Therapy

Kindergarten – In full Swing

CB gets to walk to our local neighborhood public school every morning! He may not be super-excited about leaving the house each morning at 7:10am but once he gets outside, he is ready to move and explore. He loves being outside and the walk to school is perfect. Flowers and plants to explore, vehicles of all shapes and sizes driving by, and new friends to potentially walk-with – what more could he want? He jabbers the whole way to school talking about everything he sees and shares this not only with Olem and me but with anyone walking by. CB talks with everyone which makes him already well-known at school.  It’s also garnered him several play dates with a couple of friends from the neighborhood whom he encounters on the walks to school. Beaming mama face (on the other side of this computer)!

CB lucked out this year as his kinder class only has 16 students and he shares an aide with a couple of students in the class. Socially, he is about on par with his peers. Last year he attended the 5 year old program at a nearby university program. It was play-based and allowed him to grow in his confidence and with his social skills before starting kinder. Surprisingly, eating in the noisy cafeteria with his peers has not proved to be too much to handle. Providing tasks for when he finishes eating is helping to keep him from getting into too much mischief. His headphones have also not been needed, so far. Behavior challenges have surfaced, which is to be expected, but at a lower level than we anticipated. Academically, he struggles with fine motor, math, and coordinated movement skills and his pre-reading skills are coming along, just at a slower pace. Currently, he gets 45 minutes of speech at school weekly and limited OT. He also has other accommodations and modifications based off his IEP, Individualized Education Plan. (more…)

Here and Now

I haven’t felt inspired lately to post anything so I was just thinking about what would help me in the future when I look back. One thing that is always helpful is to have an update on how CB is growing, changing, and learning. So, this is a post dedicated to CB here and now.

So far, this school year is going really well for CB. He had one tough week from Oct 12th-Oct 19th where he was physically acting out and physically responding to his friends and teachers. Then on Oct 20th, CB woke up and seemed different. He seemed calmer. From that point on, he has interacted appropriately with peers (excluding using inappropriate words with teachers and occasionally with peers). His peers seem to treat him appropriately and enjoy his company. He looks forward to going to school and from observations enjoys his time there. He is even enjoying journal time, which at this point is CB deciding what sentence to write, the teacher writing the sentence out with dotted letters, and CB tracing the letters with hand-over-hand assistance.

CB’s vocabulary and sentence structure are continuing to grow in depth and length. He can verbally express so much more. He still has difficulty saying some sounds like “l”, “w”, “f” and possibly “th”. His biggest issues are with sentence structure and motor planning to organize his thoughts. The therapists are working on asking questions and making sure he is using pronouns, articles, and correct verb structure. He still receives speech 4x a week, which really helps.

For PT, he seems physically stronger and can run longer distances than he was able to do just a couple of months ago and he can jump from higher distances. He still has problems with staying in motion while running. He normally stops after running a short distance. We are currently evaluating why this is happening (i.e., just tired, vision issues, motor-planning issues, etc.). He has an appt with a behavior optometrist in less than 2 weeks to evaluate whether the issue is vision-related (issues other than myopia or astigmatism, which are treated with his glasses).

For OT, he is slowly improving. He wore a weighted vest for the entire session today. His ability to trace letters seems to have improved. He will start a different handwriting without tears book soon in OT.

At home, we are still seeing tantrums and self-regulation issues resulting in either failed or successful attempts at hitting, kicking, spitting at, and verbally exploding at Olem, HB or me. Most can be easily mitigated but we had one on Wednesday that lasted for 20-30 minutes at home. Currently, we are exploring the technique where we remove him from the situation, briefly explain the situation, take him to a place to calm down, and ask him to let Olem or me know when he is calm enough to chat. When he says he is calm, we go back to that place where he was calming down and discuss the situation and appropriate next steps for him to be able to rejoin in the previous activity. So far, this is working pretty well. CB targets anyone around when he is upset so we leave him alone until he is calmer. This technique only works if we can remain calm during it.

On another note, he and HB play together so much and for the most part quite well. They go on so many adventures outside, build different flying contraptions and rolling vehicles out of legos, make up chasing games, and really enjoy playing with each other.

Updated blood work is just a few weeks away so I will have more results to evaluate. This lab work request also contains some stool and urine samples and additional blood work (compared to normal). This is due to a pediatric gastro we are considering and these are tests he requires his patients to get before seeing him.

CB loves most of his therapists and wishes he could see his proportionate share speech therapist every day.

 

 

Nutrition, Supplements and Therapy Update

Here is a quick summary of CB’s supplements, therapies, schooling and diet.

Supplements

  • Morning
    • Vitamin D3 – 1 drop (Franklin & Friends – 400 IU)
    • Multivitamin – 2 chewables (Garden of Life Vitamin Code Kids Chewable Whole Food Multivitamin)
    • L-Carnitine – 1 capsule (Now L-Carnitine Fitness Support 500mg)
  • Evening (Before Bed)
    • Probiotic – 1 capsule (RenewLife 15 billion)
    • Fish Oil – 1 teaspoon (Nordic Naturals Omega 3 1600)
    • Vitamin C – 2 chewables (Nature’s Plus Animal Parade Vitamin C Natural Orange Flavor) – Periodically 2-4x a week

Therapies

  • Speech – 4x a week (2 private therapists and 1 therapist through proportionate share)
  • Occupational – 1x a week
  • Physical – 1x a week
  • Extra-curriculars
    • Piano Lessons – 1 x a week (to improve fine motor and motor planning)

(more…)

Will we be moving?

The latest news with our family is that we are highly considering moving further out of town. I recently have reached out to more parents with children with special needs that live in my neighborhood to get their thoughts about our local elementary. Don’t get me wrong, it is a great school and one of the best in the entire area; however, I have received very mixed results from the parents of children with special needs. This is disheartening. I have talked with other parents with children with special needs that live in a smaller school district nearby who rave about their school system. This would also give us the chance to own more land, get more space, and live closer to the water. There is also a community space we can join with a pool, park and lake access. That could be a great option for meeting neighbors. We would live less in the middle of everything which has its benefits and drawbacks.

Our 3 week road trip ended last week. Lots of positive memories, genuine family visits, and the chance to get away from the heat. The kids traveled well, but man, I was exhausted when things were said and done. For all the positives, there was 2 solid days on the road, tension due to the stress of traveling, and the fact that these road trips really get us out of our element and get us thinking about our lives. Things surface that you may not be expecting. When we got back, I told myself that we need to find a different option for next year. However, just over a week later, I may have to already change my mind :). For all the tension, it may be a good thing for that tension to surface. Maybe with 3 summer road trips with the kids, we will be more prepared and aware of what comes from these trips. Plus, Olem was already in a questionable place so traveling with kiddos may not be the most relaxing and stress-free thing to be doing. The last 2 road trips have required us to rush back as there were other trips that got added to the end of the summer road trip. For this year, Olem had to fly out for work the day after he got back. (more…)

Desperately in Need of a Breather

Sometimes, it is all so overwhelming…the therapies, the driving all over town, the strict schedule, the constant attention on what your child is not achieving or should be working on, determining if the therapies are helping or possibly hurting your child’s progress, and watching your child struggle at most everything he/she does. Also, there is the constant worry “Is it all too much or do you need to incorporate more?” Today was one of those days where wham..I was just whacked in the face with the weight of it all. One factor is probably that it is the end of year where everyone seems like they are so ready for the school year to be over. Some of the teachers’ attitudes seem to be on the less positive side, somewhat distracted, and some flat out do not seem like they want to be involved in my child’s life right now. Maybe I am just in the same boat as those teachers and I just want out. I want a change. The end of CB’s current school year is less than a month away as well as our drive to another town 30 minutes away, 4x a week. He will also stop his PT as she is located in the nearby town, as well.

I also just feel like I don’t want to hear another therapist or teacher telling me what CB is not able to do that he should be able to or what we should be working on to help him speak better, throw correctly, walk up/down stairs appropriately, act more appropriately, …I am just so tired. Tired of thinking minutely about every little thing my son says, eats, and everything he does. He has come so far and he continues to grow and progress, but sometimes I just want to not have to worry and overthink everything we are doing and he is doing. I want to not have to go to therapy for everything and for him to just once to be able to acquire a skill easily and for CB’s little brother to not understand what we are requesting before CB does. I understand everyone has their challenges. Regardless of how it may seem, everyone has struggles and difficult times in their life.

Another factor is also that this summer, we will take about 3.5 weeks off – no therapies, no school, no sports activities. Yay! We will visit family and then stay in another home in another state for 2 weeks. I think I really need this to recharge and start everything up again feeling refreshed and ready to take it all on again.

Therapy Schedule Update

Here is a quick update on CB’s current therapy schedule and the changes we are making for the start of 2016.

For the fall, CB’s schedule was as follows:

  • Monday – 9:15am-12:15pm pre-k; 1:00pm-2:00pm private speech therapy; 3:00pm-3:30pm swim
  • Tuesday – 8:15am-12:15pm pre-k; 12:30pm-1:30pm private physical therapy; 2:15pm-3:00pm private speech therapy
  • Wednesday – 8:15am-12:15pm pre-k; 2:00pm-3:00pm private speech therapy
  • Thursday – 8:15am-12:15pm pre-k; 1:30pm-2:15pm private occupational therapy; 2:15pm-3:00pm private speech therapy
  • Friday – 12:45pm-1:30pm group speech therapy at school
  • Saturday – 8:30am-9:00am karate

Updates/Changes for the spring:

  • Starting in January
    • Tuesday – 8:15am-12:15pm pre-k; 12:30pm-1:30pm private physical therapy; 1:45pm-3:15pm pre-k (eliminating 1 private speech therapy session a week and adding some more pre-k time)
    • Checking out 2 horse therapy places. Considering adding horse therapy on the weekends and quitting karate. CB is the least excited about karate and it is still quite hard for him.
  • Starting in February
    • Monday – 9:15am-3:15pm pre-k; 4:00pm-5:00pm private speech therapy (adding more pre-k time and moving speech therapy to later in the day)
    • Wednesday – 8:15am-12:15pm pre-k; 2:00pm-3:00pm private speech therapy, 3:45pm-4:15pm swim (moved swim to Wednesdays)
    • Saturday or Sunday – hopefully horse therapy sessions

Therapy Evaluations & Fish Oil Dosage Change

This week was packed with evaluations of CB’s progress in speech and physical therapy. He had 3 different ST evaluation reports completed and 1 physical therapy report. The great news is that he has made huge leaps with his expressive language and only falls a few months behind. This test focused on CB’s comprehension of the questions asked and CB being able to verbally express his comprehension. For most questions, it didn’t matter if he replied with 1-2 word answers and his ST allowed for extra time, minimal guidance, and some substitutions due to his apraxia. He is still about 5-6 months delayed on receptive language skills. The third test was an articulation test and it placed CB at just under 2 years behind. The good news is that this was the first time the test could have even been given. 6 months ago he could not have made it through the test or been able to accurately try to make each sound. His ST also said that he made developmentally correct errors. Basically, that even though he is quite behind, the errors are the expected errors and sound substitutions given his current sound repertoire.

I should step back and mention that the first test administered was the articulation test. Even though I was glad his ST was able to administer the test, hearing the results caused me to feel extremely weighted down, unsure, and like I had a hole in my core.  All the worries started surfacing, “Will my son always be behind?”, “Is he gradually getting further and further behind?”, “Even though he seems to be responding really well to his ST, are we going to have to make changes?”, “If we have to make therapy changes, what are they?”, “Is all this therapy not helping him?”, “Am I failing him?”, “Is that first no tact, seemingly uncaring caregiver right that CB will always be behind and we are not providing enough for him?”, “This feeling hurts so bad and I feel so lost. What do I do?”… Olem and I had to go through some stuff and fortunately vocalized our worries late one night to each other. I think we both felt light again and more like ourselves. We felt like no matter what, we can handle this. Fortunately, we got the results of the other 2 ST tests today and I feel like I am floating on air. I feel hopeful!!!!

For CB’s physical therapy evaluation, he showed some improvement with some of his retained primitive reflexes (like the moro reflex) but started showing signs of retained primitive reflexes that did not seem present prior (like the fear paralysis reflex). CB’s connection with his current PT is just so-so. It is super convenient though b/c she comes to our house for the therapy and she is one of the limited few in our area with experience working with retained primitive reflexes. If we drop a therapy, I think it will be this one. Working with the retained primitive reflexes can be so beneficial though for a kiddo with Dyspraxia.

We lowered CB’s fish oil dosage about a month ago, and upped it back up last week. Just like the past, CB went CRAZY for the several days following the dosage change. Basically, CB would fixate on something and could not let it go. Primarily, it was related to sharing and stealing other kiddo’s toys. He would then scream, kick, hit, and throw a huge tantrum every time he wanted something he could not have. Last Sunday, HB had his first play date at our house with just one of his friends and his parents. In the 3 hours they were at our house, CB threw at least 6-7 kicking/screaming tantrums. Almost all if not all were around HB’s friend having a toy and CB deciding he wanted it. It was soooo hard. At the pool a few days prior, CB had a full-blown tantrum. When CB acts like this, I feel like everyone is judging me. I feel like the other parents think I am a bad parent, my child is totally spoiled, I can’t handle my child, and sometimes look at my child wondering what is wrong with him. I HATE this feeling. I HATE those glances and seeing those seemingly judging faces. During those moments, I wish I had special powers to hide CB and I in a force-field protective bubble. In this bubble, no one can see or hear us, and we can just be ourselves.

Fortunately, I think CB is now on the other side and is now showing the positive effects of the fish oil change. Today, CB seemed to be expressing himself very well. He also seemed more cuddly and mentally quick. He loves watching Daniel Tiger and he even responded to several of the questions in the Daniel Tiger show this afternoon. HB will regularly respond, but CB typically just watches. Before watching Daniel Tiger, we played with play doh and pretend for about 30 minutes. All of this was dictated by CB. CB pretended the house was on fire and we had to save his bears in the living room and then we had to save the cars and other things around the house :). He then proceeded to be a police office and a cowboy. HB remained super HB and helped the entire time. Working through the retained reflexes exercises today was even easy.

Side Note: HB has been in summer language camp for the last 3.5 weeks. He seems to be enjoying it. It was around the same time that he started having more accidents. He has been having 1-2 accidents every day to every other day lately. Sometimes, the teacher or I have showed him that he had an accident. He did not mention it to us.

The Little Light Switch and Nutrition Report Update

Just like everyone, CB has his on days and his off days. Well, lately his behaviors have been wavering quite a bit so it is more like he has his good moments and bad moments. Yesterday during his OT session, he was so positive and took everything head-on. He laughed while working with the OT on the spinning board. He actually was laughing. Just a few months ago, he was super scared and required the security of the OT riding with him just so he could tolerate it for a few spins. Whatever the OT suggested, he was on board and didn’t put up his usual walls. Most of the time for CB, his first reaction to any suggestion is no. He immediately jumps to the “I can’t do it” mentality and gets frustrated from the get go. We are currently working with him to try to shift his perspective, calm down, and try the task a few times before getting frustrated. So that was a very positive and “on” moment for CB. Today during swim class, he was totally off and sensory-seeking. He was moving the entire time and either splashing, putting water on a classmate, dumping over swim container baskets, or just not paying attention. He even was pretty off when he was in the water with his swim teacher. It is so hard to figure out what CB needs to feel focused and comfortable. Both his OT session and swim class immediately followed a nap so it isn’t like for one class he was really active beforehand and not for the other.

On another note, we got his nutrition report back and he is not vitamin-deficient anymore – yay! Now, he is still a little low on iron based off his ferritin and UBC levels, but the values continue to increase. His Immunoglobulin A levels have increased a bit. They are still low but he has moved out of the selective IGA deficiency range. We know he can produce some IGA, at least. He also had quite a low homocysteine level, slightly low WBC, slightly low carbon dioxide, slightly high vitamin e, and slightly high vitamin a levels. So most likely he still has some inflammation or bleeding. We still haven’t done the organics acid test b/c it requires the patient to not eat apples, pears, grapes, cranberries or their juices w/in 24 hours of providing the sample, and to pee in a cup first thing in the morning before eating or drinking. This is honestly too difficult right now to take on. We tried in early Jan and it was a disaster. Once CB gets in the habit of peeing in the morning before breakfast, then we will try it.

Tomorrow, if all goes well, CB will have his blood drawn for the food and seasonal allergy test. We know CB is allergic to processed soy and has seasonal allergies just based off observation. He is also battling a rash on his bottom, which appeared on and off for several months, and has shown symptoms like he may have some other food allergies. We will see if the test tells us much.

For a therapy update, CB’s ST has started incorporated straw therapy a week and a half ago. CB thrusts his tongue out when drinking from a straw. In regards to the PT developmental exercises I am performing at home with CB to work on integrating his retained primitive reflexes, this is a challenge. CB puts up a fight almost every time we perform the exercises. I need to work on a new strategy so it is not a battle. He typically doesn’t actually mind most of the exercises once we get started. It is the starting part that is so hard for him.

Glowing Glances: We visited a new park and a new children’s museum during a trip we took this past week and CB owned the playscapes. He climbed new play gyms that were not just like the ones he has seen at other parks. For CB, he has to perform tasks over and over and over before he can be successful at a task. Even then, he can forget how to do something depending on the day or environment. So it was so encouraging to see him be able to use his skills he has used in other contexts and apply them to new situations and environments. He also regularly says “of you or of ew” when prompted. Even though it is prompted, it still fills me with joy to hear him repeating the phrase “I love you”. Oh, and he regularly thanks me ” tank you or tank ew” for dinner and says “ih good”. 🙂

Argh…this restricted diet is getting to me

CB is 4 years old …

CB is handling his restricted diet beautifully. He eats most anything we put in front of him, and responds well in situations where he can’t eat something his friend is eating. The generic “I’m sorry honey but that will hurt your tummy” response seems to work fine, at least for now. I am very grateful for this; however, for the last week or so, I keep imagining our family eating out wherever and eating whatever. I find myself hoping that his progress is not connected to his restricted diet. I picture a fridge full of full fat milk yogurt, cheese sticks, cream cheese, and ice cream. OK, can you tell I am missing milk products? I make our coconut milk yogurt, coconut milk kefir, almond milk, and on occasion we have Dayla cream cheese. They suffice but I really miss animal-based milk. I also imagine a time where I am not making so much of our food and we have a clean kitchen most of the time. I seriously am not keeping up with all the cooking AND keeping the kitchen totally clean. Maybe I just need to order a supermom cape. Once I tie the cape around my neck, I will instantly be the SuperMom I would like to be. One can hope!

So, within the next week, CB will have more bloodwork done to see how his nutrition levels are. We hope this will help us to see if the diet is helping his body, to ensure he is not having any new vitamin deficiencies, and to look at a few more factors we haven’t tested for before.

CB’s OT & ST started including the ILS (Integrated Listening System) as part of his therapy. With his first OT session with the ILS headphones, he was able to ride his balance bike (a bike with no pedals) smoothly down the hall w/no headphones on. After his OT put headphones on him, he was super wobbly trying to ride the balance bike down the hall. Surprisingly by the 2nd session, he was functioning quite well with the headphones on. His ST is also providing mouth and tongue tactile input to help him be more aware of the different parts of his mouth. This should help him to be able to move his tongue, lips, and jaw more independently. CB has this issue with his entire body. He has a hard time moving various body parts independently. His OT also performed some vision exercises with him immediately following spinning exercises. It is so good to see auditory and vision therapy being incorporated in his OT and ST sessions.

Glowing Glances: CB is stringing more and more words and more and more syllables together. Before swim lessons, HB was crying b/c he didn’t want to stay in the dressing room. CB’s first impulse was to hit HB so I mentioned that CB should instead tell his brother he was sorry he was sad or ask how he could help.  CB hugged his brother and said “I sorry your sad”. It was such a beautiful sentence.

Progress: CB has been dry for the past 3 days! We changed his potty reward system to reflect a new system where he gets a car if he stays accident free for a day. We made this change about a week ago. It looks like we now get to update it to be something like he gets a car if he is accident free for 3 days in a row. The interesting thing is that the point of the rewards system is to serve as a motivator; however, CB asks for a car about every time he uses the potty. He cries about 1-2 times a day b/c he wants a car then. I am pretty  sure he doesn’t understand our current system and just waits for us to tell him he has earned a car. He doesn’t have much of an awareness of time, so it makes sense that this could be an issue for him. As I type this I am realizing, that our current chart system kind of blows and maybe our next one will be easier for him to understand.

CB’s Evaluation, Therapy, and Treatment History

CB is 4 years old …

I touched on CB’s diet in an earlier blog, but I don’t think I have gone through CB’s evaluation, therapy, and treatment history.

CB was 10 months old when his daycare provider informed us that CB was developmentally behind and did not seem to catch on to things like his peers. This was extremely hard to digest.

CB’s first introduction into the therapy world was with a warm, yet challenging Physical Therapist. He was 15 months old. She helped CB learn to walk. He started walking (ability to walk across a room) at 17.5 months. His PT would push him further than I ever would but she knew just how much to push him to help him grow and move past some of his frustration. It was a good experience and we ended therapy shortly thereafter.

CB started gymnastics at around 19 months old. We thought it pretty much worked kind of like PT as it got him moving and trying new and different physical activities. He hated the big parachute for most of the year and needed a lot of herding to keep him somewhat engaged.

The month after CB turned 2, he was evaluated by a PROMPT speech therapist and given the diagnosis of a moderate receptive-expressive language disorder and a moderate-severe neuro-motor speech disorder.  He started PROMPT speech therapy the following week 1x a week. The next month, Early Childhood Intervention (ECI) evaluated CB and determined that he had a significant speech delay. They started their services within the month and came to our house 1x a week. The ECI interventionalist helped CB with speech and social skills (i.e., sharing, taking turns). After 3 months of private ST, it was determined that the PROMPT speech therapist, although nice, was not pushing CB enough. We decided to end private ST and continue with just ECI. About 2 months before CB turned 3, a licensed ST from ECI started coming to the house 1x a week, as well. CB progressed but at a pretty slow pace. ECI evaluated CB for OT help but he was not far enough behind to get help. Although, I think if I had replied more accurately, he would have qualified. As a parent new to the special needs processes, I responded to most things with the best case scenario response. I think I replied that he ate pretty well with a fork and spoon. He still doesn’t eat well with a fork and spoon. It is still challenging and he gets food all over himself 9 out of 10 times when eating. ECI was helpful in training us how to talk to CB and how to play in a more helpful manner. My husband and I are not huge talkers so it felt very unnatural to talk about what we were doing all the time and to repeat what CB was saying. I think this information helped us tremendously and helped CB’s confidence. When we started saying what we understood him to be saying and not phrasing it as a question, I think he started to feel that we really understood him.

At 2 years 11 months, the school district evaluated CB and determined that he qualified for the PPCD (Public Preschool for Children with Disabilities) program due to his delayed speech. For his school district evaluation, he mainly produced 2-3 sounds for everything. Most of his responses were bah, buh, or duh. When the evaluator asked if we thought the evaluation was representative of his skills, we responded proudly that we thought he tested well because he had tried to answer every question with a response. He normally didn’t do that. He many times wouldn’t even provide a response when you asked him to say a specific word or to repeat after you. CB received 2 private ST 15 minute sessions and 1 group ST session at PPCD. CB also started private ST at the same time 1x a week. 2 months later, CB started taking Nordic Naturals Fish Oil, Probiotics, and a multivitamin. AT 3.25 years old, CB’s pediatrician approved blood work due to CB’s chronic loose stools (sometimes with undigested food bits) and developmental delays.

During the summer, there was no PPCD so CB attended a language camp for a month. Then he took a month long break from therapy because we were out of the state traveling. He still continued to progress during the break. When the fall semester started up, CB moved to swim classes since he could not move up in gymnastics since he was not potty trained. I am so thrilled the switch was made. He absolutely loves his swim class and the class is only 2-4 kids total each class. He also started private OT services 1x a week and increased private ST to 2x a week. CB also started karate. It is a class for kids with special needs. At 3.75 years old, I determined from the blood work performed earlier that year that CB had a much higher than average chance of being celiac. The next day, our household went (GFCF) gluten-free and casein-free. Within 2 months, we saw improvements globally for CB from speech to gross motor to fine motor to sensory awareness (he could feel temperature changes outside). Our household also went soy-free within 1.5 months of going GFCF b/c CB started to present with a soy allergy. His ST sessions at PPCD remained the same. In March, we added Physical Therapy to his schedule to focus on integrating his retained primitive reflexes. He has a long list of unintegrated primitive reflexes. She also works on other gross motor skills, as well. I perform the developmental exercises at home anywhere from 2-6x a week. For most of the exercises, I have to do them in passive mode. Surprisingly, CB handles his schedule quite well and enjoys all of the activities.

Some things we have learned along the way 1) the PPCD structure has been extremely helpful for improving CB’s executive function, focus, attention, independence, social skills, speech and potty-training skills. 2) CB has visual, auditory, gross motor planning and execution, fine motor planning and execution, coordination and balance, food sensitivities, speech, and sensory issues 3) to listen to CB and to work within his limits and abilities 4) stop/change therapy if it isn’t working 5) seek answers and ask questions 6) even though we have heard it over and over again, we are our child’s biggest advocates.

Positive Progress: 1) CB is now completely in underwear except for diapers at night. He has been wearing underwear at school since the beginning of Dec but continued to have accidents on a regular basis. We let CB direct when he was ready to start wearing underwear at home and that is working out well. He also decided this week that he doesn’t want to wear diapers during naptime. He still needs quite a few reminders so that he pees in the toilet, and not accidentally in his clothes or on the floor. He even had 3 days accident free. Yay!!

2) We arranged to meet with an expert in the dyspraxia field in the upcoming weeks! We also have talked with a director of a motor planning and coordination lab. We are feeling very positive this week and feel we are moving in the right direction.

3) We upped CB’s fish oil earlier this week. He is now taking Nordic Naturals Omega Complete liquid form .He was CRAZY for about 2-3 days. However, his articulation, fluency, and the amount of language he used improved. He also climbed a new type of monkey bar about 6 -6.5 feet tall (4-5 times) to get on a playscape.  It seems like in the past, the days/weeks or so following an increase in fish oil, CB makes a big jump cognitively, physically, and verbally. We then see a little dip and then a leveling off at a higher level from where CB started.

Low: CB still has light shiners under his eyes, a rash on his bottom, and some digestive issues periodically. Arghh…we have made quite a few diet changes but we still need to keep tweaking and testing to see what is still ailing CB.