OT with both kids.

Most times we have therapy sessions, the whole family, minus daddy, is around.  That means maybe someone is in quiet-time, or someone else is napping.  But usually, all of that goes out the window and big brother wants to play too, and little brother wants to be in the same room.  Just wait and he will want to jump in too.  Anyway, this is how we just roll with the punches around here.  I hope to tell you about how speech therapy went.  There too, we all stuff ourselves in a small office and try to be SOo quiet.  Yeah right!  Enjoy the video.

Occupational Therapy Pics

Reagan needs to build muscle in her core and crawl or pull with her arms and scoot.  This weird board helps her do it.  

This is her really exercising.  It was funny to watch.  After this she went back and forth through a tunnel to continue crawling and building up muscles. 

This is her favorite part.  She does art and then eats a snack.  We always try new things and she is tired and hungry by the end anyway.  

Sidenote:  I love the therapists!  Yes, there are two.  They are wonderful!  They care so much for Reagan and it is cute to see Reagan crawling in their laps for whatever is next.  

Some random pictures~

Because she loves yogurt and looks like Santa when she eats it!  And she still crinkles her nose!

Always helping!  He is a sweet boy!  He really is!  Even at 6:30AM!

It is so fun to have a little girl!  Even if she is a mischief maker!

WE went for a walk, or bike ride, Taylor and I.  I walked ran to keep up with him and he was so confident I really didn't need to be there for help, but rather company.  We had a blast!  I appreciated the exercise and he appreciated that we went over a mile and stopped at the gas station for gatorade and chex mix.  He even got to pay.  He loves being "all growed up!"  Anyway, on the way back he insisted we stop for every dandelion we saw!  A lot got tossed, but we still have them on the counter.  He loves to think of others.  He would go after all the beautiful azaleas in the front yard too if I let him.  Thank you Taylor for your thoughtfulness!  

Here is a smile from the cat.  It is great to be part of the Tibbs' family!

Reagan talking at age 2 yrs.

I hope this video links well to the blog.  I wish for you all to see a little bit of how R talks.  Her limited vocabulary is: mamma, dadda, uh oh, no no and then there are things she says that you can understand in context, but mostly it is shaking her head and pointing and trying to sign or verbalize as best she can.  We are working on it all.  I aim to take more videos of some therapy sessions.  We missed last week because the therapist was sick.  Stay tuned.

Sensory massage

Like promised, we took a video of a simple massage tool and massaging that we were asked to do with Reagan as often as she wanted... every 10 minutes if she wanted.  HA!  We end up only being able to do it maybe once or twice a day.  Usually at night before bed and since we do it to one child, we have to do it to all of the children.  It is interesting and strange all at the same time.  Occupational therapy wanted us to do this for sensory stimulation.  I am still trying to learn all about Sensory Integration Disorder, but this is not going to hurt anyone's development so we are up for trying it.

Hopefully, you can watch the movie now... I don't know what is going on with the computer or camera.  I am stumped. 

The kiddo's.

He is actually talking here.  Normally quiet, but he has something he has to get out.  

She is a happy girl!  Too cute, and she knows it!

This is the ham, but you already know that!

There is NEVER a dull moment!

Well, who knew that being sponsored by Kellogs would land you a good delivery that would have the UPS lady make several trips to your door, wondering if we bought half the grocery store.  We are wondering what to do with it all.  

Let's get down and play with daddy, and be goofy!

Wrestle mania.  This is so fun!  Lots of giggles and exercise!

Okay, now let's just be funny.

The kids keep us young!  They always make us laugh!

8 Months Old

In case you missed his blue eyes!  Oh, and those lips.   

Here he is with a big smile, mid laugh.  Look at those pearly whites coming in up top.  

Random...

Today, was a beautiful day!  In all I would say it was fantastic!  The weather was nice and we even enjoyed dinner out on the patio.  I stayed in my pj's until almost 11AM.  I can't remember why I got dressed really, but it may have been to go outside so that I could play with the kids and clean up outside.  Yes, I think it was.  Anyway, I started the day earlier, shaving outside but I only got one leg shaved.  I am the picture of ~ well we won't go there.  I never finished because I made some stuffed, baked apples and set the kids to organizing and then coloring and puzzles.  They ended up outside and Reagan started striping so I asked her if she wanted her potty chair outside... She ended up with her diaper off and sitting on the toilet every so often and telling us she went when really she never did.  We were all doing our own thing, Taylor riding his bike, Case in the garage, I was cleaning or picking up or something and Reagan was playing when all of a sudden she poo'd on herself and then freaked out.  I won't go into detail, in fact I will spare you!  Well, we quickly wrapped things up outside and that was the turn of the afternoon and we stuffed ourselves silly with yogurt, popcorn, and several cute little cuties (they are like clementines.)  Trent was so happy all day.  We cleaned and organized and played and made a really nice dinner, Taylor helped.  He requested Brussels Sprout salad again and we had it with some really yummy lasagna and bread.  It was just perfect weather outside for dinner and well the evening couldn't have gone more smoothly!  I have to say, it was an incredible day and even Taylor commented that he loved how we spent the time so nicely with each other!  Nothing could have been better!  The kids were pretty tuckered out and went to bed and to top it all off Casey and I watched a great movie.  It was called the Descendants, with George Clooney.  You should watch it.  I don't know what it was rated and there is cursing in it, but it was a good movie.  Sad, but real and very dramatic.  Kind of on the same lines as Juno.  Anyway, I am off to bed only a couple of minutes before midnight and I have to say it was a great day!  Maybe I will finish shaving next week.  Ha!

Apraxia of Speech

In regards to Reagan and a possible diagnosis, which has not been confirmed 100%, I went on a hunt to find out for myself what apraxia of speech was.  This was the best I found.  I also went on YOUTUBE, which you may want to do, and look up apraxia and see  how other kids speak and have a little bit of a disconnect.  I will say that I am so glad that we have already had a lot of sign language in our communication!  It helps tremendously!!!  Now, maybe we can practice a little bit more in certain areas so that Reagan doesn't get frustrated.  I will ask this week if I can video record her speech session.  No guarantees, just trying to be hopeful!  Anyway, the article is short and to the point, here goes:

Childhood Apraxia of Speech

General Information for Parents

Childhood apraxia of speech (CAS, also known as DVD -- developmental verbal dyspraxia, and DAS -- developmental apraxia of speech) is a disorder that is more easily defined by what it is not. It is not a muscle disorder. It is not a cognitive disorder (although it may have some impact on language as well as speech). The problem occurs when the brain tries to tell the muscles what to do -- somehow that message gets scrambled. It's like trying to watch cable t.v. stations without the right descrambler. There is nothing wrong with the t.v. station, and nothing wrong with your set. It's just that your set can't read the signal that the station is sending out. The child's language-learning task is to figure out how to somehow unscramble the mixed message her/his brain is sending to her/his muscles. The visible results (symptoms) of CAS are:

• little or no babbling in infancy; few consonants
• understanding of language much better than production of language
• slow, effortful, or halting speech; sometimes seems to struggle
• very hard to understand
• may make slow progress in therapy

CAS has much more effect on volitional (voluntary, creative) speech than on automatic speech. This means that the more your child wants to communicate a particular message, the harder it will be! So, if you happen to hear her/him say something once when there is no pressure, and you say, "Say it again!", you are guaranteeing that she/he won't be able to. It is vital to put a minimum of communication pressure on the child. (NOTE: Your child's speech- language pathologist will need to put communication pressure on the child.) Low-pressure verbal activities are the most important thing a parent can do to help. These include: songs (especially repetitive songs, like Old MacDonald and finger-plays), poems, verbal routines (pat-a-cake, Willoughby Walloby Woo, etc.), repetitive books (such as some of the Mercer-Mayer books, Little Bear, etc.) and daily routines (prayers, social greetings, salute to the flag, etc.). You can make other activities into verbal routines: make up little sayings or poems that you say every time you do the same thing, label instead of counting objects in counting books ("Three dogs: dog, dog, dog"), verbalize repetitive activities (e.g., setting the table: "Plate, plate, plate, plate; fork, fork, fork, fork.."), and so on. Don't make a big fuss about whether or not your child is talking or singing along; just provide a supportive environment for her/him to do so. Don't ever say "You can't have it unless you say it first" -- that's sheer torture for a child with CAS. If your child is unable to communicate effectively right now, the use of sign language or a communication board to supplement speech temporarily not only decreases the frustration but also even seems to help with speech development. Don't be afraid to try it! Dyspraxia may affect other motor functions (e.g., fine motor control, gross motor planning) and other language functions (e.g., learning grammatical function words like "the, "is", "or", etc.; learning more complex grammatical forms like passive; spelling; putting words together into a sentence or sentences together into a paragraph, etc.). Occupational therapy, physical therapy, and learning disabilities assistance are often helpful for children who have these difficulties. CAS can be a very frustrating disorder at times. It is common for children to make progress in "fits and starts" -- good progress for a little while, then none, then more, etc. Don't get discouraged! The therapy ishelping, even if you don't see the effects immediately.

An Internet Parent Support Group

Sharon Gretz, a parent of a child with dyspraxia, founded an Internet e-mail list for parents (and therapists) about this disorder which has grown into an international organization, the Childhood Apraxia of Speech Association, CASANA. There is a great deal of information for parents of children with CAS on their childhood apraxia web site.

An Article for Parents:

Stackhouse, J. (1992). Developmental verbal dyspraxia: A longitudinal case study. In R. Campbell (Eds.), Mental Lives (pp. 84-98). Cambridge, MA: Blackwell Publishers.

Some Key References for Professionals:

• Caruso, A. & Strand, E. (1999). Clinical management of motor speech disorders in children. New York: Thieme.
• Crary, M. (1993). Developmental motor speech disorders. San Diego: Singular.
• Hall, P., Jordan, J., & Robin, D. (1993). Developmental apraxia of speech. Austin, TX: Pro-Ed.
• Velleman, S.L. & Strand, K. (1994). Developmental verbal dyspraxia. In J. E. Bernthal & N. W. Bankson (Eds.), Child phonology: Characteristics, assessment, and intervention with special populations (pp. 110-139). New York: Thieme.
• Velleman, S. L. (1994). The interaction of phonetics and phonology in developmental verbal dyspraxia: Two case studies. Clinics in Communication Disorders, 4(1), 67-78.
• Velleman, S. L. (2002). Childhood apraxia of speech resource guide. San Diego: Singular.

Return to Shelley Velleman's home page.

More Reagan updates...

So, we updated a couple of days ago with great news from her radiological examination and we have continued going to all of our therapy sessions, most of which are here at the house.  For the most part, we are extremely busy!  Sometimes, Reagan is not a very willing participant and I get to see some of the ugliest melt downs.  But, she is gaining trust and enjoying more and more her glorified playtime therapy and it is great to be getting ideas on things we can work with her at home.  Mostly the sessions are about an hour and I am present on the sidelines.  I watch as each therapist assists Reagan in activity and then they take notes or study Reagan and evaluate her progress or lack thereof.  I sometimes note the things which stand out to them as concern and I might ask, but otherwise, they keep quiet and work at engaging her in different areas and try to address concerns with me in written form so that I can read their notes and ask questions as the next session comes.  With Occupational therapy, they have concern with Reagan's muscle tone and the way she sits and that she walks on her toes and she has food aversion (very common with patients with heart disease) and that she craves certain sensation.  They have me brush Reagan's feet and hands, legs and arms and then do joint compressions.  She LOVES it!  She will go get the brush for me to do it to her several times a day.  LOVES, LOVES, LOVES it!  She loves playing with the things they bring her.  Now she has played with some tacky clay, (no it isn't molding clay, it is colored and strange), they hide wiggly eyes and buttons in it and she has to pick them out.  She also uses finger paint, and other textured things to squeeze.  I have to set aside toys in the house that are for her.  I even got my hands on some silly putty, but somehow, I lost it!  BUMMER!  Anyway, they have requested that we get an evaluation from a physical therapist now, and so it is in the works.  The coordinator has just texted me that she knows we are busy, but can we see someone and get tested.  Wow!  More tests and play.  In a way, this is all good because we are learning to help Missy.  The activities we are doing keeps her stimulated and happy.  We have been successful at removing her pacifier and helping her stimulate her nervous system in positive ways.  In speech therapy, we are dealing with improving jaw movements and tongue movements for chewing.  We have been asked to target biting and I need to use any of the following foods: beef jerky, string cheese, licorice and gum, to name a few, to have Reagan use her back teeth to practice jaw movement.  This will help her muscles work and stimulate sensation in her mouth.  I am supposed to used sweet-sour-hot-cold things and stimulate her that way too.  They have asked me to get her chew toys or teething toys, all which I either already got rid of or was planning on getting rid of.  I don't have any at the moment, but if you look on-line, they have asked me to look at chewing tubes.  I can use it to help her sensory, to aid jaw movements, and provide something for her to mouth instead of other toys which she still puts in her mouth.  She will be offered it at intervals and when she is upset.  Wow!  All this is new to me.  Speech has been wonderful.  I value so much the information that I am getting and look forward to improvement with Reagan (Missy).  It is still early to tell, but today at session, the speech therapist thought Reagan might have apraxia.  I don't know much about that so if you google that, you will get answers that I will be reading right along with you.  For now, we are working with methods called prompt and repetition, repetition, repetition.  We are still producing some sounds but nothing is really connecting.  I will try to take a video to explain.   For now it is 10pm and I have to deal now with Taylor who is standing right here and wants to talk to me about being scared of monsters.  Talk to you all later.  Good night.

Dinner was delicious!

Marinated Roasted Peppers with Capers and Mozzarella

3 bell peppers,

3/4 teaspoon red wine vinegar

1 clove garlic, mashed into paste

Salt

Freshly ground black pepper, to taste (optional, I didn't use any)
1 1/2-2 tablespoons extra-virgin olive oil
2 tablespoons capers, drained (left this out, oops!) 2 tablespoons chopped fresh marjoram or basil (I used dried marjoram)
Pinch of cayenne pepper (optional)

1/2 pound ball of mozzarella, sliced 

Halve the peppers lenghwise and remove the stems and seeds.  Cut into strips 1/2 inch thick and put in a bowl.  (I used a gallon sized bag).  

Mash the garlic into a paste with a pinch of salt.  Add the garlic paste, capers, marjoram or basil, and olive oil to the peppers and toss.  Season with salt, cayenne, and the red wine vinegar and toss again.  Let stand at room temperature for at least 10-20 minutes or up to several hours.  Just before serving, season with salt and more vinegar if desired.  Scatter the mozzarella balls on top and serve right away.  Eat with some crusty bread and a glass of wine, preferably al fresco.

Herb Crusted Pork Tenderloin

Recipe courtesy Paula Deen, 2007

Prep Time:

10 min

Inactive Prep Time:

20 min

Cook Time:

1 hr 45 min

Level:

Easy

Serves:

6 servings

Ingredients

• 1 (4-pound) boneless pork loin, with fat left on
• 1 tablespoon salt
• 2 tablespoons olive oil
• 4 cloves garlic, minced
• 1 teaspoon dried thyme or 2 teaspoons minced fresh thyme leaves
• 1 teaspoon dried basil or 2 teaspoons fresh basil leaves
• 1 teaspoon dried rosemary or 2 teaspoons minced fresh rosemary

Directions

Preheat oven to 475 degrees F.

Place the pork loin on a rack in a roasting pan. Combine the remaining ingredients in a small bowl. With your fingers, massage the mixture onto the pork loin, covering all of the meat and fat.

Roast the pork for 30 minutes, then reduce the heat to 425 degrees F and roast for an additional hour. Test for doneness using an instant-read thermometer. When the internal temperature reaches 155 degrees F, remove the roast from the oven. Allow it to sit for about 20 minutes before carving. It will continue to cook while it rests.

Then we had some delicious rice.  What a perfect meal!

Reagan Update~

Oreo cookie, YUM!

Because I always scrunch my nose.

This looks a little forced, but still cute despite all of the cookie in her teeth.

Well, sorry this is so long overdue!  We do have lots to update on though.  

First and foremost, we went for another Barium Swallow Study, a study done in the radiology department that allows us to see if liquids penetrate the wrong areas of Reagan's throat or airways.  She has been on thickened liquids for nearly 2 years and we wanted to see if she was still at risk for aspiration.  Well, the long and short of it is that she is still at risk, and she still has a gurgle on her throat, and she has a slow laryngal closure, but she didn't show penetration with thin liquids and therefore we can take her off of her thickener.  There are rules however.  She still has to use straws that are very, very, very tiny.  I have some sippy cups that have straws but she still gulps and coughs at them all.  I am on the hunt for smaller straws and am almost ready to buy coffee straws.  They seem like such a waste, so the hunt continues.  Anyway, she has good tone in her voice so vocal chord is doing better but we still must exercise it with singing and certain muscle activities.  We are busy, busy, busy with all of that.  However, I will say that Reagan loves singing and she is humming constantly songs in her room, or in the car or going up the stairs or while she is playing.  She loves all music really!  

We have music therapy sessions twice a week for 30 minutes each and the young therapist comes in with shakers, maracas, bells, a drum, a guitar and we basically sing songs for Reagan to imitate phonetic sounds, we practice taking turns and following directions and she signs and well, some times Reagan love the entire thing and sometimes she is so nasty and wants to do her own thing.  She really has an attitude!  Everyone gets to witness it!  Besides music therapy, Reagan also has Occupational Therapy and Speech Therapy.  

With speech, we are practicing a method called Prompt.  Apparently, not all speech therapists are trained in this, but it is where tactile movements are initiated to help the child feel where mouth placement should be.  It is quite interesting and I am trying to help Reagan as best as I can and with her moody behavior we hope to get her to communicate more so she isn't frustrated.  The therapy we are receiving is all early intervention so I am present at all sessions and actively participating or paying close attention so that we can practice at home.  We have goals, both short term and long to which we all work really hard to master.  Reagan is really improving and loves to be praised.  

Occupational therapy is fun and just basic play that we engage Reagan in sensory activities.  They believe that Reagan has Sensory Integration issues and that she doesn't know how to organize her nervous system and therefore her body in a spacial sense.  It is very confusing to wrap my brain around it, but we do things like lifting heavy objects and playing with molding clay things and sesory balls and medicine balls and such to engage muscles and body in movement that are stimulating.  Again, I am having a hard time understanding it still so I am not the best at explaining it either.  I hope to get a handle on it soon and update with progress.  I also hope to get some footage of Reagan in therapy session.  We will see.  Keep your fingers crossed.  Hope you like the picture.