"I should've stayed in bed today. I almost did. We've had a rotten day so far. I guess I was openly miserable today because I was mildly chastised for my negativity by the lead therapist a few times. It didn't get better when we got home. Ryan fell down the stairs TWICE within 5 minutes, and both times the gate was securely fastened. The second time, he took out a post on the way down. Thank goodness it was the gate that hit it, and not his stubborn little head! He's fine, but I'm gonna gave a nervous breakdown!"
Yep, that pretty much sums up our morning. I woke up feeling very achy, coughing, and generally yuck, and was ready to call in to S.C. and say we weren't coming in today. But then I thought about it; we had the homework and evaluation meeting scheduled for this morning, so I decided I'd better drag myself in.
Ryan seemed to be in a good mood when I got up, so I thought, at least he's ready for a good day. But by the time we left for S.C., he was crying and miserable, and I couldn't figure out why.
When we started our day at S.C., Ryan was crying a lot. Then his nose started to bleed! D., who was our lead therapist today, noticed it first and grabbed me some tissues. Ryan absolutely hates having his nose wiped, so it just made him more upset as I tried to pin his arms down and hold his head, so I could clean up the mess. The more he cried, the more blood and boogers and mucous came out. Ugh.
Anyway, we eventually tried to lead him over to the Blue Room (he would not stand up and follow me today, despite various type of prompting and coaxing). Then L. showed up and said it was time to do my meeting, so I gladly left D. and B. to deal with Ryan. I knew he was in good hands.
Homework and Evaluation
The meeting was a little different this week, since H. is on vacation this week. L. did our meetings with us instead.Homework:
We kept it pretty much the same. Record any issues with manding; work on shapes and sounds barn (although we discussed replacing this one soon) and magnetic stacking blocks, fading prompts as appropriate. Keep trying one different discrete trial program each day. Keep working on waving 'hi" and "bye-bye," and "stand up/come with Mama."
I did mention my difficulties with the "stand up/come see Mama" goal: Ryan isn't getting it at home. L. suggested that I try two things: a) make sure there's a clear purpose/reason why he has to come to me and b) use an appropriate visual item paired with the command. Therefore, instead of randomly saying, "Ryan, stand up, and come see Mama," I would do this while holding his coat as we are about to get ready to leave the house. I tried this today at mealtimes (with food) and bath time (sound of tub running), and had more success.
Evaluation:
I would say this was the highlight of my day. L. had nothing but praise and encouragement for me. I got all 4s except on the "fading back tangible reinforcement," on which I got a 3. As I said last week, Ryan still needs a lot of tangible reinforcement, so it's something we have to discuss as it becomes more appropriate.
She really surprised me, though, by commenting on my initiative and quickness of picking up the skills taught in Unity. She noted that I'm actually working at a month 3 level in several areas, so she's going to make up some guidelines to start showing me how to make my own programs for Ryan, which will be especially useful once we finish Unity. She's also going to create a list of program suggestions for skills I can work on with Ryan in the future.
We also talked about which signs we might want to teach Ryan next, since he's doing so fantastic with his "more." We didn't make a decision yet, but it will be something functional.
Back to Reality . . .
Ryan had lots of fun getting wagon rides from B. while I was in my meeting. She said he independently signed "more" every time she paused (yep, he's got that one!). However, coaxing him out of the wagon was another issue entirely. She had to leave to watch J. while L.A. had her meeting. I eventually lifted Ryan and put his one foot out of the wagon, hoping he'd take the other one out. He did, but then he went floppy and almost fell down, stubborn boy.So, we went into the Blue Room and I decided we should try some new things, hoping they might interest Ryan. L. had written some suggestions on yesterday's feedback sheet, and I was eager to see Ryan's response to the new programs.
The first thing we tried was using Play Doh. L. had suggested (and D. agreed) that we'd try having Ryan smoosh it down at first. Ryan needs to work on his hand strength, and Play Doh is at every school and daycare, so it's an important play goal. We had two concerns before we started. One was that Ryan might try to eat the Play Doh (his mouthing), and the other was that he might reject the texture. Luckily, our fears were unfounded. D. rolled two medium-sized balls of Play Doh and had me show Ryan how to smoosh it flat with the palm of my hand. Then, I took Ryan's hand and HOH'ed him smooshing his ball down. His reaction was neutral. he let me do it, no problem. He also seemed interested in the Play Doh balls when we re-shaped them. He was picking them up and inspecting them. In the end, he got all +'s on the HOH trials and even showed some initiative on one of the smooshes. That is what we're looking for now: that he'll try to smoosh it down with less HOH from me, and eventually, we'll fade back that prompt.
The second new thing we tried was a new imitation: "pat head." This program is useful in at least 2 ways: 1.) the pat-your-head action is in some circle time songs, and 2.) this can eventually lead to pointing to/identifying different body parts. It took some help from D. to figure out the best way to run this program because Ryan started getting it confused with "more" and "clap hands," or he wanted to pat on his arm. One thing I figured out on my own was that I needed to get Ryan's attention up by my head while I modeled patting my head. So, I took the mini bead maze and held it up near my face. D. was impressed that I thought of that, but I must admit, I saw the lead therapists use that tactic a few weeks before. That didn't solve Ryan's confusion, though.
Then, D. suggested that we move to the table, and put the bead maze on there, to keep Ryan's attention higher up, while freeing both my hands. Then, I put my right hand over his left arm to block it, while I modeled "pat head" with my left hand, and then instructed him to do it (while still blocking his left arm). It worked! When I blocked Ryan's left arm, he would copy me and pat his head with his right hand. It's interesting how these little tweaks in the programs can make all the difference. Of course, the eventual goal is he will imitate the action without needing blocking or physical prompting.
The rest of the morning was kind of a blur. We did the shape sorter and tried some new shapes (triangle, square) and he did okay, with HOH. We did some stomp feet, and he wasn't enthusiastic (weak stomps), but he did it with the knee prompt. Then he had another meltdown, so D. and I took him into the Yellow Room to calm down and get settled before circle time. D. gave Ryan the noodle bin, and Ryan was soon quite happy, but quite messy. We were trying to block him from swiping the noodles out of the bin, with some success. Then, when it was time to head for circle, D. used the noodle bin to lure Ryan out of the room and lead him to circle. Well, he set down the bin for one second, and Ryan swiped it and knocked it over, spilling noodled everywhere! I credit D. for his patience. He just shook his head, and said to Ryan, "Well, played young man."
After the subsequent noodle clean-up, I was using the bin of noodles to get Ryan to follow me down the hall. Yeah, right. He stopped, dropped to the floor, and started bawling. He was totally angry and being stubborn. D. came out and helped me move him along, but Ryan fought us the whole way down the hall, trying to sit down or run in the opposite direction. When we finally got to the door of the circle time room, and Ryan plopped himself down in the doorway and refused to move, D. said (as L. often says), "I know it's tough, but I kind of like seeing this defiance." Yes, I know it shows Ryan cares about things, and is starting to have a clear opinion. It also shows he can be a typical, difficult, three-year-old.
After circle, Ryan nearly fell asleep when I gave him a warm bottle during snack. He ate all his yogurt, with HOH help, but he was really floppy and his eyes were just exhausted. He also had some impressive boogers coming out of his nose. Ew.
When snack was done, I tried "kick a ball" and the chunky puzzle with him. "Kick a ball" went okay; he didn't want to sit, but we got a few good kicks when we got him settled. When I let him do it standing, B. stood across from him, and they kind of kicked the ball back and forth. I think Ryan liked that; it was like how he enjoys playing roll the ball, back and forth.
The chunky puzzle was to end our day, though. He got upset, and I gave him a break between taking them out and putting them in. I said, glumly, "We haven't really accomplished that much today," and D. immediately jumped in and said, with a gentle reprimand in his tone, "Yes, you have!" After Ryan put the puzzle pieces back in, I heard D. saying something about, "You're being lazy today," and I said, "Yep, Ryan's having a lazy day today." Again, he looked at me with a bit of consternation and said, "I wasn't talking about Ryan! He's not being lazy!" Then I felt embarrassed, as he explained he was joking with the volunteer working next to him, and calling her lazy. Oops. I know a big part of the S.C.'s programming is keeping things positive and fun (it's even part of our evaluations!). But hey, I was having a rough day, and so was Ryan. Sometimes you just can't help voicing your frustrations.
When we finished with the puzzle, D. said we should head home. I think he could tell Ryan and I both needed some rest.
As you see from the Facebook snippet at the top, things didn't get much better for us at home. Ryan is fine, just cranky from his cold, the time change messing up his system, whatever. (By the way, D. mentioned that even among the STEPS group, the kids that are normally laid-back were call cranky yesterday afternoon. Must be the time change!)
We are definitely taking a day off tomorrow. We will still do our homework, but hopefully, we can get lots of rest. Poor Ryan, his system/schedule is so off; he keeps starting his nap around 3 or 4 o'clock, and then he's up until 11:30 PM. He's up right now, but I'm rocking him with one foot while typing on my laptop on the couch. However, I did take a little nap with him this afternoon because I knew he'd be up late again tonight. I really hope a day off tomorrow will re-energize us both, and get us back on track.
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