4th and assessment results

So, I'm off to a slow start on my July blogging, but am getting back in the game.

We had a great 4th of July. The kids all wore their red, white and blue and Emma was able to thank a service man in Target who was in uniform. He was really nice to her and it was the perfect thing to do on the 4th. We did most of our celebrating on the 3rd, starting with a visit to my parents' house. We brought the blow up pool and the kids had a blast in their back yard. They cooked a great lunch for us. That evening, Danny's parents brought dinner over for us and we ate really well, again! Both of our families were great to us and gave me a nice break from cooking for the day. We watched fireworks from our front yard. I have always loved fireworks and have great memories of watching them growing up and hope to create some of those same memories with the kids as they get older. For now, we'll settle with Emma thinking it's awesome to see our neighborhood fireworks from the front yard.

I think Emma is starting to get a little bored with being home, but when I suggest some new things to do, she isn't interested. She's been acting out more than normal and I'm not sure if it is just part of her age and becoming more independent with her words and actions, or if she is using that for more attention now that Kate is here on top of our lives being turned upside down with all that we're doing for Josh. We'll figure it out and I pray it is just temporary. She is a sweet little girl and I don't want to spend my days punishing her more than praising her. She and Josh can be quite a comedic pair (see below). Last week, the kids wanted an umbrella stroller from the garage and were pushing it around the house. Josh went and got Emma's bike helmet and brought it to me to put it on. I put it on him and he went to sit on the stroller. I asked if he wanted me to push him and he replied, "No. Emma." He wanted Emma to push him. She was "busy" doing art, but he was all smiles waiting for her. I made her come see him and asked how she could resist playing with that smile?!? She obliged and they had a blast!

Kate had her 4 month checkup this morning. She's up to 17 lbs. 3 oz and 26" long. She was in the 30th percentile after birth and is finally in the upper 90s like her older sister and brother were. She's very healthy and looks good! Josh has been showing a lot of affection toward her lately and really wants to give her kisses. Thankfully, he is much more gentle with his touch than he used to be. I tried to capture a kissing moment while Kate was in my lap. So sweet!

On the treatment front, we are all set to see an autism specialist in Austin in September. We will be heading to Thoughtful House in mid-September. After visiting with our nutritionist last month, she expressed some concerns with the vitamin dosages from our pediatrician. It really woke me up! I believe we are on the right path to treating Josh, but I want an expert to oversee Josh's treatment. We are working with mega-doses of vitamins and that can be toxic if not fully understood. I have done quite a bit of reading from the doctors at Thoughtful House and think that's the right place for us to be. My gut says our nutritionist is top notch and I had her re-work Josh's vitamin prescription, but I need someone on the medical side as well. I started the process to get Josh seen at Thoughtful House, beginning with about 2 hours of online forms, a complete medical, nutritional, developmental description of Josh. Since then, I've had a call with one of their coordinators to review all that information and gather more details. I faxed them all assessment and lab work we've done and also did a phone developmental assessment with them. I'll have a phone appointment with their nutritionist in August, then an exam with a doctor in September. We're looking forward to it. Until then, I'm continuing to work with our nutritionist here.

We received a lot of assessment results this past week. I requested the written reports from Josh's occupational, physical and speech assessments to send to Thoughtful House. Wow. Eye opening. I was most surprised by the physical therapy assessment. I always thought he had the fewest delays in gross motor skills (he runs and climbs, right?). However, that assessment ranked Josh in the 3rd percentile for gross motor skills based on the PDMS-2 assessment. In age equivalent, his skills ranged from 11 to 21 months. I was shocked. She had verbally told us the areas he needed work, but this is a much bigger gap than I pictured in my mind. We've been doing his exercises and seen great improvement so far. We'll see what the PT sees at his appointment next week.

From his occupational therapy assessment, his fine motor skills were in the 12th percentile, age equivalent 22-28 months. His speech percentile is 13th, but is only considered a "mild impairment." I don't get that, but I guess that is because he is pretty functional especially with his receptive language (he's come SO far here in the last 6 months!). We had been waiting to get on the schedule for all three therapies and there has been a hold up getting insurance approval for speech. I'm following up on that, but went ahead and got PT and OT scheduled to start tomorrow. OT will be on Friday mornings and PT on Wednesday mornings.

Josh is still enjoying his ABA therapy on Tuesdays and Thursdays. We met with his therapy counselor this week to go over their assessment results (VB-MAPP assessment). It tests several categories of skills expected by 18 months, 19-30 months, and 31-48 months. A child is set to attend a "typical" pre-school after passing assessments in all categories in the 31-48 month range. Josh had 3 categories in the 18 month level with gaps, the majority of categories in the 19-30 month were lagging, and he had only a few skills met in the 31-48 month grouping. Based on these results, his development plan was created and we'll get feedback on his progress every therapy session.

Honestly, it's a little alarming to see these assessment results in writing. We've been having so many more good days with Josh and we see so much progress. We often revert back to talking ourselves out of there being a problem, he's just a little delayed. So, we need these reality checks to keep us motivated to seek and provide treatments for him.

Josh is improving SO much! His fits and tantrums are significantly reduced, he is constantly picking up new words, his eye contact is improving, his balance is better. We have much to be thankful for, including the thoughts, prayers and support of our friends and family!