One World: A Dad’s Point of View

In contrast to my dear wife, I am much more private about sharing on the internet. She really wanted to share my experience so we’ll give this a shot.

Coming to terms with your child having autism is difficult. First, there’s the standard bargaining and denial while trying to attribute the signs you are seeing as symptoms of anything else. He’s not as responsive because he couldn’t hear well, the tubes will fix this. His language is delayed because he’s been focusing on developing his off the chart motor skills. Upon hearing about all the words a friend’s child of the same age was saying, I countered that my still silent toddler can push the dining room table across the room, so take that!

Eventually, we run out of excuses and have to come to terms with our child having autism. It’s a sort of mourning process, where a parent loses the child they thought they had and the life they anticipated. We dream of a life of happiness for a child, of little things like playing catch, of getting a hug and hearing “I love you” from a safe, happy, and engaging son or daughter. That dream gets shattered like a dropped glass upon accepting the diagnosis.

Over time a new dream forms with different expectations and ultimately acceptance. I look at autism as Caleb partly lives in another world. While I’m trying my best to bring him into ours, I also am trying to understand and live in his. Autism is wide-spectrum and some children will live fully in their own world or, conversely, be even more in ours. For example, Caleb will occasionally reach out and rapidly scratch my chest or face. That’s his way of communicating “I’m happy and I love you” when he’s filled with feeling good but doesn’t know how to express it. That feels awesome and brings such a smile to my face now. We also work on language and I’ve been rewarded with an extremely rare spoken “I love you” maybe 3 times in 2 years.

As Caleb grows older, we face new challenges but also new reasons to rejoice. Caleb has inherited our love of animals and has shown such interest in dogs, fish, snakes, and lizards. Incredibly, he has demonstrated deep affection for newborn puppies, even going so far as to lie down next to the litter and gently stroke them. I’ll take it! Similarly, Caleb has started playing with action figures… flying a caped superman and batman around the house. No real engagement with me but he occasionally gestures for help such as in getting them to sit in toy vehicles. Riding on my lap and getting to “steer” a variety of vehicles also gives him such joy.

While it would be nice to be able to communicate more about the animals, action figures, or vehicles, these mutual interests have formed a bridge between our two worlds. My new dream is to build upon these bridges as Caleb grows. Every child is different though and my new expectations may be too great or too small for your situation. I think, at least, that every parent should be able to find some sort of common ground interaction with their child, and that is a good place to start building a new future.

Love and Autism,

Brian

My Why

“Erin, why are you doing this?”

That question would be better rephrased as: “How could I NOT do this?”

It’s been exactly one year since “Take That, Autism!” was an idea in my head. 12 months since I bought the domain. 6 months since I put the first idea on paper and 2 months since I was brave enough to make the first post. That 1 year mark of “Take That, Autism’s!” existence is significant not because it’s the night I asked my husband to buy me the things one buys when they want a website, but because the night I thought of “Take That, Autism!” and the night I got my husband to get out his credit card on a whim, is also the night I proclaimed to the world about my son having Autism.

Close friends and family had had a year to process and accept Caleb’s diagnosis but I never eluded to it on Facebook because….boundaries (if you can believe I have any). I had thought about making a post about it before but never quite found the way to say it how I wanted to say it. I wasn’t sure if my husband wanted it declared….I didn’t know if I wanted the questions- both the ones of genuine interest AND the ones driven purely by curiosity. But what happened was I reached a point where it wasn’t a matter of what I did or didn’t want to post, but instead, what I needed to post. This is how it came out on Facebook:

“I’m Caleb. I like Potato Head, Little People, puzzles, books, and coloring. My FAVORITE thing is to play piano. I enjoy eating french fries, shrimp, yogurt, pizza, and granola bars. Summer is my favorite because I get to go swimming and I’m pretty much a mer-man. I have a daddy I’m obsessed with, a mommy who’s obsessed with me, and a sister who mom and dad say we need but no one asked for my vote. I have an endless backyard, my own room, and lots of dogs too.

I also have Autism. I like the same toys as other kids but sometimes I play with them a little differently at first. I try to use my words but it takes me more time to get them. I could play all day long but I may not always want to play with someone else.

You can feel lots of different ways about that if you want. It’s cool- mom and dad have. Me too. Sometimes I’m sad when daddy leaves for the day cause he’s part of my routine and I LIKE my routine. Sometimes I’m mad when mom puts on the wrong episode of Backyardigans. (Why hasn’t she learned “Samurai Pie” IS functional vocabulary?!). Most times though, I’m happy. I’m the happiest, most confident, affectionate little boy you may ever meet.

One thing you should never feel is “sorry” for me. Or my daddy. Or my mommy. Maybe sissy when she takes my goldfish crackers though. I’m here, happy, and healthy and that’s more than a lot of other people. Plus my mom is a pediatric speech pathologist with unlimited connections to resources and professionals- we’ve kind of got this on lock.

So, if I pop into your head later, think of me as the sweet, silly kid who likes nachos, basketball, and Christmas carols. (Who also HAPPENS to have Autism). And if you ever feel like you need to talk to my mom, send her a message. She literally spends all day with someone with Autism whether it’s a patient or her son. She doesn’t have business hours- you can talk to her anytime. It’s not all the time that you can speak to a professional in the field who is 100% honest when they say “I understand.” My mom might throw a “sista’ friend” to the end of that cause she thinks she’s cool but don’t let that take away from her credibility.

Thanks for taking the time to read all the way through and I’ll be sure to check back in with you soon.”

Check out that last paragraph you guys- that’s my why. I remember this time last March I told my husband that I thought I could help people. That I found myself in this unique position of being a professional who works with children with Autism and in my personal life I was the parent of a child with Autism. The only difference between me and you is that I haphazardly picked a major in grad school while browsing through the course catalog that gave me a set of tools that happened to specifically match up with the specialized care my child was going to need. I could have just as easily decided to major in accounting or graphic design. No one runs around with a z-vibe and articulation worksheet when they’re 6 saying “I want to be a speech pathologist when I grow up!”. I chose it because it seemed practical, it was in demand, and the classes seemed interesting enough. How fateful did that turn out to be? And I just felt like maybe I was supposed to take this unique position I found myself in and go out and do something with it. Plus, if you’ve read my Intro Post then you know a few months before we realized Caleb had Autism I had overcome a brain hemorrhage, hemorrhagic stroke, high risk C-section, and brain surgery so yeah- I was feeling a little carpe diem.

That whole bit may have sounded self promoting but I don’t mean it that way. I’m the first to tell you I’m not a parenting expert and I’m not an Autism expert. But I do have a knowledge base that is valuable and I also have the ability to understand. I understand the hard days. I understand the uncomfortable feelings you sometimes have in public. I understand the worry about maybe never being invited to a birthday party. I understand that it’s not just sometimes the little things….it’s always the little things. They’re all we’ve got, really. And so when someone tells me that something they read here helped them cope, gave them something to relate to, gave them words to a feeling they couldn’t describe- that is unequivocally, absolutely my why. Because how in the world can anyone ever do this alone?

No, I don’t feel like I’m exploiting my son. I don’t worry one day he’ll be upset that his entire life- including the struggles- has been documented online for anyone to know about. I don’t have concerns that someone will read it one day and hold it against him. Because I hope that when the day comes when he understands what it means to be an individual living with Autism that we will already have instilled the confidence in him to be proud of everything about himself. That he will have the luxury of perspective because he will have had his story told, chapter by chapter- so when he ends up where he’s going to end up, he will appreciate the journey it took to get there. Also, he’s becoming more verbal by the day, and I’ll teach him the EXACT things to say to anyone who has anything unsavory to say about anything.

So, here I am- one year later. I know on paper I’ve just gotten going but in my head, we’re doing big things together one day, you guys. That’s right, all of us. Because maybe “it takes a village” to raise a typically developing child, but for a child with Autism, it takes the whole dang continent. So, let’s unite. Let’s do it up right. I know sometimes it feels like “the struggle is real”….but if we’re in it together, it really doesn’t have to be.

Love and Autism,

Erin

Tooth Brushing Tips

Sometimes, having Autism can make it more challenging than not to stay so fresh and so clean clean (I hope you sang that along to the tune of the pop hit of 2000 by Outkast as it was my intention for you to). There was a period of time when Caleb hated baths. Hated them. It was a sensory thing. I hadn’t put everything together about him and Autism yet and at that point that was really the only thing sensory-wise that stuck out about him and since he liked playing in the pool, I decided it was behavioral. As hindsight tends to be 20/20, I think that was Autism trying to tell me something then, not him being non-compliant about having hygiene forced on him. I don’t have good advice on that one because I’m not ashamed to admit that I probably didn’t help him with the most appropriate approach then because I didn’t realize what was going on. These days, bath time is his favorite time of day and he has no qualms about having water poured over his head to rinse shampoo, washrags exfoliating his behind the ear crust, etc. Tooth brushing though- now THAT was a different story.

But again…..not always. Caleb’s sensory difficulties and stims emerge almost randomly, are intense for a hot minute, but resolve fairly quickly. At least that’s how it’s played out so far. Example, he used to visual stim HARD off of tearing paper. So I lost a lot of kid’s books in his room. Now, he’s been carrying around a pack of “first words” flashcards for 3 weeks and they’re all in pristine condition. Brushing his teeth wasn’t always a “thing” for him but about 6 months ago he decided he HATED it. He also took on some oral defensiveness in general. Brushing his teeth, having his face wiped, getting medicine, etc. Now I know some of you may read this and say “Erin, toddlers don’t love these things, in general. What’s the big deal about your kid not liking it?” To which I would reply, “I’m going to assume you’ve never taken on the challenge of brushing the teeth of an orally defensive toddler with Autism who has a limited verbal vocabulary because it’s the equivalent of how you’d feel if Neptune rose from the sea and came at your mouth with his mighty trident.” Bless your heart.

Here are some quick tips on how we said “Take that!” to brushing our teeth!

1. Consistency

No, you don’t get to just not have your teeth brushed because you don’t like it. Honestly, this helps- once he realized that this was in fact going to be happening every day of his life, I think he realized his energy and efforts would be better utilized to take me to task on something else I’d be more likely to give in about.

2. Vocabulary

We talked about it. In single words or 2 word phrases that he could understand. We made sure we knew body part vocabulary- especially vocabulary involving the mouth and the vocabulary involved with brushing your teeth. Here are some body part vocabulary ideas for you. We didn’t do this, but I’ve since discovered some Pinterest play ideas that promotes more positive and fun connotations of tooth brushing to help get kids comfortable for it to happen to them. Check those out, as well as visual schedules for tooth brushing here. Remember how helpful visual aids are for kids with Autism!

3. Control

I think Caleb didn’t appreciate that I was the only one who got an opinion about what was going to happen to his mouth and when it was going to happen. So we started using 2 toothbrushes. They were both child friendly but I used one to actually brush his teeth and he used one to play/explore around in there at the same time. So, instead of me torturing him against his will while he stood there passively, he got to be an active participant. Now that’s he’s comfortable and confident around a toothbrush, I let him brush his teeth independently first and then follow up myself with a good scrub, which he compliantly lets me do without hesitation now.

4. Approach

If I were to simply drag him in there and show him a toothbrush when he was in the midst of his aversion to it, I guarantee it would have gone nothing but TRAGICALLY. I had to prepare him. I told him it was coming during his bath and while we were getting pj’s on. I used a calm, pleasant voice. I didn’t threaten him with the toothbrush. I made it playful. That’s how we got through baths at one point. Daddy used the shower poof to play tickle monster all over him which inevitably would crack him up and give him a little sensory input and he’d end up having a few seconds of fun, which gradually increased to an entire bath time of fun! The same worked for us for tooth brushing. And I never forced his jaw open. What better way to reinforce an aversion?

5. Toothbrush Selection

It really did matter. I tried manual toothbrushes that had ninja turtles, Jake and the Neverland pirates, all of the characters. No go. Then I tried an electric toothbrush to provide extra sensory input to his mouth- YES!!!! NOW we were onto something. He liked how it felt, I liked that it was easier to manipulate because it moved on it’s own better- we were getting closer. Then, while I was grocery shopping at Kroger one day, I found our game changer. Background on Caleb: OBSESSED with stickers. Like….I’ve spent a lot of time scrubbing them off my living room hardwood cause he loves them so. Back to the story: I found a child’s electric toothbrush that came with stickers for you to decorate your toothbrush with! What better way to make the dreaded toothbrush our new best friend!?!?!? It worked. For real, ya’ll. Between that and the calm, consistent approach with instructions given on his developmental level that I made sure to pre-teach him beforehand, we conquered tooth brushing.

While we enjoy brushing our teeth now, we’re by no means masters yet. We’re getting ready to upgrade to a new toothbrush that has the red and green lights on it to tell you to keep brushing versus when to stop so we can spend more time in there. We’ve also never been to the dentist but plan on going for the first time this summer (but I started planning this summer dentist trip back in the winter cause you know…….Autism).

Grab that Spiderman electric toothbrush, a tube of Tom’s toddler training paste, and prevent those cavities! I’ll let you know how we progress and promise to record all shenanigans that ensue when we’re brave enough to break out floss for the first time……………..

Was that “toddler” or was that “Autism”?

My son is 3.6 years old. He is our first born. He has Autism. Do you know how many times my husband has looked at some shenanigan Caleb was in the middle of and legit asked me “Is that toddler or is that Autism?”

He’s not being funny- he’s not being mean- he’s being straight up. Toddlers do some crazy nonsense. Autism has its own unique set of tendencies it likes to bring to the table. If you’re a first-time parent, if you’ve never been around a child with Autism- I totally see why you’d be perplexed.

Let’s go over some scenarios:

My toddler just ran 11 laps around the dining room table and is now trying to swing from the chandelier like a marmoset who just downed a 12 pack of Mountain Dew.

Let’s break this down.

Toddlers have an insane amount of energy. Toddlers are active and sometimes fearless when it comes to climbing, jumping, and swinging from chandeliers like caffeinated primates. These are in fact things that toddlers who would be considered typically developing might do. But let’s take a closer look. Is your child simply full of energy or is your child exhibiting sensory seeking behaviors? Kids who are just being active may like to run and jump but they’ll likely do other typical things as well such as make a social game out of it, seek out your eye contact to see if you’re noticing, talk about the ridiculous things they’re doing while they’re doing them, etc. Here are some things that I noticed that did NOT strike me as typical when Caleb used to run laps around the table. He was seemingly oblivious to whether we were there or not. That was a decreased awareness to his environment. When he ran in a circle, he would tilt his head to the side and try to look out his peripheral as he was moving. That was a visual stim. That climbing up and down, up and down, up and down from the floor to the table was him seeking out proprioceptive input (I’ve talked about heavy work here). So, my pretty brass chandelier was replaced with a globe light flush to the ceiling, and chairs just started living at my dining room table full-time last November. Caleb was active and that’s ok, but the stimming and the strong sensory seeking tendencies needed to be addressed. Literally, as I write this, he is spinning in a circle in the living room, stimming off of Batman and Superman’s capes flying around with him. You do you, man.

Oh my toddler’s language is great! He can name all the state capitals, knows all the moons to all the planets, and memorized pi to the 12th digit.

But can he tell you when he’s angry? Or what he did at school today without prompting? I think sometimes people get confused between a child having a certain quantity of language overriding the fact that the quality of language isn’t what it should be. Having a favorite topic is fine. Having a highly preferred topic is fine. Talking about a topic as a fixated interest, however, is not typical. If your preschooler can tell you about a historical event, a certain animal, a region of the world, but is unable to tell you what he and his friends did at nursery school or respond to a “wh-” question without going off topic, I strongly encourage you to bring it to your pediatrician’s attention. Or maybe, you have a child prodigy. I’m not judging, here. But I know Caleb can count to ten, but doesn’t have a word for “hungry” or “hurt.” He can label his colors but doesn’t have words for all the foods he eats. He knows the alphabet, but he’s never said his name. You can have all the language in the world, but if it can’t be used functionally, it is going to make all the difference.

I’m 6 inches from by toddler’s face, saying his name, but he won’t stop watching Clifford and his big red dog self to look at me.

Who hasn’t lost a battle to the tv with a toddler? Daily!? Toddlers also can have selective hearing and are motivated simply by what they want to be motivated by. But think back for me. When did your child start consistently responding to their name? It should have been by 7 months, definitely by 9 months. If it was after 12 months, I would consider that a red flag. It doesn’t have to necessarily mean anything by itself, but in conjunction with potential other concerns you may have, it could definitely by noteworthy. Also, note to see if your child is responding to environmental sounds even if they’re not responding to speech input. Maybe they were fixated on Clifford, but did they respond when their real life dogs barked at something outside or when they heard the front door open up? Always bring any concerns about hearing to your doctor’s attention.

My toddler just had a melt down because I gave him the blue cup instead of the red cup and told him he couldn’t play in the toilet. 

DUDE!!!! This is the hardest! There are entire sites dedicated to “Ridiculous Reasons Why My Child Cried Today.” Because phrases like “terrible twos” and “threenager” exist for a completely valid reason- because the attitudes of toddlers and the attitudes of teenagers can both be terrible. And there’s a lot of social-emotional development going on in a little person in a small amount of time- you betcha it’s overwhelming. We have a hard time with this here. Part of Autism is that you can have a hard time with impulses when things don’t go as anticipated or when you need something to be a certain way because of a compulsion. For instance, Caleb sometimes gets upset with how food is presented to him. The fries need to be on that side of the plate, the chicken on this side. He wants to make it into little pieces. 100%, I caught him eating the around the chocolate shell of an M&M to get to the peanut, putting the chocolate and peanut into different piles, and eating everything pile by pile. That is a compulsion. On another note, maybe he earned some tv time but after awhile went to play in another room so I turned the tv to Pandora. He might come back and have something to holler at me about for it. That is a toddler power play. And that’s a whole different beast.

Ultimately, I always tell people that before your child is a toddler with Autism, you child is simply a toddler. And some typical things that toddlers have been known to do without concern are also things that find themselves on the “red flags for Autism” lists. While there’s no steadfast rule for every child, if you have concerns that persist, if you have a gut that a behavior isn’t quite typical, or if you’re worried about your child’s language development- always bring it up to your child’s pediatrician. Also- disclaimer- try not to be too “if/then” with development. I remember about 5 years ago, a very popular parenting magazine came out with an article that was something to the effect of “Words Your 1-Year Old Needs to be Saying.” And literally, the last sentence of that article was “if your child isn’t saying one of the words on this list, please take them to the doctor to talk about the potential for Autism.” No joke, 2 weeks later, I got a referral in my office of a mother who was concerned her 14 month old had Autism because he wasn’t saying the word “juice.” No other reason- just the “juice” thing. I will say, good for her for being worried and taking action instead of being too scared to move. But, look at the whole picture- the whole child. Trust your gut, talk to your doctor, talk to another one if that one doesn’t listen, and remember- those toddler tantrums will fade but that means fun things like toddler snuggles will too. So, no matter how he makes you feel about him behind his back sometimes, don’t forget to cover that sweet face with kisses when he turns around.

Love and Autism, ya’ll. Have a good day.

 

 

 

 

Redefining Expectations

I got the sudden urge to start cleaning every corner and closet of our master bedroom this weekend. Well, if we’re being honest, I ran out of piles to put clean clothes instead of putting them away and had to sort through the mountain and redo drawers and closets and stumbled upon some piles of stuff along the way. I’ll stay transparent. One of the things I found was Caleb’s baby book (which I appear to have stopped putting things in at approximately 8 weeks old. He’s going to be 4 this year. Ari doesn’t even have one. I assume at this point her ultrasound pictures are at the bottom of an old purse somewhere. Mom of the year, here.). I opened it up and saw cutesy things like his pregnancy announcement, footprints from the hospital, pictures in itty bitty onesies……then when I could pick my melted heart off the floor it made me think about something……

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…..things kind of didn’t turn out how I expected them to.

Caleb having Autism has now been our truth and our reality for the majority of his life…..I’ve almost forgotten those early days when it wasn’t even on my radar that he’d ever have anything other than typical, day-to-day kid challenges ahead of him. You know…..perfecting his jump shot, getting up the nerve to ask out the pretty girl from bio class, passing driver’s ed. Now, I worry about almost everything. I worry that I’m not doing enough, that I should be doing “this” not “that”, and mostly that the rest of the world may miss out on everything this amazing little boy has to offer because he has a hard time finding his words, learning the way everyone else learns, and forming social relationships. Those aren’t little things to worry about. It’s everything.

So, what I learned, was that I had to redefine my expectations. And I’ll admit that that wasn’t as challenging for me as it potentially is for others. I worked in pediatric rehab for years before Caleb came into my life- I spent all day every day celebrating small successes. I was used to taking a “slow and steady wins the race” approach and I knew that a kid I may be seeing today would likely make so much progress over the course of a decade that no one would ever believe that there was a time they needed to come see Ms. Erin two times a week. I understand that’s not the norm. I also understand that when the only child you know who has Autism is your own child that it’s a lot scarier.

If it helps, I’ll tell you all that all those glorious things that I got to be “used to” before Caleb came into my life didn’t “fix” anything for me. It didn’t give me rose-colored glasses. If anything, it mostly just took the edge off, is all. Like a cheap glass of gas station Moscato after a hectic day. Here are the three biggest things that Moscato and experience helped me redefine and establish a new set of expectations for:

Social Media Bragging:

Oh, your child is starting to learn words in their second language? Well mine said “green” 6 days ago. You potty trained your toddler by 18 months? Our goal is by Kindergarten. From the time Caleb was 1 until after his second birthday I scrolled through videos of my friend’s kids that popped up on my news feed before they could automatically start playing or hit “like” without hitting “play” to at least give the facade of support. That didn’t last forever. With acceptance comes pride. In yourself and in proclaiming how amazing your child is for the world to hear, even if the amazing things he’s doing, your friend’s kids were doing 2 years ago. And do you know what I’ve found? He’s one incredibly loved little boy because I’m certain there isn’t a single person I know who isn’t doing backflips about that child saying “green.” Give yourself some time, give yourself some grace. Expect there to be joy in the little things, make an Instagram post about it, and see how many people rejoice right alongside you.

Relationships:

Mine and my family’s. Mine and my husband’s. Mine and my child’s. This topic deserves it’s whole own post one day because leaving it at a measly paragraph feels borderline insulting. Do you know how exhausting it is to have to educate pretty much everyone you meet on why your child is how he is? “Please don’t scold him for throwing blocks- he was fulfilling a visual stim.” “He has trouble with eye contact. Do not grab his face (unless you want me to punch you in yours).” The advocacy never stops and it can be exhausting. The divorce rate in this country is already unsettling and did you know that it’s even higher in parents with a child with special needs? Caleb has an amazing daddy who is also an amazing husband but Autism has CERTAINLY made its way into the middle of arguments in this house. But do you know what’s the hardest expectation to redefine? The relationship I expected with my son. I expected that we’d sit on the couch watching Finding Nemo and I’d look at him and say “I love you, Caleb” and he’d look at me and say “I love you too mommy.” But that’s not the reality. I tell him “I love you, Caleb” and he keeps lining up his trucks. But a few hours later he’ll come climb in my lap and get his face as close to mine as he can and give my cheeks the biggest squeeze his little fingers can muster up and THAT is his “I love you too.” Squeeze away, my love. These cheeks are yours, son.

Thinking About the Future:

I’ll admit that I’m still working on this one. I’m optimistic and at the risk of sounding like a cheesy motivational poster you see hanging in the back of a preschool classroom with a kitten holding onto the end of a rope, I truly do believe that if we continue working steadily and just hang in there, we’ll get to the same end point that everyone else gets to. I would be lying though, if I didn’t tell you that things like girlfriends and the potential of maybe not having one, didn’t make me nervous. You know that space that’s just below your diaphragm and right above your stomach? I call that the mom gut. (It may really be your liver, I don’t know- I didn’t take anatomy). My mom gut always starts feeling nervous when I think about things like that. I’m working on reminding my brain and mom gut to get on the same optimistic page when I think about Caleb 15 years from now but it’s ok if the future makes you nervous. I’m trying the hardest to make this the place where I don’t redefine expectations of my son, but of myself. I expect my son to grow up to be smart, social, independent, and to have a job and family all his own one day. But I’m also going to expect myself to remain positive, believe in him, stay the course, and just. hang. on.

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Therapeutic Benefits of Music Exploration

Ari got some fun new musical instruments for her birthday and I have a “Music” category on my home-school preschool plans, so we did a music exploration session this morning with “Yankee Doodle Dandy” because it’s also President’s Day, thus I decided we’d take a patriotic route with it.

There are LOTS of therapeutic, learning, and developmental benefits from incorporating music into a child’s day. Using music and movement is part of my therapeutic plan to help Caleb with his Apraxia of Speech. Today, though, we just explored music and instruments. Just by playing with a super affordable Melissa and Doug music set,  we worked on all of these things PLUS some:

  • studies have shown that exposure to music in childhood can accelerate brain development
  • integration of different areas of development by making the body and mind work together
  • helps children learn new sounds and words
  • builds motor skills
  • strengthens memory abilities

I love it for our intents and purposes because we’re always working on:

  • imitating actions and vocalizations
  • different kinds of auditory sensory input
  • cooperative play

Caleb is really good at imitating actions now. Imitating actions is important because you imitate what you see before you imitate what you hear. Imitating gross motor and fine motor actions is an excellent precursor to imitating vocalizations and verbalizations. The love of music he’s acquired has also helped him be more spontaneous in his language use as he spontaneously comes up to us and does the motions and words to “Head, Shoulders, Knees, and Toes.” Another benefit of music for Caleb? It’s calming. When he started getting a little wild on me in the Costco checkout the other week, I distracted him with the aforementioned “Head, Shoulders, Knees, and Toes” and bought myself enough time to get out of the store calmly. When he was itty bitty and had to get shots, hearing tests, etc, YouTube videos of “Puff the Magic Dragon” saw us through.

If you’re interested, here’s some footage of our jam session this morning. We’re just getting ready for Grammy season 2032.

Ari and I have a piano duet of “Yankee Doodle” you can watch on YouTube.

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Caleb used his one-man band skills to provide the musical accompaniment to my own Yankee Doodle as well. Check out how much fun he’s having rocking out.

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 Just look at this chick!

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I know Caleb had a good time because he’s literally carried the box of instruments around the house all day with him and I randomly hear the shake of maracas coming from various rooms of my home.

Besides “Head, Shoulders, Knees, and Toes” and “Puff the Magic Dragon,” here are some of Caleb’s other favorite songs:

“One Little Finger”

“If You’re Happy and You Know it”

“Do You Like Broccoli Ice Cream?”

He also loves Christmas carols and a song from the “Build Me a Building” episode of Bubble Guppies because he likes to pretend to use a hammer and saw while he listens.

I also have made up ridiculous songs to their more popular counterparts to sing to my children throughout their little lives such as “Caleburra sits in the old oak tree” cause who’s ever seen a kookaburra sitting in a gum tree? Also, my personal favorite “AriBody” that is to be sung along to the tune of the Backstreet Boys’ “Everybody.” And let’s not forget “Do you want to go to sleep now?” that follows the tune of “Do you want to build a snowman?” which I sing pleadingly when I need them to take it down a notch or seventeen.

Rock out with your kiddos, ya’ll. It’ll be a fun time for EVERYBODY (yeah yeah).

Apraxia of Speech: Defining and Describing the Disorder

It’s Saturday night, it’s getting late (in Mom world at least), I’ve been taking care of two sick kiddos all day, but I just wanted to introduce a topic I’ll be talking about a lot coming up because it’s something we’re starting to work on everyday: Apraxia of Speech.

What is Apraxia?

It’s a motor speech disorder. What’s that? Speaking feels so natural but is actually a very intricate and complex process. A motor speech disorder means there’s difficulty with the motor planning part of moving your tongue, lips, etc. to execute the necessary sounds in the consonant-vowel combinations they need to be in to produce a target word. The words are in the child’s head, but the articulators have a hard time executing the movements to make those words.

What does Apraxia look like?

Here are some of the more common signs and symptoms:

  • delayed acquisition of speech/language milestones
  • very limited inventory of consonants or vowels a child is able to produce
  • difficulty producing multi-syllable words
  • atypical sound error substitutions and inconsistent use of those substitutions. Example: Most kids who can’t produce a /g/, substitute it with a /d/. That would be a typical substitution. If they make that /d/ instead of the /g/ every time, that’s a consistent error. If they can’t produce a /g/, but sometimes produce an /l/ or another sound or sometimes completely omit the target, those are atypical and inconsistent errors which are more concerning.
  • gap between receptive versus expressive language abilities, meaning a child can understand much more than they are able to express verbally
  • Groping: abnormal movements of the lips or tongue that make a child appear to be physically struggling to verbalize something
  • difficulties (sometimes extreme) with intelligibility

Is there a relation between Autism and Apraxia?

I am not a doctor, so I will just tell you some research statistics here. There is research that has come out in recent years that indicates a higher incidence rate of Apraxia of Speech in children with Autism Spectrum Disorder. That does not mean that having Autism means you have Apraxia or that Autism causes Apraxia. It just means that when you isolate a population of children who have Autism and another population of children who are otherwise typically developing, the group of children with Autism may have more children who have a true diagnosis of Apraxia versus the typically developing group. Dr. Cheryl Tierney, M.D. published a paper in the Journal of Developmental and Behavioral Pediatrics in 2015 that found that 64% of children who had a diagnosis of Autism Spectrum Disorder in her clinic also met the diagnostic criterion for Apraxia of Speech.

Do I have a two cents on it? You know it. I always thought….even before I zeroed in conclusively on Autism…..that Caleb may have Apraxia. He was really young and it’s so difficult to label accurately at that age, but I like to think that I am very good at my job and that I know my child very well, so it most definitely was brought up to my colleagues and his pediatrician as a possibility. Now that he is becoming more verbal on a daily basis, the fact that he is having such  a hard time coordinating that little mouth to say what I ask him to say is glaring to say the least, really.

There’s lots more I can go into about how Apraxia of Speech can be addressed therapeutically, the importance of tactile cues, etc…..but I’d be here all night and it would be overwhelming. What I would like to leave you with is the first step of what you should do if anything that you read above alerts you to red flags in your child: talk to your child’s doctor and get a script for a referral to a speech therapist. Therapeutically, for myself as a professional, it’s very important to me to determine if a child does in fact have Apraxia of Speech because whether or not it is present will absolutely dictate how we go about intervention and the order that I pick targets to work on. 

Here are some things that I WILL leave you with though!:

  • Check out some infographics and links to articles on the “Take That, Autism!” Apraxia Pinterest Board.
  • “Take That, Autism!” also has a YouTube channel now! Here are some links to a couple videos of Caleb so you can hear an example of severe apraxia. Listen for the decreased use of consonants, extreme difficulty with anything more than one syllable, limited intelligibility, etc. Some attempts sound like babble or just a vocalization as a place marker but hey…..we’re getting there. And one day, with the most intelligible speech he can muster up, Caleb’s gonna post a video on YouTube hollering “Take That, Apraxia!” Here are the links:
  • Don’t forget to follow us on Instagram @take_that_autism. Caleb has a sweet video that’s a good example of his speech abilities while he “reads” The Very Hungry Caterpillar on there.

Let me know if you have any questions! Catch me at ErinSamsell@takethatautism.org

 

 

Valentine’s Day Fine Motor and Sensory Fun

Happy Valentine’s Day, everybody! I did things for my children today that they didn’t notice such as make their homemade chocolate chip pancakes this morning into the the shape of hearts, but hey- I won’t keep score.

In the spirit of continued festive fun, we did some home-made fine motor and sensory bin activities because if you know me, you know I love a theme. Here’s what we were up to today……….

Stickers

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Fine Motor Benefits;

– practice pincer grasp

– bilateral coordination

– spatial awareness

– hand strength

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Language Benefits:

– prepositions

– noun and action vocabulary

– requesting

– descriptive vocabulary

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Water Sponges

Ok, these little gems have been around forever. They’re sponges in a disintegrating capsule that emerge into different shapes when you put them in water. *Here’s a shopping tip! These are at the Dollar Tree pretty much all the time- vehicles, animals, etc. BUT, if you shop the dollar bins at Target, they also sell them seasonally to match each holiday for just $1 also. Halloween, Valentine’s, etc. So, naturally we did Valentine’s sponges on Valentine’s Day.

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All you need to prep is a bowl of warm water (they don’t open up in cold water, p.s.). I added a couple of drops of red food dye to make the water festive.

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The sponge capsules come in different colors so you can use color vocabulary to request or identify each one before giving it to your child. Also, I like this activity for executive functioning practice because waiting for the sponges to emerge takes patience and impulse control.

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Word of caution: Your mischievous daughter may sneak attack the sponge bowl and dunk her peacock.

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A couple of minutes later, you get a dozen festive sponges! They don’t last long but will make it long enough to be bathtub toys for the evening. It’s at least worth a dollar as something new and different to do.

Tactile Sensory Bin

Benefits of Tactile Exploration:

Promotes a healthy tactile system which is necessary for…..

– feeling pain

– gauging temperature

– decreasing distractions from the environment

– playing easily with peers

– tolerating input from activities of daily living

– understanding and using new language to describe senses and feelings

Here’s How I Made My Bin:

First, I had to dye some noodles red. For that you need…..

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Food coloring and a box of pasta (I used the gluten-free box in the back of the pantry nobody ever wants to eat).

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Hydrogen Peroxide.

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Mix about 1/4 to 1/2 a cup of hydrogen peroxide in a bag with the box of pasta along with 10-20 drops of food coloring. I added all the liquid first and then the noodles, and mixed it all up by squeezing the bag around. The longer you leave the bag to mix, the more saturated your color will become. When you’re satisfied with the color, take the pasta out to dry. Don’t be like me and put it on paper towels because then the noodles just stick to the towels and you sit on your kitchen floor 30 minutes picking them off.

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I added in some other textures for us to explore. The pasta had ridges and was rough. The stones (they’re the decorative bags of aquarium or vase filling stones- $1 each) were smooth, and the candy conversation hearts were chalky.

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I also added in Valentine’s cookie cutters to mix, pour, shake, and sift the sensory contents through. Also, I felt like I needed to do something with them because instead of baking Valentine’s treats, I maybe bought Little Debbie ones instead……

*Another shopping tip: Wal-Mart always has sets of holiday cookie cutters (which you can paint with or play with play dough with if you’re like me and don’t bake) in the seasonal aisles they rotate through for $1.50. You can’t lose.

I also threw in those sponges we did.

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Ready, set, and……………..healthy sensory processing GO!

Take That, Valentine’s Day!

 

Heavy Work: WHAT it is and WHY your child needs it

“Heavy work” is kind of a buzz term in the pediatric therapy world. You’ve probably heard it a lot. You’ve probably been given handouts on it. Your friendly neighborhood OT has reviewed it with you (a dozen times if he/she is as awesome as MY friendly neighborhood OT is). But……..do you really remember what it is and why your child needs it?

If not, that’s ok. Let’s review. If you’ve never heard of it, prepare to be blown away.

Heavy work also goes with the word proprioception. Proprioception pretty much means body awareness- knowing where your body is in its environment, which is important because that’s how you navigate yourself around safely. When your child is doing heavy work activities, those activities are giving heavy resistance to their joints and muscles. When their joints and muscles get that input, it better helps them be aware of their body. Aside from being able to safely navigate through a classroom, playground equipment, your home, etc., this also is essential for things like balance and posture as well. This kind of input is also calming and can help your child’s attention span also. Socially, it also helps kids understand the concept of personal space by aiding with those body awareness abilities. Important note: this is different from vision. Some parents may confuse poor proprioceptive abilities as poor visual abilities but this it likely not the case. Call up that friendly neighborhood OT or your pediatrician if you have further questions on that 🙂 

So, why do we find that so many children with Autism have poor body awareness abilities and proprioceptive dysfunction? While exact figures vary, it is safe to say that the MAJORITY of children with Autism Spectrum Disorder have sensory processing deficits in some capacity- whether they are over responsive or under responsive to sensory input doesn’t matter. Proprioceptive dysfunction is a type of sensory processing deficit. So, it is not uncommon for professionals to treat a lot of children who need help with heavy work activities because it is an example of a sensory processing deficit, which is so extremely common in children with Autism. Another important note! Sensory Processing Disorder is NOT ADHD and it is NOT a diagnosis to be given in place of Autism Spectrum Disorder. Also, you can have Sensory Processing Disorder or sensory processing deficits WITHOUT having Autism. 

Ok, now we know the definition of heavy work, why it is important, and even why we see it so often in Autism Spectrum Disorder. Now…….what does it look like in real world terms????

Here are some examples:

Proprioceptive Avoiding Behaviors: 

– mistaken as “lazy”: may avoid “active” activities or be overly cautious during play

– avoids touch or tight clothing

– can seem uncoordinated: difficulty with stairs, for example

– may prefer quiet environments

Proprioceptive Seeking Behaviors:

– runs into people or objects

– plays roughly or seeks out “extremes”: climbing TOO high, for example

– uses a lot of pressure when touching people or things or touches people and things with extreme frequency

– difficulty understanding personal space

– chews on objects

– walks loudly (stomping)

Other signals that you may see in a child with proprioceptive deficits may include poor posture (slumping over on their desk) or difficulty with motor planning (riding a bike).

Now…..how can we address proprioceptive dysfunction? I’m so glad you asked! Remember that friendly neighborhood OT I’ve been carrying on about for the last few paragraphs? Go see her or him! Remember- I am a speech therapist, not an occupational therapist. However, I do consider myself qualified to speak on the matter of heavy work because proprioceptive sensory seeking behaviors are seen daily  in my home. “Why have my dining room chairs been pushed into various corners of the house?” Caleb needed some heavy work. “Why does he want to stand and open and close the cabinet door without plundering through the cabinet’s contents?” Cause he needed some heavy work. “What was that loud “thump” coming from the playroom?” Caleb jumping from the book-less built-in bookcase because he needed heavy work. Also, note my responses to those self-imposed questions……Caleb needed heavy work. He wasn’t being defiant. He doesn’t have parents who don’t discipline him. His sensory system is not integrated typically like yours and mine and in order for him to do all of the things expected of him in a given day, he needs proprioceptive sensory input. So, if my son jumping down your hallway in a Thor’s hammer sort-of-way is going to nudge your chotchkies off the display shelves on your wall, just don’t invite us over. We’ll meet you at the park instead.

I’m not going to make an extensive list of heavy work activities for you because I’d have to sit here all night. While the description of heavy work and proprioceptive input may seem complicated, the good news is that the solutions ARE NOT. Heavy work activities are some of the easiest and most functional activities that you could ever possibly incorporate into your daily routine with minimal effort. Click here to see my “Heavy Work” idea board on Pinterest. And also- because you know I can barely go a whole post without showing you what Caleb’s into- read about some of his favorite heavy work activities below!

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Climbing…..

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…..all of the climbable things.

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Especially up the slide. That’s one of the best!

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Is that outdoor play equipment that used to live inside my house because 18 months ago our need for heavy work was that intense? You bet. It lives outside now, like it’s supposed to. Because we’ve been working hard.

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Jumping.

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Jumping AND wrestling is an even better combination.

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Jumping to wake up sissy also counts.

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Throwing, kicking, etc.

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Running. Especially up an incline.

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Swimming. Kicking those legs against the resistance of the water? Heavy work ALL THE WAY. And you get to stay cool because heavy work breaks a sweat, ya’ll!

Before I sign off, please talk to your doctor about any concerns you have about your child regarding sensory processing abilities and any potential proprioceptive avoidance or seeking behaviors you see and ask for a referral to an occupational therapist. We want regulated, safe, and successful little ones!

This Ain’t Holland, Ya’ll

So, there’s this story that’s often told to families that compares receiving an Autism diagnosis to taking a trip to Holland when you planned your entire vacation around going to Italy. You learned Italian, got excited about the cuisine, and then when the plane lands, you walk outside and find yourself in Holland instead of Italy

Autism ain’t Holland, ya’ll.
One- let’s not compare Autism to a vacation. It’s a job. Lots of work. You don’t get a break when you live Autism. Two- if you went to the Italy Trip Store and they told you, “My bad, we gave your ticket away but here’s some Holland from the stock room,” it wouldn’t be such a bad deal. So you trade pasta for fish, the Coliseum for windmills, and wine for tulips. (Well, maybe that last trade sucks but you’re picking up what I’m putting down). Essentially, going to Holland instead of Italy is just doing one fun thing instead of another fun thing.
Autism isn’t fun. It doesn’t rock my socks. I don’t love it to the moon and back. I could think of 2349820420984098423 other things I’d rather do. My son, however, IS fun. He’s the cat’s pajamas. I adore his stinky self. I tell him daily he’s the most perfect son. But HE is not Autism.
I don’t agree that it is advantageous to advise parents who are receiving a new diagnosis that Autism is like going to Holland instead of Italy. With that said, I do understand and can even appreciate the sentiment behind it. Autism is not the worst thing that can happen to your child….it’s simply something different than what you thought was going to happen. There are awful, terminal things that can happen to our children. This is not like those things. I understand why this anecdote is recanted time and time again- I’ve personally heard it for years. But I also don’t want people to feel trivialized. Everything is relative. It’s ok, when you get a diagnosis, to feel upset and sad and mad about it. Just because it’s not “the worst thing that could happen” doesn’t mean you’re not allowed a minute to feel like it is.  What matters, ultimately, is where you end up. If you find acceptance and make the right steps to help your child, you’re allowed to feel however you’re going to feel along the way. Being told I’m “going to Holland instead of Italy” makes me feel like I’m being cut off in the middle of a feeling-like someone is saying “Eh eh eh eh….feel this, not that….it could be worse!.” I’m certain these are things people say when they do not have a child with Autism. You have to feel things in order to work through things.
Let’s advise parents differently. Let’s advise the truth- it’s going to be hard sometimes. It’s going to be a lot of work. But it’s going to be so rewarding to see the hard work pay off and ultimately, everyone is in fact going to be ok.
It felt like Afghanistan in the beginning. I haven’t found Holland yet but we seem to be sitting somewhere in the Florida Keys right now. A lot of days are sun-filled and fun but sometimes hurricanes still blow through. And when they do, we simply pick up the pieces, fortify the foundation, and wait for the sun to come out again.
Where are you all right now?