Oooh it’s been a busy day for the Quail. She’s been negotiating her space with Miss Kathy (OT) of late. Things that we KNOW she can do, and will do for us, she absolutely without a doubt refuses to do for Miss Kathy. I think there’s a few things going on- A) She’s in her terrible twos. Most development articles say that the associated social and emotional follies associated with young childhood actually start at each half year mark and smooth out by the actual year mark. during her evaluations she has always gotten the highest markest (READ- least delay) in social-emotional. So, in less technical terms- she’s tantruming. In some ways it could be construed as worse with the Quail then it was with Zuzu. With Zuzu at this age we had successfully taught her a number of signs and words and she could be prompted to use her words. We also had spent a good bit of time presenting things to her as- this or this? Which worked well for Zu. We need to be better about offering choices to the Quail as well. B) Therapy has been inconsistent. Leading up to and after her surgery in May we coddled her. We were unsure of recovery from the big event and even though she was released by her doctors within a week to return to activities as usual; we hated to push her when those stitches were so fresh. C)Sensory processing- Miss Kathy thinks this is the culprit. And I’m sure she is right- I’m sure there is some aversion- I see it as aversion to being MADE to do something versus enticing her with it- the ole- you catch more flies with honey theory. And I don’t doubt that she has sensory issues- but as to whether they deem her unfunctional or are any more incapacitating then say my aversion to florescent lights and certain textures on my feet or foods in my mouth, or her sister’s aversion to direct eye-contact and need for lots of hugs; well that I’m unsure of. I think she comes by it honestly- I think we all have sensory issues that just weren’t analyzed or diagnosed as such. I don’t see her getting this upset in other settings though. She’s a strong-willed little girl and we’ve put a lot of effort into making sure she has a voice. It’s been batted around trying therepeutic brushing with her. But I’m personally not on board. The OT sessions are rough and unproductive right now though. I know a lot of families take a break when this comes up. And I can see why- plain and simple- it isn’t working. Two weeks ago she screamed, flopped down, and continued to sob her little heart out causing little blood blisters to come to the surface and swelling around the eyes. FOR. 20. MINUTES.
Do you know how long 20 minutes is when your kid is screaming? And I don’t mean whining, I. MEAN. SCREAMING. All Miss Kathy had to do was make the slightest adjustment to the Quail’s posture or try to hand over hand direct her to push a button on a toy and more bellows would eak out resounding off the recently faded ones. It was the session after this one that the brushing was suggested. The thing is- yes- the Quail is fighting us all to some extent. But she’s also extremely loving. When enticed and encouraged (READ: DISTRACTED) she can usually be redirected to a different activity and eventually worked back around to the original one. You know when little kids get upset- how at some point they reach a point of no return and it’s no longer about the original upset- they just can’t gather themselves back together? Well it looked like that, and to be fair- and totally mom-sucked-in about it- she’s sitting in a room, being made to work/play and when she gets upset she gets no response from anyone other than being encouraged to push through it. She’s obviously crying for me to come get her and I’m not responding because I want her to focus on Miss Kathy. But I think this response could cause insult to injury. It seems she might not be a push-through-it kinda gal right now. You say tomato- I say strong-willed. Well after the 20 minute session, and the pleading, why don’t you just cathetorize me face (I’m not kidding- the exact same pleading look I’ve gotten from both of my kiddos when they have had to be cathetorized for UTI and VCUG. I picked her up, snuggled her, and after a few sniffs on both our parts pulled out the all-mighty Gerber Puff. Weak smile as she quietly accepts the peace offering. Poor lamb.
Well the session after that one as I said was where the brushing was suggested and instructed. But I have to say- any instructions that come along with- be sure not to start it when the mother has PMS….just doesn’t sit right with me. Who knows- maybe I had PMS. But the side effects of this program include irritability (apparently all around!), disrupted sleep (haven’t we just spent months training her to STTN?) and guilt all around- as my kiddo fights me and I realize that I missed another scheduled brushing- because it has to be done every 2 hours for 2 weeks. Frankly- it just isn’t going to happen. At least not at this stage. Should we end up with a series of aversions and disruptive uncontrollable behavior- I’ll think about it. But right now the main fight is during OT. So our version of pushing right through right now is to schedule her twice a week for a few weeks and see if routine can help improve things. And if that doesn’t help then next is going to be to try another OT in the office.
I do think there is something to the sensory issues, I remember with crystal clarity all the fights over nursing, that we had to reduce the stimuli and often I had to lay on her to get her to accept it. But here’s the thing about that- none of those things ended up working consistently- and our girl had two extremely serious medical conditions- duodenal stenosis and moderate dysphagia- that were completely undiagnosed at that point. The girl should not have been drinking thin liquids. I’m no expert- but the experts say- a child’s first priority is breathing- so when they gag or choke on food- their instinct to survive often gets translated into an aversion to food. I have to believe that played a large part. We finally gave up nursing in November 2009. She wasn’t diagnosed with the dysphagia until February 2010 and the surgery for the stenosis didn’t happen until May 2010. She’s got a right to defend herself against all of our best intentions.
Anyway- this was intended as a what a great day kind of post- not more of my rumination over to brush or not to brush. So today- OT- mmmm… a little better. We’re on session number 3 in the last week. We’ve also switched to having us not in the room. This was my idea. I swear one thing that I’ve heard about is good sessions when I’m not there- when I am there- well she looks to me for rescue. So while she and Miss Kathy worked on playing I could still see a few glances towards the door and lip pouts. Some tears, but nothing like the previous few tantrums. I really think right now they have to work on their relationship in order to get the most out of the session- you gotta earn respect- even with kiddos right?
Well partway through I came in and we all sat and looked through a touch and feel book. The Quail did awesome, she kissed the sheep, she patted each of the animals on the textured part with no cues and best of all-when we talked about the fuzzy dog and did the sign for it- she did it back! 3 whole times! Woo-wooo!!!!!
Then on to PT. Which has also been a mixed bag. Crawling isn’t coming easy to our girl as I’ve mentioned before. So we’re delaying focusing on standing and walking a bit and trying to focus on core strength building. Once again though- our girl is not a push-right-through kinda gal. As Mr. Mark noted, she responds better to circuit style training then repetition focus. So he’s agreed to working in that style. We’re also big fans of distraction with the gross motor activities. If she isn’t thinking about it she’s more likely to do it. In that vain we’ve seen some most excellent pilates style side lays that work both on getting her comfortable with dissociation and asymmetry as well as some lovely pilates style leg kicks and shoulder strengthening vby leaning on her arm. We also worked on inching her out of her comfort zone, with of course, Gerber Puffs. Whatever works. If you press her into that position she screams, you hold a Puff out so that she has to tilt up and lean to the side to get it and it’s over in seconds. Have I mentioned her most excellently refined pincer grasp? 🙂 So we were working on her being in quadraped- another position that when you rock her she tolerates, but when you stop she usually drops down to the ground on. But today she decided to serpentine- and much to our delight- hoisted herself up into a tall kneel! Woot-woot! We were thrilled and cheered and cheered- which of course freaked her out as she then flailed back into a hyperextension. Talk about using her super-baby strength for good!
Later in the evening we happened to all be cuddling on the couch and our sweet dear started chatting up Lovey, she started as always with, “Dada, Hi Dada.” Then happily complied with a few requests for a hug and kiss and little pat on his head. Then when I handed her the local baby doll of the evening, she reached down, said, “awwwwwww” and picked it up to her shoulder to pat it.
She’s getting there- inch by inch and holler by holler!