If you are fighting the system to get your child services, if your child is being written off as unworthy, and if you need some inspiration about how to channel your anger into something constructive, you need to read this post....
Thank you, Rachel and Aaron Coleman, for fighting for your daughters with every ounce of strength that you had (and probably then some) and then channeling your energy into providing a resource to all of us out there through Signing Time. You guys gave Hallie the capacity to use language before she could ever vocalize and helped pave the way for us to communicate with her.
How Old is Hallie?
How Old is Lea?
Showing posts with label language. Show all posts
Showing posts with label language. Show all posts
Friday, June 18, 2010
Tuesday, June 8, 2010
Ride 'em, Horse Girl!
On Saturday, Lea napped in the car with me while Hallie went off with Sharon to ride Sir G (whose real name is Sir Gawain; he's a Gypsy horse and, apparently, he doesn't really like any of his other riders but adores Hallie). Part way through Hallie's session, Lea woke up. I took her out of her carseat and let her run around in front of ARCH. Anders, pictured above, who is a very sturdy Fjord, was enjoying his lunch. Lea, of course, noticed him and screeched, "HORSIE!". I brought her over to see him and Jen, the volunteer who was hanging out with him, said that Lea could pet him. Lea pet him, and kissed him, and pet him some more. Then Jen let me put Lea on his back, which thrilled her to pieces. I ran and got Sharon and had her hold Lea while I took a few pictures.
So, even though Lea is too young to ride in ARCH's sibling program (she has to be seven to do this), she at least got to sit astride someone other than me or poor Zen.
On a related note, Lea's language is really exploding. She says five or ten new words a day and is asking for things by their name when she knows it/when she's not too frustrated to do something other than scream/whine. And she's beginning to put two words together, too. On Friday she said to me "Bubbles! My turn!" when I was blowing bubbles for her (which, as it was for Hallie, is a favorite pastime of Lea's). And on Saturday, when we were headed off to ARCH for Hallie's session, she said to Grammy (at whose place we were staying in order to avoid Saturday morning shore traffic), "Bye Bye Grammy!" How cute! It is really fascinating to me to watch a typically-developing child's language develop.
Saturday, November 7, 2009
Autism as a Spectrum
I still owe the blogosphere a Halloween post, but, before my mind becomes more addled than it already is, I just wanted to get some thoughts down on virtual paper. (Yes, I am posting at 4am again. We can attribute this to Lea's teething which proceeds full force and her mixed-up crazy lack of schedule).
On Tuesday, the New York Times published an interesting article entitled, "A Powerful Diagnosis; A Vanishing Identity" which I found very thought-provoking, particularly in light of some of my recent observations about Hallie and her development. The gist of the article is that the working group that is evaluating autism and other neurodevelopmental disorders for the upcoming revision of the DSM (Diagnostic and Statistical Manual)-V have found that there is no clear-cut clinical distinction between those who are diagnosed with mild (or high functioning) autism, PDD-NOS, and Asperger's Syndrome. They've also noticed that diagnoses morph over time; lots of kids, for example, start out with the PDD-NOS label during the toddler and preschool years but end up in the High Functioning Autism or Asperger's categories once they are in third grade or so and it becomes clear to observers what their functional level in terms of capacity to do school work, form relationships, use social and pragmatic language etc really is. So, instead of using these diagnostic terms, the DSM working group has chosen to focus on the core neurodevelopmental differences that mark everyone on the spectrum, such as problems with joint attention and social engagement and deficits in the area of communication/use of social and pragmatic language, and also give some space to the other health problems that those on the ASD also have, such as sensory issues, anxiety and attentional disorders, GI problems, food allergies, and seizure activity.
This is not a bad idea, but I can totally see how it might be controversial: Asperger's Syndrome has constituted a core identity position for lots of people in our culture and you can't just strip it away and tell Aspies that their identity no longer exists. And I think this change would lead a lot of people not to have their kids evaluated because, in our society, having a diagnosis of PDD-NOS or Asperger's Syndrome seems a whole lot less scary and is probably a great deal less stigmatizing than a diagnosis of Autism. (It's a whole heck of a lot better to be lumped in with Temple Grandin and, presumptively, Thomas Alva Edison or Albert Einstein than it is to be deemed to resemble Dustin Hoffman's character in Rain Man).
I think these are very valid points (heck, I study identity for my 'real' job when I am not raising the kids and taking charge of Hallie's complicated medical/therapeutic/and now insurance issues). But I don't really want to get into all of this.
What I do want to talk about is Hallie and how getting to know her and the issues that she confronts on a daily basis suggests to me that the working group on autism's perspective seems to be on target. In other words, as I watch Hallie grow and become more attuned to her neuroatypical (is that even a word? it should be) development, autism begins to look more and more like a spectrum and those sub-categories like PDD-NOS and Asperger's seem to hold a whole lot less water. Indeed, terms like "high functioning" or "PDD-NOS" or "Asperger's" may lead observers/teachers/parents to take the diagnosis a whole lot less seriously than is warranted; provide fewer services to the child who is, after all, "high functioning"; and lead to a romanticization of a label that may not be all that helpful in the end to the kid who is having trouble functioning in the world in which s/he lives.
1. Does language/being verbal matter?
Sure it does. I think we'd be terribly distraught were Hallie not yet speaking. Indeed, we don't have too far to reach into the past to summon up memories of the panic that we felt before Hallie did acquire speech. Hallie was a very late talker who did no babbling whatsoever (just some vowel sounds and even those were far and few between) and who went through over a year of speech therapy before language emerged, finally, some time around age 2. I don't think I spent a single day without googling terms like "apraxia", "late talker", etc back then. I read everything that I could; we tried a variety of biomedical and dietary interventions (Omega 3-6-9s; gluten-free/casein-free diets; magnesium); we invested lots of money in purchasing materials to teach Hallie (and us) American Sign Language (this was a great investment, by the way); and we took Hallie from specialist to specialist, went through numerous speech evaluations, and tried a whole lot of different therapeutic tactics. None of these produced speech, really, until we began to address Hallie's sensory needs, but more on those later.
Even once Hallie did begin to talk, her language remained sparse up until this past winter (about age 2.75) when it took off in terms of the number of words that she spoke. These days, however, she talks A LOT. She is constantly babbling, making demands on us, and, most prevalently, repeating sentences or parts thereof in what is classically known as echolalia (most of her echolalia is immediate--she'll repeat something she sees on TV or that we say to her, but some of it is becoming delayed--she'll repeat relatively short scripts that she has memorized).
But the issue here is not that she has a problem speaking--even though her little voice is raspy due to vocal cord paralysis, she can talk. The question is: can she communicate? And that's teh core autism issue that is our biggest problem, I think (though this problem clearly goes hand in hand with all the rest of the stuff that constitutes the spectrum). Hallie has very little pragmatic language. The way in which she communicates tends to be stereotyped (she learns a script like "Hi, X" or "Bye, X, See you Later!" or "Are you OK? I'm Alright" that is accompanied by fake falling) and, while she tends to use these in appropriate situations, she varies very little from the script. She doesn't have the capacity to communicate in a regular back-and-forth conversational manner with peers or adults. She can't answer questions easily, even when given a choice; has trouble reading body language and often responds to it inappropriately (so she might, for example, laugh when her sister is crying or we are angry with her); finds abstract concepts like emotions very hard to grasp and prefers to label concrete objects for us; probably has a lot of problems following narratives, especially when listening to them being read aloud when they are not accompanied by visual stimuli, even though she understands the individual words of which these narratives are composed; etc. All of this makes it hard for her to organize her own thoughts and get her own point across and, consequently, even when she does have something to say, she might stammer to get it out.
Now, that doesn't mean that we don't have a lot to work with where Hallie's linguistic potential is concerned. She has a fantastic vocabulary; is enamored of words, letters, and books; has a phenomenal memory particularly for visual stuff; and is a quick study. Oddly enough, the kind of echolalia that she manifests is, in itself a good sign. As Hallie talks more and more, she seems to be modifying her echolalia so that, while it is still scripted, she is using those scripts pretty appropriately and in a way that is individualized to the circumstances. It's kind of like she tests out these scripts by echoing them back to the TV or us and then practices them for days until she feels confident enough to use them publicly. Thus, we often here things from Hallie a good two weeks to a month before she uses similar constructions at preschool. Hallie is lacking in the department of self-confidence (we are convinced that she knows that she is different from her peers) and has an excessive degree of anxiety, particularly around social communication) and practicing her scripts a lot appears to allay some of these problems. This post from one of the autism blogs that I read sums up this phenomenon nicely.
As Hallie's language has begun to explode, it's also become abundantly clear to me that she uses the vast majority of her words and sentences to label things in admittedly more sophisticated ways ("It's a big orange tiger. Tiger says 'roar'!") or make demands on us ("I want a bigger circle icey!"). It's great that she's telling us stuff and expressing her needs, but one thing that is missing from Hallie's speech is an emotional component. Her language, like that of most kids on the spectrum who can speak/sign is imperative rather than declarative. Declarative language, as the mom who wrote this post put it, is aimed at transmitting feeling and ideas and not designed to get some sort of response. So, for example, when one says "What a beautiful day it is today. It's so warm and sunny outside and feels just like spring," one is using declarative language. It's aim is to share your perceptions with the people around you and, in so doing, make an emotional connection with them. Much of our daily conversation with friends is in the declarative form. In contrast, it's hard to form a nice human bond if all you are doing is barking orders at them ("Give me a piece of paper! I want a red crayon, please! Now I want the blocks!" aren't really conversation starters.)
The problem is: how does a parent/caregiver/teacher help a kid for whom 9o% of speech aimed at others (as opposed to scripted repeated phrases) get to the point where she expresses her observations of the universe in a way that gets a conversation and, with it a human bond, going? The one thing that others have tried that that we are working on now with Hallie is getting her to express her feelings. We hope that by modeling and using emotive language with her, where we talk about how we are feeling and why we are feeling this way, we can help her make connections between what she is feeling and why she is feeling that way (because she does feel; she just doesn't know how to express and communicate these feelings and that's part of what frustrates her). A simple case in point: yesterday in the bathtub, Hallie asked me to spray some cherry-scented (ugh!) Elmo shaving cream on the side of the tub. I asked her 'why do you want me to do this?' which is not a question she could answer (she has yet to acquire the almighty "why?" that is the bane of all preschoolers' parents' existence and would bring joy to my own ears.) Since I knew she could not answer this question, I helped provide the answer to her: "because you like it! It makes you happy!" Hallie understands 'like' and 'dislike' on a visceral level but has not expressed liking or disliking anything or anyone in a linguistic form. Likewise, she can identify a happy face (it has a smile on it) and even make one on demand, but she doesn't quite link the feeling that she has of joy or satisfaction (and I know that she feels joy; just watch her when she swings or bounces and you know she is full of glee) with the abstract word "happy." But concretizing this for her---linking the joy of playing in the shaving cream with the concept 'happy' and helping her realize that the things she likes make her feel happy and then providing her with a script helped. We did this exercise several times in the tub with the shaving cream (kind of like an ABA light exercise, in my mind) and then, later on in the evening, we did some more stuff that she liked and made her happy and substituted the new activity for the shaving cream and she repeated her new script, "I want X...because it makes me happy!" This morning, it was clear that she had internalized the lesson, at least to some degree, because she began to generalize this a bit further. I did the same thing with the concept 'scary': we visited the dentist yesterday, and Hallie always finds this scary but has never had the word for this. We talked about the appointment in advance, while we were there, and after we got home. For the first time ever, Hallie expressed to me that she was scared (she actually said "I little scared" when I asked her how the dentist made me feel); then again, this morning, she told me that "big animals are scary!" Now, among the preschool set, saying something like "big animals are scary" really could be the beginning of a very fun conversation.
So there is clearly hope there when it comes to the notion of pragmatic language acquisition but the point that I'd like to underscore is that none of this comes naturally to Hallie, who by all accounts has above-average intelligence and is likely going to end up as an Asperger's kid if the DSM-V doesn't change its approach to diagnosing ASD. It's the inability or impaired ability to use pragmatic language that seems to me to be a defining characteristic of the spectrum. Some have it worse than others, to be sure, but this is one of those things that separates folks on the spectrum from their neurotypical peers and, no matter how much ABA and Floortime and other therapies these kids get, pragmatic language on some level remains a struggle for them.
Why this is important should be fairly obvious: it's hard to form relationships with people if you cannot engage in meaningful spontaneous conversation with them; if you cannot understand their body language and cues; and if you have trouble with emotions. And that brings me to the second issue that seems to affect people on the spectrum, pretty much across the board:
2. Joint Engagement.
Again, there's a spectrum here. Some folks with autism demonstrate little to no capacity for this; others are fairly well engaged with the people in their universe but their engagement seems a bit quirky or eccentric. I'd guess that Hallie falls somewhere in the middle. Her eye contact sucks. There's no way around that. She would prefer to avert her gaze than to look you in the eye and I suspect that looking people in the eye is typically rather painful -- at least emotionally -- for Hallie because visual stimuli are so potent and so distracting to her and because she has a lot of problems organizing her sensory system. The times when she is best able to make and sustain eye contact is when she is engaged in sensory-regulating activities (like bouncing; having pillows and other soft objects thrown on her; being tossed up in the air; jumping; or playing music etc). This is because her sensory system is so out of whack and she requires a ton of proprioceptive and vestibular input to know where her body is in the universe and get herself back into equilibrium. So, if you give her this input, you can achieve joint attention and engagement (of which eye contact is a manifestation). Once you have that, you can build on the engagement to reach new levels of emotional interaction and give-and-take kinds of communication (be it verbal or gestural). If those new activities that are more sophisticated get to be too much for Hallie, she shuts down because she is overwhelmed and you need to retreat to simpler sensory-regulating activities (like tossing pillows or balls at her) to help her re-regulate herself. And sometimes those work great and other times, she is so overwhelmed that she needs to retreat for a bit before she can reengage with the people in her universe. Getting a handle on all of this is one of the most important things that we have learned from Floortime/DIR therapy. And, hopefully, over time, Hallie will learn to seek out less dramatic means of self-regulation and will demonstrate more emotional and developmental competence that will make it possible for her to stay engaged longer and in more sophisticated ways (and this will help build the blocks to logical thinking, effective executive motor planning, and the like).
The extent of Hallie's problems with joint attention/engagement really only became clear to us once Lea came into her own as a little person. Watching Lea engage with us and her universe has been a real eye-opener. For one, Lea prefers people to objects/toys. She uses her social smile and excellent eye contact to achieve a bond with me when I walk into the room (and she seems to know immediately that I'm there) and begins to flirt. She'll then do some sort of motor activity--bang some toys together, bang on a table--and anticipate or even demand that we mimic her action. This will then lead to a whole stream of 'circles of communication' that are accompanied by sustained eye contact, lots of smiling, and usually some noises/babbling. It's like a whole baby conversation and is hugely fulfilling. We didn't really have any of this with Hallie and, like pragmatic language, eye contact and joint attention did not naturally enter into Hallie's repertoire. She always preferred toys to people and still does. The inanimate world is the world she enjoys labeling and showing us. Indeed, there's a relationship between her lack of pragmatic language (her tendency to label rather than communicate) and her lack of joint attention.
Some day this labeling may morph into monologues on her favorite subjects (which is very indicative of those diagnosed with Asperger's) but regardless of whether she ever achieves the kind of verbal fluency that Aspies usually have, the core problem remains the same.
3. Sensory Dysfunction's place in the spectrum's trifecta.
A while back I wrote a long post on sensory integration disorder, so I am not going to repeat all of it here again. But the crux of the matter is that people on the spectrum seem to be out of kilter, each in his or her own way, where sensory issues are concerned. They either are over-responsive and find sensations--like noises, tastes, smells--so overwhelming that they cannot function in the presence of them; under-responsive ('ho-hum') about everything and need way more sensory information before they can respond to their environment; or some mix of the two.
That's what Hallie is like---she hears and sees so much and so well but has trouble hierarchizing oral data to glean from it the pertinent information that she needs to act; that's why she gets so distracted so easily. Visual cues, when clear and forceful enough (like the TV she loves and I have grown to hate, but also like the written word that I cannot help but love), provide much more organizing data to her and allow her to learn better. That's why we're incorporating a visual schedule into her repertoire that will allow her to anticipate the activities that await her during the school day and help her organize her life around them.
She obviously needs much more proprioceptive input in order to pay attention and function: if her feet don't touch the floor while sitting in a chair, she fidgets and needs to move around; a foot stool definitely helps to sit still longer. Her OT at school has also brought in a couple of different weighted vests to see if they help her pay attention to what's going on in the classroom during story time and circle time. And it's pretty obvious to me that, as we transition to a more formal school setting that requires her to sit at a desk and perform fairly sophisticated activities, she will require various adaptations and accommodations to her environment. We just don't quite know what these are right now.
And Hallie, obviously, also has her aversions. Most food falls under this category for her, but so does having messy hands (she will do some messy activities for short periods of time, but once she realizes that her hands are messy or greasy or whatever, she demands a wipe or needs to wash up), having her hair washed, and stuff of that nature.
Occupational therapy also really helps kids with sensory issues (regardless of whether they are on the spectrum), so we're looking forward to beginning this privately again some time this winter. What we do in OT helps us come up with ideas about what we can do differently at home and at school.
We all have our sensory likes and dislikes and most of us fidget and squirm to some extent when forced to sit for long periods of time at a desk. Some of us do better at auditory learning (that would be me) and some of us are much more effective visual learners (that would be Sharon). But the key issue is that us neurotypical types tend to self-regulate pretty well. We often do this without thinking about it: we might chew the back of a pen or a piece of gum; get up and take a brief walk or grab a glass of cold water so that we can return to our task and pay attention to it; or do less socially acceptable but still fairly normal things like bite our nails or twirl our hair. But the key issue here is that none of this sensory regulation comes naturally to Hallie. Like pragmatic language and joint engagement, this is all stuff we have to learn about her and help her learn and apply to herself. And, again, unlike her neurotypical counterparts, when Hallie's sensory system is out of whack, she will shut down (sometimes for extended periods of time, like days; she did this for a few days this week). Other kids will demonstrate their disregulation in more disruptive manners like extended tantrums. But, regardless, folks on the spectrum have a much harder time getting things back together after they have sensorily fallen apart than those who aren't on the spectrum do.
So, in the end, I am fairly certain that the new spectrum approach that's being bandied about where diagnosing autism is concerned makes more sense to me than the old three-or-four-distinct-disorders approach. To be sure, the degree of impairment matters and those who sit on the higher-functioning (for lack of a better term) end of the spectrum most likely do have an improved chance for a better outcome, especially if they are getting the proper kinds of services and treatment, than their lower-functioning peers. But regardless of whether one is high functioning or low functioning, anyone on the spectrum is going to have a whole lot of challenges where these three sorts of issues are concerned and really needs services/accommodations to help them reach their fullest potential. And maybe, just maybe, revising the DSM will help get more kids the help they need.
On Tuesday, the New York Times published an interesting article entitled, "A Powerful Diagnosis; A Vanishing Identity" which I found very thought-provoking, particularly in light of some of my recent observations about Hallie and her development. The gist of the article is that the working group that is evaluating autism and other neurodevelopmental disorders for the upcoming revision of the DSM (Diagnostic and Statistical Manual)-V have found that there is no clear-cut clinical distinction between those who are diagnosed with mild (or high functioning) autism, PDD-NOS, and Asperger's Syndrome. They've also noticed that diagnoses morph over time; lots of kids, for example, start out with the PDD-NOS label during the toddler and preschool years but end up in the High Functioning Autism or Asperger's categories once they are in third grade or so and it becomes clear to observers what their functional level in terms of capacity to do school work, form relationships, use social and pragmatic language etc really is. So, instead of using these diagnostic terms, the DSM working group has chosen to focus on the core neurodevelopmental differences that mark everyone on the spectrum, such as problems with joint attention and social engagement and deficits in the area of communication/use of social and pragmatic language, and also give some space to the other health problems that those on the ASD also have, such as sensory issues, anxiety and attentional disorders, GI problems, food allergies, and seizure activity.
This is not a bad idea, but I can totally see how it might be controversial: Asperger's Syndrome has constituted a core identity position for lots of people in our culture and you can't just strip it away and tell Aspies that their identity no longer exists. And I think this change would lead a lot of people not to have their kids evaluated because, in our society, having a diagnosis of PDD-NOS or Asperger's Syndrome seems a whole lot less scary and is probably a great deal less stigmatizing than a diagnosis of Autism. (It's a whole heck of a lot better to be lumped in with Temple Grandin and, presumptively, Thomas Alva Edison or Albert Einstein than it is to be deemed to resemble Dustin Hoffman's character in Rain Man).
I think these are very valid points (heck, I study identity for my 'real' job when I am not raising the kids and taking charge of Hallie's complicated medical/therapeutic/and now insurance issues). But I don't really want to get into all of this.
What I do want to talk about is Hallie and how getting to know her and the issues that she confronts on a daily basis suggests to me that the working group on autism's perspective seems to be on target. In other words, as I watch Hallie grow and become more attuned to her neuroatypical (is that even a word? it should be) development, autism begins to look more and more like a spectrum and those sub-categories like PDD-NOS and Asperger's seem to hold a whole lot less water. Indeed, terms like "high functioning" or "PDD-NOS" or "Asperger's" may lead observers/teachers/parents to take the diagnosis a whole lot less seriously than is warranted; provide fewer services to the child who is, after all, "high functioning"; and lead to a romanticization of a label that may not be all that helpful in the end to the kid who is having trouble functioning in the world in which s/he lives.
1. Does language/being verbal matter?
Sure it does. I think we'd be terribly distraught were Hallie not yet speaking. Indeed, we don't have too far to reach into the past to summon up memories of the panic that we felt before Hallie did acquire speech. Hallie was a very late talker who did no babbling whatsoever (just some vowel sounds and even those were far and few between) and who went through over a year of speech therapy before language emerged, finally, some time around age 2. I don't think I spent a single day without googling terms like "apraxia", "late talker", etc back then. I read everything that I could; we tried a variety of biomedical and dietary interventions (Omega 3-6-9s; gluten-free/casein-free diets; magnesium); we invested lots of money in purchasing materials to teach Hallie (and us) American Sign Language (this was a great investment, by the way); and we took Hallie from specialist to specialist, went through numerous speech evaluations, and tried a whole lot of different therapeutic tactics. None of these produced speech, really, until we began to address Hallie's sensory needs, but more on those later.
Even once Hallie did begin to talk, her language remained sparse up until this past winter (about age 2.75) when it took off in terms of the number of words that she spoke. These days, however, she talks A LOT. She is constantly babbling, making demands on us, and, most prevalently, repeating sentences or parts thereof in what is classically known as echolalia (most of her echolalia is immediate--she'll repeat something she sees on TV or that we say to her, but some of it is becoming delayed--she'll repeat relatively short scripts that she has memorized).
But the issue here is not that she has a problem speaking--even though her little voice is raspy due to vocal cord paralysis, she can talk. The question is: can she communicate? And that's teh core autism issue that is our biggest problem, I think (though this problem clearly goes hand in hand with all the rest of the stuff that constitutes the spectrum). Hallie has very little pragmatic language. The way in which she communicates tends to be stereotyped (she learns a script like "Hi, X" or "Bye, X, See you Later!" or "Are you OK? I'm Alright" that is accompanied by fake falling) and, while she tends to use these in appropriate situations, she varies very little from the script. She doesn't have the capacity to communicate in a regular back-and-forth conversational manner with peers or adults. She can't answer questions easily, even when given a choice; has trouble reading body language and often responds to it inappropriately (so she might, for example, laugh when her sister is crying or we are angry with her); finds abstract concepts like emotions very hard to grasp and prefers to label concrete objects for us; probably has a lot of problems following narratives, especially when listening to them being read aloud when they are not accompanied by visual stimuli, even though she understands the individual words of which these narratives are composed; etc. All of this makes it hard for her to organize her own thoughts and get her own point across and, consequently, even when she does have something to say, she might stammer to get it out.
Now, that doesn't mean that we don't have a lot to work with where Hallie's linguistic potential is concerned. She has a fantastic vocabulary; is enamored of words, letters, and books; has a phenomenal memory particularly for visual stuff; and is a quick study. Oddly enough, the kind of echolalia that she manifests is, in itself a good sign. As Hallie talks more and more, she seems to be modifying her echolalia so that, while it is still scripted, she is using those scripts pretty appropriately and in a way that is individualized to the circumstances. It's kind of like she tests out these scripts by echoing them back to the TV or us and then practices them for days until she feels confident enough to use them publicly. Thus, we often here things from Hallie a good two weeks to a month before she uses similar constructions at preschool. Hallie is lacking in the department of self-confidence (we are convinced that she knows that she is different from her peers) and has an excessive degree of anxiety, particularly around social communication) and practicing her scripts a lot appears to allay some of these problems. This post from one of the autism blogs that I read sums up this phenomenon nicely.
As Hallie's language has begun to explode, it's also become abundantly clear to me that she uses the vast majority of her words and sentences to label things in admittedly more sophisticated ways ("It's a big orange tiger. Tiger says 'roar'!") or make demands on us ("I want a bigger circle icey!"). It's great that she's telling us stuff and expressing her needs, but one thing that is missing from Hallie's speech is an emotional component. Her language, like that of most kids on the spectrum who can speak/sign is imperative rather than declarative. Declarative language, as the mom who wrote this post put it, is aimed at transmitting feeling and ideas and not designed to get some sort of response. So, for example, when one says "What a beautiful day it is today. It's so warm and sunny outside and feels just like spring," one is using declarative language. It's aim is to share your perceptions with the people around you and, in so doing, make an emotional connection with them. Much of our daily conversation with friends is in the declarative form. In contrast, it's hard to form a nice human bond if all you are doing is barking orders at them ("Give me a piece of paper! I want a red crayon, please! Now I want the blocks!" aren't really conversation starters.)
The problem is: how does a parent/caregiver/teacher help a kid for whom 9o% of speech aimed at others (as opposed to scripted repeated phrases) get to the point where she expresses her observations of the universe in a way that gets a conversation and, with it a human bond, going? The one thing that others have tried that that we are working on now with Hallie is getting her to express her feelings. We hope that by modeling and using emotive language with her, where we talk about how we are feeling and why we are feeling this way, we can help her make connections between what she is feeling and why she is feeling that way (because she does feel; she just doesn't know how to express and communicate these feelings and that's part of what frustrates her). A simple case in point: yesterday in the bathtub, Hallie asked me to spray some cherry-scented (ugh!) Elmo shaving cream on the side of the tub. I asked her 'why do you want me to do this?' which is not a question she could answer (she has yet to acquire the almighty "why?" that is the bane of all preschoolers' parents' existence and would bring joy to my own ears.) Since I knew she could not answer this question, I helped provide the answer to her: "because you like it! It makes you happy!" Hallie understands 'like' and 'dislike' on a visceral level but has not expressed liking or disliking anything or anyone in a linguistic form. Likewise, she can identify a happy face (it has a smile on it) and even make one on demand, but she doesn't quite link the feeling that she has of joy or satisfaction (and I know that she feels joy; just watch her when she swings or bounces and you know she is full of glee) with the abstract word "happy." But concretizing this for her---linking the joy of playing in the shaving cream with the concept 'happy' and helping her realize that the things she likes make her feel happy and then providing her with a script helped. We did this exercise several times in the tub with the shaving cream (kind of like an ABA light exercise, in my mind) and then, later on in the evening, we did some more stuff that she liked and made her happy and substituted the new activity for the shaving cream and she repeated her new script, "I want X...because it makes me happy!" This morning, it was clear that she had internalized the lesson, at least to some degree, because she began to generalize this a bit further. I did the same thing with the concept 'scary': we visited the dentist yesterday, and Hallie always finds this scary but has never had the word for this. We talked about the appointment in advance, while we were there, and after we got home. For the first time ever, Hallie expressed to me that she was scared (she actually said "I little scared" when I asked her how the dentist made me feel); then again, this morning, she told me that "big animals are scary!" Now, among the preschool set, saying something like "big animals are scary" really could be the beginning of a very fun conversation.
So there is clearly hope there when it comes to the notion of pragmatic language acquisition but the point that I'd like to underscore is that none of this comes naturally to Hallie, who by all accounts has above-average intelligence and is likely going to end up as an Asperger's kid if the DSM-V doesn't change its approach to diagnosing ASD. It's the inability or impaired ability to use pragmatic language that seems to me to be a defining characteristic of the spectrum. Some have it worse than others, to be sure, but this is one of those things that separates folks on the spectrum from their neurotypical peers and, no matter how much ABA and Floortime and other therapies these kids get, pragmatic language on some level remains a struggle for them.
Why this is important should be fairly obvious: it's hard to form relationships with people if you cannot engage in meaningful spontaneous conversation with them; if you cannot understand their body language and cues; and if you have trouble with emotions. And that brings me to the second issue that seems to affect people on the spectrum, pretty much across the board:
2. Joint Engagement.
Again, there's a spectrum here. Some folks with autism demonstrate little to no capacity for this; others are fairly well engaged with the people in their universe but their engagement seems a bit quirky or eccentric. I'd guess that Hallie falls somewhere in the middle. Her eye contact sucks. There's no way around that. She would prefer to avert her gaze than to look you in the eye and I suspect that looking people in the eye is typically rather painful -- at least emotionally -- for Hallie because visual stimuli are so potent and so distracting to her and because she has a lot of problems organizing her sensory system. The times when she is best able to make and sustain eye contact is when she is engaged in sensory-regulating activities (like bouncing; having pillows and other soft objects thrown on her; being tossed up in the air; jumping; or playing music etc). This is because her sensory system is so out of whack and she requires a ton of proprioceptive and vestibular input to know where her body is in the universe and get herself back into equilibrium. So, if you give her this input, you can achieve joint attention and engagement (of which eye contact is a manifestation). Once you have that, you can build on the engagement to reach new levels of emotional interaction and give-and-take kinds of communication (be it verbal or gestural). If those new activities that are more sophisticated get to be too much for Hallie, she shuts down because she is overwhelmed and you need to retreat to simpler sensory-regulating activities (like tossing pillows or balls at her) to help her re-regulate herself. And sometimes those work great and other times, she is so overwhelmed that she needs to retreat for a bit before she can reengage with the people in her universe. Getting a handle on all of this is one of the most important things that we have learned from Floortime/DIR therapy. And, hopefully, over time, Hallie will learn to seek out less dramatic means of self-regulation and will demonstrate more emotional and developmental competence that will make it possible for her to stay engaged longer and in more sophisticated ways (and this will help build the blocks to logical thinking, effective executive motor planning, and the like).
The extent of Hallie's problems with joint attention/engagement really only became clear to us once Lea came into her own as a little person. Watching Lea engage with us and her universe has been a real eye-opener. For one, Lea prefers people to objects/toys. She uses her social smile and excellent eye contact to achieve a bond with me when I walk into the room (and she seems to know immediately that I'm there) and begins to flirt. She'll then do some sort of motor activity--bang some toys together, bang on a table--and anticipate or even demand that we mimic her action. This will then lead to a whole stream of 'circles of communication' that are accompanied by sustained eye contact, lots of smiling, and usually some noises/babbling. It's like a whole baby conversation and is hugely fulfilling. We didn't really have any of this with Hallie and, like pragmatic language, eye contact and joint attention did not naturally enter into Hallie's repertoire. She always preferred toys to people and still does. The inanimate world is the world she enjoys labeling and showing us. Indeed, there's a relationship between her lack of pragmatic language (her tendency to label rather than communicate) and her lack of joint attention.
Some day this labeling may morph into monologues on her favorite subjects (which is very indicative of those diagnosed with Asperger's) but regardless of whether she ever achieves the kind of verbal fluency that Aspies usually have, the core problem remains the same.
3. Sensory Dysfunction's place in the spectrum's trifecta.
A while back I wrote a long post on sensory integration disorder, so I am not going to repeat all of it here again. But the crux of the matter is that people on the spectrum seem to be out of kilter, each in his or her own way, where sensory issues are concerned. They either are over-responsive and find sensations--like noises, tastes, smells--so overwhelming that they cannot function in the presence of them; under-responsive ('ho-hum') about everything and need way more sensory information before they can respond to their environment; or some mix of the two.
That's what Hallie is like---she hears and sees so much and so well but has trouble hierarchizing oral data to glean from it the pertinent information that she needs to act; that's why she gets so distracted so easily. Visual cues, when clear and forceful enough (like the TV she loves and I have grown to hate, but also like the written word that I cannot help but love), provide much more organizing data to her and allow her to learn better. That's why we're incorporating a visual schedule into her repertoire that will allow her to anticipate the activities that await her during the school day and help her organize her life around them.
She obviously needs much more proprioceptive input in order to pay attention and function: if her feet don't touch the floor while sitting in a chair, she fidgets and needs to move around; a foot stool definitely helps to sit still longer. Her OT at school has also brought in a couple of different weighted vests to see if they help her pay attention to what's going on in the classroom during story time and circle time. And it's pretty obvious to me that, as we transition to a more formal school setting that requires her to sit at a desk and perform fairly sophisticated activities, she will require various adaptations and accommodations to her environment. We just don't quite know what these are right now.
And Hallie, obviously, also has her aversions. Most food falls under this category for her, but so does having messy hands (she will do some messy activities for short periods of time, but once she realizes that her hands are messy or greasy or whatever, she demands a wipe or needs to wash up), having her hair washed, and stuff of that nature.
Occupational therapy also really helps kids with sensory issues (regardless of whether they are on the spectrum), so we're looking forward to beginning this privately again some time this winter. What we do in OT helps us come up with ideas about what we can do differently at home and at school.
We all have our sensory likes and dislikes and most of us fidget and squirm to some extent when forced to sit for long periods of time at a desk. Some of us do better at auditory learning (that would be me) and some of us are much more effective visual learners (that would be Sharon). But the key issue is that us neurotypical types tend to self-regulate pretty well. We often do this without thinking about it: we might chew the back of a pen or a piece of gum; get up and take a brief walk or grab a glass of cold water so that we can return to our task and pay attention to it; or do less socially acceptable but still fairly normal things like bite our nails or twirl our hair. But the key issue here is that none of this sensory regulation comes naturally to Hallie. Like pragmatic language and joint engagement, this is all stuff we have to learn about her and help her learn and apply to herself. And, again, unlike her neurotypical counterparts, when Hallie's sensory system is out of whack, she will shut down (sometimes for extended periods of time, like days; she did this for a few days this week). Other kids will demonstrate their disregulation in more disruptive manners like extended tantrums. But, regardless, folks on the spectrum have a much harder time getting things back together after they have sensorily fallen apart than those who aren't on the spectrum do.
So, in the end, I am fairly certain that the new spectrum approach that's being bandied about where diagnosing autism is concerned makes more sense to me than the old three-or-four-distinct-disorders approach. To be sure, the degree of impairment matters and those who sit on the higher-functioning (for lack of a better term) end of the spectrum most likely do have an improved chance for a better outcome, especially if they are getting the proper kinds of services and treatment, than their lower-functioning peers. But regardless of whether one is high functioning or low functioning, anyone on the spectrum is going to have a whole lot of challenges where these three sorts of issues are concerned and really needs services/accommodations to help them reach their fullest potential. And maybe, just maybe, revising the DSM will help get more kids the help they need.
Monday, September 7, 2009
Totally Sensational--Hallie and Sensory Processing Disorder
It's become clear to us, over time, that so many of Hallie's issues stem from her out of whack sensory system. Even though I've read, re-read, and re-re-read The Out of Sync Child, I must admit that I remain a bit baffled by how Sensory Processing Disorder and precisely how it works to impede things like fluid communication and socialization (things like eye contact, playing well with others, conversational skills); gross motor movement (like running and jumping and walking); fine motor skills (like bilateral hand use); and eating. Here is a not bad description of sensory processing disorder for those who want to read more about this.
What I do understand is this: Hallie is under-responsive to some kinds of sensory stimuli, like those involving touch and vestibular movement, and hence craves sensation (in other words, she is a sensory seeker) to get enough information to negotiate the world well. Here are a couple of easy examples: she walks and runs with a heavy foot not only because she is low tone and unable to walk and run in any other way (although she is low tone and this complicates matters further) but also because walking and running in this way gives her nerves (and sends her brain signals) the information that she needs and craves. It looks funny and it may put some undue pressure on her joints and growing limbs, but it also helps her organize herself better. Another example: Hallie likes to bury herself in things and pour things on herself---these things can be pillows, lego bricks, balls, stuffed animals, whatever. Whenever she needs to calm down, this is what she does to help regulate herself.
Hallie is also over-responsive to some other kinds of stimuli. She is a visual learner and her visual sense is a bit over-responsive. What this means is that she is easily distracted by the things that she sees--whether that's the television (a big distraction for her) or things going on in other parts of the playground, or people and animals walking down the block. She sees these things out of the corner of her eyes and is forced by her sensory system to turn around and look or to run off in the direction of these stimuli. This can be a major problem, since it often means that Hallie is constantly turning her head to the side and looking over her back when walking down the street (which leads to falling, banging into things, and not paying attention to the things that she needs to heed, like oncoming vehicles) and it also can interfere with the learning process (like not being able to listen to a teacher during storytime because something else in the room catches her eye).
What we need to do as parents is figure out how to provide her with the stimulation that she requires to receive and process information in a way that doesn't get in the way of learning, safety, and other good things like that. We've been working in Floortime/DIR and OT on these skills and I have to say that whatever we are doing is beginning to work. I watch Hallie carefully to learn what helps, and what does not help, and then we try to do those things at home. At school, we'll have to work with OTs to design adaptations that allow her to retain focus (we hope that these are minor: things like placement in the classroom near the teacher and away from doors and windows where there might be more movement and consequently more visual and auditory distractions; having Hallie sit on sensory cushions that provide her with input; the use of weighted beanbag 'snakes' or stuff like that on her shoulders that help her keep still; fidgets for her hands, etc). And she may just need to get up and run around every now and then to regulate herself so that she can return to her desk and learn. All of these modifications need to be written into IEPs to make sure that everyone understands why she needs these things and how they function and so that her teachers don't just end up thinking that she is a flighty wild-child who doesn't sit still. But that's still in the future.
Back to the present: I noticed during Floortime/DIR this past week that Hallie adored the sensation of the smooth side of a Mondo Inside-Out Spiky Stretchy ball on her feet and hands and that she really grooved on walking on the spikey surface (on the outside--not the inside...that makes her very unhappy). So, like any good parent who thinks they might just open a sensory gym in the future, I went out and got her some (these join her collapsible tunnel, play-house, inflatable ball pit, and gym mat). The ones we ordered were a little smaller than the ones we used at therapy but she enjoyed them nonetheless:
Hallie asks for these all the time (they are a restricted toy since Hallie also finds the spikes irresistible as a biting item...the knobby chewy tube I just bought her and the long silicone chewy tube she received from her feeding therapist do not have the same caché for her, though Lea quite likes them). We hoped that having the spikey balls on her feet during meal time might help her eat more appropriately (in terms of quantity and in terms of not using her food as a sensory plaything) but no dice on this one, so far. Still, we're happy with this addition to our therapy tools/toy box and will probably get her some bigger ones if we see them around.
As I said earlier, Hallie has also devised a variety of ways of providing herself with sensory input that she needs in our (very small) house using everyday objects. She used to take out all of her stuffed animals and creatures and place them in the middle of our living room and roll around on top of them; then she moved to placing them on the couch (sometimes removing the couch cushions first), along with balls, and rolling around in these; then she decided to place them behind the couch and lie on top of them, sandwiched between the couch and the wall. I am particularly fond of this variant since it doesn't involve any cleaning up of toys at the end. I'll try to get a photo of this to post.
What I do have a picture of, though, is Hallie and Eliza Grace's reaction to pillows being piled on top of them on the big chair in the living room. One of the nice things about your child having speech and beginning to communicate is that she can tell you what she needs. On Friday night, after dinner, Hallie requested pillow piling. She built her new turn-taking skills into the process by directing us: "now Hallie turn!", "now Eliza turn!", "now Hallie turn!" , "now Eliza turn!" When the big pillows were equally distributed on top of the girls, the two of them kicked them off and hooted and smiled like crazy and then the process began again.
They were so happy after all that pillow-piling that they ended with a nice smoochy.
Anyway, Hallie doesn't just crave tactile stimulation but she also craves vestibular input--basically this is anything involving motion and balance and includes stuff like swinging (Hallie's favorite activity), jumping up and down, and spinning. That's why she loves fast rides, roller coasters, and the like. At home, Hallie enjoys piling the aforementioned pillows in front of the big chair and jumping off of the chair onto them.
At the playground, Hallie enjoys typical playground activities more than your average kid and certainly more than children who are over-responsive to sensory input (that would include me...I am pretty sure, after reading a lot about dysfunctional sensory processing that I am the opposite of Hallie in terms of sensory profiles. That's why I hate heights, fast motion, uncontrolled wheeled activities, and get dizzy very easily). Now that Hallie's body works better--her gross and fine motor skills are improving--she is much more effective at meeting these needs on the playground.
Hallie and Eliza had plenty of opportunity to get all the sensory input they craved at Smith Playground yesterday:
But their favorite activity was sliding down Smith's giant wooden slide:
They would have done this forever!
Even little Lea got in on the action at Smith Playground, even if she was a bit too young to enjoy the slide (actually, she would have enjoyed it; we just were not about to put her on a burlap sack and let her slide down what amounts to a giant bowling alley on a fairly steep incline):
And she also got to get in on the teeter totter action:
Anyway, a great day was had by all. After Eliza and Anne departed for New Jersey to visit Nana (Anne's mom and Eliza's grandmother), we headed home and rested (no nap for Hallie, alas) in preparation for the arrival of Hallie's PT. After seeing Hallie negotiate the playground with her friend Alex (who came to visit and dine with us yesterday evening), the PT decided that she had mis-assessed Hallie. Yes, Hallie is low-tone and, yes, her left side is weaker than her first. But she does jump with both feet off the ground and she runs funny because of her sensory stuff and not because she has too. Ditto with toe-walking. That's why it's called idiopathic toe-walking in her case. Her heels are tight and can use some stretching. But she can probably get away with something like a Sure Start shoe inserts or Polly Wogs rather than really extensive bracing/orthotics. That's a relief because Hallie, who is a bit of a shoe queen, would bristle at wearing extensive orthotics. We will have to buy her more supportive shoes, too, I think: she walks so much better in her Keens than she does in your average Stride Rite shoes, but we're happy to do this. Anyway, our appointment with the orthopedist is in a couple of weeks and we'll know more then. But we are feeling better about this based on what the PT saw yesterday.
What I do understand is this: Hallie is under-responsive to some kinds of sensory stimuli, like those involving touch and vestibular movement, and hence craves sensation (in other words, she is a sensory seeker) to get enough information to negotiate the world well. Here are a couple of easy examples: she walks and runs with a heavy foot not only because she is low tone and unable to walk and run in any other way (although she is low tone and this complicates matters further) but also because walking and running in this way gives her nerves (and sends her brain signals) the information that she needs and craves. It looks funny and it may put some undue pressure on her joints and growing limbs, but it also helps her organize herself better. Another example: Hallie likes to bury herself in things and pour things on herself---these things can be pillows, lego bricks, balls, stuffed animals, whatever. Whenever she needs to calm down, this is what she does to help regulate herself.
Hallie is also over-responsive to some other kinds of stimuli. She is a visual learner and her visual sense is a bit over-responsive. What this means is that she is easily distracted by the things that she sees--whether that's the television (a big distraction for her) or things going on in other parts of the playground, or people and animals walking down the block. She sees these things out of the corner of her eyes and is forced by her sensory system to turn around and look or to run off in the direction of these stimuli. This can be a major problem, since it often means that Hallie is constantly turning her head to the side and looking over her back when walking down the street (which leads to falling, banging into things, and not paying attention to the things that she needs to heed, like oncoming vehicles) and it also can interfere with the learning process (like not being able to listen to a teacher during storytime because something else in the room catches her eye).
What we need to do as parents is figure out how to provide her with the stimulation that she requires to receive and process information in a way that doesn't get in the way of learning, safety, and other good things like that. We've been working in Floortime/DIR and OT on these skills and I have to say that whatever we are doing is beginning to work. I watch Hallie carefully to learn what helps, and what does not help, and then we try to do those things at home. At school, we'll have to work with OTs to design adaptations that allow her to retain focus (we hope that these are minor: things like placement in the classroom near the teacher and away from doors and windows where there might be more movement and consequently more visual and auditory distractions; having Hallie sit on sensory cushions that provide her with input; the use of weighted beanbag 'snakes' or stuff like that on her shoulders that help her keep still; fidgets for her hands, etc). And she may just need to get up and run around every now and then to regulate herself so that she can return to her desk and learn. All of these modifications need to be written into IEPs to make sure that everyone understands why she needs these things and how they function and so that her teachers don't just end up thinking that she is a flighty wild-child who doesn't sit still. But that's still in the future.
Back to the present: I noticed during Floortime/DIR this past week that Hallie adored the sensation of the smooth side of a Mondo Inside-Out Spiky Stretchy ball on her feet and hands and that she really grooved on walking on the spikey surface (on the outside--not the inside...that makes her very unhappy). So, like any good parent who thinks they might just open a sensory gym in the future, I went out and got her some (these join her collapsible tunnel, play-house, inflatable ball pit, and gym mat). The ones we ordered were a little smaller than the ones we used at therapy but she enjoyed them nonetheless:
Hallie asks for these all the time (they are a restricted toy since Hallie also finds the spikes irresistible as a biting item...the knobby chewy tube I just bought her and the long silicone chewy tube she received from her feeding therapist do not have the same caché for her, though Lea quite likes them). We hoped that having the spikey balls on her feet during meal time might help her eat more appropriately (in terms of quantity and in terms of not using her food as a sensory plaything) but no dice on this one, so far. Still, we're happy with this addition to our therapy tools/toy box and will probably get her some bigger ones if we see them around.
As I said earlier, Hallie has also devised a variety of ways of providing herself with sensory input that she needs in our (very small) house using everyday objects. She used to take out all of her stuffed animals and creatures and place them in the middle of our living room and roll around on top of them; then she moved to placing them on the couch (sometimes removing the couch cushions first), along with balls, and rolling around in these; then she decided to place them behind the couch and lie on top of them, sandwiched between the couch and the wall. I am particularly fond of this variant since it doesn't involve any cleaning up of toys at the end. I'll try to get a photo of this to post.
What I do have a picture of, though, is Hallie and Eliza Grace's reaction to pillows being piled on top of them on the big chair in the living room. One of the nice things about your child having speech and beginning to communicate is that she can tell you what she needs. On Friday night, after dinner, Hallie requested pillow piling. She built her new turn-taking skills into the process by directing us: "now Hallie turn!", "now Eliza turn!", "now Hallie turn!" , "now Eliza turn!" When the big pillows were equally distributed on top of the girls, the two of them kicked them off and hooted and smiled like crazy and then the process began again.
They were so happy after all that pillow-piling that they ended with a nice smoochy.
Anyway, Hallie doesn't just crave tactile stimulation but she also craves vestibular input--basically this is anything involving motion and balance and includes stuff like swinging (Hallie's favorite activity), jumping up and down, and spinning. That's why she loves fast rides, roller coasters, and the like. At home, Hallie enjoys piling the aforementioned pillows in front of the big chair and jumping off of the chair onto them.
At the playground, Hallie enjoys typical playground activities more than your average kid and certainly more than children who are over-responsive to sensory input (that would include me...I am pretty sure, after reading a lot about dysfunctional sensory processing that I am the opposite of Hallie in terms of sensory profiles. That's why I hate heights, fast motion, uncontrolled wheeled activities, and get dizzy very easily). Now that Hallie's body works better--her gross and fine motor skills are improving--she is much more effective at meeting these needs on the playground.
Hallie and Eliza had plenty of opportunity to get all the sensory input they craved at Smith Playground yesterday:
But their favorite activity was sliding down Smith's giant wooden slide:
They would have done this forever!
Even little Lea got in on the action at Smith Playground, even if she was a bit too young to enjoy the slide (actually, she would have enjoyed it; we just were not about to put her on a burlap sack and let her slide down what amounts to a giant bowling alley on a fairly steep incline):
And she also got to get in on the teeter totter action:
Anyway, a great day was had by all. After Eliza and Anne departed for New Jersey to visit Nana (Anne's mom and Eliza's grandmother), we headed home and rested (no nap for Hallie, alas) in preparation for the arrival of Hallie's PT. After seeing Hallie negotiate the playground with her friend Alex (who came to visit and dine with us yesterday evening), the PT decided that she had mis-assessed Hallie. Yes, Hallie is low-tone and, yes, her left side is weaker than her first. But she does jump with both feet off the ground and she runs funny because of her sensory stuff and not because she has too. Ditto with toe-walking. That's why it's called idiopathic toe-walking in her case. Her heels are tight and can use some stretching. But she can probably get away with something like a Sure Start shoe inserts or Polly Wogs rather than really extensive bracing/orthotics. That's a relief because Hallie, who is a bit of a shoe queen, would bristle at wearing extensive orthotics. We will have to buy her more supportive shoes, too, I think: she walks so much better in her Keens than she does in your average Stride Rite shoes, but we're happy to do this. Anyway, our appointment with the orthopedist is in a couple of weeks and we'll know more then. But we are feeling better about this based on what the PT saw yesterday.
Tuesday, June 9, 2009
Birthday Countdown
Unbelievably, Hallie will be turning three in two days. I am not sure where the time went (and I am quite frightened that we are now a mere 13 years away from her getting a drivers' permit...if her navigating and safety skills with her toy vehicles are any indication, watch out drivers!)
Anyway, we spent part of Saturday procuring Hallie-friendly food for her birthday bash. If you recall, last year the only thing she could eat that we had at her party was Lesser Evil Potato Sticks in Sea Salt flavor. This year, our shin-dig will feature Oreo cookies, Lays potato chips, watermelon, and pizza (we'll get regular pizzas for the masses and have commissioned a pizza with goat mozzarella from Whole Foods for Hallie so that she can enjoy as much of it as she would like). And our lovely friend, Sara, whose hands are already full (she is a NICU nurse and mom to three-year old Charlie and three-month old Aaron; she makes and sells lovely burp cloths (Keiki cloths) previously mentioned by us on our blog; and is a wonderful photographer who took some gorgeous shots of Lea as a newborn) has volunteered to make Hallie a birthday cake. We're still using allergy-friendly stuff (meaning no egg or cow dairy in it) because we're still not sure how well Hallie responds to those things, but we do know that, at least conceptually, Hallie loves cake. I bet that Sara's beautiful giraffe cake will go over very well with our girl.
Hallie is definitely getting into the birthday spirit. We've been asking her how old she is for a while now and she has consistently responded "two." Lately, we've also been inquiring how old she is going to be and she gleefully retorts: "three!"
Hallie has also finally learned how to blow (sort of...she has blown conventionally by rounding her mouth several times but cannot do this on command. Instead, she bites down on her lower lip and spits out some air. Amazingly, this does the trick and she can extinguish flames of candles that way). We've been practicing the Happy Birthday song and blowing out candles with her all week and she's been doing super at it.
Anyway, we think she's excited about her big day and we're fairly certain that she understands what it entails this time around.
On other Hallie news, she's also doing a whole lot of new fun stuff (some of which makes us really happy and others of which exasperate us no end). In terms of the former, she's been doing a lot of pretend play. On Saturday, while we were in Superfresh buying supplies for Hallie's party, Hallie kept asking for chips (she says, "a big round one!"). We happily indulged her requests and she munched her way up and down the aisles as we tossed stuff into the cart (this was a major improvement over our experience in Toys-R-Us, when she tossed all sorts of random stuff we didn't need and didn't wish to buy her in the cart for us). One of the chips Sharon gave her was more heart-shaped than round, which Hallie pointed out to us immediately and then burst into a chorus of "Love" (by Rachel Coleman, and easily among Hallie's favorite songs). Once the singing was over, she began to feed the chip to her Count plush doll (of Sesame Street fame), who kept saying "yummy, yummy, yummy" as the potato chip crumbled in his mouth. Then, rejuvenated by the snack, Count began to fly (he does, after all, have a cape) and Hallie narrated "Count is flying!" as she made him do so.
Today, she showed off her prowess with verbs while she used her mallet (from her doctors' kit) to bang some imaginary nails into her Melissa and Doug dollhouse. She turned to me and said with pride, "I build a house!"
And, finally, my favorite Hallie-ism of the day: she's been walking around all day saying "I spy with my little eyes..." and then filling in the blank with whatever she sees at the moment. This evening, she looked through the hole of her smiley-shaped potato patty and said "I spy with my little eyes Mama!" There's no question: I was very happy to be spied by her little eyes.
So, yeah, on the eve of three, Hallie is pretend playing and speaking a whole lot more. That's the best birthday present we could imagine receiving from our no-longer-so-little-girl.
Sorry about the lack of pictures, though. I promise to try to take some later in the week. But one last update: we're up to 107 days without vomit. Hallie does seem bored with some of her foods but disinterested (or even hostile about) trying new ones, not to mention drinking her milk (she does, however, like to eat the silicon straws that come with her insulated Thermos bottle, much to our chagrin). But she's been eating well enough and drinking okay enough (marginally) and keeping everything in with no real problem. So we are thankful for that, too.
Anyway, we spent part of Saturday procuring Hallie-friendly food for her birthday bash. If you recall, last year the only thing she could eat that we had at her party was Lesser Evil Potato Sticks in Sea Salt flavor. This year, our shin-dig will feature Oreo cookies, Lays potato chips, watermelon, and pizza (we'll get regular pizzas for the masses and have commissioned a pizza with goat mozzarella from Whole Foods for Hallie so that she can enjoy as much of it as she would like). And our lovely friend, Sara, whose hands are already full (she is a NICU nurse and mom to three-year old Charlie and three-month old Aaron; she makes and sells lovely burp cloths (Keiki cloths) previously mentioned by us on our blog; and is a wonderful photographer who took some gorgeous shots of Lea as a newborn) has volunteered to make Hallie a birthday cake. We're still using allergy-friendly stuff (meaning no egg or cow dairy in it) because we're still not sure how well Hallie responds to those things, but we do know that, at least conceptually, Hallie loves cake. I bet that Sara's beautiful giraffe cake will go over very well with our girl.
Hallie is definitely getting into the birthday spirit. We've been asking her how old she is for a while now and she has consistently responded "two." Lately, we've also been inquiring how old she is going to be and she gleefully retorts: "three!"
Hallie has also finally learned how to blow (sort of...she has blown conventionally by rounding her mouth several times but cannot do this on command. Instead, she bites down on her lower lip and spits out some air. Amazingly, this does the trick and she can extinguish flames of candles that way). We've been practicing the Happy Birthday song and blowing out candles with her all week and she's been doing super at it.
Anyway, we think she's excited about her big day and we're fairly certain that she understands what it entails this time around.
On other Hallie news, she's also doing a whole lot of new fun stuff (some of which makes us really happy and others of which exasperate us no end). In terms of the former, she's been doing a lot of pretend play. On Saturday, while we were in Superfresh buying supplies for Hallie's party, Hallie kept asking for chips (she says, "a big round one!"). We happily indulged her requests and she munched her way up and down the aisles as we tossed stuff into the cart (this was a major improvement over our experience in Toys-R-Us, when she tossed all sorts of random stuff we didn't need and didn't wish to buy her in the cart for us). One of the chips Sharon gave her was more heart-shaped than round, which Hallie pointed out to us immediately and then burst into a chorus of "Love" (by Rachel Coleman, and easily among Hallie's favorite songs). Once the singing was over, she began to feed the chip to her Count plush doll (of Sesame Street fame), who kept saying "yummy, yummy, yummy" as the potato chip crumbled in his mouth. Then, rejuvenated by the snack, Count began to fly (he does, after all, have a cape) and Hallie narrated "Count is flying!" as she made him do so.
Today, she showed off her prowess with verbs while she used her mallet (from her doctors' kit) to bang some imaginary nails into her Melissa and Doug dollhouse. She turned to me and said with pride, "I build a house!"
And, finally, my favorite Hallie-ism of the day: she's been walking around all day saying "I spy with my little eyes..." and then filling in the blank with whatever she sees at the moment. This evening, she looked through the hole of her smiley-shaped potato patty and said "I spy with my little eyes Mama!" There's no question: I was very happy to be spied by her little eyes.
So, yeah, on the eve of three, Hallie is pretend playing and speaking a whole lot more. That's the best birthday present we could imagine receiving from our no-longer-so-little-girl.
Sorry about the lack of pictures, though. I promise to try to take some later in the week. But one last update: we're up to 107 days without vomit. Hallie does seem bored with some of her foods but disinterested (or even hostile about) trying new ones, not to mention drinking her milk (she does, however, like to eat the silicon straws that come with her insulated Thermos bottle, much to our chagrin). But she's been eating well enough and drinking okay enough (marginally) and keeping everything in with no real problem. So we are thankful for that, too.
Friday, May 29, 2009
A Hundred Days in May!
Yes, folks, we actually hit that milestone today. Woo hoo! For those of you not following this thread of Hallie's story, this means that she has had a 100 spew-free days this year. 100 out of 148 days doesn't seem to bad to us, particularly in comparison to last year, when we only hit this milestone at the very end of August, or the year before, when we never even came close to this milestone (back in 2007, I think we had a grand total of 16 days without vomit). Anyway, we're thrilled and we hope that our saga of decreasing paper towel usage and emergency middle of the night bed stripping and trips to the washing machine will provide some hope to parents (and kids) who are still in the midst of vomit hell. It can get better.
Hallie and Lea had a great day all around. Hallie has really been into trying to draw her own hand. This started on Monday when I traced her hand on construction paper as part of her mealtime distraction. She thought that was wonderful and insisted that I do this many many times in many many colors. On Tuesday, she grabbed some paper and crayons and brought them over to me during playtime for a repeat performance of hand drawing (she was not all that thrilled when I tried to turn a brown hand into a turkey in true preschool instructor form, but that's okay since we're a long way off from Thanksgiving still). Then, when I had to stop drawing with her to take care of Lea, she grabbed a crayon and attempted to trace her own hand. Today we tried to teach her how to go around her fingers with the crayon and she did a pretty good job of it.
Hallie also had a grand time painting and then finger painting during Early Intervention OT. She really loves to paint and must have spent at least ten minutes of uninterrupted attention on this today. She was particularly fond of us painting her hands so that she could make lots of handprints on the paper and very quickly figured out how to paint her own hands. Ultimately, she was a big mess, but a happy one, and I do have to remember that we need another IKEA stepstool so that she can wash her hands at the kitchen sink since going up our steps to the bathroom would have tracked paint everywhere. Hallie still cannot climb the stairs holding onto just a hand or a banister--she needs both--and crawling would have left lots of handprints on the risers of the steps that would have been a pain to clean up (even with washable paints).
One of the things that was really interesting to me is that Hallie ate VERY well after finger painting. She downed an entire hot dog (without skin), a bunch of cheese, quite a bit of watermelon, some prunes, and a couple of ounces of milk within a half hour or so and with no protest. She still needed her usual TV distraction but I wonder if giving her some sensory input that stimulated her tactile senses helped her eat more effectively. I've got to try this again to see if this is a pattern. If so, there will be a lot more finger painting around here on a regular basis.
Hallie also did great at private OT today. Our regular OT was off on her honeymoon, but having an unfamiliar person fill in did not phase Hallie in the least. She went into the room, took off her shoes, got on the mat, and proceeded to do her swinging-on-her-tummy-while-picking-up-beanbag-animals-and-tossing-them-into-the-barrel routine with great attention. She also quickly mastered a new obstacle course (crawl through a tunnel, pick up a puzzle piece, climb over a tumbleform, place puzzle piece in the puzzle, and then repeat another dozen times) and even pretty happily attended to a table-top activity (not her strong point, in the least) for about three minutes after that. The second table-top activity (stringing beads on pipe cleaners) was a bit of a hard sell for her, though. She was tired, and though she had no trouble with the actual task since she really is using both of her hands bilaterally much more easily these days, she was done with OT by that stage. It seems like she has the capacity to follow structures for 45 minutes, with some breaks and change-ups, but fatigues after this. I am not sure if this is because all of her therapies have classically been 45 minutes long or whether it's because she's two, or whether it's because, given her generally low tone, her body gets tired being 'on' all the time. Anyway, it will be interesting to see how she adjusts to preschool, which is obviously longer than 45 minutes, in a few weeks from now.
Hallie is also beginning to further expand her speech. Today, as usual (despite injunctions placed on this practice), she climbed up onto the pack and play and grabbed a picture down from the bookshelf that it abuts. She brought it over to me and said: "Picture of Lea!" Of course, it was a picture of Hallie back in the NICU, but pretty much any baby picture these days is a picture of Lea. She totally loves her little sister and is excited when she sees her or any representation that might be her. And, if Lea is not with her (for example, when we go off to therapy without Lea), she gets very concerned. She looks over at the empty carseat next to her and says, "Lea! Lea! Where'd she go!" And, when she wakes up in the morning, the first person she greets these days is Lea. She'll often climb over me to get to her sister and wave at her and say "Hi, Lea, Hi!" or "Lea, wake up!" (which is usually not what I want Lea to do and definitely not what Lea wants to do at that moment).
Lea, meanwhile, was her super cute self, as usual. She's talking a ton right now and sounds pretty much like a little kitten meowing when she does. I think she's just exploring the different sounds that she can make with her voice, and that is very cool to see (and listen to).
Lea had a very nice day and was chill throughout all of it, until 10:30pm, when she just wanted Mommy to come downstairs and feed and hold her. The pattern around here is that Sharon takes Hallie up to bed somewhere between nine and ten pm and spends about an hour upstairs. Lea's internal alarm seems to go off somewhere around ten and eleven and, after that, she really needs Sharon to comfort her.
Lea had a very nice day and was chill throughout all of it, until 10:30pm, when she just wanted Mommy to come downstairs and feed and hold her. The pattern around here is that Sharon takes Hallie up to bed somewhere between nine and ten pm and spends about an hour upstairs. Lea's internal alarm seems to go off somewhere around ten and eleven and, after that, she really needs Sharon to comfort her.
And, speaking of Sharon, one of the projects that she worked on back at her old job just won an AIA (American Institute of Architecture) award. I am very proud of her.
Finally, Sharon called the hippotherapy center down by her family (who live on the Jersey Shore) and hopefully we'll hear back from them soon. I think that hippotherapy will do a world of good for Hallie and I can't wait to see her astride a horse.
Thursday, July 17, 2008
Where's the Beef?
So we're doing a beef challenge this week with Hallie. It would be excellent to have an additional protein source (her only protein source thus far being goat milk products; she's great with these, but her diet doesn't afford her a lot of variety). She doesn't seem to like the taste of those little jars of beech nut baby beef terribly much (can you blame her?) but has done okay on the two ounces of it that she's had so far (one yesterday and the other today). So, after a bit of research on Applegate Farms (an organic brand carried by Whole Foods) that yielded information about a very good set of policies concerning their lack of use of gluten, their dedicated practices to avoid cross contamination with dairy products, and the like, I decided to pick up a package of their organic hot dogs tonight and try them out on Hallie. Worst comes to worst, I figured, we'd actually eat these (unlike the many jars of rejected baby food that we have stacked in our cabinet). We do like our hot dogs around here (pretty occasionally, but still) and I insist on organic ones, and since I do most of the shopping, Sharon has to put up with these (which actually are quite tasty) in lieu of her preferred Oscar Mayer ones (side note: Hallie's pulmonologist *is* actually Oscar Mayer...grandson, I think, of the lunch meat-hot dog guy, and a fabulous doctor all around. I'm not sure if we'll see him or someone else on Monday for our 6 month checkup that is about 3 months late, but we are looking forward to hanging out with the pulmo fellow, Liz, whom we actually miss. She loves Hallie, and the feeling is quite mutual. I am sure that Liz will be surprised at how big Hallie's gotten).
Anyway, back to the topic at hand: I brought them home, boiled up about a third of one, skinned it, let it cool, and chunked it up pretty small. We weren't sure what to expect because Hallie gave me the mother of all food averse I'm-not-eating-no-way-no-how-you-cannot-make-me-so-there tantrums last night. So much so that I gave up (trying not to show my exasperation) and handed over the feeding reins to Sharon, who managed somehow to get four 'sticks' of goat mozarella, two slices of banana cut up into sixths, and a few sticks of pear into the kid over the next hour and a half. It's very clear to us that our toddler knows how to chew and can chew and swallow safe foods, but that she is as stubborn as a mule and that food is her controlling mechanism of desire (or lack thereof), probably because of her long history of hating it and it hurting her. In any event, tonight she was pretty good and, once she deemed the hotdog both safe and tasty, chowed it down pretty nicely. A couple of chunks did end up in her high chair, but this appeared to be more related to toddler lack of eating coordination than to an effort to hide and bury them and fool us on her part. (It is pretty interesting that she inspects her food the way she does. Her initial response to chunks of food that do not appear to be french fries or potato sticks is to say 'all done' and swat at and clear them. But she stopped doing this with the hot dogs once she actually tasted their yummy salty goodness and realized that this was indeed what the famous pigeon was talking about when he found a hot dog and deemed it a taste sensation and splendor in a bun. Just hold the bun for Hallie, unless of course we can figure out how to make a bun from potato, goat milk, pears, apples, bananas and prunes or some subset thereof).
We'll see if Hallie's pro-hot dog stance continues tomorrow and how she fares with beef more generally. She usually begins reacting to a food to which she turns out to be non IgE allergic by the third or fourth day of a trial, and tomorrow is day three. We certainly are hopeful that she is not one of those rare FPIES kids who is so allergic to cow milk that they are also allergic to the cow that produces it.
In related news: today is day 82 of the year that is vomit free, and the only day in the past 10 that she did vomit was Sunday, when she hit her head on the wooden frame of the futon. This is spectacular (not the head hitting part) and gives us great hope.
Her language is also progressing nicely. Tonight she brought her Baby's First Colors book over to Sharon and both signed and said (quite clearly, to us, at least) "colors." She says "upstairs" when she wants to go up, and "outside" and a bunch of other multisyllabic words. And she is internalizing the need to be polite. Now she almost always says and signs "Please" (she says "Pleasy") if she wants something and without fail says and signs "thank you", which sounds much closer to how it is supposed to sound---it used to sound like 't---oo" and now sounds like "tank-ooo". She has also been saying "hello" quite clearly into phones---both real and perceived---and yesterday evening had her first real phone conversation with Grammy. She said "Hello", "Grammy", "Doggie" and "Bye Bye" pretty much in that order. Grammy was quite thrilled. She is still probably only 25% comprehensible (maybe a bit less) to others, but this is quite impressive progress given that Hallie hardly babbled at all until November/December, had nary a word back in January, and only about 40 words or so at the beginning of June. Now she has so many words or word attempts that we've kind of lost count.
Hallie has also refined her sense of style. I call the first picture "The girl with the go-go boots" (her favorite item of clothing). Note that she is only wearing a diaper since she has become quite adept at removing her pants.
The second picture is Hallie's updated Russian peasant girl look. She insisted on undoing one of the straps of her Elmo/Cookie overalls and walked around with them that way most of the day. The rest of the day she decided that overalls were too much to wear altogether so she stripped them off and just hung out in her t-shirt.
I have some pics on the camera of Hallie's impressive attempt tonight at body art (using washable markers; she's mastered taking off and replacing the flip top on her new ones, but still insists on using her teeth instead of her hands...does this count as fine motor skills?) but I am too tired and lazy to upload them right now, so these will have to wait until my next post.
Anyway, back to the topic at hand: I brought them home, boiled up about a third of one, skinned it, let it cool, and chunked it up pretty small. We weren't sure what to expect because Hallie gave me the mother of all food averse I'm-not-eating-no-way-no-how-you-cannot-make-me-so-there tantrums last night. So much so that I gave up (trying not to show my exasperation) and handed over the feeding reins to Sharon, who managed somehow to get four 'sticks' of goat mozarella, two slices of banana cut up into sixths, and a few sticks of pear into the kid over the next hour and a half. It's very clear to us that our toddler knows how to chew and can chew and swallow safe foods, but that she is as stubborn as a mule and that food is her controlling mechanism of desire (or lack thereof), probably because of her long history of hating it and it hurting her. In any event, tonight she was pretty good and, once she deemed the hotdog both safe and tasty, chowed it down pretty nicely. A couple of chunks did end up in her high chair, but this appeared to be more related to toddler lack of eating coordination than to an effort to hide and bury them and fool us on her part. (It is pretty interesting that she inspects her food the way she does. Her initial response to chunks of food that do not appear to be french fries or potato sticks is to say 'all done' and swat at and clear them. But she stopped doing this with the hot dogs once she actually tasted their yummy salty goodness and realized that this was indeed what the famous pigeon was talking about when he found a hot dog and deemed it a taste sensation and splendor in a bun. Just hold the bun for Hallie, unless of course we can figure out how to make a bun from potato, goat milk, pears, apples, bananas and prunes or some subset thereof).
We'll see if Hallie's pro-hot dog stance continues tomorrow and how she fares with beef more generally. She usually begins reacting to a food to which she turns out to be non IgE allergic by the third or fourth day of a trial, and tomorrow is day three. We certainly are hopeful that she is not one of those rare FPIES kids who is so allergic to cow milk that they are also allergic to the cow that produces it.
In related news: today is day 82 of the year that is vomit free, and the only day in the past 10 that she did vomit was Sunday, when she hit her head on the wooden frame of the futon. This is spectacular (not the head hitting part) and gives us great hope.
Her language is also progressing nicely. Tonight she brought her Baby's First Colors book over to Sharon and both signed and said (quite clearly, to us, at least) "colors." She says "upstairs" when she wants to go up, and "outside" and a bunch of other multisyllabic words. And she is internalizing the need to be polite. Now she almost always says and signs "Please" (she says "Pleasy") if she wants something and without fail says and signs "thank you", which sounds much closer to how it is supposed to sound---it used to sound like 't---oo" and now sounds like "tank-ooo". She has also been saying "hello" quite clearly into phones---both real and perceived---and yesterday evening had her first real phone conversation with Grammy. She said "Hello", "Grammy", "Doggie" and "Bye Bye" pretty much in that order. Grammy was quite thrilled. She is still probably only 25% comprehensible (maybe a bit less) to others, but this is quite impressive progress given that Hallie hardly babbled at all until November/December, had nary a word back in January, and only about 40 words or so at the beginning of June. Now she has so many words or word attempts that we've kind of lost count.
Hallie has also refined her sense of style. I call the first picture "The girl with the go-go boots" (her favorite item of clothing). Note that she is only wearing a diaper since she has become quite adept at removing her pants.
The second picture is Hallie's updated Russian peasant girl look. She insisted on undoing one of the straps of her Elmo/Cookie overalls and walked around with them that way most of the day. The rest of the day she decided that overalls were too much to wear altogether so she stripped them off and just hung out in her t-shirt.
I have some pics on the camera of Hallie's impressive attempt tonight at body art (using washable markers; she's mastered taking off and replacing the flip top on her new ones, but still insists on using her teeth instead of her hands...does this count as fine motor skills?) but I am too tired and lazy to upload them right now, so these will have to wait until my next post.
Sunday, May 25, 2008
No Small Potatoes
Well, I think we've passed a food trial here. Seems that Hallie does fine with VERY thin (no lumps) potato puree made with goat milk but not goat butter, which is too rich for her (anyone out there need any goat butter? We have four pounds in our freezer!). This may sound like small potatoes, but it's pretty huge to us, given that our kid is otherwise confined to goat milk, goat yogurt, and pureed pears. There is so much you can do with potatoes and of course this opens the potential for the beloved french fry down the road, not to mention oh-so-delicious passover baking mixes (I suspect that some of the gluten free varieties are just as scrumptious).
This milestone also makes it possible for the immediate reintroduction of the "sticks" -- Sea Salt flavored Krinkle Sticks from A Lesser Evil. Of course, this opens up a new complication: our local branch of Whole Foods, which was where I discovered this bland-tasting-baked-but-not-fried snack food, no longer carries them. And the Sea Salt flavor is out of stock at the Wegman's. So, of course, being a resourceful mom willing to suspend disbelief in utter defiance of all the evidence of food products we have stacked to the rafters in our basement, on top of the fridge, and in the aforementioned freezer, I purchased a CASE of the sticks from Amazon last week. At the rate at which Hallie consumes them (no more than eight at a time, and more typically three or four), we will have enough to last us through kindergarten.
Anyway, we're thrilled, regardless.
The other nice thing about mashed potatoes is that Hallie can feed them to herself, sort of. Unlike pureed pears from Earth's Best, which are runny, which makes handing Hallie a bowl and spoon a messy prospect that is sure to leave us guessing about her actual consumption, potatoes not only stick to your ribs but also to the spoon. Hallie loves self-feeding, so this works out for all of us and may at some point in the future allow us all to eat together at the table without one of us moms feeding our kiddo.
Anyway, potato being a success, we're ready to move on...apples here we come.I leave you with a cute pic of Hallie looking like a little kid...and a brief mention of her new milestones: she is now really saying Elmo (over and over), her own name (very cutely), 'mama', and otherwise babbling like crazy. It seems like she's really hit her stride language-wise these past couple of weeks and we could not be more thrilled. Oh, and we have one more vomit-free day to add to the list...45 days this year so far, and some of our less than stellar days were a result of a certain toddler hitting her head on various objects or not getting her way 100% of the time, so I am not sure that they really count.
This milestone also makes it possible for the immediate reintroduction of the "sticks" -- Sea Salt flavored Krinkle Sticks from A Lesser Evil. Of course, this opens up a new complication: our local branch of Whole Foods, which was where I discovered this bland-tasting-baked-but-not-fried snack food, no longer carries them. And the Sea Salt flavor is out of stock at the Wegman's. So, of course, being a resourceful mom willing to suspend disbelief in utter defiance of all the evidence of food products we have stacked to the rafters in our basement, on top of the fridge, and in the aforementioned freezer, I purchased a CASE of the sticks from Amazon last week. At the rate at which Hallie consumes them (no more than eight at a time, and more typically three or four), we will have enough to last us through kindergarten.
Anyway, we're thrilled, regardless.
The other nice thing about mashed potatoes is that Hallie can feed them to herself, sort of. Unlike pureed pears from Earth's Best, which are runny, which makes handing Hallie a bowl and spoon a messy prospect that is sure to leave us guessing about her actual consumption, potatoes not only stick to your ribs but also to the spoon. Hallie loves self-feeding, so this works out for all of us and may at some point in the future allow us all to eat together at the table without one of us moms feeding our kiddo.
Anyway, potato being a success, we're ready to move on...apples here we come.I leave you with a cute pic of Hallie looking like a little kid...and a brief mention of her new milestones: she is now really saying Elmo (over and over), her own name (very cutely), 'mama', and otherwise babbling like crazy. It seems like she's really hit her stride language-wise these past couple of weeks and we could not be more thrilled. Oh, and we have one more vomit-free day to add to the list...45 days this year so far, and some of our less than stellar days were a result of a certain toddler hitting her head on various objects or not getting her way 100% of the time, so I am not sure that they really count.
Saturday, May 3, 2008
Language Explosion?
Ever since the acquisition of "whoa!" the other night, Hallie seems to be going through something of a language explosion, apparently related to her recognition that consonants and vowels can be linked together to form words.
As I noted, it started with "whoa" and Hallie remains fascinated by saying this over and over. Because the original "whoa" (prompted by me) was related to me knocking over the stroller, Hallie likes to go over to her Maclaren stroller, knock it over, and say "whoa." Then it's my job to stand it upright again, and her job to knock it over and say "whoa" again. You can see how this might provide hours and hours of endless fun.
We didn't get this on video yet, but we have been promoting the broader use of the word "whoa" and Hallie's complied by exporting this to other situations (especially when prompted to imitate us). In this lovely video of Sharon swinging Hallie, Hallie uses "again" and "whoa":
But "whoa" was just the beginning. Last night, Hallie was all about words. She followed me into the kitchen as I was getting her dinner put away and spied the bubbles in the cabinet under the sink. I'm not sure how she saw them (it was a very tiny bottle, nested among a huge number of poorly-organized larger bottles and boxes of wraps and such) or how she recognized them (this is not a bottle of bubbles we use much; she has seven or eight other bottles in circulation in the living room and dining room that we do use), but she noticed them and called out "Bubble". Not "b," or even "bu" or "bu-bu" but "bubble." Well, with that kind of speaking, you know we were going to indulge the kid. So, while this is not the best video ever taken in the history of the universe, this is what we got:
On top of this, Hallie seems to be able to "bird" now (with reference to the red bird in Brown Bear, Brown Bear and is doing a better job of attempting to say "dog" and "fishie". She has also said "teacher" when we got to the teacher page in that book, too. That's useful, since that's what I do (when not blogging). "Architect" might be a ways off so she might have to refer to Sharon as a "builder." But, heck, we'll take plain old "mommy" which we hope is forthcoming one of these days. (Hallie still says "um-ah!" in a very long, drawn-out kind of way when we ask her to say "mama." Yesterday, though, I did hear one regular-sounding "mama" and a few whiny ones from our girl, so there's still hope that she might master this skill by Mother's Day.
But even if she doesn't master that skill, we do have an advanced Mother's Day gift from our girl: 2 more vomit free days...making it 4 days in a row without vomit and a whopping 5 out of 6 of the most recent days that have been spew-free. Amazing how much more peaceful the house feels without us rushing about cleaning up upchuck.
As I noted, it started with "whoa" and Hallie remains fascinated by saying this over and over. Because the original "whoa" (prompted by me) was related to me knocking over the stroller, Hallie likes to go over to her Maclaren stroller, knock it over, and say "whoa." Then it's my job to stand it upright again, and her job to knock it over and say "whoa" again. You can see how this might provide hours and hours of endless fun.
We didn't get this on video yet, but we have been promoting the broader use of the word "whoa" and Hallie's complied by exporting this to other situations (especially when prompted to imitate us). In this lovely video of Sharon swinging Hallie, Hallie uses "again" and "whoa":
But "whoa" was just the beginning. Last night, Hallie was all about words. She followed me into the kitchen as I was getting her dinner put away and spied the bubbles in the cabinet under the sink. I'm not sure how she saw them (it was a very tiny bottle, nested among a huge number of poorly-organized larger bottles and boxes of wraps and such) or how she recognized them (this is not a bottle of bubbles we use much; she has seven or eight other bottles in circulation in the living room and dining room that we do use), but she noticed them and called out "Bubble". Not "b," or even "bu" or "bu-bu" but "bubble." Well, with that kind of speaking, you know we were going to indulge the kid. So, while this is not the best video ever taken in the history of the universe, this is what we got:
On top of this, Hallie seems to be able to "bird" now (with reference to the red bird in Brown Bear, Brown Bear and is doing a better job of attempting to say "dog" and "fishie". She has also said "teacher" when we got to the teacher page in that book, too. That's useful, since that's what I do (when not blogging). "Architect" might be a ways off so she might have to refer to Sharon as a "builder." But, heck, we'll take plain old "mommy" which we hope is forthcoming one of these days. (Hallie still says "um-ah!" in a very long, drawn-out kind of way when we ask her to say "mama." Yesterday, though, I did hear one regular-sounding "mama" and a few whiny ones from our girl, so there's still hope that she might master this skill by Mother's Day.
But even if she doesn't master that skill, we do have an advanced Mother's Day gift from our girl: 2 more vomit free days...making it 4 days in a row without vomit and a whopping 5 out of 6 of the most recent days that have been spew-free. Amazing how much more peaceful the house feels without us rushing about cleaning up upchuck.
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