NEW Ocupational Therapy

We decided to change both OT and PT at the same time to a new facility with fewer distractions.  Last week we had our OT evaluation and today was our first therapy session.  The first two sessions we will be seeing the company owner - a well versed therapist.  From there we are scheduled to work with a younger, less experienced woman.  I have plans to discuss this with the owner (who we saw today).  I love young therapists - I appreciate their energy and knowledge of new practices and their newness  prevents pigeon holing Jayden based on his diagnosis.  I also appreciate the skill that comes with experience, however.  Having been around the block, an experienced therapist knows what to look for and has a variety of tools for treatment.  In this case, I'm just not sure if I am comfortable with a younger therapist - when I met the younger therapist during the evaluation the owner treated her much like an intern giving me the impression she is pretty "green". 

So today we saw the experienced therapist.  At first, I had mixed feelings her: she doesn't put up with any misbehavior and is very strict.  In the beginning I was taken aback by this but by the end of the session I saw how well Jayden responded to her that I would like to work with her more and try to incorporate some of her strategies into my daily interactions with Jayden. When Jayden didn't like doing a task, he would throw the object which she would make him pick up.  She would also ask him to use words or signs to communicate.  At the end of the session, he signed all done beautifully then signed all done again tonight when done with his meal!  This is a sign we have been working on forever but it is now clear that he is using it. 

Its amazing how much can be accomplished in a 50 minutes session (rather than the 30 minutes we have had the past year and a half).  The session began with several hand activities - playing/squeezing a ball, pushing buttons, gripping toys and placing them in their slots.  Its clear Jayden has week hands and needs more strength in his fingers.  He also needs to work on his oppositional something or other -- basically, he should put his forefinger and thumb together to do work. I really liked how in tune the therapist was to sensory issues.  We weren't able to get into much detail in today's session but she is clearly very experienced in sensory integration.  I would like to discuss the results of a sensory profile I completed during the evaluation - put that on my list of topics for next week!  She did some oral motor work and would like to see Jayden making more mouth shapes - she feels his upper lip is tight and showed me a few exercises (hopefully I can replicate them at home!!).  Then we finished with balancing on a wedge like contraption and putting together puzzle pieces. 

Pulmonologist Check Up

We visited with a new pulmonologist this time around (so we could be seen at a closer location).  The pulmonologist asked many questions and quickly looked at Jayden's throat.  His recommendation was to not have another sleep study at this time and to continue check-ins once a year.  He reached this conclusion based on the following:

1. Jayden has stayed on the same height and weight growth curves since his last sleep study.  (i.e. he is not overweight)
2. He does not wake up at night gasping for air or choking.
3. When he does have an apnea occurrence (stops breathing) while sleeping, it is only for a few seconds (according to my not-so-scientific observations) and he goes on sleeping afterward.
4. Although he is a loud sleeper (he is a mouth breather) he is not snoring.  In fact, his snoring has improved since his last sleep study
5. His tonsils, while present, are not abnormally large and therefore he does not seem to be at risk for obstruction.

All in all, I agreed with the pulmonologist that a second sleep study was not warranted at this time.  I am actually relieved that I can check that off my list!  Sleep studies are not fun and I would rather not have to go through one unless I think his apnea needs a closer monitoring.

NEW Physical Therapy

After having complained about our previous therapy provider, I decided to make a change and try a new facility.  We moved Physical and Occupational Therapy to PT in Motion/OT ECT in Carlsbad and today was our first PT session (after the evaluation).  So far, so good!  We worked a lot on Jayden's core since it is so weak.  Started with sitting in a chair and trying to pick up beans and toys with his feet.  He loved the game!  Our hopes is he will need less lumbar support as his core strengthens.  Then we moved on to some balance work on the ball and side sitting.  Kirsten, our PT, had Jayden sit on a small ball - about the size of a soccer ball and play with a peg board.  I love how she incorporates fine motor skills into the activity!  We ended the session with more balance work on a horizontal punching bag.  The 50 minute session FLEW by and I could tell Jayden was tired on the way home.  The session was very different from our previous therapist's program.  The past month or so we have been focusing on stepping on objects (balancing on one leg), kicking towers, and stepping up and down a step.  While these are certainly activities that Jayden needs work on, I liked today's focus on the core and I think we will see that as the core gets stronger, everything else will fall into place.


Side sitting while putting coins in the piggy.

Balancing while sitting on a soccer ball and poking out pegs from the peg board.

Normalcy

I spend a lot of time analyzing Jayden - his behavior, eating patterns, sleeping patterns, energy levels.... I am always asking: "is this normal?"  Well today, he put me at ease.  Today, he was a typical toddler:  on the move, opinionated, energetic and getting into trouble!  He kept me on my toes all day running around the stores while we did some shopping, getting into every nook and cranny in the house, refusing to nap and letting us know when he wasn't getting his way.  And is he hyperphagic yet?  NO WAY!!  The kid ate almost nothing all day as he refused one meal after the other.  Apparently, he will eat a lot if he LIKES something but has no problem forgoing food if it isn't from his limited menu.

Sometimes I wonder what "normal" is.  Today was as "normal" as they come.

Cheers!


Photos from yesterday's Santa Train Ride below.

Stacking Blocks!

There was a period of time when it felt that Jayden's development was stagnant - nothing was changing.  Lately however, I feel Jayden is doing new things daily!  Just this afternoon I watched as he stacked blocks into a tower, 3 high!  This is something we have been working on in therapy for months but he just had no desire to do at home.  Last week, I noticed he randomly stacked two legos - I thought it was just by chance.  Then this afternoon he is stacking and stacking.  Clearly he knows how to stack blocks!

I bought Jayden a book of photos a few weeks back -the book was another priceless purchase.  He loves to flip through the pages and point and photos which I repeatedly label for him.  Today he found the photo of a brown pony which looks much like the pony he rides each week:  kvika.  Clearly, he recognized this pony and he kept signing more - I think he wanted to go riding!!

Jayden is trying to get over a cold right now.  I look forward to him looking better soon so we can get out of the house and participate in activities again.  I think both of us are going a bit stir crazy!