Tuesday, October 7, 2008

Experiencing Early Intervention

The Early Intervention experience is okay so far. It's just that the time to get the evaluations done was long. I called in July. The services coordinator came right away. It was everything else that was slow-going (mainly due to fiasco with first psychologist.)

To determine Jaden's eligibility for services, he was seen by a multidisciplinary team of evaluators:
  • a speech therapist
  • a special education teacher
  • an occupational therapist
  • an audiologist and
  • a psychologist
The speech therapist said that it looks like his receptive language is delayed and that may be due to his hearing. She recommended for us to get his hearing tested and she recommended a psychologist. Hearing test--okay. Psychologist? I wasn't sure why. When I asked, she just said that the psychologist may help us to determine why he's not talking.

I took him to get his hearing testing and the results were inconclusive. The audiologist said that in the booth, he responded to some sounds and ignored others and sometimes it looked like he heard something, but nothing was played. When she tried to put plugs in Jaden's ears, he wasn't having it. She recommended him redoing the test or getting a sedated ABR hearing test. I wasn't thrilled about redoing the test in 3 weeks because it might be inclusive again.

I was interested in the ABR hearing test, but I didn't like the sedated part. I did some research on the internet to find out more about this test and came across a site that developed non-sedated ABR technology. I called them up to find out if there were places in my area with their technology. There were. The first center I called said they had stopped using the technology. I guess because the technology is still somewhat new, they have some issues to work out. So at this point we are waiting for his next hearing test appointment.

All the evaluators noticed that Jaden didn't respond to his name. My husband and I noticed that too. We would say to each other, "Look at how he's ignoring us." We didn't really think he had a problem with hearing, but I wanted to know for sure. I was so disappointed that his hearing test couldn't solidify that for us.

The special education teacher said Jaden made good "b" and "d" sounds. But his speech is severely delayed for his age. He also said that his temperament was calm and gentle--usually, children who can't communicate their wants and thoughts have frequent meltdowns and are somewhat irritable.

The occupational therapist was interesting. She asked about his pointing (he finger feeds himself Cheerios.) She tried to get him to color on paper (she said he should be scribbling more.) She noticed Jaden putting everything in his mouth (we know that.) She noticed him looking at us from the side of his eyes (I didn't notice until that day and haven't seen him do that since.) She asked if he stumbles a lot (no), knows fear or how to be careful (I believe so. He climbs up on the table and carefully climbs down.)

I asked her if Jaden's putting everything in his mouth is a bad habit that can be broken. She said the OT will give him a sensory diet to satisfy his urge to have something in his mouth. I'm thinking if he gets various textures of food, maybe he won't put inappropriate things in his mouth as much. She also noticed that he likes to throw himself on the sofa and bean bag. The OT, she said, will most likely bring tunnels for him to crawl through to satisfy that need and to teach him how to look for and find something he likes at the end of the tunnel.

Now the psychologist. After playing phone tag for a few days, the first psychologist to call me kept asking me why did I think Jaden needed to see a psychologist. I said that it was at the recommendation of the speech therapist and special education teacher. They felt that a psychologist could help determine why he's not speaking. She asked me if, other than the speech, there were concerns I had about his development and behavior--was he overly aggressive, or reclusive. I said no. She said that normally when parents want their child to see a psychologist, they have a concern about certain behaviors and things like that. So we decided that if I felt I needed her services at a later time, I'll call.

When Early Intervention followed up on that appointment, I told them what was said. The gentleman didn't understand why the psychologist questioned me like that and didn't make the appointment. So they had another one to call me.

With the second psychologist, Jaden was a little miserable because he had just woken up and he wasn't feeling well. He was very clingy to me. But the psychologist said that he could see right away that he's not making eye contact and I can't remember what else. The doctor sat down with me and said that Jaden is not talking because he hasn't learned how to communicate. He made sure to explain that it's nothing I've done or didn't do. Then he gave an example that every family has an Uncle Joe who didn't speak until 5 years old. The difference is Uncle Joe still knew how to communicate what he wanted by pointing, nodding, and gesturing.

He said that I would have been very disappointed with just speech therapy because Jaden hasn't learned the basics of communication yet.

He wrote on a paper PDD and showed me how it's broken down.

Pervasive Development Disorder
  • Autism
  • Asperger's
  • Rhett
  • Childhood disintegrative disorder
He said Jaden's condition is called PDD-NOS and that good, intensive communication therapy involving ABA (Applied Behavioral Analysis ) would help him learn how to communicate--make eye contact, point to what he wants, etc.

I mentioned that Jaden grabs and pulls. He'll grab my hand to color a picture or he'll pull on my shirt for me to pick him up. But that wasn't acceptable communication according the psychologist.

I'm grateful to this psychologist because I was wondering if there was a name for this "severe speech delay." I thought about autism. My mother even mentioned it, but I didn't want to be the one to offer that term. I wanted to hear first what "the experts" thought it was, and I thought I had to wait until our family meeting with the evaluators to find out. At least now I can come better prepared with questions.

Another observation that all of the evaluators pointed out was Jaden walks on his toes. I'm aware of the neurological implications toe-walking has. I looked it up because Jaida, my oldest, walked on her toes too and still does. I'm not too concerned about him walking on his toes, but I'll look into it again.

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