Clear as Mud (Trip to the Allergist)

Yesterday afternoon was Michael's allergist appointment. We were there to discover if allergies are playing a part in his nasal congestion and habitual mouth breathing. When we made our appointment we were told to make sure he wasn't on any antihistamines for 5 days prior to the appointment so that skin testing would be valid if the doctor decided to test.

Monday night, and again the morning of the appointment I told Michael that we were going to a special doctor to help figure out why he has trouble breathing through his nose. I told him the doctor might decide to do a special detective test to figure out if his body is allergic to certain things. I explained that some people have bodies that get confused and think regular things like tree pollen and cat or dog hair are germs. Then those people might get stuffy noses when they are around those things.

I told him that the nurse would write on his back and use a special device to poke his back several times. I showed him some of the less scary google image search results of pictures of skin testing on children's backs. I think I struck a good balance, because he was intrigued at the idea of the "detective test", but not scared.

After collecting a little bit of family medical history and listening to my concerns, the doctor decided to do a skin test. I held a shirtless Michael in my lap with his chest to my chest. His arms were around my neck. The nurse drew some lines and numbers on his back first and then cleaned his back with alcohol soaked cotton. This made him giggle. She had all seven pricking devices ready to go. She was two down before he realized that he didn't much like what was going on. She got two more done before he managed to voice his first complaint. She was done by the time I finished telling Michael he could choose a small bag of candy when we were done.

When he realized she was finished he decided it wasn't worth getting upset and asked for his candy instead. After that he hopped back up on the exam table and watched Wall-E on the iPad for the 15-20 minutes it takes to complete the test. I only had to remind him he couldn't touch his back once or twice. The kid loves Wall-E.

The doctor came back in to read the test results. As far as I could tell that was based upon the size of the wheal (mosquito bite like bump) in each spot. Her rating could be from 0 (no reaction) to 4++ (large reaction). They tested 54 things. Michael had no reaction to 32 of those. He had a 1+ reaction to 13 substances. He had a 2+ reaction to 2 more. He had a 3+ reaction to horse, cat hair, pigweed, and kochia. He had a 4+ reaction to dog. He had a 4++ reaction to oak. Well, that seemed like a lot of reactions to me.

Then she explained that the magnitude of the reaction does not correlate to the magnitude of actual allergy symptoms experienced by the patient. ?!?! So, some people might have a huge allergic reaction to something their allergy skin test showed as 1+ and no reaction at all to something their skin test showed as 4+. The only thing she could say for sure was that the substances he didn't react to at all would be unlikely to cause allergy symptoms. So, of the things he does react to (21 things!) any of them could be causing the most trouble? Or all of them? Or none of them? Well, how on earth is that useful at all?

I left with the instructions to continue Flonase at night and try switching from Claritin (which didn't seem to help) to Zyrtec in the morning. Call her in 8 weeks if that doesn't seem to be helping. In addition to the medical treatment we should try to reduce allergens in our home starting with keeping the cats out of his bedroom and washing all his bedding in hot water once a week.

Somehow I expected more. I thought we would get a definitive answer about whether or not allergies are contributing to the mouth breathing problem. I thought that if allergies are a contributing factor we'd know which ones, specifically, are the problem and could react accordingly. Instead, she isn't actually convinced allergies are the issue. Any allergic symptoms could be caused by one of 21 things. And taking medicine and cleaning the house may or may not help.

Great. Clear as mud.

I'm hoping the ENT visit on Friday will be much more helpful. Aren't I the optimist?


__________________

One year ago I wrote a post on how to use gestural prompts during therapy with children with apraxia (or any other severe speech delay). One year later we still use gestural prompts in every single therapy session. They are a powerful therapy tool. The video I linked to in that post is very helpful if you've never actually seen someone using gestural prompts before.

Initial V: Free Speech Therapy Articulation Picture Cards

Initial /v/ Card Set

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.

I recommend you print on cardstock and laminate for durability.

Description

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

Key Features

• This set includes 12 therapy cards with the target word and picture on the front, and the difficulty level and a carrier phrase on the back.
• The words are all CV or CVC in syllable shape.
• 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.

Permissions

I give permission to copy, print, or distribute this card set 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 this card set. Let me know if you find errors or 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 Set Activity and Game Suggestions

1. 10 Card Set Game and Activity Ideas
2. Simple Speech Card Puzzles
3. Speech Card Stories
4. Speech Card Caterpillar
5. Speech Card Game: What's Hiding?
6. Speech Card Game: Speech Switcheroo (An Uno-Style Game)
7. Speech Card Game: Magnetic Speech Cards

Contemplating Homeschooling

I have two children who are only a little over a year apart. From late 2007 through late 2010 I fantasized about sending my children to school. It was going to be the best thing ever. I would first spend a year at home regaining my sanity and then consider going back to work part or full time.

I like my profession. Becoming a parent also gave me a whole new perspective. Becoming a parent of children with speech issues gave me new insight. Getting back into the schools as an SLP would be wonderful. I itch to exercise my skills with children who need help (other than my own). I want to use my professional skills. I want interact with other adults. I want to make a difference in the lives of children.

And yet, a little over a year ago I found myself beginning to daydream about homeschooling. My children were outgrowing their toddlerhoods and entering into the preschool years. We were able to start doing some structured activities. Michael began learning his letters, letter-sound correspondences, and how to read practically by himself. It was all exciting and fun. And I was following some blogs of homeschooling parents. And so the occasional daydreaming began.

There are so many advantages. We would get to dictate our own schedule rather than having it dictated to us. We could visit family without worrying about missing school. I could customize content and pace of learning to each child individually. It is more efficient. We could accomplish in 2-4 hours a day what a school takes 7 hours to accomplish (not counting the homework time schools involve on top of school hours). My children could have stimulating, individualized education and still have time leftover to spend with family, pursue independent activities, play, and just be kids.

I feel like homeschooling could be a gift. It is a gift to the children. They get to learn at their level and pace with time leftover to spend with family and just be kids. It is a gift to our family. Instead of yanking everyone out of sleep and rushing out the door in the morning we can determine a schedule that works for us. Instead of picking kids up from school and doing homework until dinner, dinner, bath and bedtime we would have time for recreation, exercise, activities, and play. When we get invited to a special family event in Louisiana (ex. Easter Crawfish Boil/Birthday Party) we could go because we wouldn't have to be back at school on Monday.

On the other hand, it wouldn't all be roses. It is expensive. We'd need curriculum materials and we'd be giving up my salary indefinitely. I'd give up the opportunity to practice my profession. That's huge.

Another challenge... Hmm. How do I put this? It's an awful lot of together time. I love my children, but I know myself. I need a certain amount of "by myself" time in order to stay sane and happy. That's just who I am. I get that time right now during the two mornings a week the children are in preschool. If we went to full-time homeschooling I would need some way to get a minimum amount of time to myself, in my own home, to stay sane.

I also have to remind myself that in daydreams everything is perfect. The children are always perfectly behaved. Learning is easy, seamless, and fun. Lesson plans and materials magically present themselves to be used at just the right moment. Meaningful friendships and socialization for the children develop easily through some as yet to be determined activities/homeschooling groups. There are rainbows and unicorns. No one ever gets sick. You get the idea. I know that reality will be different.

And then I start browsing potential homeschooling curriculum materials. Oh, bliss. I love browsing curriculum materials. There are so many good options out there. I have already decided on some. You know, if I were to homeschool, I would use... Just theoretically.

I haven't made any decisions. Michael has one more year of preschool before he'd be starting kindergarten so I have time to decide. I'm thinking of getting some homeschool materials and trying them part-time in the meantime to get a feel for it. (Hello Rightstart Math Level A!... Hello Handwriting Without Tears preschool curriculum!)