Monthly Archives: December 2016

A Day In The Life: Raising Three Autistic Toddlers

by Brittany Reiger

Thump. Thump. Thump.

I wake from the thumping of the dog’s tail at the end of our bed. I turn to look at the clock. 1:47 am. I roll over and listen.

Thud. Thud. Thud. Thud.

Here she comes. I sigh and get out of bed to see my 5 year old running down the hallway, with all three of her comforters.

“Benelli, let’s go to the couch”.

We do this about 4 nights out of the week so she knows the drill. We both climb onto the couch which is nowhere near big enough for the two of us. I lay there looking out my big sliding door wondering how long it will take her to fall back asleep tonight, cursing the Melatonin gods for not working longer. She wiggles her body all over the couch, squealing, getting the sensory input she so loves and craves. I drift off. I wake a few minutes later to her trying to get up.

“Benelli, go to sleep.”

She hops back on the couch & continues wiggling & speaking in her own ‘Benelli language’. This back and forth of me drifting off to sleep and her trying to get up to dance around continues until I hear my husband’s alarm go off at 5 a.m. I am always so relieved to hear that sound, unlike most people. I get up and ask him to relieve me until he leaves for work so I myself can get a little more sleep until I have to start my busy day. I fall asleep.

6 a.m. he wakes me and I begrudgingly drag myself out of bed. Benelli is finally asleep on the couch.

“When did she fall asleep?”

“5:30”

He has made my pot of coffee already that I will drink all of before I leave for the day at 8:30. This hour between me waking & the other two rising in an hour is the quietest time of my day. I savor it. I make each lunch for the day. Mine, Benelli’s, Adeline’s, & Gunner’s. Each child has their own food preference and so I make three separate lunches containing completely different foods. Benelli, mac n cheese and yogurt. Adeline, pop tarts and cereal. Gunner, peanut butter sandwich and fruit snacks.

Benelli wakes. She comes into the kitchen and says, “muuulk” (milk). I grab her bottle and fill it with her 1 mg of Prozac and her milk. The Prozac has been her godsend. She was such an angry, violent, lost child before it. I make sure to start everyday with it, to make her brain happy. She runs squealing to the couch to calm herself with her favorite comfort, her bottle.

I hear Adeline in the back. I walk down the hall wondering how she is going to bolt out of that room. Adeline is either the happiest little human or a raging little tornado. I open the door. This morning, she is smiling. She walks down the hall scripting Wonder Pets. When she sees her sister has a bottle she starts. She comes up yanking my hand, but she can’t think straight on where to take me so she drops to the ground and starts kicking me, hard. I have to think every time what of the million things it could possibly be to set her off. I am usually pretty good at knowing. I grab her a bottle as well and begin to fill it. When I hand it to her she is happy again. I load up their backpacks for the day.

I have to wait 5 minutes before I know the bus will be there to dress them. They do not understand the concept of wait and if they are dressed and the bus is not there it will result in an instant meltdown that has the potential to throw off their entire day.

7:45. I dress Adeline. Adeline does not know how to dress herself so I dress her. She is just figuring out to give me an arm and a leg for me to put the clothes on. I go to brush her hair which is a sensory nightmare to her. I have become skilled at my ninja like reflexes to brush her beautiful long blonde hair.

7:50. I put Adeline on the bus to her Autistic Support Preschool through the IU. I kiss her and tell her I love her as she continues to look out the window.

8:00. I dress Benelli. Benelli is getting better at helping me dress her. She tries her best, but usually stuff is in the wrong hole and she gets frustrated, so I help guide her.

8:10. I put Benelli in her van to go to her Autistic Support Preschool at Easter Seals. I kiss her and tell her I love her. Sometimes, she will say, “I luuuub yyyyoou”. Sometimes, she happily waves her head back and forth squealing, excited to start her day.

I go inside and wake Gunner. At least one of my kids likes to sleep. I dress him for his day, which is usually about the equivalent to wrestling a slippery alligator. He thinks this is funny. I grab all of our things and we go to the van. I take Gunner to our neighbor’s house who babysits him. I drop him off and every single time I leave I think how grateful I am to have someone I know watching him who accepts him for his learning differences and his limited speech.

I go to work.

Work is my place of mediation. Although, I rarely have the ability to go, between doctor’s appointments & meetings, the random few hours a week I get to are my recharge.

*Ring, Ring*

Doctor’s office

Work.

*Ring, Ring*

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Work.

*Ring, Ring*

Speech Therapist

Work.

*Ring, Ring*

Teacher

Work.

…and just like that it is time to leave. I have a meeting to attend at school. Sometimes I feel like I have spent my entire Motherhood in a meeting.

Meetings. They always last so long. I have some of the most amazing staff for my children. I have been very blessed in that sense. The majority of the time though, I am overly exhausted. So, after about an hour I have to try really hard to pay attention. Honestly, most of the time I begin zoning out and I feel like Charlie Brown listening to his teacher. I sit in these meetings knowing I probably look like I staring lifelessly at everyone. I wonder if they know I try so hard for my children. I wonder if they know I am not trying to look uncaring, my brain is just friend. I hope they know I spend every waking second of my life trying to improve their lives and that if I tune out during a meeting, it is not intentional by any means.

The meeting is over.

I head home to make sure I get Gunner in time so that we can be home to get the girls’ off their buses.

Gunner greets me with a big smile.

Smiles keep me going.

We get home to get the girls off their buses at 3:20 pm.

Benelli says, “muuuulk”. So, again I get her a bottle and give her milk.

Gunner starts yelling at hitting my leg. I try asking him what he wanted, but his day most have been tiring so the words are missing the connection. I ask him if he wants milk & he continues hitting me, yelling. I give him a bottle and he happily runs to the living room.

Adeline gets home. This is one of the tough parts of my days. The majority of the time she comes home in a complete meltdown rage.

I take her out of her car seat and she runs into the house…. screaming. She is on the ground screaming & I try offering her any of her comfort items, but nothing is working. She flops around the house following me, using me as her punching bag, kicking. This can go on for 10 minutes to an hour. Finally, she calms enough to take the bottle and runs to her tent bed to calm herself more. The next two hours I walk on eggshells with her. School takes everything out of her and she can not cope.

Benelli, “eeeeaaaaat”.

I start cooking, mac n’ cheese.

Gunner comes up to me.. “I C” which means fruit snack. I have no clue where he got the I C from, but every time I give him a snack I reiterate “snack”.

I realize it’s been 10 minutes since I have last seen Benelli. I panic and wonder if I made sure to double lock all the doors. Making sure everything in the house is locked & double locked with 2 elopers is crucial. Yes, I did. So, I begin searching the house. I open the bathroom. I forgot to shut off the water under the sink, so Benelli has once again flooded out the bathroom, as well as smear toothpaste all over the walls, and poop. I close my eyes. I breathe.

“Benelli, go play.”

I clean up the bathroom.

She will try to sneak in to do this another 10 times tonight.

Mac n Cheese is ready.

“Benelli, Adeline Gunner.. EAT”

They all run to the table. Benelli eats with a spoon, Gunner is hit or miss, but Adeline will only eat with her fingers. Gunner eats 2 bites and runs away to the living room. Benelli begins making cheese art on my sliding glass door next to her seat. “Benelli, eat”. She wiggles around in her seat squealing, happily. We have to remind her at least 20 times during dinner to please sit. She is always on the move. Adeline takes the longest to eat. She eats one noodle at a time. Benelli tells me “All Done”. She gets up to go play. Adeline then quietly gets up to go play.

My husband gets home around this time and we eat our own dinner while getting up a few dozen times to pull the kids off the entertainment center, a dresser, or a table. Our meals are cold before we finish.

After dinner is my favorite part of the day. I read books with Gunner & just sit. The girls do not like us to join them in play so we sit with them and when they want our affection or a touch they come to us and sit in our lap or grab our face. There are only words spoken by my husband and I, but we have a non verbal language with the kids that we all know. Adeline prompts me to sing by grabbing my mouth. Benelli places my hand on her back for a back rub. Gunner comes and relaxes his little body in my lap for snuggles. It makes the hardships of the day worth it.

7:45. Bath time. All three kids go into the tub and it is sensory water play wonderland. There is water covering the walls and the ceiling, and of course myself, by the time we are finished. After I dry them all off and send them out of the bathroom, I spend 10 minutes drying the walls and floors.

I make their bottles for bed. Benelli gets concoction of Melatonin and milk. Adeline gets a concoction of Melatonin, Miralax, and milk. Gunner just gets milk.

“Give Daddy a kiss”. Finally, after 5 years everyone in the past month runs to Daddy and kisses him. It took so much work. Years of this every single night and finally they all do it. It is moments like this that we feel immense joy from all the hard work. While the other two are silent for this, Benelli says, “Daddy, I LUUUB YOUUU”.

They all grab their bottles and run to their rooms.

I kiss Gunner good night, tuck him in, and close the door.

I go to the girls’ room. I kiss them goodnight, tuck them in, close the door, and sit on the floor in the darkness. As my eyes close due to the sheer weight, I have to tell Benelli a few dozen times to “Go to bed”, and she hops back in. I sit there with my eyes closed, mentally and physically drained. My body hurts. My soul is tired. Every day I wonder how I got through it all. Every day I pray for a little more independence in my kids so I do not have to do every single thing for them. Every day I feel like I cannot do it again, there’s no way, my body is going to give out. But every night as my eyes are closed, I sit there smiling, because I know that I did my best and those three little souls who take up every ounce of my heart are depending on me.

I go to bed & I pray for a full night’s sleep. I pray that I have a better day tomorrow.

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Augmentative and Alternative Communication (AAC) Fact Sheet & Myth Buster

by Ani Soghomonian & Bridget M. Coady, MA CCC-SLP

As a speech-language pathologist in the preschool setting, I often use pictures, devices, and language boards to help children communicate and learn language. These are known as “augmentative and alternative communication” (AAC) methods. AAC can teach language vocabulary and structure, and enhance the communication of children with special needs. Sometimes, parents express concern that these visual supports and communication devices will hinder or replace their child’s natural verbal speech. This is not true. “Are we giving up on their verbal speech?” parents ask. “But I want my child to talk,” they say. In order to address these concerns, I recently created a handout in collaboration with a speech-language pathology graduate student who worked with me at Easter Seals. The graduate student researched articles on AAC and its impact on speech and language development. Together, we translated the research into easily understandable terms. The end result was a parent-friendly, research-based fact sheet about AAC.

Augmentative and Alternative Communication (AAC)
Fact Sheet & Myth Buster
“Communication is the essence of human life” -Janice Light (1997)

 1)What is AAC?

  • A way to enhance the communication of people who have significant speech and language impairments (Light, Binger, Agate, & Ramsay, 1999)
  • AAC can have positive benefits for natural speech production—using AAC intervention will NOT inhibit the production of speech
  • A way to help language skills develop (Romski & Sevcik, 1996)
  • Includes all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas (ASHA)

picture icons, speech-generating devices, gestures/signs, language boards

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2) I’m worried my child’s speech production will be inhibited if he/she continues to use AAC as a way to communicate. What if AAC negatively impacts my child’s ability to learn speech?

  • AAC will actually facilitate the development of speech for many children with developmental disabilities (Romski & Sevcik, 1996)
  • This is no research that suggests AAC will hinder the development of natural speech
  • AAC is highly beneficial because it may:
    • Reduce the pressure on the child to speak verbally
      • This can reduce stress and facilitate the production of speech naturally (Lloyd & Kangas, 1994)
    • Reduce the motor and cognitive demands of speaking, and focus on the goal of getting the message across instead

3) What is communicative competence?

  • It is a child effectively communicating his/her message to the listener
  • It is the central goal of AAC intervention (Light, 1997)
  • AAC can help create effective communicators
  • It is about the people:
    • AAC is just the tool; it is the people and the interaction between them that is the main focus!
  • It is learned:
    • Children must be taught how to use their AAC system to be effective communicators
    • It is a step-by-step process that takes hard work, commitment, and instruction—that’s where SLPs and parents come in!

4) How do we build communicative competence? (5 steps)

  • Identify meaningful and appropriate opportunities for communication
  • Prepare for these opportunities by teaching the child who uses AAC
  • Ensure conversational partners provide support, such modeling use of AAC system
  • Have the child participate in these opportunities at home and in the classroom
  • Reflect on experiences and learn through them
  • It focuses on the 4 purposes of communication:
    • To express our needs and wants
    • To build relationships or friendships with others (Light, 1988)
    • To share information (Light, 1988)
    • To use social etiquette; For example, “Thank you, have a good day” (Light, 1988)

5) My child has been using AAC in speech therapy for a while now, but I am not seeing any increase in the amount of speech he/she is producing. Should I be concerned?

  • Each child’s speech and language development is highly individualized, so there is not a straightforward answer. However, research shows that some individuals who are using AAC intervention may take somewhere between 6-25 sessions to show speech gains (Millar, Light, & Schlosser, 2006)
  • Your child’s SLP will monitor the effectiveness of the AAC system on communicative competence, social interaction, language skills, and speech production.
  • Your child’s intervention will be changed as deemed necessary, and in the best interest of your child and your family.

Main Points:

  • SLPs and parents should not hesitate to use AAC with children whose speech is inadequate to meet their communication needs.
  • AAC has significant benefits for developing the language skills and communicative competence of many children.
  • AAC can have positive benefits for natural speech production—using AAC will NOT inhibit the production of speech!

Additional Information:

References

Light, J. (1988). Interaction involving individuals using augmentative and alternative communication: State of the art and future research directions. Augmentative and               Alternative Communication, 4, 66–82

Light, J. (1997). “Communication is the essence of human life”: Reflections on communicative competence. Augmentative and Alternative Communication13(2), 61-70.

Light, J. C., Binger, C., Agate, T. L., & Ramsay, K. N. (1999). Teaching partner-focused questions to individuals who use augmentative and alternative communication to enhancetheir communicative competence. Journal of Speech, Language, and Hearing Research42(1), 241-255.

Lloyd, L. L., & Kangas, K. (1994). Augmentative and alternative communication. In G. H. Shames, E. H. Wiig, &

  1. A.Secord(Eds.),Humancommunicationdisorders (4th ed., pp. 606–657). New York: Merrill/Macmillan

Lloyd, L. L. & Kangas, K. (1944). Augmentative and alternative communication. In G.H. Shames, E. H., Wiig, & W.A. Secord (Eds.), Human communication disorders (4th ed., pp 606-657). New York: Merrill/Macmillan.

Millar, D. C., Light, J. C., & Schlosser, R. W. (2006). The impact of augmentative and alternative communication intervention on the speech production of individuals with          developmental disabilities: A research review. Journal of Speech, Language, and Hearing Research49(2), 248-264.

Romski, M. A., & Sevcik, R. A. (1996). Breaking the speech barrier: Language development through augmented means. Brookes Publishing Company, Maple Press Distribution Center, I-83 Industrial Park, PO Box 15100, York, PA 17405.

 

Seasonal Sensory Success

by Alyssa Brief, MS, OTR/L

Making PlayDoh from scratch with common household items is a tried and trusted OT activity that can provide opportunities to develop hand skills while providing sensory input. With the holiday season now upon us, my OT group at the Philadelphia division’s Approved Private School recently enjoyed a seasonal twist to the traditional recipe- Gingerbread PlayDoh! This is an excellent (and wonderfully scented) therapeutic activity that is safe to eat since it is made exclusively with baking items. Making homemade Gingerbread PlayDoh can literally add some spice into families’ lives during vacation time off from school or on a Snow Day. Fun and safe for all ages and abilities, Gingerbread PlayDoh offers a fun play experience for children who are sensory seekers. This holiday season, I’m feeling incredibly thankful and lucky that facilitating creative sensory play opportunities is part of my job as an Occupational Therapist at Easter Seals.

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Gingerbread PlayDoh Recipe:
1 Cup Flour
1/2 Cup Salt
1/2 Tbsp Ground Ginger
1/2 Tbsp Ground Cinnamon
1 Tbsp Vegetable Oil
1/2 Cup Water
Mix ingredients together and knead until the ingredients reach consistency of PlayDoh. For longer lasting use, keep refrigerated in a sealed container. Enjoy!

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Giving back this holiday season!

by Kathryn Wallace

At Bucks this fall, we provided food baskets to families in need. Each classroom and department made 1-2 food boxes. As a staff, we celebrated with a pot luck breakfast when the boxes of food were collected. This year, we decided to do the boxes early so our families could have the food in time for Thanksgiving!

Staff in Bucks County giving back

Staff in Bucks County giving back

Science Leadership Academy

by Sandy Masayko

Nine Senior Engineering students from the Science Leadership Academy, a Philadelphia public magnet high school, and their teacher, John Kamal, visited Easter Seals at the end of October.  Prior to their visit the students interviewed Sandy Masayko using FaceTime to learn about projects that required engineering solutions.  Learning that the students at Easter Seals need to have toys adapted to meet their special needs, the students selected Easter Seals as a site for their engineering and design project.  After an introduction to concepts of Assistive Technology, the student engineers toured the school and observed children and teachers in action. The students have now begun their project by taking apart and repairing switch operated and adapted toys back at their lab at the Science Leadership Academy.

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Laurie McGowan, Assistive Technology Specialist, demonstrates to students how eye gaze technology works.