The Weekly Review: Week 64

SLP Resource of the Week

E.J. at toddlerapproved.com came up with a simple idea for using matchbox cars as a learning game to address early language concepts such as colors, counting, matching, directions, and prepositions. She simply printed out parking lots with rectangles the size of the cars. Pre-print some with colors already in, and leave some blank. Your child/student can color their own pattern and then park the cars in that pattern. She includes a link to some printables she's already made.

Blog Post of the Week

My favorite blog post this week was short and sweet, but I found it inspiring in a way I find difficult to articulate. I just enjoyed Jessica's son's ingenuity and her excitement and pride in observing it.

Ava this Week

So many things seem to be going on with Ava lately. The strong independent streak she's always had is blossoming further. I can't help her climb down from her carseat, help her choose or put on her clothes, or help her take her clothes back off. And yet, when she determines she'd rather have something done for her she can ask oh so sweetly. She's just so adorably manipulative.

Michael played "camp-out" one morning by spreading every blanket he could find on the floor of his room. Since then, Ava has been sleeping on her floor instead of her bed on a little pallet made of blankets. She seems quite happy there and sleeps the usual amount of time, so why not?

She was delighted to return to speech this week for the first of the four summer sessions provided by the schools. She loves going to "big girl speech" and the program is well designed and implemented so I couldn't be happier with the services we're receiving from the schools.

Weekly Michael

I was sitting on the floor working on a project and Michael wandered over. He clearly had something on his mind that he wanted to discuss and I was curious about what he wanted to share. "Mama..." he began. "If we have an accidental baby it can sleep in Ava's room."

Umm...

It took me a moment to process what exactly he was talking about. "Well, sweetheart," I countered, "We're not planning on having an accidental baby. Usually mommies and daddies plan to have babies when they want to start a family, or if their family isn't big enough yet. Our family is complete. There's you, and Ava, and Mommy and Daddy and that's enough for our family."

Michael was not to be deterred from his hypothetical sibling though. "Yes, mama..." he replied in an exasperated voice, as if I weren't paying enough attention, "but if we had an accidental baby we could let it sleep in Ava's room."

I'm pretty sure I heard by husband lingering in the hallway snickering to himself as he eavesdropped on the conversation going downhill from there. I would have done the same thing. It was actually pretty funny in retrospect.

Ava's and Michael's Weekly Home Therapy Notes

It's kind of been a slacker week on the home therapy front. I blame summer. :-)

Losing a Syllable: Bittersweet

Daddy has become Dad. Mama has become Mom. Michael articulates the single syllable distinctly and with a flavor of satisfaction. It feels right. He turned 4 1/2 a couple of weeks ago and I didn't even notice the half-year anniversary. He's getting older and more mature right on schedule. Somehow, I simultaneously enjoy hearing him call us by slightly more mature labels and feel a little twinge of sadness for the extra syllable I lost. I loved "Mama". At least I get to hold on to it a little while longer with Ava.

Article Response: 'Sensory Integration Therapies' Lack Evidence, AAP Says

I recently read a news article: 'Sensory Integration Therapies' Lack Evidence, AAP Says. Recently the American Academy of Pediatrics has announced that there is little research-based evidence for Sensory Processing Disorder (SPD) and sensory integration therapies designed to address SPD. The article is well written. It begins with an anecdotal personal story about a now-grown child with SPD who greatly benefited from therapy. The article goes on to review the lack of quantitative research in the field. However, the author interviews experts in SPD who discuss the work going on right now and progress being made and so overall the article is very well balanced.

My response to this article is personal - not professional. I am not an expert in SPD in any way. When Ava had just turned two, she was an essentially speechless and fearful child. The few pseudowords she had been attempting were being abandoned as she turned to gesture to communicate. She was scared to go to daycare and would only play at playgrounds and indoor playplaces when they were empty. As an SLP, I focused in like a laser on the delayed speech and attributed everything else to side effects of her being unable to communicate.

We began speech therapy and she made great progress at first. Her phonemic inventory expanded. After using communication boards and sign language as a bridge for a few months, her dependence on gesture began to decrease. She began using words and then word combinations. I was elated. Then there was a significant plateau.

I finally began to pay attention to some other issues. Even though we were getting lots of verbal communication at home, she was still silent at school. At a noisy playground she wouldn't leave my side. At a relatively quiet playground, she'd go play only until another child approached her. Then she'd retreat. She loved the bath, but hair and face washing was terrifying for her. Brushing teeth was a nightly screaming and wrestling match. She was an extremely picky eater and getting worse fast. She was also extremely sensitive about touch. She always, even as an infant, preferred to eat with silverware rather than her hands. She wouldn't touch (and definitely wouldn't eat) messy foods. She wouldn't fingerpaint or otherwise engage in messy media. It wasn't until I brought up some of these issues at an IFSP meeting that our case manager and speech therapist noticed the huge red flags that were, in retrospect, extremely obvious. At that point we got an OT evaluation and began receiving services to address sensory issues.

The change in Ava following six months of sensory-based therapy was nothing short of life altering for our family. Ava is still a picky eater, but well within a typical range for a 3 year old. She plays normally on a playground and interacts typically with her peers. She enjoys participating in art activities even when that involves fingerpainting or helping me mix up a salt dough with her hands. We can wash her hair and brush her teeth without pinning her down while she screams. And those things are just items on a checklist.

Fundamentally, she is no longer overwhelmed by her world. It is a profound relief to watch my daughter experience her world comfortably rather than through the defensive shield she was trying to erect to try to protect herself from overstimulation. Not coincidentally, her communication improved at the same time. She began to use her speech in school and in social settings. The additional practice and carryover skills resulted in functional improvements and also broke the plateau in terms of learning new speech skills as well.

I know we are not the only family to experience profound changes as a result of therapy designed to address sensory issues. I talk to other parents who have had similar experiences regularly. I sincerely hope the specialists in this area continue to do quantitative research and begin to publish.

My recommendation at this time would be that an OT evaluation couldn't hurt. If sensory issues are an issue for your child do a trial period of therapy with an occupational therapist experienced in the area of SPD. Judge for yourself whether or not you are seeing changes. For us, I knew significant changes were in the works after about 2 months of therapy and we were discharged after six months of therapy. Post-therapy, Ava interacts with her world in a much more typical fashion. I also continue to use some techniques and strategies taught to me by our OT to maintain that progress (particularly in the area of eating). That six months of sensory therapy with an amazing OT was absolutely one of the best things we've done for Ava and I have no regrets or doubts about the therapy's effectiveness.