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2015 February - This Will Be Funny Later

Archive for February, 2015

Developmental Evaluation

Age: 21 months, 1 week

The big news this week is her developmental evaluation. I took her in yesterday for a sensory and motor delay evaluation. I’ll provide links for the tests I know the names of, for any readers who know about (or want to read about) Such Things. For motor skills, they used the Peabody Developmental Motor Scale 2nd ed., which was interesting to watch but didn’t give me any idea how she was doing. For the sensory evaluation, I simply filled out a pretty short form about how she reacted to various things (I didn’t catch the name). Some of them were difficult for me, questions about whether she reacts more strongly than most children. Of course, she’s my only child and I frankly don’t have a lot of experience with children except for her, so I have no idea. I haven’t heard back about either of those evaluations. I guess they have to add up her scores to figure out what they think. The therapist who was doing the testing said that she guessed J’s score would come back borderline. She could probably benefit from some occupational therapy, but doesn’t need it.

Partway through the occupational evaluation, they asked if it would be okay to have a speech therapist take a look too, since it seemed to the therapist that she might benefit from getting her speech evaluated. Sure, why not. It would be nice to have her thoroughly evaluated. So the speech therapist came in, and started testing her using the REEL-3 booklet on receptive and expressive language. She did fine, no issues there. 84th percentile for receptive language (what she can understand) and 70th for expressive (what she can convey). No real surprises.

Then the therapist pulled out the Goldman-Fristoe Articulation book (here’s a video of this test). It’s basically a book of pictures and you evaluate how well the child articulates each word. It’s designed for children 2 years and older, so J at three months shy of 2, she wasn’t evaluated at a standardized level. However, she definitely did not articulate. In actually trying to get her to say a series of words, it became plainly obvious that she refuses to attempt any word with 3+ syllables, and most words with 2 syllables. Of the words she does say, most middle and all ending consonants are just elided entirely. If she were 2 years old, J would be well below the 50th percentile. That’s really more of an interesting note, since the test isn’t designed for children under 2, and 3 months is a really, really long time for a toddler, especially in terms of language development.

Given how able she is to understand and especially to communicate despite her articulation skills, I’m not really concerned. I think she’ll respond super rapidly to speech therapy. She’s generally very compliant and enjoys doing things for others. The therapist checked to make sure there was no physiological cause (hellooooo tongue tie) underlying her speech issues, and there isn’t. So it’s really just a matter of teaching her how to use her tongue. I’m really excited for her to start therapy, since everyone involved seems to agree that it should really help her with her tantrums/frustration level and with the aggression she’s showing other children (biting or shoving because she can’t tell them to stop doing something). We should be able to start next week.

**word list removed**

 

Not So Weekly Update: February 18, 2015

Age – 20 months 4 weeks

It’s going so fast. I can’t slow this childhood down at all and I’m struggling  to keep up with posting!

Last week, J got really sick. She started throwing up at 1am Friday night/Saturday morning, and threw up every 10-20 minutes for hours and hours. We finally got a doctor appointment and he gave us some Zofran (an antiemetic). We got it into her about 3pm. Poor girl was puking pretty much constantly for 14 hours. Once the Zofran hit, she was down to every 1-2 hours. That lasted a day or so before it dropped to every few hours, but after 3 days she was still puking pretty regularly. She wasn’t keeping anything except a little bit of breastmilk down. We had an urgent appointment every single day last week, mostly to make sure she was still hydrated enough. (I’m convinced this whole ordeal would have been much much worse if she wasn’t still nursing. I was able to keep her hydrated despite the near-constant vomiting, and I am convinced that’s the only thing that kept us from going to the hospital for an IV.) Each time the doctor saw her, I was told it should clear up within 24 hours at the most. On Wednesday, she’d been puking for 5 straight days and we were almost out of Zofran. I finally got to see one of her regular pediatricians, who gave us more Zofran and had an X-ray taken to make sure there wasn’t a blockage of some kind (there wasn’t). But things didn’t really improve much. By Wednesday she was puking every 5-6 hours, and that was unchanged by Friday when we saw the pediatrician I like most in her practice. She sat down and talked with me for a while, and ended up diagnosing J with “retch” or mechanical gastritis. Basically, she had thrown up so much that her body couldn’t stop. Her stomach was too irritated and her whole system primed to respond to that irritation with vomiting. She said it could take up to a month to clear up (UGH!) but it wasn’t contagious and J should be able to go back to daycare, as long as we sent her with a bland food diet. She also said J would regain the weight she’d lost from not eating for a week (nearly 2 pounds) with no problems. She also gave us Prevacid, to help calm J’s stomach down. J got her first dose Saturday morning, and by Saturday afternoon she wanted to eat again. Demanded to, in fact. I was so excited that she wanted to eat one that I gave her a strawberry without thinking about the bland food order. Oops! She demanded many strawberries and ate about 1/3-1/2 a pound of them before she stopped screaming for more. Fortunately, they stayed down. Yay! She had thrown up just before I went to the grocery store, but that seems to have been the last of it. It’s now Wednesday, and she hasn’t thrown up since! And her appetite has come roaring back. She’s definitely doing everything she can to put those 2lb back on.

Since going back to daycare, we’ve been having a lot of trouble with biting. I think her molars might be moving around. What a crazy time the last few weeks have been! A double ear infection, then gastritis, now teething?

Oh yeah, not sure I mentioned that.. The other week the daycare was complaining that her balance was really off, and asked me to take her to the doctor. Turned out she had ear infections in both ears! Ow! A quick round of antibiotics cleared that up, and we learned about how to give a toddler liquid medication when she refuses. After she had spat out two doses, we called the pediatric nurse line and asked for alternatives to the vile pink goo they expected her to take. They told us to mix it with chocolate pudding, which would disguise the flavor of just about anything. It worked! Sort of. She hated it less, but realizing how much we wanted her to eat the pudding was enough to keep her from wanting to. I ended up swaddling her in a towel, then once I got a single spoonful into her mouth she would calm down enough to eat it. She wouldn’t take it unless she was wrapped in a towel though. One evening, near the end of her 10 day course of antibiotics, she actually got out a towel, spread it out, and lay down on it so I could wrap her up! Silly girl! But whatever, it made getting liquid medication into her so much better.

So recently, she’s been biting. A lot. Not interested in teethers, only people. She’s biting her arm, her friends at school. The other night, she bit me while nursing. Ouch! I told her no, absolutely no biting, and I don’t want to snuggle with her if she is going to bite. After talking to her about how it hurts me when she bites, I let her nurse again. She bit me again, I think to test me, and I did the same thing, only this time I waited a much longer time before letting her nurse again. She was pretty upset, but so was I! Then last night while she was nursing, she kept unlatching and saying, “no bite. No bite. no bite mama.” It was really cute. Every time she said it I told her that was right, no biting mama, thank you for being so gentle and not biting. And she didn’t bite me once! It was very sweet. But, she’s still biting at school and still biting herself. I’m not sure what to do about that. I’m hoping it’s just teething and not part of something larger and more serious.

Like, for instance, developmental delay. The daycare talked to me a while ago about getting her evaluated for motor delays. She’s more unaware of her body than they would expect, and seems very clumsy for her age. She’s also biting herself (and others) and will do things like jab her hands and arms with her spoon or fork. The clumsiness I’ve always attributed to her genes. Like my mother always said about me, she comes by it honestly! She does come home with a lot of bruises on her shins and knees and bottom, all clearly from falls. We’re having her evaluated next week, and I’m honestly not sure what I’m hoping for. It would be nice if we could improve her clumsiness and address anything going on for her, but it will be hard to get her to a bunch of occupational therapy appointments and it’s not well covered by her insurance.

Otherwise, things are going well. Her vocabulary has really taken off in the last couple weeks, and I think everyone is enjoying how much better at communicating she’s getting! She’ll point to new colors and sign, “blue” and look at me, repeating until I tell her the color and the sign. So far I’ve learned blue, red, orange, pink, green, yellow, purple, black, white, grey, brown, silver, and tan. Some of them she can sign back, some she can’t. But she tries all of them! I think soon I’ll have to stop updating the list of words she knows. It’s getting hard to remember them all unless I update the page every day. Many of the words she uses now seem to have a few different meanings. “Mine” means mine but it also means, “I want to do it.” “Bye bye” means bye bye, but it also means, “Let’s go” and “I don’t want this” and “Go away.”

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