Tuesday, September 27, 2011

Evaluation Time

Last week we received T’s evaluation after 18 months of OT and it showed some significant improvements. It also showed several areas that hadn’t improved at all, and some that had even gotten worse. His OT suggested a few things to try, a PT evaluation, a full function vision evaluation and starting a cognitive program called, “How Does Your Engine Run?”
His biggest improvements were in his fine motor skills. This makes sense because he gets two OT sessions a week dealing with fine motor skills. Once in school and part of his private weekly OT appointment covers the fine motor stuff.  He also improved slightly in the length of time he was able to focus.
Pretty much all of the other issues he has have either stayed the same, or in some cases gotten worse. Now, to be fair, I don’t actually think he’s really gotten worse. Here’s my hypothesis on why he’s showing some sliding in certain areas: now that we’ve had the label of SPD, I’m more educated on what is SPD related, and what is normal kid stuff. So when I filled out the parent questionnaire this time, I was able to provide more complete answers, so in reality, I’ve gotten better at recognizing SPD symptoms. Ones that he has had all this time, but I never included them on the parent evaluation form before.
T’s occupational therapist agrees that this is likely true. She also points out that he is coming up on his 5th birthday, and is going through some significant changes physically and developmentally. These are often times of regression at worst, and stagnancy at best. We have a bit of both.
I took T for his evaluation to see if he would benefit from physical therapy, and in the 2 weeks since the OT evaluation was done, some of the concerns have righted themselves. Still, he will probably need some form of physical therapy for his core strength and balance issues. He is also slightly behind in his cross body coordination. However, the Physical Therapist only believes that he will need PT on a short term basis of 3-6 months. They believe that with the OT we will see a marked improvement in his gross motor skills.
As for the other sensory stuff, the stuff that has shown the biggest lag in improvement, we will be looking into starting the “How Does Your Engine Run” program in the next few weeks. I still have some research to do on the program, so I will be ordering the book soon. We also have the functional vision evaluation scheduled for next week.
All in all, I am very excited to see what progress T will make in the next 6-12 months with his new tools. I am forever thankful that these tools are available to him, and that he is such a great sport when it comes to participating in all of the evaluations and therapies we involve him in.
Does anyone else use the “How Does Your Engine Run?” program? I would love to hear about your experience!

Thursday, September 15, 2011

The Bunny


I’m in love with a bunny. No wait, I’m serious! This magical bunny tells T when he should be sleeping, and when he should be awake. This is vitally important, especially as we head into fall and T’s sleep schedule tries to shift from early, to “Oh my goodness, this time actually exists?” early.
T has two distinct sleep patterns, one for spring/summer and the other for fall/winter. In the spring and summer T goes to bed at 6:45-7am and sleeps well for close to 12 hours. In the fall/winter he starts waking earlier and earlier, no matter what time he goes to bed. We creep to as early as 4:30am some days and for a couple of night owl parents, that is downright painful.
So as summer starts to come to a close, I have noticed this pattern starting again. T was waking 5, 10, 15 minutes earlier every morning and panic started setting in. Frankly, I can deal with anything after 6am, but when I see that time creeping earlier and earlier the dread sets in. You see, I just can’t make myself go to bed at 8:30pm so I am well rested and more importantly, friendly, at 4:30am. So I hit the internet for help.
We are a sleep sharing family (by choice, not necessity) so we have T’s twin bed pushed up next to our king sized bed. So a lot of the methods to get your kid to let you sleep until a reasonable time just won’t work for us. We can’t put a gate on his door and allow him to play in his room until we wake up, his room doesn’t exist. We aren’t willing to let him cry it out until he finally falls back to sleep. But we also aren’t willing to get up at 4:30am. That’s when I found it, the bunny.
The bunny is a “sleep trainer” clock. There is a sleeping bunny and a running bunny, and when it’s time to stay asleep, or in T’s case, quietly relaxing in bed, the sleeping bunny picture is lit up. When the clock reaches the wake up time it lights up the running bunny, signaling to all that it’s okay to wake up mommy and start the day. Luckily, the brightness is adjustable, so kids like T, who need almost complete darkness to sleep, aren’t bothered by a bright night light.
We set the bunny to wake up at T’s normal waking time, which was 5:45am when we bought the clock, and have set it 5 minutes later every 2-3 nights. The method so far has worked like a charm. If he wakes before the bunny, I can remind him that the bunny is still sleeping and that means he should be too. So far it has been such a great visual tool to help T know when an appropriate wake up time is. Since he can’t read a clock yet, the bunny is a life saver.
Before buying the clock, I asked T if he thought it was a good idea. I asked him if he wanted something that had pictures or a colored light that told him when it was wake up time and then we hit Amazon to find the perfect one. T immediately begged for the bunny, and I ordered it that night. We spent 2 days talking about how the bunny worked, and what the reward system for following the bunny’s cues would look like.  The day the bunny arrived T was so excited and told me, “Now I’ll know when to sleep and when I can wake up, I won’ be so tired anymore!”
It’s been a week since the bunny came to our house and he is now waking T up at 6:00am. T is sleeping better, and so am I. I love that darned bunny!