Dentist

I've been putting off this appointment for years. But since little sister was ready, I decided to try the 2-for-1 approach. She did AMAZINGLY well (which is good and bad as we'll see). She wanted to be first, the dental assistant was wonderful to explain every step and make it fun, she ate up all the attention and let her polish and do flouride and even x-rays. And she's barely 3.

Then we switched and the assistant mistook Carver's size for being more advanced, went right to x-rays and didn't sugar coat it. We spent 10-15 minutes fighting him to hold perfectly still (only happens during a movie if his thumb is in his mouth) and got several very poor pictures of the ends of his teeth. This not only used up all of sister's patience, but all of Carver's. He wouldn't do anything after that. Except spray the water tool. On the station tray and, at the very end, on the window. He was putting the fire out, of course. :)

The blow by blow story is really secondary to the fundamental problems this experience highlighted again.

His sister is passing him up, despite being half his size. I shouldn't have taken them together and set us up for inevitable comparisons.

I really thought I'd talked to the dentist about Carver. But it occurred to me after that I thought we were seeing a hygienist, who knew about Carver, and instead we saw an assistant who didn't have a clue. And didn't pick up on the clues very readily. It wasn't fair to them or Carver or me. But I didn't mean to let that happen. Honestly, how am I supposed to know exactly how he'll react to a new experience? I don't. I do the best I can and then we'll know better for next time.

Hopefully he'll forget and next time we'll go just the two of us to my favorite hygienist and we'll go nice and slow.

And hopefully I WON'T forget and I'll remember to educate everyone as much as possible just in case.

Wake-up call

Lately, I've faced a lot of reality. I exchanged emails with Carver's preschool teacher and SLP -a speech language pathologist, formerly known as a "speech therapist." :) It turns out Carver's not speaking much at school. I had figured that his IEPs and progress reports reflected his ability to perform in structured, formal testing situations and didn't worry too much about the low age equivalencies given. But I wanted to be sure. I was really surprised to find out that he's NOT talking at school. Strings of 3 words at BEST. Mostly single-word utterances. WHAT?! He's talking volumes at home. Granted, articulation is a major hurdle. But he's not letting that stop him. He speaks in paragraphs at home, disjointed sentences strung together with semi-colons or ellipses. So this is a major discrepancy. And it has me concerned for MANY reasons:

1. How can speech therapy be effective at school if he's not talking?

2. Why isn't he comfortable enough at school to talk? He used to talk up a storm at school - last year, different classroom, different teacher and therapist. What's happened?

3. I can't count on the school system. I've been coasting and it's time to get back in the driver's seat.

4. The clock is ticking and we're just under 2 years away from kindergarten. I'm kicking myself for wasting so much time.

SO... I'm diving into the search for a private speech therapist. I'd been on a waiting list and didn't know what else to do. Now we've been accepted to the local therapy center, but I'm not just taking whoever I get. Next Monday we meet with the first recommendation from my pediatrician. (HELLO?! Why didn't I ask him sooner? He's fabulous and knows an awful lot more than I realize.) I'm willing to drive about 30 minutes for therapy, the local place is 15 minutes. I'm hoping we're looking at every week. I've resisted the cost ($25 co-pay each visit), but how can I NOT do it?

But more importantly, it's good for me to have these moments where I get myself back on track at being Carver's #1 advocate. It's exhausting to worry all the time about him, to be constantly teaching and coaching him. I have 3 other kids, laundry, dishes, meals, church responsibilities, a husband and so many more parts to my life. It's a sticky balance between feeling guilty that I'm NOT doing more for Carver and letting myself relax to the point that I'm not doing much at all.

Whew. Add to all that the fact that I keep looking at my sweet 4 year old and wondering when he'll use the toilet and I want to throw in the towel completely!

Vision Therapy?!

Okay, I've been slacking. I'll have to talk about IEP's later, but this story needs a bit of a preface. At our IEP meeting a couple weeks ago, Carver's OT suggested we consider having him evaluated for vision therapy. She works with his fine motor skills and one day used kidney beans as part of their therapy. One fell on the floor and he tried to pick it up, but instead of grabbing the bean, he fixated on a red stain on the carpet and repeatedly tried to pick THAT up. So she started wondering about depth perception, etc.... I loved that she was thinking about the whole picture, considering how we might help him. I welcomed the suggestion. She gave me a few places to try and I set up a free screening for today at place in Bellevue with a certain Dr. (OD). I have to admit I was a bit skeptical going in. Vision therapy isn't exactly mainstream and I'm mostly a mainstream kinda girl. I'm going to try to be fair to him as best I can, but when I can't help myself, I'll switch to italics.

It was in a nice enough office in a medical part of town, near the hospital. The staff was friendly, there were toys, the doctor was exceptionally friendly. He asked questions, looked at Carver's eyes with lights, watched how he "tracked" a ball on a stick. Or, in Carver's case, how he did NOT "track" the ball on a stick. The dr. turns to me and says, "this is huge. see how he can't even follow the movement of the ball?"

Hmmm... my skepticism is growing by the minute. The room is fascinating, full of crazy optometry equipment, a video screen, files, books, computers, monitors, chairs, lights, the whole gammet. Everything I've read on SPD tells that in such a stimulating environment, they have a hard time focusing.

He asks him to name things on the screen, which Carver can do. He puts special lenses over Carver's eyes, follows them with a light and determines that his vision is unimpaired. I figured as much. But he also said that Carver has a hard time focusing on things up close (bringing his eyes together) and probably sees double. I think he ascertained that from the two tries he gave him to look at that same little ball on a stick. But the dr was between me and Carver and I'm not exactly sure where that conclusion stems from. The doctor demonstrated for me what it might be like to look at a written page and see double (not that I couldn't imagine this.)

He asked about our insurance, who it's through. I told him Blue Cross and he said, but what company? I told him Derek's employer and he said confidently, "oh, then it'll be fine."

What?! It's a small company. How does he know? Weird.

He kept pressing me to say that Carver doesn't want to look at books, that he prefers to do other things. But Carver loves to be read to. He asks questions, points to things, wiggles around on the couch like crazy - yes. But books haven't been an issue for him in a long time.

So he recommended an addition full evaluation ($290 out of pocket) and then personalized vision therapy. They'd look into insurance costs for us for that. I asked him what vision therapy might look like for Carver. He said that they do a lot of it at home now, downloading therapy homework on the computer and then submitting it back to the office. We don't have to come in all the time.

HELLO! Carver is 4!! He can't use utensils or pencils with consistency. He's supposed to do homework on the computer!?!?

Also, they do pictures that they can only see one part at a time without using both eyes together, using games and whatnot. That made more sense, but it's still pretty nonspecific.

He said a lot of crazy stuff that I won't be able to remember accurately. Here's the gist, without any of my commentary thrown in, I promise. He's been doing this for 40 years and can always figure out what is going on with kids. If he just thinks about it long enough, he can find the reason for their behavior. Sensory motor processing issues (he called it something like that) is really just that the kids are stuck at a lower form of development and they haven't reached vision yet (since it generally comes later in the developmental process). If you do vision therapy, it'll fix all the other stuff because essentially it'll fix his SPD. He gave the example of sitting on his stool. He relies on vision to keep himself there, but if you're wiggling all around to find the edges of the stool and understand gravity, that's just socially unacceptable. It's not wrong, these kids are born obnoxious, they just need to be taught to use vision to understand the world instead of their tactile senses. He recently went to a workshop where someone taught him that speech is related to our thought process because it's like talking in your head! (He said this was great enthusiasm, certain that he was enlightening me on this point, as well.) Vision is integral to this process. I'm still unclear how he connected that. Oh - maybe it was because if we could see what was really going on around us, we'd be able to communicate about it. I think that was it. On our way out, he asked about Carver's eating and said that we crave what we're allergic to and we should really consider switching to soy or eliminated wheat if that's what he likes. Talk about random, although food issues aren't to be ruled out. I just didn't think OD's were nutrionists or gastroenterologists. I asked how attention span played into it and I think he said that vision therapy would help him focus on things longer, that his behavior would drastically improve.

WHOA. I don't know what to say to all that!! Seriously?! He downplayed the importance of language, assured me that vision therapy fixes SPD because we just need to give Carver a new way of gaining information. It was absolutely crazy. I've NEVER met a doctor so completely uneducated in SPD - EVER. It was mind boggling.

Even with all my inward rantings and my outward struggles not to look at him like he's crazy while he's talking to me, I think there could be a grain of truth mixed in all of that mumbo-jumbo. I get the idea that helping Carver focus and track things with his eyes would help his ability to do fine motor skills. It might even help him learn to take in his environment in a more organized, controlled way. But we are not going back there. I'll look into another place or two and see what comes of it. Sheesh! What a waste of time. At least it was free.