special education preschool classroom is too restrictive for a speech only student, although that wouldn't be determined without a full team at the IEP meeting.

I like the sound of the intensive speech sessions. I'm not sure what their criteria are for recommending two vs. four sessions a week, but I'm going to argue that Ava could certainly benefit from four sessions a week. I think I would prefer to have her participate in that program to less time spent individually. I feel like she would benefit from a well-organized cycles approach in addition to the intensive, individual motor-planning style therapy she's getting from me. Logistically it is going to be challenging. I'll be responsible for transportation which means I'll have a two hour round trip to fit into our schedule 2-4 days a week. Even the thought of that makes me cringe, but you do what you need to do. I can't turn down this kind of opportunity even if the logistics are difficult.

So, that's the story at the moment. We'll see what actually happens at the meeting.