Therapy

I was thinking about blogging this afternoon about PJ's therapy, when I realized I'd never blogged about what was putting her in therapy in the first place! Some of you may remember how slow PJ has been to start solids. We didn't try to introduce them until she was 11 months old because she has some food allergies, and studies have shown that waiting until they're closer to a year gives the gut time to close and makes preexisting allergies less severe, and can prohibit the forming of new allergies as well. Well, by 14 months she was STILL not at all interested in food. Paper, toys, fingers, pretty much anything else went straight into her mouth without any thought, but food? Not so much.

Once we moved out here, I contacted someone at the Early Childhood Intervention office to get some advice. They gave me the names of two feeding clinics in Denver, both of which had no openings until the fall. I made an appointment at the STAR (Sensory Therapies And Research) Center for September 16, and in the interim continued to encourage PJ to eat whatever she showed an interest in. By September, she was up to Cheerios, goldfish, crackers, mac and cheese, and bread--but that was it, and in extremely small amounts. You could give her an entire box of Cheerios, but she'd still only eat 4 or 5. Given the types of foods she *was* willing to try, I started to suspect a sensory issue. Soft foods, purees chewy foods (with the exception of mac and cheese, go figure), and things like that she refused to even try. But crunchy foods she seemed to love.

On September 16 I took PJ to the STAR center for a two hour evaluation. While there, she was observed by a psychologist, pediatrician, physical therapist, occupational therapist, nutritionist, and speech therapist. They watched her play, watched her walk, and most importantly, watched her eat. She charmed the pants off every one--no surprise!--and showed her true colors during the snack time, refusing to try the apple sauce or dried fruit but happly sampling all the crunchy items they offered.

After the eval, I took her home, put her down for a nap, had some lunch, then went back for the 2.5 hour debrief with Dr. Toomey, the psychologist and head of the STAR team. Their conclusions:

1. PJ has low normal muscle tone. She fakes her strength by locking her joints, which explains her loping walk, but which will ruin her joints in the long run if she's not taught NOT to do it. The low muscle tone extends to her mouth, where her tongue is both not strong enough to move properly and also simply doesn't know how to move properly to move food within the mouth, ball it up after chewing, and get it down her throat. Speaking of chewing...

2. She doesn't know how. She grinds her lower jaw forward and back, rather than in the rotary fashion that people normally use to eat. Another issue that muddies the waters is that...

3. PJ is an "under-responder" to certain kinds of sensory input. Her sight and hearing are just fine, however, she experiences with less intensity stimuli that engages her sense of taste, touch, and smell. While at the eval, Dr. Toomey passed a vile of very strong peppermint under PJ's nose, and she acted like it wasn't even there. She didn't seem to differentiate between a garlic chip or a tart apple-cinnamon one. This explains her frequent choking as well--she "loses" food in her mouth because she can't feel it as well, and when the food accidentally makes its way to the back of her throat, it's a total surprise.

(Another issue they suspect, which doesn't have any bearing on her eating, is renal tubular acidosis. Her height and weight both dropped off from the 85-99% to the 25-50%, between her 12 month and 18 month measurements. Insufficient caloric intake affects weight first, and then height, so if this drop had been because she was only nursing and not eating, then they wouldn't both be in the same percentage range anymore. Apparently this issue self-corrects in the majority of kids around age 3, and there is medication they can take until the body can do it itself--we've got an appointment with our new ped coming up and she'll take a blood test to determine if PJ has RTA or not. I have no idea what happens if it doesn't self-correct--I didn't think to ask, and I don't want to Google it for fear of what I might find.)

So, what does this all mean? According to the STAR team, about 6-10 months of weekly therapy to help her learn how to chew properly, as well as working on her core strength and willingness to try foods of certain textures. Our first steps have been to adjust her high chair so that her hips, knees, and ankles are all set at 90 degrees when she eats; her core strength is so poor that sitting in a high chair is difficult and uncomfortable, and her focus is taken from trying to eat because she's trying to just stay upright. The 90/90/90 should help her be more comfortable, so we've got a ghetto rig of boxes and phone books for her feet to rest on so everything bends properly. Another priority has been to get her attached to some kind of "lovie" so that she has something to go to as we start to cut down on breastfeeding. With all the nursing, she's rarely hungry enough to care about solids, and obviously that needs to change. We've managed to get her interested in a little doll she got for Christmas last year, though it's not something she turns to yet for comfort. They said it would take 2-3 weeks, though, and we're just now finishing week 1, so we've got some time.

We'll also be putting her on a more rigid feeding schedule, the outcome of which (i.e. no more nursing every five minutes) I'm greatly anticipating, but the implementation of which I am not at all looking forward to. A detailed mealtime routine which we'll follow at all meals and snacks will come next, as well as daily muscle-strengthening exercises. And of course the therapy.

I'm really interested to see what the therapy is like. There are some things that just don't make sense to me--like how she could have low muscle tone and a supposedly weak core, but still be able to fling her legs over her head when she's lying on her back, or how she can pick up things that are seriously heavy when you're her size. And what about this whole "under-responding" thing--is that something you can change, or is it just something she'll have to deal with for the rest of her life? The folks on the STAR team are really fantastic, and I know they'll be willing to sit and hash out all our questions and struggles and frustrations as we embark on this new experience.

So there you go--there's the big update. I'll write more this afternoon or evening to report on how the therapy went. Wish us luck!

Remembered it!

Abby's other silly mis-use of a phrase--file under "unclear on the concept":

Me: Time for a bath.

AJ: But I want to play with my sticker dolls!

Me: Well, bring them upstairs and you can play with them while I take my shower.

AJ: *big huff* That's not fair!

Quotable kids

Abby has picked up some new phrases lately from, I suspect, her new obsession, Olivia. (It's a Noggin cartoon based on some books--kinda cute, actually.) The thing is, she doesn't completely understand how to use them. Case in point:

1. I asked her to hand me something PJ had dropped. She sighed, picked it up, handed it to me and said, "I quit."

2. We're walking through a parking lot the other day and she lets go of my hand and jogs around to my other side. "I want to hold this hand. It's fine by me, of course."

And I'm kicking myself because there was another one that I can't remember. Dangit.

We were watching Disney's "Earth" today--not nearly as good as we had hoped, and it terrified poor Abby--and when the elephants came on PJ said, "Cow!"

"No, elephant," I said.

"Cow."

"El-e-phant."

"Moo?"

"Elephant!"

"Cow."

When the monkeys came on she kept saying, "Mommy!" I was not about to let that one go. So I kept saying "monkey" and eventually she said, "Moh-key!" So now she has cow, monkey, doggie, and caaaat. 

Now if we could just get 'elephant'...

Walkin' in September Wonderland

Well this was a surprise...

Like our first snowman of the season?

The real shocker is that it was in the low 70's yesterday. And darn it, we were just at Target giggling over the snowsuits and talking about how we'll have to think about getting those for the girls "eventually." Who knew 'eventually' would be less than 24 hours later?

One thing is for sure: I'm having hot chocolate with my lunch!

Poetry in motion

Guess what iPhotobooth does besides taking silly pictures? It takes video! Who knew!? Not me. But once I found the feature I couldn't resist letting the girls play...

PJ loves her Blue's Clues, just like her sister.

The one drawback to Colorado

FAIR WARNING: If you are squeamish about creepy crawly things, you probably shouldn't read the rest of this post. If you're cool with them, or your curiosity is going to get the better of you regardless of your fears, then scroll down to read the rest.

There aren't many things about Colorado that I don't like. I can only think of a handful: The way they hardly post any speed limit signs, so you go for miles wondering if you're speeding or if you're ticking off everyone behind you. The "no double turns" signs we see at some intersections in Denver and have yet to learn the meaning of. And then these little gems:

That's a wolf spider. It gave me the fright of my life when I went to put out the garbage the other day. Luckily our exterminating service had been to the house recently, and this is one of the spiders they spray for, so it was on its last legs when I found it. At first I thought it was dead because it wouldn't move even when I tossed things at it. I managed to sweep it out of the garage, where it stayed for quite a while, though when we went out with Dan later in the day it started to move again. 

Once I was over my initial heart-slamming, hand-shaking shock, I was able to get pretty close and really examine it. If you click on the link, you'll see an illustration that shows the unique design on the upper half of its body. You can't tell in this picture, but it has that same "union jack" design on it. It was actually really cool to see. They're poisonous but not lethal, and so far we've only seen two others, and both of them were outside the garage, yay. 

There's not much I'd change about our new home, but I have to admit this is one of them.

PAX of mind

We drove up to Broomfield today to meet with some friends of ours (yay! friends for all four of us!) at the fun mall up there. The weather was overcast and cold, which was a bummer since the plan was to hang out and let the kids play at the outdoor park there. Luckily, there's an indoor park as well, and we had a great time--Abby even made her first Build-a-Bear! (Pictures to come.)

It took us about an hour to get up there, but it took us nearly twice as long to get back because we got a flat tire 2 minutes out from the mall. Thankfully we have the totally awesome PAX run-flat tires, which allow you to drive for up to 125 miles (only 50 mph though) so you can get to a tire place or home or whatever. We didn't feel comfortable getting on the freeway, so--three cheers for nav systems!--we programmed the route home using surface streets only. It was a long, long drive--and a rainy one, too, sometimes very much so, but it was a blessing since even in 55mph areas no one was going that fast--but it was an interesting drive as well. Minimizing freeways on the nav is a great way to see more of the state--talk about a roundabout route!

So we're home now, and who knows what the night's going ot be like. PJ didn't nap until we left the mall, and she slept for nearly 2 hours, so I'm guessing she'll be going to bed around, oh, midnight or so. *sigh* Abby slept for a lot of the drive, too, so she's also wide awake. Dan's found a couple places we can call tomorrow, provided they're even open, to see about getting the tires changed--we figured we might as well get winter tires so we're prepared.

What a day!

First Day of School!

I hadn't been planning on starting to officially homeschool Abby for a few years. The methodology I plan to follow recommends holding off on academics until they're 6 or 7, and using the years before that to build a child's interest in and understanding of the natural world--lots of nature walks, spending time observing plants and bugs, exploring the geology of your area, etc. But we see a big bus come every morning and pick kids up right outside our house, and Noggin (the little kid Nickelodeon channel on cable) has been talking a lot lately about school, so naturally Abby's been asking. So I figured, why not?

We started the day with a first day of school picture on the front step, of course!

Once upon a time Abby would give a great smile for pictures. Now, not so much.

After that we went grocery shopping, then when we came home and PJ was down for her nap we got out the base ten kit Abby had been eyeing in my office for weeks.

They're wooden units (ones), rods (tens), flats (hundreds) and cubes (thousands) that help teach place value and number sense. 

She loves these things. And there are a bunch of different ways to use them, so I keep changing it up so she doesn't get bored. She asks to "play" with them nearly every day now. We also started a number line--no picture of that yet, sorry--that will go up to 100. Right now we're in the 50's. For now it's just to help her learn to write numbers and count, but we're doing the odd numbers in green, the evens in red, then circling the numbers divisible by 5 in black and the numbers divisible by 10 in blue, so that eventually we can use it to learn how to skip count. ("Let's count by only saying the numbers circled in black! 5, 10, 15, 20...") I also have a gigantic post-it note pad, the kind you put on an easel for meetings, and have the Lord's Prayer, the first 2 verses of Genesis 1, and the first stanza of Psalm 23 written on them and posted on the wall of the loft. Abby likes to copy the words into her own notebooks, so we're killing a few birds with one stone there--scripture memory, spiritual development, and handwriting. :)

Then it was lunchtime, so Abby made egg salad with our Magic Bullet. (LOVE that thing!)

She really loves to cook with me now. She asks at every meal if she can help. We bought her a learning tower and it's been great--gets her up at just the right height, and no fear of falling off. 

After lunch we worked on Gigi's birthday present (can't tell you what it was since certain relatives will be receiving the same thing for their birthdays or Christmas), but with that we learned patterns, sequence, following directions, and worked on fine motor control.

Her favorite thing to do for the last couple days has been to work on writing her letters. I bought some kindergarten paper--with the pink top line and blue base line and dotted middle line--and wrote the alphabet on a page in Sharpie, then put it in a page protector. She writes on it with a dry erase marker. She has definitely improved her neatness and pen control, just in the last few days!

We also tended to our first experiment with gardening--a "see the roots!" kit we bought from, of all places, Bass Pro Outlet Store. (I also got a totally awesome outfit for the fall there--their clothing rocks!)

Now, the instructions never said anything about transplanting them, so we didn't, but I'm convinced they're smothered in their test tube homes and that this is why we have not gotten any actual vegetables. The greenery is different for each, at least, so we get some good comparison practice there. And the roots are indeed cool to look at. But I was hoping to be able to actually eat them eventually. Oh well. We'll just consider it a baby step to next year's Square Foot Garden.

Tomorrow we'll have "gym class"--Abby's first ever swim class, actually. It's a mom-and-me type deal, and sadly she is not excited, but I'm hoping once we're there she'll get into it. She's also signed up for her first dance class, but that doesn't start until October. My plan is to do one class a month at the rec center. There are SO many to choose from, and so many things that I wouldn't be able to do--a music class, Spanish, dancing, dancing, and more dancing. :)

So there you have it! Abby is officially in preschool! :)

Stuck inside

At the end of August our street was resurfaced, so we were stuck inside for a day because we didn't want to have to hike the kids up and down the hill to where we would have had to park. So we made the morning a little more interesting than usual to make up for not getting to go anywhere like we usually do.

We started with buckwheat pancakes. Abby got to help--she broke her first egg! (Broke is a good word for it, too, let me tell you.) Thanks to Eric Carle we had a whole narrative to go with the story. (Jack woke up, looked out the window and thought, "I'd like to have a big pancake for breakfast....") 

Despite how the picture looks, PJ never actually tried any of the pancake. She did, however, try to spear it with the fork. Even though she basically still doesn't eat solid foods (we have an evaluation at the Star Center's Feeding and Swallowing Clinic on the 16th, yay), she's trying to use utensils nowadays--she even puts her Cheerios on a spoon once in a while!

After that it was bath time, with an extended play time for the girls.

After we were dressed we made paper bag puppets.

(Days like these are great for dressing in your favorite leotard, don't you think?)

After that was lunch and naptime and then I had to work on my scenes, so unfortunately it was all pretty much downhill from there. But, regardless, we had a good time!

Tiny Town

A week ago (or was it two?) I took the girls to Tiny Town with a friend of mine from California. She has a daughter Abby's age, named Chloe, and the two of them have really hit it off. Eventually I'll have some more pictures--my camera died and my friend Christine got some really cute ones of the girls.

Tiny Town was originally a private residence back in the 30's. The family that lived there had one little girl, and there were no other houses, much less kids, in the "neighborhood." On the weekend the father would go into town and bring some kids out to their property to play with her so she wouldn't be lonely. But to keep her occupied during the week, he built her a playhouse that was was scaled down to kid size--1/6 of full size. Not sure who kept adding to them, or when the property became the little town that it is, but now it's a fun little destination with dozens of these 1/6 scale structures, some of which are sealed and some of which, as you'll see, the kids can go into. 

Many are replicas of actual buildings; last month a new one was added and it was even on the news: A FedEx mail store. There's also a 1/6 scale train that you can ride on, and of course that's all Abby wanted to do the whole time we were there. She and Chloe rode with two other little kids in the caboose, and I was a little concerned that halfway through she might freak out and want to get off or something. But when it was over she begged for another ride, so I guess it went well!

Hanging out at the picture show:

'Hey kids, ya gotta pay yer dime just like everyone else if ya wanna catch the show..."

Run for the hills! It's the Penny Monster!

I love this picture:


Penny Jane chilling in church:

Penny Jane working on her breaking and entering skills:

I'll post the pictures from Christine as soon as I get them. She had some great ones that Chloe took of Abby in the caboose (she's as enamored with cameras as Abby is).