I've had multiple people mention the last week that 9/25 was my last blog entry. Whoops! This blog break was brought to you by a weekend of rest at my parents' house, Danny travelling, Josh not sleeping at night anymore, several assessment appointments with the school district, and the flu running through the entire family! I still haven't gotten ahead on cooking and laundry since we all had the flu, but we're getting back on track again. At least we all weathered it well and are recovered.
I started off the month with a relaxing weekend with my parents. Danny took a Friday off of work. Kate and I headed to my parents' house on Thursday night and stayed there until late afternoon on Saturday. It was nice to have some time to relax, take a nap, and my parents took good care of me with good company and wonderful food. Much needed break!
Emma is doing well in first grade! Her reading has really taken off and impressed us. She's not just getting through the words now, but she reads as if she's telling a story and gets what is going on. She is wonderful with Josh. In August, we did a training session at Josh's ABA therapy center that included Emma so she could learn what to say to him and how to help teach him to take turns and to respect things that are hers. She is a great role model to Josh on how to play and to use his imagination. She's constantly modelling new words to him and includes him in her imaginary play so well. Last night, she built a "tent" between the couches with a blanket. She had Josh going in the tent with her and they went to sleep. He loves Emma so much and I couldn't ask for a better big sister. She's such a great help to me, just by being a helpful big sister, willing to help with Josh or Kate very often.
Kate has started to crawl! At first, she would make a scoot or two to get to a toy, but once it clicked, she's all over the place on a mission. She and Josh have had their first "fights" over toys. She'll take a toy from Josh, he'll scream and take it back, and she'll scream. What an attentive baby - her eyes are following everything that is going on and she is very intent on being involved. I am so thankful for Kate being such a good baby. I've been taking her to Josh's therapies and several assessments with the school district this month and I never have concerns about taking her with me. I call her my portable baby. =)
Josh is continuing to progress. I am getting compliments from all of his therapists. I filled out a follow up form for Thoughtful House this week and here are the areas I highlighted as progress:
- Increased expressive and receptive language
- Improvement in behavior problems and head-banging
- Improved eye-contact
- Improved sensory issues. We can drive over speed bumps without screaming or even a mention of it in the car! We can drive next to a semi. Sounds that used to send him overboard into head-banging bother him much less.
- Expressing needs better and physically coming to get us occasionally when he needs something
- Reduction in visual stimming (running next to a wall or surface and watching out of side of his eyes, or watching fans and objects that spin for prolonged periods of time)
- Playing with more toys appropriately
- Improvement with obsessions with fans, turning them on/off and things that spin. Also, improvements with needing to carry objects with him frequently and obsessing about what toy he goes to bed with.
- He has started to sing songs again and allowed us to finish reading an entire book to him.
We have attempted getting out more and facing situations we would have avoided in the past. We went to the big pumpkin patch that we have gone to since Emma was almost 2. It's very crowded and we didn't think Josh would handle it well at all. We were wrong and he had a great time, including going on a tractor hay ride where he sat with Emma with no issues with the sound of the tractor. He also went on a bounce house slide with Emma three times! Josh has never cared for bounce houses at all and we were floored he did it, especially in a crowded place. We couldn't exactly get his attention for pictures, but hey, I can't have it all, can I?
Because we started speech services through the state ECI program (Early Childhood Intervention) when Josh was 19 months old, they fed us to the school district for evaluation and to qualify for services when Josh turned three. So, this past month, Josh and I have had several meetings and evaluations with the school district. I did an intake form assessment with a diagnostician, the autism evaluation team performed the ADOS autism diagnostic test at the school, the autism evaluation team observed Josh at our house with a few friends over, the physical and occupational therapists evaluated Josh at the school, and the special education teacher spent some time with Josh to create goals for him. I also had a meeting with the autism evaluation team to go over their detailed report on Josh. They diagnosed him with PDD-NOS (Pervasive Development Disorder - Not Otherwise Specified) on the autism spectrum, which was the same diagnosis we received from the developmental pediatrician. They were very thorough and I was impressed with their observations of Josh as well as the details of their assessment. They really praised the path we were on and how much Josh has accomplished with early intervention. It was nice to hear such encouraging words and their positive outlook for Josh's future. I also met with an in-home trainer from the district and took a tour of the school they were recommending Josh attend PPCD class (Preschool Program for Children with Disabilities). We had our ARD meeting, where we agree on district services to be offered to Josh. Prior to going to the ARD, I learned of some insurance changes that will be in effect in January. The Mental Health Parity Act requires that insurance coverage for behavior health have comparable limits to that of medical health. ABA therapy is considered psychiatric therapy (I'll save my thoughts on that for some post that I'll probably never have time to write). Our insurance plan covers 30 behavior health visits/year, 60/year for treatments received more than once a week because they are considered "intensive." Anyway, I have confirmed with our insurance carrier as well as our benefits administrator at my husband's work that we will have NO limits next year!!! We have been planning to pay for the majority of next year and trying to figure out how, so this is a HUGE relief. ABA is the most expensive treatment. However, in conjunction with his medical treatments helping him feel better and able to learn, ABA has changed our lives. Anyway, all of that is to say that we are opting to keep Josh in the ABA center 5 days/week next year and will work with the school district for speech services. He starts speech two mornings a week after Thanksgiving. I am planning on continuing with his private speech therapist once a week until we see how the district therapist goes. As in all therapies, it depends mostly on how your child clicks with the therapist.
To end on another high note, Halloween was great! I didn't know how to best handle it. I can't break traditions Emma loves - she has already sacrificed a lot (diet changes alone are enough!!!). We tried getting Josh to pick out a costume, but he was more interested in the Halloween snow globes on display. So, I bought him a Superman costume and we tried to get him to wear it for Emma's school carnival. We put it on, he looked down at it and said, "off." I took it back and didn't know if he understood what we were talking about with Halloween. It's one of the communication challenges. Sometimes, we wonder if we're even close to being on the same page, and other times he floors me with his very clear understanding of what is happening around him. I thought the candy would be torture for Josh. We really have to watch sugar with him since it feeds yeast issues he has in his digestive system. Initially, we planned on having him help pass out candy and if it became too much for him, we'd put it on the porch and be done for the night. The more I thought about it, there was no way Emma's friends were going to come over and leave the house dressed up without him having issues. There is always a way to include him and my plan was for him to go on a wagon ride and bring his favorite snacks for the ride. So, an hour before her friends came over, I asked if he wanted to be Greg from the Wiggles (we had the shirt from when Emma insisted on being Greg when she was 3). Josh went straight to his room and worked as hard has he could to get his clothes off and find the Greg shirt. He rode in the wagon and a few houses in, got up to trick-or-treat. I took a breath preparing for the tantrum to eat the candy, but he put it in his pumpkin bucket and proceeded to pull the wagon himself. For a few blocks, he just pulled the wagon as if he were on a mission to make the wheels spin as fast as he could. Out of the blue, he dropped the handle, picked up his bucket and went up to a house. I prompted him what to say and after his "thank you" he marched back to the wagon, placed his bucket in it and pulled it until he reached the next house that looked right to him. When we got home, I have him one of his diet compliant cookies and all the candy disappeared to an Emma-disclosed location. I really enjoyed that night. I will look back on it often to remind myself not to underestimate what Josh understands and to motivate myself to give Josh more opportunities to surprise us. Even though Josh didn't "get" Halloween the same way other kids did, he had a good time and he felt a part of what all the other kids were doing. He was so proud and deliberate on his mission. I was proud, too.
The day has finally arrived! Josh is three! For how much we've been through this year, I have had to take a step back several times and remind myself how young he is. He is still a baby. Since Emma was a baby, we have attended several birthday parties for her and her friends. I always thought a birthday party at The Little Gym was the perfect place for a three-year-old party, and pictured that was where we'd celebrate Josh's third birthday. Well, the Little Gym by us is closed now and my vision of a perfect birthday party for Josh was different than I had planned. However, my expectations were far exceeded. The months preceding Josh's birthday, I kind of dreaded him being three. I worried that the gaps between him and typical kids would be widened and more obvious. I worried that he wouldn't get the idea of a birthday party and I pictured him screaming when we sang Happy Birthday to him.
