Saturday, December 23, 2006

Merry Christmas from the pond

Homemade roasted tomato soup, beef bourguignon, and Ginger Pumpkin Tiramisu (I just made that one up as I went along) are in the refrigerator. The Homemade Granola is toasted a cooling in the kitchen. If Diva Frog ever goes to sleep, I'll get to help Santa with his wrapping and tomorrow night I might even get to sleep.

We had a long couple of months leading up to winter, but most everything is settled now and we plan to enjoy the holiday before the real work begins. Little Frog has been having sever itching/pain attacks that we are still trying to figure out. When he gets stressed, red splotches begin to appear on his body (sort of like hives, but less defined and not raised). He scratches, and then screams. When he screams more splotches appear and he scratches some more and screams louder. Episodes can last between 5 and 30 minutes. When they are over, he laughs or picks up a toy and plays and the splotches fade away. Other times, he starts screaming out of the blue grabbing at his genital area in what appears to be extreme pain. These episodes are usually shorter. We've spoken to the doctor, but she needs to see him in the midst of these attacks. Other providers and caregivers have suggested wheat intolerance, yeast overgrowth, anxiety disorders, testicular torsion, allergies, or dry skin. When I put his symptoms into the medical website searches it comes up "rabies" - I don't think so. We are looking into referrals for a pediatric urologist, gastroenterologist, naturopath, developmental optometrist, and who knows who else. Any other ideas out there?

We've lost a nanny (had a healthy baby boy early this month), and a DIR tutor in the last six weeks. Little Frog also picked up an Apraxia diagnosis. The school SLP, of course, is skeptical and tells me that the diagnosis does not change anything - her last idea was to teach him sign language using verbal behavior techniques that require teaching four signs at one time and giving him a maximum of 3 seconds to respond with the correct sign. She had seen video tapes at a two day conference. I asked her how that was going to work with a child who has severe motor planning issues and auditory processing problems. She had seen the videos - that was all she needed to know. We also have issues with the special ed teacher who is having trouble reconciling our DIR methods with her "highly structured ABA" - not - program. Living in a small community, there are not a lot of options, but I've been very bummed out thinking about how hard it is going to be to educate all the special education and general education staff we will work with in the future when we are having this much trouble with an SLP and a special education teacher who specializes in ASD kids.

To top it all off, due to the rather dramatic slow down in the local real estate industry, it looks like I will be dusting off the old law degree next month to generate additional income and provide further employment opportunities for those who work for my family's business. I'll be the newest (and in some cases only) disability, education and elder law attorney in town.

Hope everyone is having a happy holiday, making lots of memories, and enjoying the company of family and friends. We are treasuring Diva Frog's excitement (as much about giving gifts as receiving them this year) and Little Frog's new found delight in Christmas Light displays and Christmas Trees.

I wish you a New Year filled with peace, love and happiness -

Saturday, September 09, 2006

On The Road with Little Frog

Little Frog had appointments with Rosemary White, his OT and our DIR Coach, and Judith Bluestone from HANDLE in Seattle last weekend. We spent the night in Seattle and made a mini vacation out of it. Little Frog did remarkably well at both appointments and seemed to enjoy the attention. I think it was also a treat to have mom and dad all to himself for two whole days.

Rosemary has been my touchstone when it comes to Little Frog's progress for several reasons. She is an amazing therapist with very strong credentials having studied with Jean Ayers, Stanley Greenspan and Serena Wieder. She is a certified DIR therapist and instructor who sees clients and lectures all over the world. Of all of our various therapists and professionals, she has the depth of experience and can compare Little Frog and his progress with many other children to give us an idea of how he is doing. Because she is several hours away from us, we only see her every three months which gives her a different persepctive on Little Frog. She also has a wonderful rapport with Little Frog and with her other clients. Her Australian accent has captivated Little Frog from the beginning. Daddy frog used to imitate it to get Little Frog's attention. I hear her voice in my head as I apply the DIR principals and techniques she's taught us. We've been told that we, as a family, are very good at DIR. But there is a magic quality that we always achieve in a session with Rosemary that can be very illusive at home. We apply the techniques and we get the results, but it is at a much slower pace. When we work with Rosemary, Little Frog always shows us how much further he can go under the right circumstances.

This session, Rosemary coached us through examples of letting Little Frog make his intentions clear and keeping him in the interaction even when he begins to physically pull away. She pointed out that this time, he did not fully disengage, but remained tuned into what we were doing even when he needed to take a break. We were able to use a few more words and big motions to keep his attention. We model from a distance when he pulls away, but we also slow way down to give him more time to show us his intent. We experienced this rather dramatically on two occasions during his session. When Little Frog indicated he wanted more wheat thins, instead of simply responding his sign for more or following his modified point, we moved the crackers to a high shelf and played that they were out of our reach. We worked with Little Frog to come up with a plan to get to the crackers. This involved finding large cushions we could stack to get higher. Later we enlisted the help of a dog puppet who was able to reach the top shelf. Finally we worked on how Little Frog could climb on mom or dad's back to get to the top shelf - when this was successful, we did a victory lap with giggles and happy shouting from atop mom or dad. Not long ago, not getting the cracker right away would have been the end of Little Frog's tolerance for the interaction. This time he stuck with us through the long sequence and ultimately, the interaction became more important than the cracker. Little Frog decided that the victory lap was much better than crackers. Suddenly he was looking for methods to show his intent to get a ride. We kept him in the moment from one activity right into another.

Little Frog also discovered, when dad slowed down and waited for him to show his intent, that it is fun to have control of a situation. Little Frog wanted tickles and raspberries from dad. Rather than just giving him another when he signed more, Dad moved very slowly and kept stopping and asking "what now?" Or "where do you want a tickle?" Little Frog had to physically direct dad's head or hand to the spot where he wanted the tickle. Little Frog is still feeling the "high" of this control and wants to engage in this play again and again.

At the HANDLE appointment, we discussed his program and his response to everything so far. Judith seemed pleased with his progress to date. We modified a few of the exercises - such as letting him do his turtle over a surface other than my back, and adding a simultaneous tapping of his left and right hands with his left and right feet during the accentuated stomp. She also added a few exercises including some alphabet work that Little Frog is really enjoying.

Little Frog was very happily exploring the room by climbing on a chair to the window sill and onto a table. He was acting very stealthy about the whole process while watching us to see if we were watching him. Dad said he moved like a big cat and Judith asked him if he thought he was a panther. At this, Little Frog stopped what he was doing and gave Judith, then the rest of us, a very happy, proud, knowing look as if to say "why yes, Judith, I am a panther - thanks for finally noticing". We played with the panther idea, naming all of the other animals Little Frog had traits in common with - a cobra when he wound himself around mom's neck, a bat when he hung upside down and sensed movement from across the room, a frog when he swims in the pool, etc. He seemed very attentive to these ideas and happy with the game.

Judith suggested we draw shapes and letters on Little Frog's back with our fingers - identifying them after we drew them. He went to each person to have them draw something different for him. We plan to expand this exercise giving Little Frog cards he can give to request different shapes, letters or numbers. Later we plan to draw the shape, letter or number and ask Little Frog to give us the card with the item we just drew on his back. Judith also chanted the alphabet and the letter sounds to him as we did the accentuated stomp. He really paid attention and asked for more of this. "A says ah, B says buh, C says kuh, D says duh, . . ."

Since returning from Seattle, Little Frog has been easily agitated (lots of screaming, pinching, frustration), but he has also been really engaged for long periods of time. He is seeking us out for playtime. He is being very insistent and persistent in getting his ideas across. He ran back and forth while I read him a book. I thought I lost him and put the book down. A few minutes later, I found the book in the playroom where he had taken it to continue reading the story on his own. He has started saying "ug" to Daddy Frog with outstretched arms followed by a hug for dad. He has started saying "iss" to me and presenting his forehead for a pressure filled kiss. He is watching more TV - the programs, not just the theme music. He still wants a lot of water play on his own or with a partner. He has made new discoveries about how water moves in his pool - including his new favorite, stand on the edge of the pool and the water runs out of the pool over your feet.

Things we are noticing:

1. Lots of eye contact.
2. Longer time periods for problem solving.
3. More hints at words.
4. A lot of finger play -
touching individual fingers to his thumbs.
5. Better auditory processing -
can tell where sounds are coming from,
and can focus on one sound at a time better.
6. More self-correcting -
will stop mid arm bite and start to blow,
will stop just before pinching another child and pat
the child then move away.
7. Intensified pressure seeking -
seeks pressure from other people.
8. Slightly less drooling
(still likes to spit liquids, but seems to know he
is not supposed to do it in the house).
9. Still mouths, but also explores objects with his
hands and fingers.

Overall, I think we have made some progress over the summer. It will be interesting to see how the transition to school goes next week. I'm hoping to work with some of the para-educators to show them what we have learned from DIR and HANDLE.

Wednesday, August 30, 2006

A Frog of Discriminating Taste

Our little frog has been a picky eater from the start. He was a great nurser (probably as much for the sensory experience as for the sustenance), but once the semi-solid foods came along, he had a narrow and discriminating palate. Around this time, Diva frog went from an adventurous eater to the toddler half-dozen. This left me playing the role of the short order cook for several years.

"one moo juice, one city juice - hold the hail", "burn one
high and dry with an order of frog sticks", "one GAC and an
order of cackle fruit - wrek'em".

Diva frog is coming back around and I can almost get away with fixing a family dinner.

Little frog's limited diet has always puzzled me. He mouths everything he comes in contact with unless it is presented to him on a plate. When introducing new foods, he will start gagging when he sees the plate approaching from across the room. We have consulted with our GP, OT and nutritionists and applied various techniques and suggestions from books and friends. We've limited food, we've given access to new foods, we've tried various diets and tested for food allergies and sensitivities common in autism with elimination procedures. We've tried disguising foods and giving supplements. None of this has changed little frog's preferences or eating habits. He wants sweet or salty, crunchy, simple carbs and dairy.

We've been most successful with 1. Sibling rivalry - he seems to think things on Diva Frog's plate taste better than things on his plate - and 2. Having a conversation with him about protein and the role it plays in good nutrition. Over the last few weeks he has, on his own, - tried Diva frog's hamburger, eaten chicken nuggets instead of french fries when both were offered and picked turkey and cheese over crackers and a cookie. We are still waiting on fruits and vegetables - but he did sneak a carrot off the counter when he thought I wasn't looking.

He does share my passion for cookies. While a store bought cookie will do in a pinch, he knows a "good" cookie when he sees one. This has been great motivation for communication. He has gone out of his way to come up with non-verbal communication strategies to tell me he doesn't want just any cookie - he wants me to make him a cookie. As a long time amateur baker - I love the compliment! He will bring me baking sheets from the cupboard. He will insist we open the pantry where he selects the shortening container with the picture of the cookie. He climbs on the counter to look in the cookie jar. He brings me frozen cookie dough from the freezer. So far, I haven't been able to get him to help me make the cookies (watching the dry ingredients being poured into the bowl makes him gag), but he did come in to sample the cookie dough yesterday (a new texture).

I was watching Food Network's cookie challenge the other day. Five amateur bakers competing for a $10,000 prize. One mom told the story of how her son suffered significant hearing loss as a baby. When the problem was corrected, she used baking as part of his speech therapy regime. I hope that someday, little frog and I will have a similar story to tell and our own cookie creation to go with it.

click here to purchase Frog Chef Magnets

Tuesday, August 22, 2006

Progress Report

Little frog had a little break this weekend as I went to a trade association convention and he stayed with grandma. He reportedly had a wonderful time - spent long days in his wading pool. He came home grumpy, aggressive and wound up. A quick swim in the big pool helped with his regulation. He was actually doing very well - climbing up the stairs, turning around and jumping into the pool on our count of "one, two, three, JUMP" or "on your mark, get set, GO" or "ready, steady, GO". He even got himself turned back around, frog paddled back to the stairs with no help and did it again and again.

Last night we got back on track with his HANDLE, Listening, DIR, and dietary supplement programs. I noted the following:

1. After three days without any refelxology, his feet were very tight and sensitive and we had to work up to our old routine. After two days of refelxology, he is back to his calmer state and seems more connected.

2. While listening to "The Listening Program," he turned on one of his musical toys. This is not uncommon - he likes to have three musical toys going at once each playing a different song. With the toy in one corner of the room and me on the other side of the room near the middle of the wall, I began to snap loudly with the beat of the toy's song. Little frog, standing in the middle of the wall opposite the toy, became very attentive. He stopped moving and looked first at the toy, then at me, then back at the toy. It was clear that he was hearing both sounds and distinguishing where the sounds were coming from. I don't know if this was new for him, or if it was my keeping time that he had just noticed. We are beginning to see little frog keep time to the music, changing with the meter and speed of the song.

3. He took an interest in the "3-D" glasses that came with one of Diva frogs DVD's. Judith wanted him to try them at his HANDLE evaluation, but in true little frog nature - If you want him to, he won't. Today, when I offered them to him he first ran away. Later, when I was able to approach from behind and very slowly lower them in front of him about 6 inches away from his face, he stopped. He grabbed the glasses and pulled them right over his eyes. He took them off and put them back on. He ran to the window and looked through the glasses at the back yard. He threw them on the floor and jumped up and down with his fingers in his ears. Now, every time he notices the glasses, he stops and looks throughout them for a few seconds then moves on. (I've spent a significant part of this afternoon researching Irlen Lenses).

4. He has been doing a lot of non-verbal communicating, but has not been using any signs or PECS cards. Today I went back to motoring him though the sign language - I, want, cookie, please. More, cookie, please. I, want, more, chip, please. He became completely passive about the signing, letting me puppet him - but as we were trying to form the more sign he said "mo" and as we were trying to form the cookie sign he said "kie" and as we were trying to form the chip sign he said "ip". He has done this before, but not so many word attempts in one interaction.

We don't know what intervention to chalk this up to - probably a combination of all of them along with little frog's determination. But it's progress - so we will take it!

Wednesday, August 16, 2006

Ladies and Gentlemen, 4 Green and Speckled Frogs Proudly Present Diva Frog

Diva frog has been happily helping me put this blog together - picking out pictures and previewing some of the posts. She hasn't said anything yet, but I can read her pretty well (When is this going to be about me?! - we don't call her "Diva Frog" for nothing ;0).

Diva frog has always been off the chart with her developmental milestones. At 18 months she was talking in paragraphs, she crawled for about four days then got up and walked and never looked back. She was reading in pre-school and works fractions in her head at age 7. She seemed so advanced that we missed signs of trouble in little frog because we did not feel it was fair to compare any child's development with diva frog's.

Diva frog is a born negotiator and debater. She is always quick to point out why our answer to her question is not entirely correct. This can be wearing even on a mommy lawyer frog! Diva frog has also been very "adult" from a young age. She has a very old soul. She is patient, kind, and tolerant - qualities that serve her well. She is also painfully shy and has a perfectionist complex that boarders on an anxiety disorder. I too was like this as a child. I know the pain it caused me and am tempted to find her some help with this. But, I also out grew it or grew into it and I know she will too. There are just some life lessons that must be experienced to be learned. We have been asked by most of little frog's professionals if we see any signs in Diva Frog. She does have her quirks, but they are more anxiety related than ASD.

Before little frog came along, Diva frog was the center of the universe. A fist child, and first grandchild on both sides of the family, who lived in the same town as both sets of grandparents, a childless Aunt and Uncle, and two great-grandmothers. We didn't know how she was going to take to a new sibling. She was convinced the baby would be a girl named Zoe. "But what if the baby is a boy?" we asked her. "She's not." answered diva frog. "We won't know for sure until the baby is born." we told her. "She's a girl, but if she is a boy we can name him Olie" (she was a big Rolie Polie Olie fan at the time). Now I do have some Scandinavian heritage, and Olaf is a family name, but we didn't think we could do that to our new baby boy. We bought diva frog a doll named Zoe and she was willing to let us pick little frog's name.

She had a ball helping me take care of baby little frog. She managed to sleep through the nights of screaming, and she kept her cool better than daddy and I when the screaming started up in the car. She kept bringing me little frog's baby blankets saying "Does the baby need this now?" When I said no, she would use it to put pooh bear, tigger, piglet, gopher and baby doll Zoe to bed. We had sleeping babies all over the living room. Diva frog would also entertain baby little frog. She wanted me to put him in his carrier so he could watch her as she danced and sang and put on plays. She was very excited to hold him, but as he was 10lb, 11oz at birth, she told us to take him back as soon as he was placed on her lap. She was also very excited about his first bath. She was disappointed when I didn't float him in the big bathtub, and his SI issues made his response to that first bath less than endearing. But overall she handled the transition with grace and continues to be an amazing sister.

She does have days when she feels very cursed to have a brother at all. Usually because of regular old little brother stuff like getting into her room or chewing on Barbie's shoe. Occasionally it is related to the autism - she is afraid she is going to get pinched and sometimes the shrill shreak that goes on and on is too much to take. But, overall, she is very attached to her little frog brother and loves him for who he is.

I'm sure there will be more issues as the kids grow up. (I'd love to hear from anyone who has tried sibshop and get your impressions.) We try to spend a lot of one on one time with diva frog and let her know how incredible we think she is as a person and as a big sister. We let her know that we know it is not easy to have a brother with autism. But we also point out that it is not easy for little frog either and that she also gets to do some pretty neat things that she might not have gotten to do if we didn't have to deal with autism - like skip school to go to the zoo when it isn't so crowded, or have season tickets to the Seattle Children's Theater so she can have mom all to herself for several weekends each year.

She is an incredible ballet dancer and loves her gymnastics class. She sings and dances all the time. She writes short stories on her computer. She has a lot of friends and is a very sweet child.

We are blessed to have two amazing children to raise, enjoy and learn from.

The Ballerina Frog picture can be purchased as wall art from:

Netkids Wear

Diva Frog in pictures

Monday, August 14, 2006

Little Frog's HANDLE Program

HANDLE methods and exercises are proprietary information. Judith made it clear that she did not mind if I shared the information, but because the exercises are recommended individually based on an individual's needs and must be done correctly (she requires caregiver's and clients to demonstrate they know how to do the exercises)they should only be applied after an evaluation by a trained HANDLE therapist.

I am not a HANDLE therapist or an occupational or physical therapist or a doctor. I am a lawyer and know better than to put myself out there as someone qualified to make a diagnosis or healthcare recommendations. Therefore, the following is a brief description of the program created especially for little frog. I will briefly describe the exercises and what they are intended to do for little frog, but I will not provide instructions on how to apply the techniques. If you are interested knowing more, go to The Handle Institute . DO NOT try these exercises based on my descriptions - find someone who can show you how they are supposed to be done.

Little frog's HANDLE Program consists of 15 exercises and gentle reflexology work on specific points. Judith also suggested we experiment with copper to ground little frog and help him discharge built-up, pent-up energy; find gentle ways to detoxify his system (he mouths everything he comes in contact with - except food)such as steamy showers, rough towel rubdowns and transdermal footpads; finding ways to increase protein and amino acids.

SKULL TAPPING/FACE TAPPING: These exercises are described in The Fabric of Autism. It is a rhythmic tapping along a preset pattern across the skull and face. It is designed to enhance interhermispheric integration and provides gently organized stimulation of the sensory-motor cortex (skull tapping) and awaken, organize and intergrate and relax the trigeminal nerve (face tapping).

INTENSE SUCKING: This exercise is to be done with the eyes closed. It is designed strengthen the round ring sphinctor muscles in the body. Closing the eyes also causes the eyes to converge and helps with binocularity. (a warning from Judith - don't try this if you have a problem with crossed eyes).

BLOWING: Again, this exercise works the sphinctor muscles and works on oral motor issues.

CHOCOLATE EARS: This is a modified version of a cranio-sacral therapy procedure called "ear pulls". It is designed to release tension in the connective fascia in the cranium, including those of the vestibular system, the sinuses, the dura mater and pia mater. May enhance auditory and vestibular functions. It is performed with a very light touch on 4 parts of the ear. Each point is "touched" for no more than 5 seconds. When done correctly, there is a warm melting sensation at the points that are touched.

JIGGLE BRIDGE: This vibrato like motion is applied to specific points on the body where the connective tissues (fascia) converge. It is designed to help release energy flow in the body. Beneficial in helping with digestive disorders caused by tension and irregular flow within the alimentary canal. It can help reduce tactile sensativities in the palate. It may also relieve tensions of small muscles in the skull, neck and chest.

BUZZ SNAP: This is an energetic tugging version of "this little piggy" for fingers and toes. It is designed to increase kinesthetic and proprioceptive input, helps desensitize tactile hypersensitivites, enhance differentiation of individual digits and increase muscle tone and circulation.

ACCENTUATION STOMP: This exercise is described in The Fabric of Autism. Two stomps with your left foot, then one stomp with your right. This activity develops a high level of integrative functions, enhances differentiation of movement, reinforces lateraltiy, provides vestibular and proprioceptive stimulation, and can increase muscle tone.

HUG AND TUG: This exercise is also described in The Fabric of Autism. It is actually hard to describe. It is a bending and unbending of fingers. Ideally it is done with both hands crossed in front, simultaneously "hugging" bending the finger on one hand while "tugging" unbending the same finger on the other hand. When done correctly it also involves putting pressure on specific reflexology points on the fingers. This is one of the most difficult exercises for us as little frog can not stand to have his hands crossed in front of his body while manipulating his fingers. It is designed to enhance interhemispheric integration and articulation and differentiation of hands and fingers.

CRADLE HEELS: This is just what it sounds like. When he is willing, I cradle his heels in the palms of my hands. Sometimes he pushes his heels against my hands. Sometimes I am only allowed to hold my hands near his heels without actually touching them. This is where the reflexology points are for the digestive system.

REBOUNDING AND CHI: Little frog thinks this is fun! I literally bounce him back and forth between my hand when they are placed at various places on each side of his body. It is designed to help normalize energy flow.

ANKLE AND WRIST ROTATIONS: This one is harder for little frog. I usually save it until he is almost asleep or just waking up. It is a very slow, very controlled, very gentle symmetrical simultaneous rotation of both ankles and both wrists upto 180 degrees or to where resistance is met. It promotes better breathing and relaxation through diaphragmatic release. It also enhances rhythmic synchronicity between both sides of the body and brain.

TURTLE: This is where I help little frog do a backbend over my back. It is designed to provide vestibular input in a position of full support. It also opens the diaphragm for efficient respiration and helps to counter forward-flexed postures. I've even made up a song and dance to go along with it . . . "Let's make a turtle, let's do it well. I'll be the turtle, you be the shell. 1, 2, 3, ...." If I can figure out how to post video clips, I might post this one - it's silly, but it's fun!

SPINAL TWISTS: This one reminds me of yoga class. Your head turns one way and your knees go the other way. It is designed to normalize energy , encourages midline crossing, and gives the internal organs a gentle massage, with can support detoxification.

PEACEMAKER MASSAGE: This requires a special massage ball provided by HANDLE. The massage is done with the ball and follows a pre-set pattern that covers shoulders, arms, hands, fingers, spine, buttock, legs, feet and toes. It is designed to help regularize tactile functions an muscle tone, enhance kinesthesia and proprioception, and reduce uninhibited reflex responses.

TWO-FINGER SPINAL MASSAGE: This massage is described in The Fabric of Autism. It runs from the top of the spine to the bottom then back up again shifting the direction of the pressure in your fingers to match the direction of the stroke. It stimulates the Autonomic Nervous System and helps to regulate the body's responses to our vital activities such as respiration, circulation, digestion, etc, and modulates the reaction to stress and other threats to comfort or survival.

The descriptions of the exercises above are condensed versions of the hand-outs we received from The Handle Institue as part of the evaluation. I reiterate - DO NOT TRY THIS AT HOME WITHOUT FULL DESCRIPTIONS AND SOMEONE TO DEMONSTRATE THE TECHNIQUES.

Getting a HANDLE on Little Frog

For little frog's 4th birthday, we took him to see Judith Bluestone at The Handle Institute. I learned about Judith through her book, The Fabric of Autism. Judith is autistic and grew up learning to deal with a variety of sensory integration issues. She spent more that three decades teaching special education and studying neurodevelopment. She developed her own holistic method and founded The HANDLE Institute (Holistic Approach to NeuroDevelopment and Learning Efficiency). I had the chance to hear her speak at a seminar for an Autism Society in Washington State. I was impressed with her ability to explain many of the behaviors and disfunctions of autism from a neurodevelopmental standpoint in a manner that the lay person could follow. I was also taken with the great respect she has for her clients. This is an area that I am especially sensitive to after reading the stories by various non-verbal autistic adults in Douglas Biklens' book, Autism and the Myth of the Person Alone.

Little Frog's evaluation began with a two and one-half hour observation. Judith and Kate (a second Handle therapist) had reviewed the pre-evaluation paperwork I sent in. Judith met us at the door to the building and allowed Little Frog to follow his bliss as he explored the new surroundings, running up and down the halls, into and out of various offices, storage rooms and the staff breakroom. Throughout the observation she spoke to him as a reasonable, rational individual and only asked us questions about him after telling him her plan to do so and waiting for his reaction. We knew little frog had receptive language skills even though he would fail any school test for them. He can not usually show you he heard you and understood you by following a direction. He gives other, more subtle clues. It was obvious that he figured out right away that Judith also knew he could understand her and he seemed to appreciate it. His clues were much less subtle with her than usual. She also pointed out, when she or we began talking and little frog up and left the room, he was still listening. In fact, she observed he seemed to have less trouble with auditory discrimination from a distance. (we already knew he had less trouble with visual processing from a distance). He demonstrated this by returning to the room ready to participate in the activity we had just been discussing. She also did not make a lot of demands for little frog to do things. He has a great deal of trouble with motor planning, especially when the objective is not an idea from his own mind. This makes most evaluations pointless - he is not going to put the puzzle together or stack the blocks or color on the paper when requested to do so. Judith spent most of the observation period observing. She provided some different stimuli (noise from toys, objects with different textures, red and blue lensed paper glasses) and watched how he responded. She also spent a great deal of time noting his postures, gate, eye movement, hand positions, and looking at his feet and hands (providing some pressure to different reflexology points with little frog's permission.)

During the course of the observation she asked us some rather startling questions about any problems little frog had with heart murmur, testes, and allergies. All of these are issues for little frog. None of these were mentioned in the paperwork I provided. She said she sensed these were problems from the way he protected certain parts of his foot when he walked and certain hand positions he maintained. She put her hand into the position his was in and felt a pulling across her chest near her heart. (on a side note - Toe Walking protects the heal area, associated with the organs of the digestive track, from extra pressure. Do you know anyone who has intestinal and gut issues who walks on their toes?) I tried this technique the following morning when little frog kept protruding his lower jaw and tensing his face for no apparent reason. When I tried it, my sinuses exploded. Little frog had been very stuffy when he woke up that morning.

At the end of the observation, we were excused for a two hour lunch break while Judith and Kate reviewed the tape, their notes and our paperwork. As it was little frog's birthday, we went to the Seattle Center. He did really well. He sat in a chair in the Center House for a good 20 min. while Mommy and Daddy had a quick lunch (he had a giant cookie, having eatten his during the evaluation). We went to the "Fun Forest" and after watching for a little while, little frog had his first Merry-go-round ride followed by the, aptly named, frog bouncer and then the flying elephant. All smiles and giggles - no melt downs, no biting or scratching, no running away. A very successful outing :0) We followed the rides with a quick car nap then went back to HANDLE for the results of the eval.

Judith spent another two hours going over her observations and findings. She provided us with a program of simple exercises that, if done one after another, could be accomplished in about 30 min. a day. She also talked to little frog about protein and what it does for the body and brain and what types of foods would be good sources of protein; the idea of blowing on his arm when he got frustrated or felt like biting it; and what each exercise was designed to do and how it might help. Here is the matrix she designed for little frog. It shows his strengths and weaknesses and how they interconnect. How his blocked input from proprioceptors, nocioceptors, and the fascia resulted in more mouthing and biting to get sensory input. How fascial and lymphatic restrictions impacted his vestibular system and in turn his ability to differentiate sounds. She also noted the lack of visual perceptual, visual spacial, visual motor and auditory intergration. Some of this mirrors what we have learned from occupational and speech therapy. The difference here is we have something we can do to work on strengthening the underlying weak systems that should allow the occupational and speech therapy to work better. Here is the matrix Judith arrived at for little frog. Click on the image to make it bigger. I'll talk about the exercises in the next post:

Saturday, August 12, 2006

Frog's mom - feeling more like a toad.

ESY ended on Friday and we now have several weeks to fill with one on one home therapy. If today was any indication - we've got our work cut out for us!

The goal - at least five 30 min. sessions of Floortime along with all the other DIR moments we find during the day. 30 min. of The Listening Program in two 15 min. chunks. 16 elements of little frog's HANDLE program, interspersed throughout the day including a good round of reflexology. Increased protein consumption. Decreased sugar consumption. (In addition there is the need to keep Diva frog entertained for the remainder of the summer. Run a business. Refinance the house. Jump start the new Special Ed PTO for the local school district. And organize an Oktoberfest dinner/auction for 200 real estate professional to benefit the foodbank. Yes, I am a glutton for punishment. Yes, I need to learn to just say no.)

Today little frog decided to really make me work at Floortime. We are working on level 3 with an emphasis on praxis, so I am trying really hard not to take the lead. Just when things started getting good - little frog is off like a shot - no more circles, thank you very much! Floortime is exhausting on two levels - physically keeping up with a whirling dervish and mentally keeping ahead of the game, while following the child's lead. When we are getting nothing accomplished, I can't help but try a little hand-over-hand coaching. Today it was hitting the baseball with the plastic bat instead of biting it, and doing the "shout" dance with Elmo (I even tried to add some hand movements that crossed the midline).

I also tried to work our HANDLE exercises into the Floortime. HANDLE exercises are much more hands on and today little frog was very hands off. Here, too, little frog is to be in charge. The concept of "gentle enhancement" means I need to get his permission before I proceed. However, not doing the exercise at all is not an option if you want the program to do any good. So I negotiated with my non-verbal son all afternoon and again all evening. "I'll only touch your feet if you give them to me - there shall I start? (kick, squeal, run) Ok, you're not ready, I'll wait." We got 70% of the program done - but it was a wrestling match and I never was allowed to touch his feet.

The Listening Program requires him to keep headphones on for 15 min. twice a day. He enjoys the music, but it is hard to keep the headphones on when you are jumping on, off, and over your bed. He also insisted on keeping three other electronic toys singing and/or talking while he listened to the music. Most of the time I was chasing after him trying to get him to put the headphones back on. It didn't take long for me to start having my own sensory issues! My clothes started to bother me; the noisy toys were giving me a headache; I couldn't stop rubbing my face . . .

Overall I guess we didn't do too badly. We had an outing to the park. He ate some turkey and cheese at lunch time. We got in almost all of his listening, some of his HANDLE, and at least kept the Floortime concept alive. He had time in the bathtub and we got his hair washed. I wasn't bleeding from any new scratches or bites. He was asleep by 10pm. It wasn't pretty, but we didn't give up - so hooray for us and we'll see if we do it better tomorrow.

Speech Therapy is no place for Frogs!

I don't call my son little frog in real life - only in cyberspace. He does have, however, some very "frog like" traits. He adores the water, any water, and has an uncanny knack for finding it - in bathtubs, swimming pools, glasses, mud puddles, fountains, birdbaths, sinks, toilets, ice machines, condensed on cold windows, running out from under piles of melting snow, falling from the sky, etc., etc. Being cold and wet is fine with him. He is a terrific jumper and has incredible muscle definition for a four year old. He has an unnervingly good sense of balance, leaping from the sofa, to the footstool, to the hearth, catching himself by mere toe-holds.

In real life, little frog went though his anti-frog stage. He did not play with his frog toys, discarding the jumping frog to play with the spring loaded container instead. He loved "Little Bear," but did not watch the parts with the zen master frog. He ignored his frog shaped water toys, even the ones that would spit water, in favor of the elephant watering can. Most dramatically he demanded again and again in his own non-verbal style that all frogs leave the speech therapy room. The frogs in the match the card set were unceremoniously dropped on the floor. The jumping frog tiddly-wink toys were chewed on then spit out across the room from the therapist. Frog books resulted in arm biting and pinching. And the next reference to "frogs" sent him under his blanket for the remainder of the session. The therapist said she had another autistic client who felt the same way about cows. Another therapist suggested that because frogs (especially animated ones) have such big mouths and long tongues, little frog may have made a negative association between them and speech therapy where so much oral motor manipulation goes on - - - He does hate "manipulation" of any kind!

Today, 5 Green and Speckled Frogs is his absolute favorite song. He even participates in and enjoys circle time at school when this is the song of the day. He asks me to sing it again and again or play it over and over on the piano. So the therapist may have a point - it is ok for frogs to eat delicious bugs and jump into nice cool pools, but frogs do not belong in speech therapy.

Little Frog's first year in pictures

A few photos of little frog's first year.

Diva frog was enamored of little frog from the moment we brought him home. She was able to sleep through the screaming! Little frog is really lucky to have such a great big sister :0)

Little frog loves to swing (and bounce, and hop, and climb, and run, and spin). Our baby swing got quite a workout. Note the clenched fists - early signs of proprioceptive issues and tactile hyper-sensitive (later became hypo-sensitive)- we didn't know what we were seeing at the time.

Little frog is a very good driver. Not only could he maneuver his walker just about anywhere, he was happy to give Diva frog a ride down the hall.

The summer of 2003 was pleasant in the Northwest. A good thing, as little frog would live outside if we would let him. Here is the boat, pool, playpen at grandma's house.

The photo of little frog at his first birthday party did not publish. The frosting on the cake was a hit, but the rest of the party was a bit overwhelming. He disappeared into the house and we found him waiting in the bathtub for someone to turn on the water.

Thursday, August 10, 2006

Welcome to the Pond

Welcome, I'm so glad you found us! We live in the wet wilds of the Pacific Northwest. After college and graduate school, my husband and I came home and settled down near family in the small town where we grew up.

Our first little tadpole, diva frog, was born in 1998. She was early to talk, early to walk, an inquisitive little "grown-up" from the moment she was born. By age 3 she was known as mommy's little legal assistant and was quick to give the City attorney her opinion on everything. Today diva frog is a true girly girl - complete with a pretty in pink wardrobe, Barbies and Polly Pockets galor, and ballet and gymnastics classes every week. Her life is a musical and she is the star - singing every solo.

Our second tadpole, little frog, was born in 2002. 10lbs 11oz, sunnyside-up with his head turned to the side, little frog was born via c-section after days of start and stop labor and hours of unproductive pushing. Little frog came into the world with a strong startle reflex and extremely powerful lungs he was not afraid to use. For the first few months of little frog's life he screamed long, loud and hard, nursed voraciously (45 min at a time) and slept sporadically. Being the experienced frog parents we were, we declared him colicky and began to apply all the home remedies and old wives tales. But little frog was a conundrum. He detested riding in the car and screamed as if he were being tortured. He had a very high tolerance for physical pain, but could not tolerate a light touch or anything brushed against his skin. He loved the sound of running water, the vacuum cleaner, the TV, and musical toys, often rocking on his hands and knees while listening. He cried when the sound stopped. But he did not startle or even turn his head to look when you called his name or banged pot lids together behind him. He loved to be held or swaddled tightly and rocked or bounced with great energy. He would look at you and light up when you entered a room with a charming grin and a twinkle of delight in his eye. He did not care at all if you left.

He crawled with his left hand turned out. He had an uncanny ability to drive his walker, maneuvering it into and out of tight spaces like a professional. When he walked, he walked on his tip toes (sometimes on the knuckles of his toes). When he ran, which was most of the time,it was always fast and furious with little regard for what lie in front of him. At 18 months he did not speak, he did not wave, he did not point, he did not seek us out for help, he did not reference us for reassurance and he did not turn to us for comfort when he was hurt or sad or afraid. Diva frog pointed out that he never looked at her eyes, only at her mouth. The pediatrician told us not to worry, but to have his hearing tested if he did not have some words by age two. We began our own research and slowly came to realize that our little frog was swimming in the deep, dark water of autism. Deep and dark to us because we had so little understanding of how he perceived the world or how he felt. Deep and dark for little frog because he had been learning to navigate these waters on his own.

Today little frog is four years old. We are still traveling the maze of therapies and interventions. Some have helped, some have not. Little frog continues to grow and learn. He still does not talk. He only points to show us what he wants, not to draw our attention to what he sees or hears. Sometimes he comes to us for help, although he is still a fiercely independent problem solver (which makes toddler-proofing the Lilly pad a big challenge for mom and dad). He does come to us for comfort, and is beginning to look to our expressions to help make sense of new situations. He still has his smile and the twinkle in his eye and he continues to charm everyone he meets. And just a few days ago, on his birthday, he looked directly into diva frog's eyes as if to say "Look at me! Look at what I can do!" and smiled his delight just for her.