Our journey through autism

Posts tagged ‘speech’

Other Progress

The summer was all about IM and SLP, after those programs finished he continued regular OT.

Occupational therapy: Bilal had major improvements since last year and we thought he was getting close to discharge, every time this comes up, I get super excited to be finally done with it all, but also really nervous, afraid to stop therapy but still need it. His evaluation came up beginning of September and he did well, but still had weaknesses with hand/eye coordination and more visual aspects of OT. Also his handwriting does need improvement so it was determined to continue with OT for at least another year and then re-evaluate again.

Vision therapy: Bilal did once a week vision therapy for the prescribed 6 month program and did really well and strengthened his eyes. She told us to continue with some therapies at home and come back in once a month and then once every 3 months just to keep track and make sure of things. Future therapies would require a bit more maturity to do activities like the 90s popular Magic Eye, relaxing and pulling certain eye muscles to see hidden images. She also said the light box therapy of SLP would be beneficial for Bilal’s convergence and eye teaming issues. In all honesty we haven’t kept up with our vision therapy exercises like we should. We really need to add it back in somehow because his OT and PT therapists say he’ll either need glasses or more vision therapy.

Magic-eyes-magic-eye-16383884-2551-1681

Magic Eye*

Physical Therapy: Earlier in the year Bilal was temporarily discharged from PT, he wasn’t gaining anymore from it, but the evaluation test didn’t give us a good score. There is a test for below 6 years old, that Bilal (then 6 years old) did great on. The other test for above 6 year old, he did really bad on. His therapist suggested to re-test him after he completed his summer intensive to really see whether he would need more PT or not but in the mean time we would put therapy on hold. Mid-September he was re-evaluated for PT on the 6+ years test and he did great, passed on all areas and she said the IM made a huge difference with speed, precision and overall focus and attention.

Myofunctional: We are still doing myofunctional therapy once a week, almost ready to move on to phase 2 swallows. Its a slow therapy, as its hard to change eating habits, something that has to be done every day and he can satisfy his hunger even if he eats incorrectly. A change like this has to be a conscious effort from Bilal himself and there is just no 5-7 year old that would bother unless his mother constantly reminds him.

Speech: He was discharged from private speech therapy in June 2013 and from school based speech therapy at the end of Kindergarten. He is speaking clearly with vast vocabulary and infrequent grammatical errors. His OT therapist suggested that he be evaluated for speech again which concerned me and it turns out that the specialists are called Speech and Language pathologists, and he needs help with the language part now not speech and articulation. Bilal has major trouble writing and putting together a sentence, he may know the answer verbally, but tell him to write it down and he’s lost, he cannot organize his thoughts into words to be written. Like with everything else, things don’t come naturally to Bilal, he has to be taught and trained to do things, to have tasks broken down into smaller parts, and then put all together in time as he masters each little goal. He will be evaluated next month and depending on the results on that will be taught how to organize his thoughts and write them, for example, creating word boxes, learning sentence parts, editing and proof reading, its like an English language lesson but therapy. This is exactly what Bilal needs, with homework he either has no clue what to write or he talks too much and doesn’t directly answer what the question is asking for. Looking forward to this therapy, the therapist I met said that after 6 weeks with her we’d see improvements. She’ll help him with his homework and give him tips and tricks.

Other activities: Bilal is still doing piano lessons, with a recital twice a year, he’s on his 3rd piano book now and is doing well, we went through a period where he refused to practice and a lot of crying, screaming drama but a bit after the SLP his attitude improved and his behavior during class is a bit more serious as well. Other than that, he has a science and technology after school class once a week, concentrating on how science sometimes appears as if its magic (getting an egg through a bottle) and then later on basic programming and robotics involving Lego. He also goes to Sunday school every week learning about Islam doing really well there and little by little trying to teach him some basic Arabic words, proper pronunciation is very difficult for him but he understands us well.

Overall like all his teachers and therapists keep saying Bilal is a happy typical little boy, loves computer games, Lego Mixels and just being silly and funny.

* The image that appears in the above Magic Eye is that of penguins.

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Welcome Back

Hello everyone,

Welcome back, I’ve left the world of blogging and just got busy with life and raising 2 little boys and all that entails. So what have we been up to, I could say nothing really, doing the same as any other parent of young boys would be busy with, school, after school activities, sports, family outings, etc…  or I can concentrate on all the different therapies we’ve done and those have been interesting.

Where have I left off? That we’ve just started Kindergarten and things were looking great… now we’ve started 1st grade almost 2 months ago and alhamdullah its been going really well. Bilal did really well in an integrated classroom last year with typical peers. He still had an IEP that covered speech goals, OT goals and language arts special needs. He had trouble writing and was pulled out of class for an hour to get help with writing assignments. He learned to read mashaAllah and within class he was in the top reading and math group. He had friends in class and on the bus. Just overall a great first year of official school. By the end of the year he was discharged from school based speech therapy and promoted to first grade along with his peers with the remainder of his IEP goals.

During the summer we were busy with 2 different intensive therapies so we weren’t able to join any summer camps except for a 3 week pre-Ramadan Islamic camp. In the coming weeks I will dedicate a blog post to each of those therapies. Interactive Metronome (IM) and the Sensory Learning Program (SLP). InshaAllah I will try to keep the blog up-to-date and current as the original purpose of the blog was to help others taking the same journey and help them learn from our experiences and learn about the different therapies available for their children.

Speech Therapy Discharge

Speech Graduate

A certificate that they printed out for Bilal’s hard work.

 

By the grace and blessings of God, after 2 years of weekly speech therapy Bilal has been discharged from private speech therapy. He went from barely speaking, unable to even answer the questions “What is your name?  how old are you?” to being an inquisitive chatterbox. Its been an incredible journey. His lack of speech was our first sign that something wasn’t right, it was the most obvious delay. I didn’t know that the reason he hated to color was because of fine motor and shoulder weakness. I didn’t know that he couldn’t kick or throw or catch a ball. all those physical things weren’t obvious, I thought he should reach those milestones later. So speech was the most obvious delay but also the quickest remedied and the ability to speak made a load of difference to his behavior.

His developmental pediatrician gave us a prescription for Children’s Healthcare of Atlanta (CHOA) for speech and OT, so there we went they asked to look at his IEP and the school evaluations and said they could help us with speech but not OT because it would then be a repetition of services and insurance problems and what not. So we went elsewhere for OT and they took him in right away and carried out their own evaluations and started therapy immediately even if it were a repetition he greatly needed all the therapy he could get then. So I wasn’t really happy with CHOA at first but he had an amazing relationship with his therapist Ms. Leslie so I stayed there. She met with him every Wednesday to work on all aspects of speech, whenever she wasn’t available for any reason they would re-schedule with the first available therapist. I’m sure they were all great therapists but they didn’t know Bilal and he didn’t know them, they just worked from Leslie’s notes so the session was quite pointless really, until once they rescheduled with Ms. Rhonda, she had a different way of doing things but she sang and hummed a lot and Bilal loved it and really enjoyed her sessions which were about only a handful of times during those 2 years. Last year’s evaluation Bilal scored a mildly below average in a lot of areas of the test, this year, he scored above average in vocabulary and comprehension and within average in all other areas. His lowest scores were in grammar or sentence recalling structure, within average but on the low side. He is required to get a re-evaluation once a year to make sure everything is still on track, or if he regresses or doesnt correct those minor mistakes soon. During our last session I’d get teary a lot, we’ve come a long way and these weekly sessions had become a part of our lives. I got thank you cards for Ms. Leslie, Ms. Rhonda and the receptionists at the front desk. I got them a cookie basket which they loved and devoured within the first hour after delivery. I will really miss them all at CHOA and we’re looking forward to the rest of our journey.

 

***Side Note***

I get a lot of traffic to the blog with people searching for speech therapy services in Riyadh, Saudi Arabia. It’s been two years since we were there and I don’t know if anything has changed since or not. At the time we only found speech therapy services provided by Sulayman Al-Habib Hospital on King Fahad Road, they had 3 therapists whom were usually overbooked, they were all Arab. A Saudi, a Jordanian and a Lebanese, we went with the Lebanese and she was willing to carry out the sessions in English, her English wasn’t perfect but it was good enough for basic speech. I dont know whether the other two use English or not and I really don’t know how Arabic speech therapy would go about with all the different accents and dialects, do they use that or use standard Arabic which is harder.  They didn’t have a designated time slot for each patient, it was a first come first serve basis, which isnt really effective with long term care. I would suggest to start there and ask the hospital or therapists about other options. I wish you all the best of luck, but I would suggest especially for expats to look for care outside of Saudi Arabia.

Progress to date

Alhamdullah Bilal continues to make progress with all his therapies and classes. I’ve heard it more than once from his therapists that he’s their little success story. Quick update list below.

Speech: His private speech therapist is considering depending on his annual re-evaluation in June to discharge him. His myofunctional therapist is almost done with articulation and will soon move on to improving chewing and swallowing. I’m looking forward to that as he’s a messy eater, looks like he’s a famished caveman devouring his food, he tends to over-stuff and gag. Strangers understand him now clearly and he’s able to ask and answer questions. He can read some words, and spell and he’s great with math and numbers and patterns.

OT: His private OT therapist is considering depending on his annual re-evaluation in September to discharge him.

PT: In January he had his annual evaluation where he met all his goals except those concerning throwing/catching a ball and upper body strength. It’s mainly for fine tuning and a lot of the time she works him like an athlete getting specified exercise. He’s doing so well that his therapist is considering using Bilal’s progress in their case studies and she’s asked me to write a summary to be placed on the center’s website for other parents to read about.

Piano lessons: He’s down to only 1 color sticker on the piano, he knows his finger placement and his notes to date and he’s just a little music genius when he’s in the mood and not acting all silly. His teacher is saying he’ll be ready for the spring recital in June. Cant wait, he’ll do 2 solos and 1 duet with her.

Swimming: Bilal’s taking typical swim lessons at the YMCA and he’s completed the first class (PIKE 1) and just started PIKE 2, this class has a total of 4 kids and so far he’s the weakest swimmer but he can repeat it again if needed, overall he’s doing well.

Horseback riding: He’s riding solo, steering the horse by the reigns, going through the obstacle course all the while trotting and posting, he looks like a little cowboy.

Socially: The other day we were at McDonald’s and at the table behind us a group of boys maybe 7 years old were playing with their wind-up toys and Bilal was watching them the whole time while he ate with a smile on his face, one of their toys fell below our table and Bilal gave it back saying “here you go” and when the boy took it and said “Thank you” Bilal got this huge smile on his face it was adorable, we urged him to go play with them, so he went up “Can I play with you?” thankfully they said yeah and he tagged around with them the whole time, not really with them as they were already friends and older but they still included him. He didn’t look weird only shy like any typical kid.  He’s playing really well with his younger brother, sharing, taking turns, asking and answering questions, fighting, again all typical. Another thing, we’re currently potty training his little brother and doing the whole sticker chart every time he goes in the potty so the first day we were of course making a big deal, cheering, stickers, high fives etc and Bilal was getting jealous as expected wanting a sticker when he went to the bathroom too. I sat him down and explained to him that he was feeling jealous but that he shouldn’t because he’s a big boy been using the potty for 3 years now and when he was learning he got stickers and toys, and a fancy potty chair and he learnt and did a good job but now it’s his brother’s turn. Just needed to say it once after that every time his brother used the potty he would cheer along with us and run and get the sticker chart for his brother looking truly and sincerely happy for him.

Other: due to his speech delays we concentrated only on English therapy and speaking it around the house. Now we’ve added more Arabic and he’s picking it up slowly a few words, not too badly pronounced and soon inshaAllah we want to include him in a Sunday program to learn more Arabic and Quran and have more Arab or Muslim peer interactions and maybe friends. They also do a little of Spanish at school which he enjoys and picking it up well.

I cant say it enough alhamdullah (Thank God) he’s doing amazing and I also cant help I get all teary when I think about it, so proud of him.

IEP Transitional Placement Meeting

Last week we had Bilal’s IEP transitional meeting for kindergarten placement. We also went over his goals and updated goals required for the remaining of the school year and the beginning of the next school year till his 6th birthday. It all went really smoothly and alhamdullah I’m glad by the attention and dedication his team have for Bilal’s continued progress. Ms. Norton the special ed instructor from Manning Oaks was invited to attend and she continued to take down a lot of notes and better explain the system at her school. It was agreed that he attend typical kindergarten with speech, OT and 2.5 periods a day of special instruction mainly for writing and any other instruction he would need. His OT has been reduced from an hour a week to half an hour a week. He’s got scissor cutting and pencil grip learnt but just needs to improve his arm alignment while holding the pencil to press harder and be able to actually write instead of draw his letters, smaller and neater writing. His only remaining special goals are the use of a “fidget toy” something to keep his fingers occupied so he can pay attention better, and a little one-on-one talk with a teacher to learn that he doesn’t need to be a perfectionist and speed his work. His speech goals are mainly to improve articulation and grammar structure and be able to use more adjectives.

We did it! 2 years of special education and therapy have prepared him to attend a typical kindergarten with typical peers, he’ll have a normal day at school with reading, writing, math, science, social studies, art, music and PE. He’ll ride the typical bus to and from school. He’ll move from a class of 9 students (7 boys, 2 girls) to a class of a maximum of 22 students with a more equal mix of boys and girls

Towards the end of the month local schools have Kindergarten Tours, where parents and little kids can tour the school, have a snack at the cafeteria and take a ride in a school bus, parents take home the registration package and have any questions answered. Then the week before school starts (August) they have orientation again to tour or ask questions and by then their homeroom classes and buses would have been assigned and we’d get our school supply lists. I’m super excited and optimistic that Bilal will do just fine and hopefully make a friend or two inshaAllah.

Kindergarten Observations

This month we’re busy with figuring out the best kindergarten placement for Bilal and later in the month we’ll have our transitional IEP meeting. So last week his teacher told me to contact the special ed instructor (Ms. Nateli) to tour the special ed kindergarten at Alpharetta Elementary. I went and saw the class and and had a chat with her. The class was set up exactly like his current Pre-K class and there were only 5 boys in the class (no girls) this year, they appeared to be high functioning but who knows who will be in the class next year. I felt it would be a repetition of the last two years for Bilal and not really beneficial, I feel its time for him to be included into the real world and deal and interact with typical peers and learn early on what the world is like. So she told me to contact the special ed instructor at his home school (Manning Oaks) to observe a typical kindergarten class and see the resource room and better understand Bilal’s other options. So a week later I go and meet her (Ms. Norton) and she takes me to the resource room, this is a small classroom where students who are having trouble with a certain subject can get pulled out and get more one on one instruction, the class usually doesn’t get any bigger than 6 students. It happened to be a math class, an area where Bilal will not need special instruction, but I understood the system. The teacher was explaining the word problem slowly and step by step, they solved it using different visual aids, drawings on the board, finger counting, block counting. The students get sticker rewards for good behavior and when they acquire a total of 25 stickers they get a prize from the treasure box. The whole time she kept taking notes on Bilal and asking how Bilal would cope with certain situations and explaining what a typical week was like. Then we went into the typical class. It’s set up very like his current Pre-K class but larger and with several tables (desks), they were also working on math word problems, but it was on the board and they were using terms like signs, equations, and solutions, they didn’t use much visual assistance. They move around a lot from group work on the floor to sitting in their chairs and writing the problem in their notebooks, to centers for play learning and then switching around again. Ms. Norton was very helpful explaining everything and taking down notes. She will be invited to attend the IEP meeting and give her opinion about Bilal’s placement as well.

From what I saw I feel Bilal would do fine in the typical class and he can be pulled out to the resource room to work on handwriting skills, and he’ll also be pulled out for his Speech and OT  sessions.  I’m nervous but ready for this IEP meeting to be over with.

Progress Update

This post is way overdue and I really have no excuse, part busy and mainly part lazy. It’s been a little bit over a year since we got our US official diagnosis, a year of school and private therapy and activities. What a year its been! Its been busy but a good busy, yes I’m driving around pick up from school go to a therapy pick up baby bro from daycare get home and repeat all over again the next day, but so worth it alhamdullah. A week after school let out we had a follow up visit with his developmental pediatrician, she did a re-eval and he scored at the developmental age of 4 years 1 month (he was 4 years 8 months old at the time) a gap of only 7 months, she was really impressed and told me to continue what I was doing whatever it was and come back for another re-eval 9 months later in Feb. I was so happy and proud of Bilal in only 9 months of school and therapy he has grown almost 2 years developmentally, when we went in for that initial eval he was almost 4 but developmentally at the age of 2. I don’t know what it is that really made a difference, prayer mainly,  he was going to school everyday, private speech, OT, and PT, therapeutic riding, hippo-therapy  music therapy, adapted swimming, myofunctional therapy, adapted piano, adapted summer sports camp, a couple sessions of feeding, was it a particular thing or all of those put together that helped Bilal communicate and grow so much I will never really be able to pinpoint it. Also his younger brother is growing up and developing well and he has a constant playmate that might teach him things. Since we started school and therapy Bilal has turned into a totally different kid, no more tantrums or headbanging, he’s speaking in sentences, answering questions, started asking questions, he’s finally made progress with holding a pencil and writing, he states his feelings and opinions, he rarely gives me any trouble (unlike his little bro, pre-terrible twos). The really autistic behavior that still stands out I guess would be occasional toe walking, pacing when really bored, sometimes he’s locked in his own world when playing or concentrating on something, incorrect social interactions, eye contact avoidance, and picky eating. His pronunciation has improved greatly but still no L or R both are Y or W sounding but he’s working on it and its getting better.  I’m excited about what this new school year and therapies will bring for Bilal’s continued progress. I need to write another post soon about how he’s been doing these past 3 weeks since school as started again, I’ll try to write that one real soon. 

Just asking anyone who reads this to remember Bilal in your prayers and pray for continued growth and progress. Thank you.

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