Wednesday, September 24, 2008

Update on Jayce's therapies

You remember my "WE GOT TEFRA!" post?

Well, we got back into Occupational Therapy (OT) and Speech and Feeding Therapy (ST) at the local hospital at Pediatric Rehabilitation Services. I love everyone at Peds Rehab. They are so great. So wonderful. They love the kids, they bend over backwards to make sure everyone is receiving the best care possible.

We were so fortunate to get back into ST/Feeding with Miss Candy (yes, her name really is Candy... how appropriate for a feeding therapist!) Candy was really great with Jayce last Spring. Although our progress was slow in my eyes, she assured me that there are 32 steps that a child with autism must take in order to try a new food willingly. That word is crucial. We do not want to make food a battle, we do not want Jayce to be afraid of food, we want Jayce to enjoy eating and to see it as a pleasure.

Candy has just come back from another conference dealing with food aversions. She is now loaded down with tricks to get kids like Jayce to see food as "safe".

I was amazed at how well Jayce did on Tuesday. Normally, Jayce won't even tolerate a new food on his plate in front of him. He tries to get up out of his chair, he turns his head, he starts to tantrum. This time, Candy called the applesauce "mud" and the pasta "worms" and the peanut butter "dirt" and the cheerios "circles". And they just played. She had him touching all the above foods with the greatest of ease! Now, he did exhibit some defensive behavior when something got to be too much for him. He splays his hands on the side of his face as if he is saying, "Stay away from my face! Don't come near!" and also a lot of head turning and nose crinkling. Jayce will actually crinkle his nose at just the mere thought of food or the mention of the word.

Our plan is for Jayce to work 60 minutes on feeding one week and 60 minutes of speech the next week. We used to do 30/30, but it was hard for Jayce to switch gears and we felt like we weren't accomplishing as much as we could. Jayce's expressive speech has come a long way! He is now categorized as a "mild" expressive speech delay. His vocabulary has greatly expounded and he is putting words together for sentences. Now we need to work on pragmatics. The way he uses language. Jayce might talk a lot now (thank goodness!) but its hard for him to string words into sentences using proper structure. He uses almost no pronouns or adjectives, unless he is repeating exactly what you've just said. For example, he was obviously thinking about the EEG test the other day and was telling me about it.

"Doctors," he said. "No touching the wires, Jayce. Go nite-nite bed. Doctor's bed. All gone take a nap doctors. Pretty hat! No touch the wires."

All that will get better with time and more therapy. We are very careful to model the correct way he should be saying something. If he says, "Jayce is messing with washer" we say, "I am messing with the washer" so he'll then repeat the phrase that way.

However, his receptive language assessment showed that he is now in the category of "severely delayed". This is no surprise to us, considering he can only follow a one-step direction and doesn't seem to understand what we say a lot.

Another funny example....

Jayce was eating a bag of cheese-its in the car one day. We got home and he immediately rushed to the laundry room to see if the clothes were done in the washer so we could put them in the dryer. He laid his bag of cheese crackers down on the floor so he could put the wet clothes in.

A few minutes later he announced, "All done dryer! Clothes in the dryer!" and went off to play.

I asked him, "Jayce, where are your crackers?" and Jayce responded, "Crackers? Want crackers?" I looked on the floor, but didn't see them. "Jayce, did you leave your crackers in the laundry room?"

"Crackers laundry!" he says excitedly. All I can think is Oh no. he put the bag of crackers in the dryer!

"Jayce, where are your crackers? Can you find your crackers?"

He says, "Oh no! Crackers! Gotta find it! Its lost!"

"Jayce, did you put your crackers in the dryer?"

He gets really excited now and says, "CRACKERS IN THE DRYER!!!"

Usually, when he repeats himself like that, you can take that as an affirmative answer. I was getting worried now so I stopped the dryer and pulled out all the wet clothes looking for the bag of crackers. Again, he tells me, "crackers laundry dryer!" so I pull them out a second time, with no luck.

Finally, I walk through the kitchen and see the crackers on the counter, where they have been this whole time. Jayce must have put them there, but he totally didn't remember (or understand) that we were looking for them.


We also met his brand new OT on Tuesday. I loved her! And first impressions mean a lot to me. So far, my gut has not been wrong! She and Jayce hit it off very well. She is young and energetic, fresh out of MUSC (where, coincidently, his old ST by the same name now works!). She seemed very knowledgeable about Sensory Integration Dysfunction which is primarily the reason we see an OT anyway. It was a very smooth transition.

So, that's it. That's what we are going to do every Tuesday from 1-3 pm. We are still looking into other programs as well for Jayce. And he gets ST and OT again at school as well. This is going to be a great year for him :)

2 comments:

  1. Such awesome news! YAY!

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  2. That's so great. Good for you and all your hard work. Good idea about calling the food different names. I will have to try that here. :)

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