Wednesday, February 18, 2015

Reflections

I spend so much time thinking about my kids.  I notice it the most when I am in the shower, alone.  I will stop and think what am I thinking about? and it's always them, always, and not like oh my gosh, they are so cute, but how can I move them ahead?  What other comment did someone say? etc.

We went to Pittsburgh to see Dave Hammer.  We left on Valentines day.  As we were getting ready,  Landon was helping me put toys in bags and he was excited to go somewhere.  I told him we are going somewhere to see if you can talk better/more.  Alex was his usual nervous self when getting going and he was saying how he doesn't want to go.

Off we go.  We are about an hour from home and realize the storm is hitting us and going against our direction, so we just driving into it.  We stopped at a rest stop and got back in the car to some horrible snow.  I called my dad to check the radar and he sat it would be pretty heavy for the next two hours.  We were going maybe 40 mph on the highway and I told Alex it's fine if he wants to stop to stay somewhere else, then continue on, but we just continued you.  The thruway was closed on one side soon, and we realized two people had died.  There were cars off the road everywhere, and finally the traffic stopped.  The police told us to stay in our cars and we would be there awhile.  It was about 90 minutes before we could get going and that part was horrible.  11 cars were off the road and many, many accidents.  We finally got there in 10 hours instead of 6.

We had a lot of fun at the Children's museum.  More on that later.

We had a two day evaluation with Dave Hammer.  Landon is funny sometimes.  Last year when he was evaluated, he cried and sat on my lap and did it.  This time, he just looked away, like ha ha, you can't see me.  He also hit.  Dave was better with him the 2nd day and seemed to have taken some time to think about Landon.  It was frustrating, and I understand it better now as I read Dave's comments on the apraxia kids website, that he wants a wide sample and a risk taker to be able to say yes, I hear apraxia.  I am certain Landon has apraxia.  I have a huge sample on him and he has all the soft signs too, but anyways, Dave gave him a working dx of apraxia.  He had a lot of comments.  Some hurt a lot, and others maybe could be helpful.  He is a nice man, but global apraxia is still rare and still misunderstood and that is so hard.

Here are the comments:
-signs and gestures can be used for tx to elicit sounds, but not expected for him to imitate them.
-use of device and one device needs to be done
-riftin chair for him to sit in during tx, for part of it, maybe 10-15 minutes, with lap tray
-cloze procedure with music is helpful
-finish activity, He cannot dictate every activity
-motor planning, sometimes it shows up globally for him, but dave felt sometimes Landon did not even try enough to say it was motor planning (to me that's lack of confidence, but)
-needs to work on representative play
-use slow rate of models, gives his body time to process and then motor plan
-genetic testing should be done for both of the boys
-he is a puzzle-- hate that
-receptive language: "not possibly developed at age level." "not convinced cognition and receptive language is high."  BS. should not say that. we know how global apraxia impacts those tests
-"I keep reading in all his reports and paperwork that he is a smart, bright little boy, and I just don't see that." (cue tears)
-home practice- narrow the focus.  targets in tx narrowed, cant have too much coming @ him. 10 minutes targeted speech practice, 2x per day and then work within context
-higher expectations
-Landon needs predictability, routine
-he recovers quickly
-he is pleasant
-he can engage well
-he laughs to get out of work
-a  few suggestions for his sLP like she took too much time between practice opportunities, don't bounce on 1st sound, not /i/ /n/, but /in/, and he wrote down the sounds he heard him use during his 90 minutes with my guy:
which were 6 consonants and 5 vowels.

I am not sure it was worth it yet.  I feel a little disappointed, but I know Landon needs to work on overall imitation.  I still don't think global imitation has to be the precursor for speech.  I am not sure.

I guess overall Landon tried and worked hard, but he ignored some requests and then I did not like Dave painting him with a broad brush in regards to cognition.  Very unfortunate.

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