Friday, January 31, 2014
Thursday, January 30, 2014
|He made a choose-your-own-story, speed story.|
Wednesday, January 29, 2014
As a result, she has some somewhat disproportionate skills.
While her ability to execute speech regressed and was delayed for a time, her language abilities themselves are quite remarkably advanced. Her vocabulary is enormous, her pronunciation well above her age level, and her ability to use sign language and spoken language seamlessly is fascinating. I believe she has a brain for the spoken word and could easily learn several languages and speak them nearly flawlessly if provided good instruction to begin with.
Her ability to provide emotional expression is far less developed. It took her a very long time, and she is still learning that the words for emotions are specifically connected to and described feelings. This is a very abstract concept for her, and on her bad days completely eludes her, especially when her words fail to surface. She has a difficult time differentiating between any emotions that are not to the extreme, and even then can't tell the difference between someone who is pretending to express an emotion or is actually expressing it. Some of this is purely age related, but she is not likely to simply "pick it up" as most other toddlers do. We will have to explicitly teach her, and a great deal of her understanding may simply come from memorization rather than intuition. She is not without empathy, she is simply confused about when and how to show it.
Her abstract thinking skills are much weaker, as is her ability to "pretend" or use her imagination. We have seen some improvement in these areas, but the majority of her play is still mimicked behavior, rather than spontaneous and creative pretending.
One of the most interesting things that Miss V shared with me though has to do with the way Kit hears. Kit displays and always has displayed an overwhelming preference to listen with her right ear. As an infant and still to this day, she primarily sleeps with her right ear exposed, listening even when she sleeps. When attempting to get her attention, she is more quick to respond when her name is said on her right side, whereas her response time on her left side takes her twice as long, if she responds at all.
I insisted on having her hearing tested thoroughly, because even though I knew she could hear, I wanted to make sure that she didn't have and impairment in hearing certain tones, either low or high, or that there wasn't a minor deformity that could cause distortion. She doesn't, her hearing is in fact impeccable.
She simply prefers to listen with her right ear. This is likely because she is such a logic and pattern based thinker that she can easier process things that primarily enter that ear better. It allows her to sort and identify and execute responses faster.
This means that her left ear is not processing proportional stimuli. To improve this we have been encouraged to engage the emotional side of her brain by way of humming, instrumental music, general sound effects, and emotional language.
Basically it boils down to, when we need her to follow instructions, understand a new concept or word, or identify facts or objects, we need to talk to her on her right side. But when we are trying to appeal to, or, express emotions, commendation, and bonding, we need to talk into her left ear.
In order to help calm her right side, we always begin her OT protocols on her left side. This has a two-fold purpose. One, it helps ease her mind into the routine. And two, we are using her less sensitive side to "teach" her more overstimulated side. Even so, there are many days where we get through her left side work only to be very nearly kicked in the face when I go to work on her right side. I've learned to duck and weave pretty quickly, and this is where electronic distraction comes in especially handy. That, and the promise of lollipops if she lets me "work on" her legs.
Well, that is the general gist of the Occupational Therapy that we have been implementing with Kit over the last three months. We still have a long way to go, and her needs will grow and change almost as quickly as she does. But now, I'm beginning to have a better idea of how I can best help her navigate her daily disagreements that take place between her hemispheres!
We are making progress.
Some days more than others, but progress indeed!
Tuesday, January 28, 2014
We are all born with reflexes, and as we grow these reflexes become integrated into our nervous system. In a way, they lay dormant until our body has a need for them again. This is normal, and vital to growth and balance of our complex body systems.
We are using the Masgutova Method primarily to address Kit's sensory and reflex issues. Kit has a lot of reflex issues and these directly contribute to problems with other sensory systems, problems with emotional regulation, difficulty complying and following directions, play skills, and speech. In short, they are related to basically everything.
I will give you an example of how essential integrating these reflexes can be.
I have written before about Kit's excessive need to chew and mouth things well beyond the teething stage.
Turns out this tendency occurs in relation to an improperly integrated Babkin reflex. When this reflex is properly integrated, it allows the hands to relax and spread wide instead of wrapping into a fist like a baby's hand does. But this reflex affects more than just the hand. When integrated it allows everything from the fingers and palm, up the wrist, through the elbow and shoulder, following the neck line directly to the jaw, to be fluid and relaxed and allows each individual part to perform optimally.
When this reflex is not properly integrated it results in the storing of tension in the hands (think tight, clenched fists), the wrist (contributing to poor handwriting), the elbow (resulting in more jerky, less coordinated movements), and can be especially interrupting to proper use of the jaw, specifically in the areas of chewing, and speech. Symptoms can include excessive mouthing and chewing of non food objects, clenched or tight jaw, teeth grinding, and speech difficulties, among others. These symptoms become more profound when one is under emotional distress.
The way we work to integrate this reflex in Kit is to put direct pressure with a thumb in the middle of her palm, firm, but not squeezing, for seven seconds. Then we manually stretch the muscles in her hands in five different directions, holding each stretch for seven seconds.
The earlier in the day that we do this, the more effective it is, and this is one that needs to be performed a minimum of three times a week, but she could really benefit from it daily.
For a while it was unclear to me if it was really helping her or not. The changes happened gradually so they weren't super noticeable. In fact, it wasn't until I stopped all her protocols, unintentionally, back in December that we started to see how much they really had been helping her. They didn't stop working right away either. It took about three weeks not doing them to start to see old behaviors and tendencies returning.
Then the storm hit. Over the course of the last three weeks, Kit has literally fallen apart. Even though I actively restarted our OT routine over a week ago, she continues to regress. She is doing things again we hadn't even realized she had stopped doing until it was smacking us in the face again. Quite literally some days. Her aggressive tendencies have returned, she's hitting, biting, pinching, kicking, and pulling hair again. Her seeking behaviors have intensified. Lots of jumping, spinning and running in circles again. She HATES to be touched more than ever before, especially on her head and legs. She is pushing on everything again, wants to nurse all the time again, has difficulty feeding herself, is back to chewing on her hand intensely, and will go through a pack of gum a day easily. And the worst parts of all, her sleep is a disaster, her eye contact is more fleeting than ever, and she is far less verbal than she was just a month ago.
Do I believe OT was working? I believed it did before. But I am now 1000% positive that it is essential to her being well regulated and able to stay our relatively calm, but very happy girl.
Why do I have difficulty performing these protocols with her everyday?
1.) Because four other people live here and need major portions of my attention and energies as well.
2.) Because she is not always a willing participant, and they won't work if she won't comply.
3.) To do just the daily essentials requires a minimum of 45-60 minutes daily ( 2-3 hours for all of them, not to mention all the other sensory diet activities we constantly work in all day!). That is a long time to keep Kit cooperative, and the only way to really do it is to buy her attention via electronics. I'm still really struggling to put together a daily routine, but this is on the top priority list of daily events. I am determined to make a routine that benefits us all, but is as smooth as possible!
4.) A good portion of it takes a physical toll on me. Many of the protocols require odd positioning for me, mainly because she is a toddler and cannot help me more by following more directions. It can be exhausting to administer these to her when she is cooperative, when she is not, it can be...much harder.
Nevertheless, we are getting back on track, and now I feel like I have seen the jewels that make all this worth it. Her smile, her songs, her glittering eyes, and her "I love you, Mommy", are worth every minute and drop of sweat I put in!
Stay tuned for Part 3...it gets even more brainy!
Monday, January 27, 2014
Most of her protocols also have to be repeated several times. Some three times, others 4-6.
This gives the brain practice at receiving these new messages. Plus it helps to instill muscle memory.
As the body relaxes and her brain begins to properly interpret the new information, a transformation begins to take place. Stress hormones are replaced with endorphins, breathing becomes regular, muscles becomes less tense, the heart rate slows and becomes steady.
These are the optimal conditions for a brain to work in. Parts of the brain begin waking up and communicating better. Focus increases. Muscles all throughout the body begin to receive clearer instructions, and can respond with greater accuracy. All of these responses combine to create a more cooperative setting inside the body.
Sometimes the results are not immediately visible.
We are literally rewiring her brain and teaching it things that most people automatically learn. This can take weeks to months to really see results, and we will have to do regular maintenance and tweaks for years.
Friday, January 24, 2014
Thursday, January 23, 2014
I'm trying very hard to find the silver lining in my baby not napping.
She still desperately needs one.
Her mind and body are completely dysregulated. She's litterally fighting a battle inside her body.
When she can't nap, the entire afternoon and evening feels hijacked. Nothing happens the way its supposed to. None of our goals for the day get met.
She doesn't get happier and calmer, but rather continuously more tightly wound, more oversensitive, and looses not only all emotional control but her words and ability to verbalize her needs as well.
Yesterday, the entire afternoon and evening I spent either trying to get her to sleep, or engaging her in soothing activities trying to prepare her body and settle her brain to be receptive to sleep later. She had a terrible time falling asleep last night. And she woke up at least five times in the first three hours of the night after she fell asleep.
The big kids need my help and attention, but they can't get it when I'm consumed with trying to keep my toddler from hurting herself or me or litterally tearing things to shreds. She has bruises today from throwing herself around and banging into things yesterday. I have bruises and sctatches from her. And the big kids are lonely and bickering because their lives are disrupted as well.
This is where it feels like I'm surrounded by storm clouds and can't steer my way out.
I really want to see that silver lining. ASAP...
Today was horrible.
This thought kept rattling around my head all afternoon and evening.
As I rocked and sang and did sensory integration therapy in what was quickly proving to be another failed attempt to get Kit to nap.
Argh! Come on!
As I hear the big kids bickering on the other side of the bathroom door.
Ugh! Good grief!
When Zak informs me that Kit has smeared chocolate on the dry erase board.
I just knew this was going to happen!
As I am cutting Thinking Putty out of Kit's hair because I couldn't reach her in time to take it from her, and of course she wouldn't bring it to me because today was just not a complying sort of day!
The list continues throughout the evening, and to my great surprise but wonderful relief, stopped just short of me getting thrown up on.
In fact, nobody threw up today.
No one needed x-rays.
Daddy arrived home safely.
Kit did eventually fall asleep, despite having emense difficulty staying that way.
It's ok that the kids didn't do much school.
It's ok that they messed up our pizza, we ended up with two!
Because despite the hiccups, and derailments, and unexpected twists and turns, and even the tears...
Today was still good.
We smiled. We laughed.
We got a few chores done.
I hugged each of my kids today and told them I love them.
I understood my baby even when she lost her words.
I was here.
I was engaged.
I worked hard and contributed to the good of the day.
And we all went to bed content.
Today was good!
As I look back over the course of our day's events.
There were so many things that could have been better. But they weren't any worse, so that in itself is worth celebrating.
I made a difference.
As I remember that weathering the storm doesn't mean we don't get wet, but that we got to see both sides of it. That we experienced it.
This right here is life! From Thinking Putty to free pizza! I got to experience it all.
As I think about tomorrow, but...
Please! Let them sleep in!
Wednesday, January 22, 2014
Tuesday, January 21, 2014
- You might see a toddler just playing around.
- I see her avoiding putting pants on because even soft fabrics bother her when she is feeling tired or oversensitive, and also trying to get deep pressure by pulling her legs tight to her chest over and over. So I make a game of it to help fill her need so I can help her feel like a toddler just playing around.
- You might see a cute little girl in a mismatched outfit having fun making the balls spiral down and assume I'm letting her pick her own clothes and that this is a regular, fun outing for us.
- I see my baby in the only clothes she would tolerate that day after several outfit attempts, stimming on the balls spiraling and me carefully watching for the right time to redirect her elsewhere because she is becoming obsessed and possessive and not interacting with anyone, much less the other kids we came with, BUT, considering the last time we tried an outing like this, seven months before, led to me avoiding taking all three of my kids anywhere by myself for months, this time is SO much fun and she is doing great!
- You might see a cute little girl nicely playing with puzzles and adore her ponytail.
- Absolutely! She is so cute! But I also see what a huge deal it is for her to be regulated enough to tolerate a ponytail and that it had been nearly a month since she last tolerated anything in her hair. I also am soooo proud of her for not simply insisting on dumping the pieces to every puzzle and then crying until I put them back together so that she can dump them again over and over. Instead she stacked them over and over. BUT! When her friend came in the room and started to do one, Kit not only allowed it, but helped, by handing her pieces! And then went on to settle into working several of them herself, thus transitioning herself from a stim into a joint and interactive activity with both her friend and me, AND using the toy appropriately!
- You might see a cute little pink bundle, and might worry that she's cold.
- I love this picture! She is so cute and it makes her look so tiny. But when I see her this way it also makes me sad. I see her so oversensitive that she absolutely would not tolerate pants or socks or long sleeves. And it is also keeping her from allowing a blanket to cover her. But she is desperately trying to self regulate, so she curls up into the tightest ball she can to create as much deep pressure input as possible.
- And, yes, I worry that she might be cold. I will try countless times to cover her, only to have her wake angry, shoving and kicking the weighted blanket, that took us months to get her used to sleeping under, away. If I touch her skin to feel her temperature, there is a 75% chance that it will wake her, so I make sure the heater is on and have pants ready to put on the second I feel she will let me. Obviously, I'm not going to get much sleep waking up constantly to check on her and be awakened each time she pushes off the blanket again.