Garrett's Developmental Journey

New things...

2011-06-02T21:11:00.000-07:00

Garrett says bubble. He likes when people blow bubbles with their gum and will come up and say bubble dee. We're not sure what the 'dee' part is. His teacher thinks it might be please, but I'm not sure.

Garrett does not qualify for extended school year. After spring break, he recouped his skills within two weeks. His teacher did give me a list of some summer camps for special needs kids (and even one for their siblings as well!).

We have WORDS!

2011-05-04T20:07:00.001-07:00

In the past two weeks, Garrett has started saying MORE and YES. He's also copying the intonation of his name.

He's pretty amazing.

The Puzzling Piece iPad Challenge

2011-01-23T14:55:00.000-08:00

We have accepted the challenge from The Puzzling Piece to sell 60 puzzle piece necklaces and key chains. In return, they will give Garrett an iPad!

You can find more information on our family blog.

New IEP

2010-12-18T22:41:00.000-08:00

Todd, Bronson and I sat through a 3.5 hour IEP meeting on Friday. Yup.

THREE AND A HALF HOURS.

I think the ten of us were all starving by the time we got out of there. No one had eaten lunch and we went from noon to around 3:30. It was during Garrett's school time, so he was in class. Bronson did very well playing in the room and going to his friend, the principal, when he needed something. She even had him go into the auditorium for the holiday assembly for a little while. He loved it.

Garrett has an entirely new IEP now. We even changed his IEP category. His last IEP was classified as Developmental Delay and while that is one of his diagnoses, it doesn't entirely encompass what his needs are. He is now classified under the Autism category, which we all think is a better fit.

His last IEP noted delays in fine and gross motor skill, but he did not have services for either of those in his IEP. He has been evaluated at his new school and now has some new goals and new services being provided. They'll be addressing his sensory and safety issues as well as his motor skills.

The school's Speech-Language Pathologist will be working on some augmentative communication devices for Garrett to use during school, like a "one-step communicator". We spoke about sign language since his private speech therapists and his ABA team had been working on that for the past year. I feel like he is too prompt-dependent and the sign language has become frustrating for all of us. The SLP feels that sign language often increases prompt-dependency, making it ineffective.

The team feels that being in an inclusive environment is working well for Garrett. In just a few weeks, he has made some great progress in transitioning and in playing with his peers.

It was a long meeting, but honestly, I didn't mind because we got a lot done. I feel like this IEP is more thorough and that this team actually cares about Garrett.

The Wonderful World of Special Education

2010-11-22T10:52:00.000-08:00

I met today with Garrett's teacher, the school's Occupational Therapist, Speech Pathologist, and Principal. We were filing to modify his current IEP (Individualized Education Plan). They noticed while reviewing his IEP from Virginia, that although Garrett's scores for motor skills were extremely low, there were no services for OT or PT. There was one OT goal in his IEP, but no services. We're going to correct that.

They are going to observe and see what kind of help he needs. If further evaluations are needed, they'll create and assessment plan.

One of the biggest modifications to his IEP is that he went from a self-contained Special Education classroom to an inclusion setting. So far, he seems to be doing well. His teacher said that he's been doing well with eye contact, and is even starting to give eye contact with some other students. He even tried to join some other students while playing on Friday. I'm very excited to see how he does the rest of the year.

Wanna see what a change in routine does?

2010-11-04T11:14:00.000-07:00

No ABA and no school has taken it's toll on Garrett. His nap schedule is all over the place and I'm not sure what to do about it. Trying to keep him occupied while trying to unpack and take care of Bronson is nearly impossible.

His school registration has to be signed by our Sponsor (Daddy), and since Daddy isn't available right now, the paperwork is just sitting on my desk. Sigh.

We notified Tricare ECHO that we've moved, but they can't assign us a new ABA provider until we have a new ABA referral. So we went to Garrett's well child visit today and got a referral for the developmental pediatrician, and now we have to wait for an appointment with them to get the ABA referral.

I'm really not sure how much more of this I can take. At least we know that we'll be here for two years. But I'm pretty sure that we're looking at getting out after that. These moves are horrible for Garrett. The break in therapy and the break in routine almost destroys any progress that we've made.

School and ABA

2010-10-02T14:19:00.000-07:00

Garrett has ABA for two hours, four days a week. We drive the 35 minutes home, feed him some lunch and send him off on the bus. When he gets home, he usually doesn't wake up as I get him off the bus.

He gets up at 6:45 and is going non-stop until 3pm. This poor kid is exhausted.

I don't know how well he's doing in preschool because he can't tell me. There's a notebook that comes home every day to tell me what they did in class but I don't actually know how HE is doing.

I still feel like he's making some progress developmentally, but his behaviors have gotten worse. The spitting has returned. The headbanging has come back, too. He actually kicked himself in the head today while we were in the car.

I know that this is going to take a long time, but it's hard to watch.

First day of school

2010-09-07T17:26:00.000-07:00

We had a very busy day today. We rushed out the door at 6:45am to take Daddy to work and head across town to ABA. Got out of ABA at 10, home at 10:40, packed his big backpack and ran outside to wait for the bus at 11. He didn't get home until after 3 this afternoon and he was exhausted.

I'm assuming that he had a good day because I didn't get a call from his teacher. But since he can't tell me how his day went, I have no clue. His bus aide said that he spit the whole way home, which doesn't surprise me, considering how tired he was.

Hopefully the week continues without any problems.

Preschool!

2010-09-02T20:43:00.000-07:00

Garrett will start special ed preschool next Tuesday. We went to the school to meet his teaching team tonight. He loved the classroom. He went straight for the trampoline.

Garrett will be taking the bus to school after ABA and will be at school for three hours, five days a week. He'll be getting speech at school. They didn't include Occupational Therapy in his IEP, but his teacher said that they do work on fine and gross motor skills and if she sees something that needs attention, she'll make sure that they put it in for him.

Updates and such

2010-07-10T17:52:00.000-07:00

We are working on eating with utensils now. He's doing pretty good, we just have to keep an eye on him and make sure he doesn't try to use his other hand to grab the food.

He really likes to draw, but he started chomping on crayons again, so we're sticking with a magnadoodle for now.

His ABA team is concerned that he is prompt dependent. He knows the sign for drink. He has used it independently on occasion. He knows when he is expected to use it, but will not sign it unless he is being prompted. We have slowly started to use less hand over hand, but I still need to touch his elbow for him to sign. This isn't good.

We thought that he knew what his signs meant, but now we're not sure. We tried to teach him "please" at his OT session on Friday. As soon as we took his hand, he started to sign drink eventhough there were no cups in sight.

So many new things!

2010-06-05T08:39:00.001-07:00

Finally, at 31 months... Garrett draws with crayons (instead of eating them).

He also eats spanish rice and plays peek-a-boo.

Applesauce!

2010-04-11T21:55:00.001-07:00

Garrett has been eating applesauce since Tuesday. I tried to feed it to him with a spoon and he wouldn't go for it. I was ready to give up, but decided to put some applesauce right on his tray. He tried to move it and didn't like that it stuck to his hand so he wiped it on the edge of the tray. When it still didn't come off, he licked his fingers. His face lit up, so I knew that he liked it. I set the whole bowl of applesauce in front of him and let him go at it. He shoveled into his mouth with his hand.

He's had it four times since then and he really likes it.

Another big step for Garrett.

Occupational Therapy - Session 2 with Michelle

2010-04-05T08:36:00.000-07:00

Michelle gave us a new sensory brush and taught me to combine the brushing protocol with joint compression. We did 10 reps at the beginning of the session and Garrett calmed down almost immediately. He sat down and played with us for about 40 minutes. I'm supposed to do it every two hours, but Michelle said that we can just try to do it 2 to 4 times a day and work it into our routine.

Michelle is really trying to work with me on Garrett's feeding issues, since most of his problems are sensory related. We made a list of foods that he will always eat, foods that he eats in cycles, and foods that he always refuses. She also made note of his new preference for straight-from-the-freezer frozen waffles and the fact that he takes bites of bagels, spits them out and then goes back to them to eat.

We are going to combine textures to see what he does. It's going to be a lot of trial and error.

He signs drink!

2010-03-26T16:21:00.000-07:00

Garrett has been signing drink at ABA for a few weeks now, but he would never do it for me. I've still been doing hand over hand and making him sign before I give him a cup and he would just grunt and get mad at me. Today, we did the same thing. I made him sign hand over hand the first time. He took a drink and handed the cup back to me and then made the sign with him hand and I pushed it to his face and said "drink". The next time around, he did it by himself!

THIS IS HUGE!

2010-03-21T17:59:00.000-07:00

I was sitting on the couch tonight watching a movie with Bronson. Garrett was playing with some toys in front of us. Suddenly, he walked up and climbed on my lap. He does this every once and a while, so I didn't think anything of it.

But then he grabbed my hands and put them on my face.

He initiated a game of peek-a-boo!

This is BIG!

Update to head banging

2010-03-14T15:05:00.000-07:00

We met with a physician's assistant at the base clinic on Friday. She said that Garrett has a hemotoma and that if the behavior doesn't stop, he will eventually develop a bone callus.

No bueno.

She did recommend a helmet. I picked him up a martial arts sparring helmet at a second hand store. It doesn't fit him correctly and he hates it. I sent an email to his OT, since we won't see her again until Friday. I'm also thinking about sending an email to his developmental pediatrician and see if he can get Tricare to cover a real "special needs" helmet. Those are pretty expensive since most of them are custom fit.

The PA said that the next step is anti-anxiety meds. She said that's the last resort, but unfortunately, it would be next step if we can't get him to stop with behavioral therapy and the helmet doesn't deter him. I would HATE to put him on meds already. He's still so little.

Head Banging

2010-03-11T16:34:00.001-08:00

The head banging stopped for two or three weeks. He's doing again and now he's hitting his head even harder. I made him an appointment with a doctor in the military clinic. It's not his regular doctor, so we'll see what happens.

I'm pretty sure that our only options are medication, a helmet or just continuing with ABA and trying to find a different behavior that fills the need.

I really don't want to put him on medication. He's so little.

Eye Stim

2010-03-04T13:09:00.000-08:00

Garrett has been doing something with his eyes for the past two months or so. We call it giving the lights dirty looks because that's what it looks like he's doing. We usually stop him before he gets too into it. Today when I picked him up from ABA, he was doing it while I was talking to his therapists. I didn't stop him because I was getting a recap of his session. After a minute it went from what you see in the video below to rolling his eyes back. I finally put my hands over his eyes and said that it was creepy. One of the ABA therapists said that it's actually stim. I've never let it go that far, so that had never occurred to me.

Today's Update

2010-03-03T12:22:00.001-08:00

Garrett woke up with a runny nose this morning. It wasn't too bad, so we packed up and drove through the slushy snow to ABA. When I picked him up, they said that he had done great with his program but wouldn't eat or drink. They said he was pretty grumpy and that his nose had been running constantly. At least he did his puzzle and shape sorter!

After a nap, Garrett had a fantastic speech session. He did the shape sorter. When he was finished putting the shapes in, he tried to reach his hand in and grab one of the pieces. His therapist said "Open?" and he replied with "oh oh oh". One of the highlights of this week's session was the blanket swing. We've done it with Garrett before. He liked it, but never really communicated that he wanted more, just that he like it. Today, we did it once and he repeated the therapist when she said "Wee!". When we stopped, we both let go of the blanket. He stood up and came over to me. I asked him what he wanted and he took my hand and put it over the corner of the blanket and said "Wee." I'm so excited! Unfortunately, the blanket swing takes two adults, so I can't do for him all the time.

Speech Therapy, 2/24

2010-02-24T12:10:00.001-08:00

Garrett session this afternoon was great. He decided to sit on his trampoline for the entire hour, which was just fine with us. Every once and a while, he would stand up and jump, then sit back down with a toy.

He gave us a lot of eye contact today. We were trying to get him to sign "more" by withholding toys that he needed. He could see them and would try to grab the therapist's hand to show her that was what he wanted, but she stopped him. He eventually would hold out his hands for us to manipulate, but still resisted us trying to make his hands touch. About twenty minutes into his session, he did sign "more" once. He wouldn't do it again.

He is making a lot more vowel sounds now. My favorite is "oo yee". Mostly because it sounds awesome.

ABA progress and a new speech therapist

2010-02-17T16:37:00.000-08:00

The report from ABA this week is that Garrett is no longer head banging. He still gets frustrated and rocks, but isn't getting to the point where he is hurting himself. He was very resistant to signing last week. I've been trying to get him to sign for the past year with no luck. The past two days, he has let the therapists sign hand over hand with him. Today, I tried it with him during out afternoon snack and saw it in action. I showed him some cereal and he put his hand up for me to manipulate. I put his other fingers down and said "cereal". He then looked at me and nodded.

We met Garrett's new speech therapist today. We went over the program and Garrett's goals. We talked about using pictures of people and objects that Garrett knows and getting him to point. We'll see her again next week.

Garrett started ABA today!

2010-02-09T09:02:00.000-08:00

His therapists are great!

I stuck around for the first 20 minutes or so. He was fine when we arrived, but once the other kids started coming in, he freaked out. He started banging his head on the floor. They asked what I usually do to stop him, and I told them that I usually just slide my hand under his head. They just wanted to make sure that they're doing it the same way. I took some rice cakes in for his snack. He saw them on the table and instead of getting the attention of the therapist that was sitting at the table, he came across the room and tried to take my hand. I folded my arms, which he didn't like. But he did go and stand next to the table and wait for the therapist to pick up the baggie. Then he gave her eye contact and was rewarded with praise and a rice cake.

When I picked him up after the two hours, they said he did great. He slammed his head into the floor a few more times and now has rug burn on his forehead. He didn't show any warning signs that he was going to bang his head (like throwing a tantrum, or going on all fours), so they didn't have time to slide their hand under before he'd already hit the carpet once. The carpet in the playroom is not soft. Hopefully that will deter him from banging his head after a few days.

One of the therapists did some hand over hand signing with him. He didn't object, so she said that she'll keep trying and see how he does with it. They are going to write up his plan this week. I was told that he showed some interest in an insect puzzle and a shape sorter. Those are the lowest level toys that are, so he's literally starting from the beginning. It really does show his developmental levels. I say it all the time, but he's a 10 month old in a two year old's body.

We'll see how he does tomorrow.

Jumping through hoops

2010-02-06T18:16:00.000-08:00

I feel like I have neglected this poor blog because there hasn't been much to report. Garrett has been without therapy for over two months. He is going back to a lot of his behaviors (head banging, spitting, not eating). It's been very depressing to see all of the progress we were making disappear.

But this week, we finally have some news!

We got our notification that Garrett's records had been transferred for ECHO and we were given two options for ABA therapy. I called and spoke to the one out of Suffolk, and they have a center that's local. They have openings Tuesday, Wednesday and Thursday mornings for two hours each. I told her to go ahead and sign Garrett up. We both contacted our ECHO coordinator and if we've jumped through all of the right hoops, Garrett should be starting ABA on Tuesday.

We also got a visit from the early intervention coordinator this week. I signed all of the paperwork and they'll be writing up a new IFSP for him. Our coordinator will be coming back this Wednesday with some other forms for me to sign, and Garrett will begin Speech and OT before the end of the month.

Yesterday was a HARD day.

2010-01-21T07:33:00.000-08:00

Tuesday night, Garrett was having tummy troubles again and there was nothing I could do to comfort him. He threw up three times and was in so much pain that he couldn't sleep. He was trying but he would just wake up screaming a few minutes later. It was horrible. I finally brought him into bed with me to see if I could do something to make him feel better. I tried to rub his back, but he didn't want to be touched. He took my hand, placed it on his tummy, and then rolled over. Neither of us slept that night.

He was finally starting to drift off around 6:30, when Bronson came in and woke him up. We all got up and changed clothes. I fixed breakfast. Garrett only ate two bites of his toast. He started falling asleep on the stairs around 10, so I carried him up and put him in his crib. I usually change him back into his pajamas before he takes a nap, I made the mistake of not doing that.

When he woke up before 2, I went into his room and saw poop on the wall.

Yeah. Yesterday SUCKED.

After two baths, more laundry and disinfecting everything upstairs, I came down to feed a now starving Garrett. I made him a protein shake (hemp milk, rice protein, strawberries and bananas) and that was sufficient to fill his little tummy.

He went to bed at 7 pm and woke up at 8 this morning. Today is already a million times better than yesterday.

New routines

2010-01-17T13:34:00.001-08:00

With Garrett's communication difficulties, even something as simple as a drink of water requires a routine. It has taken almost the entire six weeks that we've been here to get this down. He still has trouble with it sometimes, but if I give him a cue, he knows what he is supposed to do next.

I leave a cup on the edge of the bar by the fridge where Garrett can see it. If he wants a drink, he guides me to it and I'm hoping he will eventually point to it. I pick up the cup and hand it to him, giving him another opportunity to communicate with me.

Garrett hands me the cup and I fill it with a half inch of water.

When he is done drinking, he has to hand it back to me to indicate that he wants more. If he doesn't hand it back to me, he's done. It has taken a LONG time to get this part down. Even now, sometimes he'll forget and he'll throw the cup down and scream at me. If he does that, I'll wait until he picks it up again (which has only happened once), or he guides my hand down to pick it up, and we start over again.

Note: Did anyone notice all the eye contact in these photos? Crazy! Because he's looking at the camera. He's not looking at me.

He's been approved!

2010-01-15T12:03:00.000-08:00

We got our referral authorizations this week for Garrett's therapy. He's authorized to receive services for Speech and OT. And it's at least twice what he was getting through Montgomery County.

We're still waiting on approval for ABA and that will hopefully come through next week.

Trampoline!

2010-01-11T08:08:00.000-08:00

I finally got around to setting up the trampoline that Garrett got for Christmas. We decided not to spend the extra money for one with handles because we thought he would hurt himself. But right now, I'm almost wishing that this one had a handle. Garrett doesn't have the core strength to stay balanced while he jumps. He's all over the place. I can stand there and hold his hands, but then he wants me to pull him and make him jump. I want him to do it on his own, so this might take a little while to get used to.

Garebear, The Mashed Potato Eater

2009-12-30T20:27:00.001-08:00

It wasn't just a fluke! Garrett will happily eat mashed potatoes now.

*note: The spoon is just for show. I always put utensils with his food just in case, but he never uses them.

Look what my boy can do!

2009-12-29T09:37:00.000-08:00

I've had these on my camera for the past month, but I just had to share.

I'm so proud of Garrett!

It takes a lot of concentration for him to put the blocks together. He gets easily frustrated if he can't figure out how to turn the block at just the right angle so he still needs some help. This is something else that we're still working on.

For Christmas, Garrett got some toys that he's used in therapy over the past six months. We'll be playing with those from now on, too.

What a difference a month can make.

2009-12-29T04:58:00.000-08:00

Garrett did not do well with this move. He was at a few different houses on the day that the movers came. By the time we got him home, he went straight to bed. When he woke up, I changed his diaper and then let him loose to run around. He walked around the living room and dining room and noticed that everything was gone.

He flipped.

Luckily, we had kept his little chair that he eats in. I sat him down and put his tray on and all was right with the world for a little bit.

It took him a few days to get settled into the new house. Once our household goods were delivered he did much better. He has his own room here, which is a great improvement for him.

Since we've been in the new house, Garrett has made a great discovery. He can take me by the hand and guide me to something that he wants. This is much better than dealing with a twenty minute screaming fit and having to guess. We're still working on it, because he doesn't point or gesture, he just takes you to the general area of what he wants. It's not perfect, but we'll take it!

He has not started his early intervention therapy yet. We're waiting on referrals and couldn't get in to see his new developmental pediatrician until January. We have met his new primary care manager and he is awesome. He put in for our specialty referral and asked about Garrett's improvement with speech and OT. When I mentioned the dietary intervention, he listened. He didn't look at me like I was crazy, so he gets a thumbs up from me.

Great progress!

2009-11-20T09:32:00.000-08:00

Garrett began following simple directions this week. He still doesn't respond to his name 100% of the time, but that one's gonna take some time. He will bring me an item and he'll sit down in his chair when asked.

I took him to the Ophthalmologist on Wednesday. These appointments are challenging for a kid that doesn't like his head touched. It took two of us to hold him still, but they were able to get what they needed pretty quickly. He is farsighted, but within a normal range for his age. No glasses for now, but they said he should be tested in 18 months.

Garrett's speech pathologist brought us some visual helpers yesterday. We've used them successfully for snack time and are working to build his understanding. I'm hoping that we can eventually use these helpers so that he can understand more routines.

Garrett is cutting molars and just wasn't up for his occupational therapy session today. He played with some Mega Blocks for a few minutes and then spent the rest of the time snacking and watching Bronson build a big tower.

This was our last week with these providers. We've loved working with both of these ladies. I'm hoping that our providers in Virginia will be just as wonderful. We've been spoiled here.

Garrett loves muffins!

2009-11-14T20:52:00.000-08:00

I've been making muffins for the past two weeks or so, just to hide fruits and veggies for Garrett. We've tried a few different combinations, just replacing the oil with baby food purees. I've also chopped up some apples into some of them.

It's working. He'll eat any muffin I throw in front of him, with the exception of pumpkin. Which is just fine, I'll keep my pumpkin puree for myself. :)

STOP THE PRESSES!

2009-11-09T18:33:00.000-08:00

This may be a totally lame thing to get excited about. Typical parents of typical children don't usually get excited about little things like this. But I am no typical parent.

Garrett ate mashed potatoes with his dinner tonight. He has avoided anything with that texture for over a year. I always put them on his plate anyway and am not surprised when he doesn't even touch them.

Not so today! He dug in with his fingers, wiped his hands off on the tray and then licked his thumb. I thought for sure that he would spit it out and make a huge deal of it like he normally does. Nope. He just kept going back to load up his fingers.

So what did this mommy do? I changed my facebook status and twittered about it.

STOP THE PRESSES! Garrett just ate mashed potatoes! Take that, Oral Motor Sensory Issues!

Developmental Peds - Visit Two

2009-10-30T10:25:00.000-07:00

We met with Garrett's Developmental Pediatrician yesterday. It was a follow up visit to go over the tests that had been ordered 2 months ago.

Genetic testing, hearing and the MRI all came back normal, which we already knew. Our ABA referral had fallen out of the system while we were waiting for the EFMP and ECHO paperwork to be filed. The doctor put that referral in again, but now it's close enough to our move that I doubt Garrett will start ABA until we're in Virginia. I asked the doctor about a nutrition consult and he gave us a referral to the pediatric dietitian at Walter Reed.

The doctor also filled out paperwork for us to get a disabled placard through the Nevada DMV. That will make things a little bit easier while Todd is deployed.

GFCF cupcakes were a hit!

2009-10-27T19:46:00.001-07:00

Garrett loved his birthday cupcake!

I used a gluten free yellow cake mix from Cherrybrook Kitchen (using canola oil instead of butter) and Pillsbury Vanilla Funfetti frosting. I now have eleven unfrosted cupcakes in the freezer that I can pull out for special occasions (like our Halloween playgroup on Friday).

One thing that I learned from this is that Garrett will eat cupcakes. We've given him cake before and he usually just smashed it into crumbs. I'm going to try to make some GFCF muffins using fruit and veggie purees to see if we can get something besides chicken, pretzels, chips and apples into his tummy.

Back on the diet and my baby is now 2

2009-10-26T07:02:00.000-07:00

Since I got my commission checks from my end of September Pampered Chef shows, we can put Garrett back on the GFCF diet. This time, we're going slower and following the "Going GFCFSF in 10 weeks!" recommendations on the TACA website.

Garrett has been dairy free since Wednesday. He's drinking fortified almond milk now. We're still looking for a good margarine/butter replacement. We have the Smart Balance with Flax Oil, but haven't been impressed.

Garrett turns 2 today! I'm making a regular cake for the family and some GFCF cupcakes for Garrett. We'll see how they turn out. I'm a little nervous.

Garrett has been off his diet for a week.

2009-10-17T15:54:00.000-07:00

It was a family decision to take Garrett off of his GFCF diet until after we move. Todd said that he can't tell a difference. I think he's just not paying enough attention. I can tell a difference. Garrett's speech pathologist could tell a difference when she met with him on Thursday. His eye contact is pretty much non-existent now. He wouldn't engage with us during his speech session. He spent most of the time staring at the floor.

Small update

2009-10-01T09:45:00.000-07:00

Both boys were sick last week, so Garrett did not have therapy.

This week, we started Garrett on probiotics. We're using Nature's Way Primadophilus® Kids. I picked the 30 ct bottle up at Whole Foods Market for around $7. I also purchased some xanthum gum and potato starch so that I can do some GFCF baking using the flours that I bought a few weeks ago. One of the TACA moms gave me a copy of Special Diets for Special Kids and I'm very excited to start using it.

Garrett had a great OT session yesterday. He referenced Bronson a few times while Bronson was playing with a different toy.

Today, the speech pathologist brought the More Than Words dvd. We went over some goals for Garrett (like more eye contact, taking turns, etc.) and showed a few ways to get some interaction and give him an opportunity to communicate.

This week's OT and Speech sesions.

2009-09-17T18:06:00.000-07:00

Both of Garrett's therapists mentioned some great improvements in his attentiveness and interaction.

From Garrett's Occupational Therapist:

Garrett is now on a GFCF diet and mom feels he's really responding well. He is now pointing!

Garrett played with us for an hour with just one trip to his room to get a book. We introduced brushing with a sensory brush and he enjoyed it, especially on his hands. He played and explored a variety of toys and showed true joy when playing with the accordion tubes. He also let us help him with a hammer toy and shape sorter. He did much more referencing of mom and big brother.

From Garrett's Speech Pathologist:

Great Session! Garrett was both easier to engage and stayed engaged for longer periods. We were able to get Garrett to let us intrude on his play with a magnetic writer and beads. We imitated him and then he imitated us! ... Garrett loved Row Row Your Boat. A slow version with lots of pull & push calmed him. Garrett said "down" at the end, playing up/down from mom's lap!

He did say something that sounded like "down" after I said down and let him fall backwards. He wouldn't repeat it again. I am going to keep working on it.

Garrett is making excellent progress.

2009-09-10T07:20:00.000-07:00

Garrett flew to California with me for a week to attend my sister's wedding. He did very well on the flight there.

I am constantly amazed at the progress that Garrett is making. He gave us a lot of good eye contact this week. He even played a face to face game with my sister, Stephanie. I had to get it on video because I wasn't sure that people would believe me.

He would not have done this a month ago.

Garrett's occupational therapist came yesterday. She was so proud of him for staying with us. He had to get away for a few minutes, but he came right back. He attended to the activities and even let me take turns with him for a little bit.

Garrett started pointing!

2009-08-26T07:39:00.000-07:00

While at the TACA "coffee talk" last night, Garrett grabbed someone's phone off the table. He pointed to the screen.

That was the first time that I've ever seen him point. I wasn't sure if it was intentional or not, so I didn't make a huge deal about it.

But he did it again this morning! We were playing with the See n' Say and he pointed to a few of the animals. Now I'll just have to focus on getting him to point to things that he wants and we'll have some non-verbal communication going on.

I'm so excited!

We've gone GFCF!

2009-08-21T06:20:00.000-07:00

We are on day three of the GFCF diet. Garrett doesn't have much variety in his diet anyway because of his food aversions and sensory/texture issues.

Things he will eat:

waffles
pancakes
cereal
yogurt
chicken nuggets
cold baked or grilled chicken
peanut butter sandwiches
french fries
popsicles
candy

I have found GFCF replacements for most of those items, but our go-to meal for Garrett has always been a peanut butter sandwich. If he wouldn't eat what we were having, he would have a sandwich. I refuse to pay $6 for a little tiny loaf of gluten free bread, so he's going without right now.

One of his other problems is that he won't eat what he doesn't recognize.

For breakfast this morning, I gave him GFCF waffles, scrambled eggs, banana and rice milk. I knew that he wasn't going to eat the eggs, so I spread some peanut butter on his mini waffles. He wouldn't touch them. After watching him pushing them around the tray for 10 minutes, I finally stepped over and shoved a piece in his mouth. I know that it's something he'll eat, but he doesn't recognize it as something he likes. We have to do that a lot.

Official Diagnosis

2009-08-17T16:31:00.000-07:00

Garrett had his appointment with his Developmental Pediatrician today. We weren't sure what to expect at this visit. We weren't sure if he would just be gathering information for a future diagnosis or if we would be jumping right in.

The doctor took Garrett's history, some family history and asked us questions about his development. He then did some tests with Garrett (a peg board, cup and blocks, etc.) and did a quick physical exam.

Then came the hard part.

Although we were expecting it, I don't think we could ever be fully prepared to hear it. Garrett is autistic. We've known that for 3 months, we just needed an official diagnosis.

Now that we have a diagnosis, we can enroll him in the Exceptional Family Member Program. He will also qualify for ECHO, which will cover his Applied Behavioral Analysis.

Audiology, appointment #3

2009-08-12T12:40:00.000-07:00

Today we went to Walter Reed for another pediatric audiology appointment. They asked us at our last visit to have Garrett practice wearing headphones to prepare for the tests. Garrett doesn't like having things in, on or anywhere near his ears.

They tried inserts and Garrett pulled those right out. I held his hands, but he still rubbed his head and moved all over so that the inserts would fall out.

The ditched that idea after a few minutes and started the normal testing. Garrett remembered this part and was looking for the bear and the bunny as soon as we sat down. They brought out the pegs to get his attention centered. Unfortunately, with Garrett there is no middle ground. He is either not interested in the toys and is looking around too much or he's so focused on the toys, he doesn't turn at all when they start the sounds.

They tried the individual ear testing again, but with headphones. That lasted all of 30 seconds. Garrett wanted nothing to do with them.

They tried to get a fluid reading. This is when the meltdown started. He had already put up with us putting things in and on his ears, but holding him down and sticking stuff in his ears... He was done.

They want us to come back next month for a PABR (Pediatric Auditory Brainstem Response) test.

General Testing Information:

For some children, reliable results from behavioral hearing tests cannot be obtained. The ABR can provide useful information about the amound and type of hearing loss and the function of the auditory nerve.

During the ABR, sounds are presented to the child's ears through earphones while he/she sleeps or rests quietly in a bed or chair or in a parent's lap. Small electrodes are taped to teh ears and head to measure the response. The test usually takes about one to one-and-a-half hours.

The ABR is a noninvasive, safe and painless test. It requires that the child remain still and quiet. Some children will lie quietly or sleep, but many will require a light sedation. If sedation is indicated, your child's appointment will be coordinated with the Pediatric Sedation Unit; a pediatrician will evaluate your child prior to the sedation and give medical clearance.

They want to sedate him. I don't blame them. Todd isn't too thrilled with this idea.

Speech Therapy session 3

2009-08-06T20:27:00.000-07:00

Garrett is still not talking, but we're really working on getting him to communicate in other ways. Eye contact is a big thing right now. We've been trying to wait until he looks at us to do what he wants.

Today during speech therapy, he was playing with a Little People house that has a bell on it. He can't make the bell ring by himself. He needs either Chris or I to do it for him. He would try to push it and when it didn't work for him, he would grunt. Chris would wait until he looked up before she would ring the bell. At first, he would only look as high as her hand, so she raised her hand up to her cheek. That brought Garrett's attention upward and he began to look up at her to communicate that he wanted her to ring the bell again.

I've been doing the same thing when he wants to jump. I'll make him jump once. I know that he wants more because he bends his knees, but I wait until he looks up at me before I will respond.

Garrett loves it when Chris brings out the beads. He loves to shake them around, or put them on the ground and rake him fingers across them. Chris would like me to put some beads in a container that Garrett can't open. He'll need to communicate to me that he needs help to open it if he'd like to play. I have a plastic shoebox that I can use, but I'll need to go buy some beads for him.

Occupational Therapy session 3

2009-08-05T07:20:00.000-07:00

Garrett is making great strides with his early intervention services. He played with Bronson for a few minutes today. He never shows any interest in what his brother is doing, so this is a HUGE thing. Our OT brought some Peek-a-blocks today, and since Garrett was so interested in them, she's leaving them with us until she comes back next month. He likes them because of the texture. He gets that sensory input on his hand when he pushes them together.

Here are the OT's notes for today:

Garrett did not leave us at all today. He was engaged in toys and focused. Does less spitting when engaged in play. Approached brother who was playing with a toy and started playing at same time. Held up toys to get eye contact - then gave to Garrett.

He takes me by the hand

2009-08-04T05:43:00.001-07:00

This past week, Garrett has started taking my hand. He started doing it when we were getting ready to leave the apartment. Friday, we had some company, including two boys around Bronson's age. The three of them were running around the apartment playing and just having a good ol' time.

Their good ol' time was too much for Garrett.

He walked over to me, grabbed my hand, and lead me to the front door. There was too much going on and he wanted to leave. Garrett spent the remainder of their visit in his crib by himself. He was completely content to just sit there and stare at his sheet.

He has lead me to the door a few times since then. He doesn't lead me to anywhere else, just the front door.

Occupational Therapy, session 2

2009-07-29T07:29:00.000-07:00

We had another great OT session this morning. I'm so happy that I'm learning how to join his play and attend to his sensory issues.

We got some great people games in today. He let me sing to him. He played wrestle the ball with the therapist. He even chased Bronson down the hall a few times.

I learned to do deep joint compression on his knees and ankles. He really responded to that. He communicated that he wanted more by touching the therapist with his leg or raising his leg up to her hand. He also liked it when I held him under his arms, picked him up off the ground and made him jump, but he didn't like facing me when I did it.

We were able to redirect stimming twice. I've involved Bronson in this process. When he sees Garrett spitting, he gives him his teether or chewy tube. It doesn't work every time, but I also tried to make Garrett understand that he can spit all over his mouth toys, but he's not allowed to spit on the furniture.

Structured Play - block sorting

2009-07-28T11:50:00.000-07:00

I've been working with Garrett and doing some structured play. He's usually okay with putting blocks into a cup and dumping them out again, then he goes into his sorting mode. Today, he didn't want the cup. We went straight for turning, sorting and throwing. I pulled out the camera so I could document his process.

Garrett will play now!

2009-07-26T17:34:00.000-07:00

It's only for a few minutes when I sit him down to do it, but he's not protesting nearly as much. I sit him down twice a day for a few minutes to play with his blocks or his stacking rings. He will take the rings off the pole, but he doesn't want to put the blue ring on first. He always tries to put the orange or the yellow ring on and then gets mad because the others don't fit or that there's empty space at the bottom. This morning, he put the yellow, orange and red rings on. He then picked up the green and blue rings and took off down the hall and threw them at the front door.

He will put blocks into a container if I'm doing it. If I just pull the blocks out, he starts taking them out of the bucket and placing them in front of him. He turns them around so that the red side is up. If there isn't a red side, he chucks it behind him. It's something that if you weren't looking for it, you wouldn't really notice, but once you realize what he's doing, you think about how weird it is.

Garrett's first occupational therapy visit

2009-07-22T07:39:00.000-07:00

The OT came by this morning. It was more of a meet and greet to see what he can do than an actual therapy session. He did more for her today than he would for the evaluators last week. He was pretty mad, though. We wouldn't let him out of the living room. Once we got him to calm down, he would play for a few minutes.

He put blocks into a cup with a 2 inch opening, then turned it upside down to get them out. His OT said that he can play, we just have to get him to sit down and do it. She thinks that he is taking in information, just not doing anything on queue. He also played with the stacking rings. Usually he just throws them, but after some protest, we were able to get him to take them off and put them back on once. He had no interest in doing it again.

She is going to change our service plan and have Garrett do therapy once a week. She is going to start with fine motor skills and build from there. She wants me to make him sit and play twice a day for 5-10 minutes; just to get him used to sitting and playing. She sees a lot of potential and is glad that we're getting him started now.

She also said that Bronson scares her with the things he can do. She thinks that Garrett may be just as intelligent, we'll just have to bring it out.

Therapy

2009-07-20T17:08:00.000-07:00

Garrett has been approved for two hour long sessions of occupational therapy. He is also being set up for speech therapy once a week for two months.

We got a call from the occupational therapist today. She wants to come by on Wednesday and meet Garrett.

YAY!

Present Developmental Levels

2009-07-13T10:22:00.001-07:00

Garrett had another evaluation today by two members of the early intervention program. They used the M-Chat, Mullen Scales of Early Learning and 20 month ASQ (Ages and Stages Questionnaire).

Here are some stats from their report.

Cognitive Development - 7 months
"Explored the puzzle but did not place pieces, turned cup upwards, showed interest in book as hinge, turned a few pages at one time. Did not attend to pictures."

Receptive Language - 1 month
"Enjoyed looking in mirror, attends to words and movements, put arms up to be picked up. No response to whistle, does not turn to name. Does not follow simple directions."

Expressive Language - 8 months
"Does not play peek-a-boo, plays with sounds, vocalizes when he wants something. Plays with consonant sounds "g", "d", "t". No real words, shook his head no (Mom had not seen this before)."

Social-Emotional - 8 months
"Prefers to be by himself. Does not acknowledge 2 1/2 year old brother. Does not take interest in toys. Will watch ball bounce. Does not like to be cuddled. Goes off by himself often."

Self-Care - Dressing 14 months, Feeding 18 months
"Cooperates with tooth brushing. Allows Mom to wash his face. Does not use utensils but will finger feed. Drinks water from open cup with assistance. Sleeps well. Sucks through straw."

Fine Motor - 11 months
"Took 4 blocks out. Did not stack blocks today. Turned pages several at a time. Used hand as rake to pick up penny, partial pincher grasp. Transferred toys from one hand to another. Did not use 2 hands together."

Gross Motor - 17 months
"Can walk up and down stairs non-alternating. Runs stiffly. Not kicking ball yet. Threw ball underhand. Stands, squats. Will roll over onto stomach from back."

Summary Statement and Recommendations:

"It was a pleasure to meet Garrett and his family this morning. Garrett is a 20 month old little boy who was difficult to engage. He was interested in test items on his own terms but did not appear to understand directions given. He sometimes later imitated actions made with test items. Garrett did not respond well to auditory stimuli in general. Garrett makes a few sounds that he frequently repeats in strings. Garrett qualifies for service with infant and toddlers by showing a 25% delay in several areas: receptive and expressive language, problem solving, dressing and hygiene, fine motor and social skills. M-Chat indicates a need for further evaluation. Parents have already scheduled an evaluation with a developmental pediatrician in August 2009."

Follow-up strategies and activities:
Try some deep pressure to calm or prepare Garrett for activities. Gently push down on.
Offer choices of food. Begin with 1 he likes and 1 you know he doesn't want. Reaching or looking at 1 is okay.
Imitate the sounds Garrett makes then model the one word that seems appropriate. ie. "yes", "apple".
Give Garrett more opportunities to communicate by waiting for him to indicate by sound, word or gesture that he wants more of a food he can see in a clear container.
When Garrett is playing, try to join in his play.

Both evaluators commended us on following through with our instincts and getting Garrett the help that he needs. The earlier we can help him, the better.

One of our evaluators was a Speech Pathologist. She showed me how to imitate Garrett and model a word for him during our snack time. Because we're moving, we'll miss the next session of their More Than Words class, but she is going to come to our house and do it privately.

Garrett's Story

2009-07-08T08:51:00.000-07:00

At Garrett's 18 month well child visit, his pediatrician was concerned about his speech delay. She referred him to audiology and told us to contact our county's early intervention program. It was shortly after this visit, that my husband and I started noticing that he didn't do a lot of things that other children his age were doing. It wasn't simply the fact that he didn't talk. He had no communication at all. He didn't gesture. He didn't sign. He didn't even pull you in the direction of something that he wanted.

He still doesn't.

As I was blogging some things that he was or wasn't doing on our family blog, I had a few friends and family members mention autism. The more I thought about and researched characteristics of a child on the autism spectrum, the more overwhelmed I became.

At the end of June, he has his intake evaluation with the county early intervention program. He was now 20 months old. That was the first time that I had ever seen him stack 4 blocks and draw a line with a crayon. Both of those took some prodding and a lot of reminders to not put them in his mouth. The results from that evaluation were not surprising.

Communication - 0
Gross Motor - above cut-off
Fine Motor - cut-off is 40, Garrett scored 30
Problem Solving - cut-off is 30, Garrett scored 10
Personal/Social - 0

Garrett has also had two hearing tests. His first test was not valid because he was throwing a fit. We went in again at the beginning of July and he tested within a normal hearing range. They have now ruled out a hearing deficit as the cause of his speech delay.

He has been referred to a Developmental Pediatrician. He also has another evaluation to see which early intervention programs and therapies he qualifies for.

Welcome to Garrett's Journey.