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Sunday, January 20, 2008

The Good, The Bad, and the Yummy

This has been an odd end of the week and weekend, to say the least.

All week long, Hallie has been refusing to speak; even old chestnuts like "diaper," "big bird" and "teddy" had disappeared. This had Jenny, Hallie's speech therapist, pretty frustrated and upset. On Thursday, after she left, Ami, Hallie's nanny, was equally upset and vowed to redouble her effort to get Hallie to use whatever small vocabulary she has. I guess it was pretty hard to watch Hallie spend an hour avoiding saying the word "book."

So imagine my surprise when I received an email on Friday afternoon that Hallie's speech therapy had discontinued because she was insufficiently delayed. Within a split second, I had Jenny on the phone. She had been equally dismayed by the message when she got it that morning from Hallie's caseworker.

Can you say, oh no?



Hallie sure can.

But, as Jenny informed the Early Intervention caseworker, they'd be hearing from us as quickly as you could mouth the words 'speech therapy' (presuming, of course, that you are not Hallie).

Needless to say, I had shot off an email, left a message for on the never-answered office phone of said case worker, and tracked her down (via cell) in the field. I had also called her supervisor asking to file an appeal.

Jenny concurs with our assessment: Hallie does not use her words consistently enough to qualify them as real speech at this point, and, while her reception is pretty amazing, her spoken language needs lots of work. Not to mention the feeding issues. Which of course Jenny did mention when she spoke to the case worker, who retorted that OT could handle them. Except for the fact that our OT has not been trained to handle them, whereas our Speech Therapist has. Anyway, we're no shirking violets around here and we'll do what we need to do to get Jenny reinstated. But it's a major pain in the butt to have to deal with this.

Happily, there have been some positive developments in terms of communication and oral motor skills on Hallie's part this weekend and they have, for now, overshadowed our upcoming bureaucratic battle.

First, we received our first two Signing Times DVDs from Amazon and Hallie LOVES them. Not only does she enjoy watching them, but she has learned an entirely new (and pretty extensive, for her) repertoire of signs from them. She has been signing 'eat' all week (before the dvds came) but now signs 'milk' and means it, too. And she has randomly signed 'car', 'play,' and we think she tried to do 'fish' earlier on today. We have great hopes for progress in communicating. Like just now, we were giving her juice, and she signed milk. We replaced the juice with milk and avoided a mini Hallie tantrum (or at least whine).

Second, we finally made some REAL progress on solids. Friday evening, Hallie kept signing 'eat' and asking for Gerber Puffs. So I kept giving them to her. She must have had at least 25 of them, and none came back up. This was unprecedented. Plus, she was chewing really well and seemed to move the food around in her mouth much more effectively than ever before.

So, Saturday morning, spurred on by a lot of positive reinforcement from my preemie blog moms group members, we decided to try some solids with Hallie. Sharon was the intrepid one; I just stood back and let the magic happen. And it did: Hallie had 6 graham cracker sticks and a few fruit flavored cheerios for breakfast. It was clearly a lot of work for her to get these down, but she did it. She concentrated really hard on eating and sent very clear signs when she was all done. And after all this work, she seemed happy and relieved to swallow down her fruity purees. Lunch was a repeat performance, though she was a bit more tired and only had 2.5 graham crackers and a few bites of mushy pasta. She did drink a bit less than average, but this was okay.

And so, for a reward, we took Hallie to her first professional sporting event, the Philadelphia Kixx indoor soccer game. Actually, I lie: we would have gone regardless since Sharon's firm sponsors the team. Since we had a couple of extra tickets (turns out that kids don't need 'em and our niece Megan wasn't able to come down to visit after all this weekend), we brought Karina and Mark and Vanessa along. Everyone had a great time and the kids were really well behaved.




So, it ended up that yesterday was our second day this year that was both vomit and urp-free and our fifth day without vomit if you do not count the urps.

Today has been a bit harder--Hallie was tired and had a backlog of poop (more on this later). But she did manage to get in and keep down some cheerios and had a ball with the graham crackers and her latest food, rice chex. Even if they did not stay in, she was having fun and this counts for a lot. We're trying to be more laid back about things in general and are hoping that this sends her a signal.

Hallie's also been talking more, and finally learned how to blow. This seems like a small feat but we were a bit concerned that she seemed unable to do this. As Jenny has pointed out, Hallie is pretty low-tone around her mouth and we need to build up those muscles so that she can eat and talk more effectively. Of course, she's turned it into yet another tactic to avoid bites of food she doesn't want. What can I say, my kid is a master when it comes to avoidance tactics!

Anyway, back to the being laid back theme: it's a good thing we are since we had a few blowouts from both sides earlier this evening. First, Hallie splashed a bit of water on herself during her first (yes, there were more) bath and spewed forth some of her lunch (we have no idea how much). It's possible that she aspirated a tiny amount or it's possible that she was working on a 'gift' for her mommies.

I got her out of the tub and quickly dried her off and got her into some clean clothing. Then I began to smell some poop. This seemed odd since I had just cleaned her up from a pancake-poop (as we refer to it affectionately) immediately prior to her bath. But the smell was pretty strong. And got stronger. And then I felt the wet spot on my jeans. Fortunately, Sharon got home just around the time when I thought I'd need to deal with this alone. It turns out that Hallie pooped through her onesie, through her pants, onto me, got it onto Sharon, and ended up smearing numerous other objects and places before we were done. I guess she's cleared out now!

Which reminds me, I gotta go do my sixth load of laundry since Thursday. Oy!

5 comments:

Jennifer said...

hmm...

reminds me of the poop episode with Ari. She was very little and we were changing her diaper when she decided to go. Legs in the air and poop on EVERYTHING - walls, dresser, my hair. You name it, it had Ari poop on it.

We laughed, but it was very gross.

I think I'm in a unique situation here. Arianna has NEVER used EI services besides nutrition that came two weeks ago (and whom we probably won't see again) and our caseworker is actually trying to come up with ways to keep her in the program when in reality she doesn't need it... they also offered to pay for her Gymboree classes last year... maybe they've got too much money?

The I hear of states that don't even offer it until there is a documented disability such as autism or CP... that's sad. It makes me feel incredibly lucky.

Aidan's mom said...

I have a thought Abby. When Aidan is about to master something new his skills in other areas seem to "decompensate" just before mastering the new thing. I remember his speech almost seemed to regress in the week before he walked. Then as soon as he walked, BINGO! He immediately recovered what he had and then had what I can only refer to as a language explosion.

I wonder if maybe Hallie is working on a skill that you just won't be aware of until it shows itself?

Oh...and the poop thing! Ugh...that is the worst. Except I was in public when it happened and I looked down at tan khakis to see a huge brownish stain on the leg where he had been sitting. Smelly and embarrassing to boot!

Lori

BusyLizzyMom said...

Five days with no major barf, that is huge. You guys must be so excited. ELizabeth has huge low tone issues with her mouth and only began to bite at 2 1/2. We do lots of blowing (soap bubbles, cotton balls, whistles etc). Keep on chasing the SLP she needs to follow with Hallie's oral motor skills, that is too big a job for an OT. We had to go private (at $130hr) but feel it is very important to keep Elizabeth from learning bad habits.

24weeker's Mama said...

Aloha Abby, Hallie looks super cute as always. My baby started rice cereal, fruit & vegetable in December & he did well.

Trisha said...

Wow. What a weekend! It's great that Hallie is picking up more signs. I have found them so helpful with Caleb. He's 25 months old and is JUST starting to say some words. He too just started to "blow" things, and no one ever told me this could be due to low tone...interesting. Don't get too discouraged with her speech. She understands what you tell her, follows directions, etc and according to our ST that is much more important than actually saying words at this point. I am sure Miss Hallie's just taking her sweet time, like my little stinker! I hope you can get your ST back!