Yesterday, 3 different times, Oliver spent a few minutes dumping water from the bathroom sink onto the bathroom floor.
This morning Wynter and Oliver crumbled rice cakes onto the bedroom floor while eating them.
I'm pretty sure I hear Oliver dumping water on the bathroom floor again as I write this...
Yep.
You know that phrase, "Pick your battles"? Those are "pick your battles" moments for me. Yeah, they make huge messes that I normally end up cleaning up, but they also are fun moments. I could get all scholastic here and say that I'm allowing them to explore cause and effect, gravity, textures, and have fun while doing it... and they are doing all that, but my main reason for letting these messes get made is for a moment of peace and quiet. I know what they are doing, that they are safe, and that nothing is being damaged, and no one is getting hurt.
Sometimes the messes are worth the joy.
Letting them color on the walls with washable crayons is another one of the messes worth the joy, for me.
If it's something that isn't wasteful, or harmful, or damaging, and can easily be cleaned up then I try to let them do it.
Sometimes I'll even join in...
when I do, I find the kid in me again.
P.S. I do clean up, or help Oliver clean up the water on the floor right away because it is dangerous and can damage the floor. We all stay safe during these mess making moments.
Friday, March 29, 2013
Tuesday, March 26, 2013
And That Smile...
I have to admit that I thought I was prepared for the possibility of autism. I'd certainly entertained the thought and dismissed it, only to entertain it again, enough times. Yet, here I am, completely overwhelmed, and exhausted.
I think emotionally I was ready to begin this journey, at least in part. The possibility that Oliver is mildly autistic doesn't bother me. It doesn't frighten me. It doesn't worry me. What worries me is the thought of Oliver not receiving services he needs. Thankfully, at least for this year, I don't have to worry about that. Oliver qualifies for Occupational and Speech therapy, 20 sessions of each. Hopefully within a few weeks Oliver will be evaluated by Early Intervention and they will qualify him for preschool services through the public school system, through which he'll also receive any therapy he needs as well. So, for this year, regardless of if he receives a diagnosis of Autism Spectrum Disorder or not, he'll be getting the extra help he needs, and we'll be learning how to help him at home too.
Yesterday, Oliver had his appointment with the neurologist. I'm not sure what I was expecting, but I definitely wasn't expecting that the doctor would be simply doing an evaluation very similar to the one our new pediatrician did. She simply observed and interacted with Oliver, asked me questions about him and Wynter, and then told me to bring him back in six months. She seemed to focus on odd things, like the fact that Wynter doesn't seem to be showing any autistic symptoms right now, and the fact that Oliver and I are fairly similar (does she think he just inherited every single "quirk" from me?), and she seemed to think that if Oliver received speech therapy and preschool services he will just blossom and the things we see as symptoms of autism now will disappear.
I have to admit that I initially felt disappointed and frustrated that she didn't order tests (because I had expected at least that much), and to a small extent I did feel like she wasn't listening to me. At one point we were discussing Oliver's words, he currently says "hi" or "hey" and "no" somewhat appropriately, and without prompting. He's begun to try and imitate some other words if we say them first, one of them is "Mama". However, he hasn't noticeably connected that word with me, and he might imitate "Mama" but then he will go on to start saying "mamamamama", so I can't even be sure he understands that it is a word at all. When he imitated the word at the neurologist's yesterday she seemed to take that as an indication that he knows what he is saying and who "Mama" is, even though when she asked him "Where is Mama?" he wandered in my direction but didn't look at me, point at me, or actually go to me.
I don't want to exaggerate Oliver's problems. More than anything I'd love to have him turn and look at me and say "Mama" and know he understands what he's saying. I also don't want to understate the issues we're seeing and dealing with, that won't help anyone. It irritates me when others seem to minimize what we're concerned about. It's also hard to trust my emotions on this. The neurologist did say she saw a great need for speech therapy and preschool services, so logically I don't think she was minimizing anything. She did seem to think all his problems stem from his speech delay, which I disagree with and so that put me emotionally on edge. I have to remember she's a neurologist who specializes in pediatric neurology and specifically in epilepsy in children, which is not what we're dealing with. She's important to the diagnosis because, as far as I understand, she looks for any underlying neurological cause, but it is the developmental pediatrician who will be able to give a more in depth look into Oliver's developmental delays.
In the mean time, Oliver's smile brings me out of this maze of questions and doctors and appointments, and back into the here and now to enjoy him as he is. God didn't make any mistakes when he made Oliver, and his smile is a constant reminder to find the joy in him just as he is right now.
I think emotionally I was ready to begin this journey, at least in part. The possibility that Oliver is mildly autistic doesn't bother me. It doesn't frighten me. It doesn't worry me. What worries me is the thought of Oliver not receiving services he needs. Thankfully, at least for this year, I don't have to worry about that. Oliver qualifies for Occupational and Speech therapy, 20 sessions of each. Hopefully within a few weeks Oliver will be evaluated by Early Intervention and they will qualify him for preschool services through the public school system, through which he'll also receive any therapy he needs as well. So, for this year, regardless of if he receives a diagnosis of Autism Spectrum Disorder or not, he'll be getting the extra help he needs, and we'll be learning how to help him at home too.
Yesterday, Oliver had his appointment with the neurologist. I'm not sure what I was expecting, but I definitely wasn't expecting that the doctor would be simply doing an evaluation very similar to the one our new pediatrician did. She simply observed and interacted with Oliver, asked me questions about him and Wynter, and then told me to bring him back in six months. She seemed to focus on odd things, like the fact that Wynter doesn't seem to be showing any autistic symptoms right now, and the fact that Oliver and I are fairly similar (does she think he just inherited every single "quirk" from me?), and she seemed to think that if Oliver received speech therapy and preschool services he will just blossom and the things we see as symptoms of autism now will disappear.
I have to admit that I initially felt disappointed and frustrated that she didn't order tests (because I had expected at least that much), and to a small extent I did feel like she wasn't listening to me. At one point we were discussing Oliver's words, he currently says "hi" or "hey" and "no" somewhat appropriately, and without prompting. He's begun to try and imitate some other words if we say them first, one of them is "Mama". However, he hasn't noticeably connected that word with me, and he might imitate "Mama" but then he will go on to start saying "mamamamama", so I can't even be sure he understands that it is a word at all. When he imitated the word at the neurologist's yesterday she seemed to take that as an indication that he knows what he is saying and who "Mama" is, even though when she asked him "Where is Mama?" he wandered in my direction but didn't look at me, point at me, or actually go to me.
I don't want to exaggerate Oliver's problems. More than anything I'd love to have him turn and look at me and say "Mama" and know he understands what he's saying. I also don't want to understate the issues we're seeing and dealing with, that won't help anyone. It irritates me when others seem to minimize what we're concerned about. It's also hard to trust my emotions on this. The neurologist did say she saw a great need for speech therapy and preschool services, so logically I don't think she was minimizing anything. She did seem to think all his problems stem from his speech delay, which I disagree with and so that put me emotionally on edge. I have to remember she's a neurologist who specializes in pediatric neurology and specifically in epilepsy in children, which is not what we're dealing with. She's important to the diagnosis because, as far as I understand, she looks for any underlying neurological cause, but it is the developmental pediatrician who will be able to give a more in depth look into Oliver's developmental delays.
In the mean time, Oliver's smile brings me out of this maze of questions and doctors and appointments, and back into the here and now to enjoy him as he is. God didn't make any mistakes when he made Oliver, and his smile is a constant reminder to find the joy in him just as he is right now.
Friday, March 15, 2013
Oliver and Autism
God's timing is just so perfect. A few weeks ago I read a blog post about waiting patiently on God. A verse was referenced that I wrote on a note card and put on a wall in our home that I see many times each day. I began reciting this verse to myself with Oliver's speech in mind.
Shortly after that a guest speaker addressed a class about PDD-NOS that Andrew's mother, Sheree, is taking. Although I don't believe that Oliver fits that specific diagnosis, some of the things mentioned by the speaker connected with Sheree in relation to Oliver. Soon after we were talking on the phone about Oliver and she asked if we'd considered PDD or any other ASD (Autism Spectrum Disorder). I shared the story of the doctor visit in which I broached the idea of delays other than speech and our doctor basically laughed at me. Shortly after that conversation my sister, Kayla, asked some similar questions. Along with that, one of my close friends was horrified that any doctor would laugh at my concerns and strongly encouraged us to find a new pediatrician, and my mom, Sandy, has also been encouraging us to at least get a second opinion. Finally I began to see that I am not just seeing things that aren't there, others around Oliver were also expressing deep concern.
When I told Kayla the story of what our last pediatrician had told us, that basically none of my concerns were any more than a mothers over concern, she began finding out information for me. It was Kayla that got Dr. S's information, and pushed me to make that phone call. I am so thankful that she is more aggressive than I!
Now that I feel backed by a medical professional as well as family and friends, I am doing more in depth research, and the more I read the more signs I see in retrospect and currently. Anything that I'm not sure about I am simply observing because I don't feel comfortable putting a symptom on Oliver that truly isn't there. In the list below I mention two signs that I'm not sure about yet, but seem to fit. Please don't think that the more symptoms I read, the more I place on Oliver, it is quite the opposite. Some of the things I've read were surprising to me, even though Oliver does them, I never would have guessed that they were signs of autism. So, as promised, here are Oliver's symptoms:
(referencing Classic Signs Of Autism from The Autism Book by Dr. Robert Sears)
"But if we hope for what we do not yet have, we wait for it patiently." -Romans 8:25That verse became a hope and reminder that I held close to my heart, and continue to do so.
Shortly after that a guest speaker addressed a class about PDD-NOS that Andrew's mother, Sheree, is taking. Although I don't believe that Oliver fits that specific diagnosis, some of the things mentioned by the speaker connected with Sheree in relation to Oliver. Soon after we were talking on the phone about Oliver and she asked if we'd considered PDD or any other ASD (Autism Spectrum Disorder). I shared the story of the doctor visit in which I broached the idea of delays other than speech and our doctor basically laughed at me. Shortly after that conversation my sister, Kayla, asked some similar questions. Along with that, one of my close friends was horrified that any doctor would laugh at my concerns and strongly encouraged us to find a new pediatrician, and my mom, Sandy, has also been encouraging us to at least get a second opinion. Finally I began to see that I am not just seeing things that aren't there, others around Oliver were also expressing deep concern.
When I told Kayla the story of what our last pediatrician had told us, that basically none of my concerns were any more than a mothers over concern, she began finding out information for me. It was Kayla that got Dr. S's information, and pushed me to make that phone call. I am so thankful that she is more aggressive than I!
Now that I feel backed by a medical professional as well as family and friends, I am doing more in depth research, and the more I read the more signs I see in retrospect and currently. Anything that I'm not sure about I am simply observing because I don't feel comfortable putting a symptom on Oliver that truly isn't there. In the list below I mention two signs that I'm not sure about yet, but seem to fit. Please don't think that the more symptoms I read, the more I place on Oliver, it is quite the opposite. Some of the things I've read were surprising to me, even though Oliver does them, I never would have guessed that they were signs of autism. So, as promised, here are Oliver's symptoms:
(referencing Classic Signs Of Autism from The Autism Book by Dr. Robert Sears)
- Speech Delay
- Little or no language. I've also begun to notice some beginnings of repetitive speech as some words begin to emerge. One of his new words is "no", and yesterday I heard him saying it over and over again with no real purpose. I think I said no to Wynter and then Oliver repeated it to her, and then continued repeating it even as he went back to what he was playing with. Maybe that is just him exploring the new words he is finally figuring out, but I'll be keeping an eye on it.
- Social Delay
- Decreased imaginary and pretend play. According to Dr. S his imaginary play is about what one would expect from a 1 year old, which is what I've seen myself. Wynter is doing the same imaginary play that Oliver is, and Oliver did not do any imaginary play until more recently.
- Tantrums that are more extreme than usual. This was a hard one for me to be sure about. I didn't want to place this symptom on Oliver if his tantrums were just him being a toddler. However, especially when he's had inadequate sleep, or an unusually busy day, his tantrums are becoming more and more obviously extreme. Here is a video of a typical tantrum that he might have on a fairly regular basis, and that is an example of the more mild tantrums. A more extreme tantrum will involved flinging himself everywhere, screaming at the top of his lungs, hitting, falling to the ground, and more. It is difficult to deal with, and maybe even harder to watch.
Before I go on, I want to note that I do not believe autism to be an excuse for a tantrum. Oliver needs to learn coping skills that will help him choose reactions that are more appropriate when he is frustrated, angry, or generally upset. I understand his tantrums often stem from being frustrated that he cannot communicate well with us, but hitting, screaming, and the occasional biting are things we are continuously working on with him. - Often won't return a happy smile when a caregiver engages with a smile. This one is not one I'm 100% certain about. I never noticed it being a problem as he does often smile, but yesterday I made a point to purposefully smile at him and he did not smile back. Again, today, I've made a point to smile at him several times, even asking him to smile, "Can you give Mommy a smile, Oliver?" and he did not smile in return any of those times so far. So this one is an ongoing observation. Andrew has wondered to me several times if Oliver is a happy child, and I never understand why he would ask me that. Perhaps he subconsciously noticed a lack of smiling when engaged with a smile?
- Poor eye contact. Oliver will give us eye contact when prompted to, but Dr. Sears explains that toddlers ought to be initiating eye contact on a regular basis, not just when prompted.
- Difficulty with transitions from one activity to another (will have a tantrum).
- No fear or understanding of dangerous situations. Dr. S demonstrated this to me when Oliver readily touched the light on one of his medical instruments (the thing they use to check inside ears), but Wynter would not touch it because she was afraid it might be hot.
- Unusual obsessions or movements
- Self-stimulating behaviors and repetitive movements. (Please ask for more specifics if you want them, they are too difficult to describe here.)
- Restricted to certain foods and is unusually reluctant to try unfamiliar ones. Again, along with the tantrums, I was reluctant to say his refusal to try new foods fell under "unusual" but the more I learn the more I feel confident saying that this is an issue.
- Overly aggressive or self-injurious. (Please ask for more specifics if you want them, they are too difficult to describe here.)
- Abnormal responses to sensory input
- Bothered by large crowds, noises, and chaos. I think this one is pretty obvious to anyone observing Oliver.
- May not crave cuddling, hugging, and other close contact and may even. Oliver has never been huge on cuddling, even as a baby. He only wants it on his terms now, but will give hugs, sit in our lap, cuddle, etc. So this may not be an issue after all, but it could be.
Thursday, March 14, 2013
Entering a Whole New World
This post might be really disjointed. I have so much to say, but it's all a jumble in my head right now. I'm sorry if it's hard to follow.
This last Wednesday, March 13th, I took Oliver for a well-check visit with a new pediatrician. Our previous one hadn't been listening to any of our concerns (unless they become un-ignorable) and the last time I'd tentatively approached the idea of more global developmental delays than just speech, in Oliver, he smirked and laughed off my concerns, even interrupted me several times. He tried to appease me by silently skimming an Aspergers check-list, and then assuring me there was no cause for worry. Not only did I feel like he saw me as an overly concerned mother to be placated and ignored, I began to convince myself that I was seeing problems where there were none, and I began to seriously doubt my own instincts.
Thankfully, I have people around me who are not so easily deterred. My mother continued to express concerns, encouraging me to seek a second opinion; Andrew's mother expressed some observations that might indicate Oliver could be on the autism spectrum; and then my sister expressed those same concerns and asked if we'd consulted his doctor about possible autism spectrum symptoms. Others have expressed their own concerns/opinions regarding Oliver's development in the last year as well, but it was really this sequence of events that pushed me to seek out that second opinion.
I am so glad I did!
Our new pediatrician, Dr. S, completely validated all my concerns, and was proactive from the moment I met him in listening to me and moving forward. In the one visit he asked me questions, observed Oliver, went through an autism risk assessment called M-CHAT with me, and last but not least he agreed that Oliver displays many behaviors and developmental delays that more than call for further testing and evaluating.
Dr. S gave us referrals to a neurologist and developmental pediatrician, as well as setting up a referral to the Early Childhood Intervention program who will do their own assessment and help us place Oliver in a preschool program that will provide therapy to address any developmental delays/issues he is diagnosed with. That is the exciting part! We finally have a medical professional supporting us and helping us move forward. The hard part is that all of this will take time. An ECI representative should contact us within a month to set up an in home assessment, the wait time to see the neurologist is expected to be about a month to a month and a half, but the developmental pediatrician has a wait list of 1 year. Along with that, Dr. S told me that the neurologist will likely run a myriad of tests, possibly even an MRI. (I'm actually reading a book by Dr. Robert Sears about this whole process and there are string of things the neurologist may or may not test for, and it seems there are many different kinds of tests that they do. The neurologist will likely be the one to make the diagnosis of autism, if that's what we're dealing with, which is likely. The developmental pediatrician can also make that diagnosis, but we probably won't see her until after all the tests are done with the neurologist.)
So, I want to refer back to that M-CHAT assessment now. There are 23 questions on the assessment, 7 of which are trigger questions. Dr. S asked me each question and I answered to the best of my knowledge, and then he scored it. Out of the 7 trigger questions (referred to as the Best7 on the test sheet), only 2 must be failed in order for a child to be considered at risk for autism. According to my answers Oliver failed 5 out of the 7. If you want to see what the M-CHAT test goes over you can find it here. I'm not going to share what questions of the best7 Oliver failed right now.
I won't lie, coming away from that visit to Dr. S with a way to move forward and a fairly good idea of what we're facing, was a huge relief. I've been struggling with the possibilities of what could be going on with him for months, and yes, autism was brought up and considered. To finally not be the one sorting through all the different possible diagnosis, causes, etc. was a huge burden off my back. However, today (Thursday, as it's almost Friday now), the enormity of autism spectrum disorders and the wide range of symptoms that Oliver could experience settled heavily on me. There is so much I don't know about autism, and now so much I need to learn. I've begun by buying and reading Dr. Robert Sears's book on autism and autism spectrum disorders, which so far has solidified my belief that Oliver is autistic. For those of you curious, I will list Oliver's current symptoms in the next blog post (which I'll do tomorrow since I can't even keep my eyes open right now).
Regardless of Oliver's final diagnosis, one thing remains the same: Oliver is my wonderful, smart, fun little boy who I love very much. A label won't change that, it will only help us understand him better, and hopefully allow us to help him more as well.
This last Wednesday, March 13th, I took Oliver for a well-check visit with a new pediatrician. Our previous one hadn't been listening to any of our concerns (unless they become un-ignorable) and the last time I'd tentatively approached the idea of more global developmental delays than just speech, in Oliver, he smirked and laughed off my concerns, even interrupted me several times. He tried to appease me by silently skimming an Aspergers check-list, and then assuring me there was no cause for worry. Not only did I feel like he saw me as an overly concerned mother to be placated and ignored, I began to convince myself that I was seeing problems where there were none, and I began to seriously doubt my own instincts.
Thankfully, I have people around me who are not so easily deterred. My mother continued to express concerns, encouraging me to seek a second opinion; Andrew's mother expressed some observations that might indicate Oliver could be on the autism spectrum; and then my sister expressed those same concerns and asked if we'd consulted his doctor about possible autism spectrum symptoms. Others have expressed their own concerns/opinions regarding Oliver's development in the last year as well, but it was really this sequence of events that pushed me to seek out that second opinion.
I am so glad I did!
Our new pediatrician, Dr. S, completely validated all my concerns, and was proactive from the moment I met him in listening to me and moving forward. In the one visit he asked me questions, observed Oliver, went through an autism risk assessment called M-CHAT with me, and last but not least he agreed that Oliver displays many behaviors and developmental delays that more than call for further testing and evaluating.
Dr. S gave us referrals to a neurologist and developmental pediatrician, as well as setting up a referral to the Early Childhood Intervention program who will do their own assessment and help us place Oliver in a preschool program that will provide therapy to address any developmental delays/issues he is diagnosed with. That is the exciting part! We finally have a medical professional supporting us and helping us move forward. The hard part is that all of this will take time. An ECI representative should contact us within a month to set up an in home assessment, the wait time to see the neurologist is expected to be about a month to a month and a half, but the developmental pediatrician has a wait list of 1 year. Along with that, Dr. S told me that the neurologist will likely run a myriad of tests, possibly even an MRI. (I'm actually reading a book by Dr. Robert Sears about this whole process and there are string of things the neurologist may or may not test for, and it seems there are many different kinds of tests that they do. The neurologist will likely be the one to make the diagnosis of autism, if that's what we're dealing with, which is likely. The developmental pediatrician can also make that diagnosis, but we probably won't see her until after all the tests are done with the neurologist.)
So, I want to refer back to that M-CHAT assessment now. There are 23 questions on the assessment, 7 of which are trigger questions. Dr. S asked me each question and I answered to the best of my knowledge, and then he scored it. Out of the 7 trigger questions (referred to as the Best7 on the test sheet), only 2 must be failed in order for a child to be considered at risk for autism. According to my answers Oliver failed 5 out of the 7. If you want to see what the M-CHAT test goes over you can find it here. I'm not going to share what questions of the best7 Oliver failed right now.
I won't lie, coming away from that visit to Dr. S with a way to move forward and a fairly good idea of what we're facing, was a huge relief. I've been struggling with the possibilities of what could be going on with him for months, and yes, autism was brought up and considered. To finally not be the one sorting through all the different possible diagnosis, causes, etc. was a huge burden off my back. However, today (Thursday, as it's almost Friday now), the enormity of autism spectrum disorders and the wide range of symptoms that Oliver could experience settled heavily on me. There is so much I don't know about autism, and now so much I need to learn. I've begun by buying and reading Dr. Robert Sears's book on autism and autism spectrum disorders, which so far has solidified my belief that Oliver is autistic. For those of you curious, I will list Oliver's current symptoms in the next blog post (which I'll do tomorrow since I can't even keep my eyes open right now).
Regardless of Oliver's final diagnosis, one thing remains the same: Oliver is my wonderful, smart, fun little boy who I love very much. A label won't change that, it will only help us understand him better, and hopefully allow us to help him more as well.
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