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Saturday, October 31, 2009

Hallie's October Milestones

This is going to be a bit perfunctory because time is running out on the month of October and if I don't write this post soon, I'm going to turn into a pumpkin. How seasonal of me!

Hallie really has made some great strides this past month, and I'm going to bullet point them below. These are all themes that I am sure to return to, again and again.

1. Potty Time. Hallie is nowhere near being potty trained. However, she is making great strides in going to the potty, particularly at school. This began under her former PCA, Latasha, who used to take Hallie every hour to sit on the potty. Hallie didn't do much while sitting there, but she got used to the potty back in August. Since returning to school, she's been continuing to go to the potty, but instead of being asked to go, she's been volunteering to go by raising her hand every time her teachers asked "who has to go to the potty?" after nap time was over. Then, some time in late September, Hallie began to actually go potty while sitting on the potty after nap time. And, most recently (as of this week, really), Hallie has been asking to go to the potty at various points during the day and most of the time, actually using the potty. Admittedly, this has sometimes been part of her effort to get out of naptime (Hallie is beginning to slowly phase out the nap, much to our chagrin), but most of the time, Hallie's need is genuine. At home, Hallie has been less consistent about potty use. For about a week, I had her going every morning when she woke up. She would sit on the potty, read her 'book' (catalogs of kids' stuff that overflow our magazine rack), point out the various costumes that she likes or the toys that the vendors are hawking to our kids, and then go potty. We had a nice routine down, but after my mom had her stroke and I left town for New York for four or five days and started disappearing on the weekends, the consistency and routine seem to have been broken. So Hallie has been more reluctant of late to go potty at home, but I have no doubt that she'll start things up again as soon as we decide to attempt potty training in earnest. According to our Floortime/DIR god, Stanley Greenspan, completing potty training is actually a whole lot easier once "why?" questions kick in, and so we'll give Hallie a few months. If no "why?" questions emerge, we'll try to potty train her in some other way. But we do have some confidence now that Hallie will eventually be out of pull ups.

2. Communication. As you can tell from the asking to go to the bathroom bit that Hallie is mastering, she is beginning to communicate a lot more effectively. Most of this communication is still in the realm of showing us stuff and demanding things of us, but even these skills are more sophisticated than they used to be. Hallie is pointing at stuff consistently, which is a big deal for kids on the spectrum. And she is describing them much more fully. For example, she might say "that's a scary orange pumpkin" rather than her just "orange pumpkin." And she's making much more specific demands of us, too. Most of the time she speaks in four to six word sentences. And she speaks a whole lot more than she used to, too. Not just at home, either, but also at school. Every single one of Hallie's teachers and therapists have noticed this and remark about this in their communication notes and verbally to me when I pick up Hallie from school.

But what's really exciting to me is that Hallie and I are beginning to have real conversations that don't just involve greetings, demands, and descriptions. For example, a few weeks ago, after I picked Hallie up from school, we took one of our usual stroller walks. There's this one section of Front Street where dogs often go with their owners to play, and, as we were passing by, we spied a dog and her person playing catch with a tennis ball. Hallie was quite enthralled with this and I decided to stop so that she could watch them engaged in their game. As we were watching, Hallie and I talked about the dog, what the dog was doing, and how the game looked like a lot of fun. The dog's owner noticed us so she came over with her dog, who gently licked Hallie. Hallie told me that the lick really tickled her and started to giggle. This was a simple exchange, but a meaningful one. We had a nice string of joint attention, a lot of back and forth banter, and the whole thing seemed so spontaneous and wonderful to me. Clearly, Hallie felt the same way.

On top of this, Hallie is asking more complex and nuanced questions. She has been asking some fairly simple "W" questions for a long time now, such as, "where'd 'x' go?" or "where's mama?" but hasn't ventured much beyond this level of questioning. Over the past month, however, Hallie has begun to ask new sorts of questions. She'll show us something and inquire, "what shape is it?" or "what color is it?" or "what animal is it?" and then answer her own questions (she's known shapes, colors, letters, numbers, etc since before she turned two). Now this isn't a bad level of progress but the language/communication skills that Hallie is using in this process is still pretty rote and scripted. We're pretty sure that she was doing this because they are learning shapes, colors, letters and numbers and animals at school and so she's used to hearing these questions. And, let's face it, we used to ask her questions like this all of the time and so she's just giving us back some of our own medicine (she does the same thing when she pops pieces of food in our mouth).

But then something new happened about ten days ago: Hallie began to ask us questions that she could not quite answer and that were far more abstract. This started one day after Floortime when we were waiting for the elevator. Hallie loves elevators and she is fond of pressing the buttons to summon the elevator and to send it to the floor to which we need to go (she is pretty darned good so far at not turning elevators into locals or alerting security). Anyway, when you press the 'down' button, it lights up blue. When the elevator approaches your floor but before its doors actually open, the button goes from blue to its regular unlit state. So, Hallie pushed the down button, it lit up, and then the blue light went off. Hallie turned to me and asked, "What happened to the blue?" and I explained what happened. This is the closest we've gotten to a "why?" questions thus far and was an exciting development. I know it sounds silly and that most parents probably don't take note of when their kids start asking abstract questions but in our lives, the smallest milestones are often among the most meaningful. Hallie has begun generalizing her abstract questioning skills a bit, asking me about the noises she hears but cannot identify when we are out taking walks together. I hope that this blossoms into full-blown constant inquiry into the way the world works and promise to refrain from complaining about how I can't get my kid to stop asking 'why?' if she ever begins to do this. Indeed, right now, I cannot think of anything more wonderful than being barraged by incessant questioning.

3. Pretend Play. This is also something that kicks in late and incompletely for kids on the spectrum and has been a serious concern for us. Hallie's play skills are less functional than those of her peers, and this is often suggestive of a lack of what is called Theory of Mind (basically imagination, which allows one to imagine oneself in various predicaments and allows one to imagine that others have different views of the universe than one's own). In order to have a well developed theory of mind, you need to be able to do symbolic play and pretend play. Over the past month, Hallie has demonstrated that she is beginning to do just this. She has been performing some basic scenarios with her play sets, having her firemen go up the stairs in the firehouse, put on their fire fighting garb, and get into their truck. Or having the baby who is part of her dollhouse doll set get up, go to the potty, get into her high chair, eat, and then go take a nap in bed (demanding a blanket and that the lights be turned out for this last one). This scenario is not all that different from Hallie's own routines, and that's part of what's involved in pretend play, too: it's a way of working out one's emotions about familiar, and not so familiar, routines in one's life. It's great to see Hallie doing this, and doing this on her own (in other words, she initiates the play and scenario and I don't provide it to her).

Hallie is also doing a lot of dress up, both at home and at school, and is becoming quite fond of more elaborate ways of acting while in costume. In addition to playing 'fairy princess', 'policeman' and 'cowboy,' Hallie's 'pretend falling' routine has become more detailed. Now, she no longer just fakes a wipe out and asks herself "are you okay?" and replies "I'm okay!" Instead, she fakes a fall, asks for help getting up, demands that I place a band aid on the 'injured' spot and replies, "yeah, that's better!" I think we're going to be investing in some bulk band-aids around here (and a smaller supply of the Sponge Bob band-aids that Hallie picked out on the Amazon website).

4. Making friends. It seems that Hallie is very popular at preschool. One day, about two weeks ago, I was dropping off Hallie in the morning for her full day at school. We were a bit late, as usual (getting our not-a-morning-kid out of bed and fed and at school by 9:00am is almost always a bit of a stretch for us). We were headed up the stairs when I overheard one of the kids asking her dad if Hallie would be at school that day because she really wanted to play with Hallie. Just then, we got to the top of the stairs. The little kid in question, D-., was elated to see Hallie and called out: "Hallie!" in an excited tone. Hallie responded, with a similar level of enthusiasm, "D-!", and the two little girls hugged. That afternoon, when I picked up Hallie at school, we decided to head across the street to the recreation center playground to enjoy the nice weather. D-., her mom, and her little sister were all there, along with a passel of her little schoolmates.

At first, as is typical of our outings to the playground, Hallie needed to swing a lot. The other kids were off running around and climbing on the play structures and I tried to get Hallie to join them, but she needed to do her own thing. Then, her little friend D-. approached us and began to swing, too. Hallie took this as her cue to ask to get off of the toddler swing and onto the big girl swing. The girls swung for a while when D-. suggested to Hallie that they go off and play "Princess Castle." D-. is verbally advanced and has an appropriate imagination for her age (which is about the same as Hallie's) and is something of an alpha girl. Hallie willingly followed her and D-., another little classmate, G-. and Hallie scaled the monkey bars and raced across the bridge while D-. and G-. concocted a narrative around the defense of their princess castle. After a while, I joined in by playing the Scary Big Giant, which all the girls thought was a riot.

Hallie's princess castle play lasted less time than that of her peers, and she returned to swinging for a bit. But then the girls, and a few of their other classmates, decided to decamp to a playing field behind the playground that had a pitchers' mound that seemed particularly well-suited to building a sand castle that the kids could decorate with leaves from one of the small trees on the edge of the field.

Hallie had a blast helping with this project. And she completely enjoyed a brisk game of chase with her friends.

Hallie was happily exhausted by the time we left the playground about forty-five minutes later. I was equally elated: Hallie seemed so engaged, needed so little help and support from me, and seemed to fit in with the others incredibly well.

We've been to the playground with schoolmates a couple of times since then and Hallie has some good group play days and some days when she prefers to do her own thing (swing a lot, slide a bit, try out hanging on the monkey bars, and climbing). But the group play thing is going a whole lot more smoothly, particularly when one of her peers provides some structure (a narrative, a goal, etc) to the play.

Being an older sister is also great for Hallie's play skills. Lea is getting to an age where she really likes to play and is a very sociable little creature. Hallie adores Lea and frequently initiates play with her (her phrase for this is "more silly with Lea").

She'll often walk up to Lea and get in her face, make great eye contact with her, and begin to babble in a Lea-like way (her name for this is game is "A-Ga!", which is the syllable that Lea often babbles. And she is thrilled that Lea can now participate in the activities that Hallie enjoys, both at home and on the playground.

Of course, Hallie is never terribly thrilled when Lea grabs one of her toys and will often sternly admonish her little sister with phrases like "No, Lea, that's my toy." But this, too, is a good thing. Carving out her place in the world, even at the expense of sharing skills, is important for Hallie to do.

5. Gross motor and executive planning skills. Chief among the developments we've seen this month is Hallie's newfound capacity to steer and pedal a tricycle with ease. Amazingly enough, she has managed this feat at home. Anyone who has ever been to our house knows that it is tiny and that the living room/dining room is frequently toy strewn. So it's a minor miracle that Hallie has managed to perfect her bike riding skills in our house, but somehow she's managed to pull off riding around the passes between our living and dining rooms and frequently finding a way to do so without hitting a wall, toys, or family members.

Hallie is very excited that she has learned to do this . Lea is likewise excited by the tricycle and often will tag along with Hallie by trying to hold onto the back of the trike while Hallie is pedaling.

Needless to say, we don't have a high tolerance for this dangerous practice and remove Lea when she tries to hold on to the tricycle's 'trunk'.

Hallie's ability to walk up and down stairs has likewise improved. She needs more support going down than she does going up but it's clear that she's getting the notion that she needs to alternate her feet when climbing up or down the stairs. Now if we could only break her of her new habit of trying to jump from one stair onto the next....

6. Decreased GI problems. Even though Hallie has had several small colds since starting back up at school in September, we've not been seeing any real increase in vomiting or reflux. And she's even eating a decent (for her) quantity of cow's milk products (mostly regular cheese pizza but also trace amounts in various snack foods like Goldfish crackers and cheese puffs--both of which Hallie really enjoys--and packaged bread and the like). We are now on day 220 without vomit and, even more significantly, Hallie has only vomited twice in the last three or four weeks. It's gotten to the point where I really have lost count of the days and that is a nice thing, I think. On top of this, Hallie has weathered three colds since early September with no uptick in spewing. This is definitely cause for celebration around these here parts!

And speaking of celebrations, stay tuned for an update about our extended Halloween preparations and celebrations...


Kirsten Wood said...

The most remarkable thing about this post may be that it was posted at 2pm, not 2am??

But seriously, great to hear about these new/improving milestones for Hallie. The playground is especially encouraging, I think. It must be so exciting to see her go off and play with friends and feel like you can just watch, instead of having to intercede. Keep up the great work! (For I'm in no doubt that while Hallie deserves major plaudits for her own progress, you and Sharon -- and her teachers, to a lesser extent -- are the prime movers, so to speak.)

abby said...

Yes, 2pm. I think that's a first. I hope it's a trend since being up at 2am these days is correlated to Lea being up at 2am with teething pains. And she's been doing this A LOT lately. It's amazing that Sharon and I are at all functional right now...

Only the Sheppards said...

Hallie's doing so well! What huge gains in such a short time! She's so amazing :)

Not sure if you got my email, but please let me know if I can be of any help!

Sara Cohen said...

So exciting to hear all about Hallie's latest development! I would love to get all the kids together sometime if we can manage before sick season sets in. The why questions are in full force at my house and although I get sick of them, I remind myself that Charlie took a really long time to talk at all and how nice that he won't stop talking...perspective is a wonderful thing sometimes! I love the pic of the girls on the slide...definitely a keeper!