CrazedPhotoMom

A Natey Update

I don't have any great recent photos of Nate, so I thought I'd go back and get some of my favorites from when he was a year or less.

This is one of my absolute favorite shots of Nate. He was 7 months old.

This series of shots are also favorites. He was about 8 months old here. And he had discovered his shadow.

I just thought this one was funny because his shirt says "Busy Bee" and at school, each day they have a busy bee that helps in the classroom. :)
About the chubbiest Nate's ever been. He was about 5 months old.

Now on to the actual update. Before Christmas (at least I think it was), we met with the teachers and therapists along with a behavioral specialists who focuses in autism. As I mentioned a while back in one of my posts, Nate's been doing so well that his IEP was no longer accurate, thus why we met. We discussed his progress a little and focused on some new goal areas. Due to the specialist only seeing Nate once (at the most twice) before our meeting, I honestly felt that he really didn't provide any useful information. But I hope in the future, he can give us some insight on ways to further help Nate. Anyway, the meeting was a quick one and shortly after that, we scheduled a new IEP meeting.

And that meeting was yesterday. I have to say it was the very first time that I've left an IEP meeting and NOT felt like I'd been kicked in the stomach. I've said it before and I'll say it again...I KNOW Nathaniel is delayed significantly in speech and in some social areas. And I KNOW that he's made amazing progress in a year and a half that he's been in school. And I KNOW he'll continue to do well. BUT...when you see it all written out in black and white, it really makes you feel like you've been kicked in the gut. But yesterday, I left feeling fabulous and I'm sure that it's because he's doing so well.

Here are a few of the goals that was on his IEP previously:

• Increasing his tactile sensory tolerance
  -this is basically doing stuff like finger painting, Playdoh; previously he would do it but only for a minute or two and he always had to have something to wipe his hands on immediately after he was done. His teacher said that not only will he do it for an extended period of time now, but he's choosing to do it all on his own.
• Cutting a 5" line first within 1" of the given line and then stepping it down to within 1/2" of the given line
  -Nate originally would cut once and then rip the rest instead of continuing with the scissors. Now he can do it with minimal assistance.
• Maintaining a tripod grasp on writing utensils during coloring/writing for 1 minute (and up to 3 minutes) before needing physical assistance to correct hand placement
  -This one is still a work in progress. I made a post about it not too long ago with pics to show it. He's doing SO much better but still doesn't quite have the tripod grasp perfected. He holds it with the thumb and 3 fingers instead of the thumb and 2 fingers. But he RARELY uses a palmar grasp anymore.
• Put on and take off outdoor clothing (boots, hat, mittens, coat) with minimal assistance
  -He has this pretty well mastered as well!
• Given multisensory prep (sand tray, chalk) he will imitate the upper case letters of his first name
  -Completely mastered! He can write his first and last name. :)
• Participate in non-preferred activities
  -I was elated to hear his teacher say he doesn't have any non-preferred activities within the classroom anymore! :)
• With adult prompting and preferential seating, Nate will maintain a direct gaze to picture books being read during story time starting at 3 minutes working up to 6 minutes
  -We're still working on this one. They give him a lot of special attention to try to keep him engaged. They ask him questions, give him his own copy of the book and direct him back to the book by saying his name or asking only him a question, when his attention drifts.
• Yes/No questions - given 10 question answering up to 8 of them correctly
  -I think he's mastered this one as well. If not, he's very close.
• Increasing his MLU (mean length of utterance) to 2-5 words
  -This one will always be a work in progress I think. He definitely has upped his MLU a bit but it's still not where it should be.
• Increasing his receptive language skills of the following grammatical structures by pointing to pictures or objects - pronouns (I, you, he, she), prepositions (on, in) and verbs (have do, ing)
  -Again, this is still a work in progress and has proven to be a difficult concept for him.
  

So y'all following me so far? I know it's a lot to read but bear with me. :)

In the discussion before Christmas, we brainstormed what some new appropriate goals should be. And yesterday, we got the rough draft and made a few changes and here's what we came up with:

• Increase Nate's MLU to 4-6 words
  -In the last 5 months or so, we've seen his MLU jump up significantly; even up to 7 word sentences or 2 sentences together. But he's really been focusing on other areas lately, so we've seen his MLU drop back down to 4 and 5 words. The SLP (who we LOVE and think is fantastic) said she's not concerned because he's really concentrating on other concepts. It WILL become a worry if it continues to decline and not pick back up at some point.
• Increasing receptive and expressive language skills in the following areas: pronouns, prepositions, quantitative concepts (more, most, all) and negatives (not)
  -This goal is one that was carried over from the last IEP. As I said, this has been a difficult concept for him to grasp. He seems to do ok with pronouns associated to himself (my, mine - although he rarely uses "I") but when it comes to you/your, he/she he struggles and overgeneralizes. Prepositions, he gets a little bit of on/in, over but not consistently. He has no concept at all of more, most and all. And he's not real fond of negatives.
• Increasing his expressive language with "wh" questions (who, what, where, when, why)
  -This is an emerging skill and one that we feel he is really concentrating on right now, which has drawn his MLU down. Most people don't even think about asking questions...it's natural, everybody does it, etc. Not the case. Up until the last month or two, Nathaniel has NEVER asked questions. He'd never asked what something was, or who someone was, etc. Nothing. But he's taken cues from the twins and is realizing that asking questions actually has a purpose. And he seems to be catching on quickly. I'm often plagued with "whatcha doin' mama?" while I'm cooking dinner or cleaning the kitchen or surfing the internet. We've also heard "where's daddy?" and "sissy, where are you?" as well as "what's that noise?" I really want to work on getting him to start asking "who is that?" and "what is that?"
• Shoe tying
  -Nate's OT (who is also fantastic and wonderful) says she sees no reason why he can't learn to tie shoes by the end of the year!
• Writing his name with the appropriate casing on a line at the top of the page with 1" letter size and then working to a 1/2" letter size with minimal cues
  -Nate has no problem writing his first and last name currently. BUT - he has mixed casings, some upper case and some lower case. And his letters are on the large size, even though they've been consistently been getting smaller over the last 5 months. The casing I think it's just laziness. He knows that writing a lower case I is easier than an upper case one, so he uses the lower case.
• Complete a 2 step motor obstacle in correct sequence
  -This goal actually ties in with a classroom goal of following stepped directions. We want to get him to follow multi step directions such as color the circle, cut it out and paste it onto another piece of paper.
• In a group setting, Nate will follow 2 step directions
  -This ties in with the motor obstacle
• Asking and answering "wh" questions in a group setting
  -Again, this is getting him to not only ask those "wh" questions but also to answer them correctly
• In a group setting, given preferential seating and verbal and visual cues, he'll attend to storytime
  -This is also a carry over from the last IEP. It's basically what I mentioned above. He'll get his own copy of the book, they'll ask him questions specifically to keep him involved and they'll say his name and/or point to the book when he gets distracted.

And that, my friends, is it in a nutshell. Those goals will be what we work on for the next year. Honestly, I'd LOVE to see him master those things in a few months but if he doesn't, that's ok too. He'll get there eventually.

I cannot stress enough how hard this little guy works. He's at school from 8:30am until 3pm 3 days per week and then from 8:30am until 12:30pm the other 2 days. He puts in long hours and handles it really well most days. I'm so proud of him!

Some other things we chatted about during the meeting yesterday. In the very near future, they're going to choose his kindergarten teacher for next year. Once they choose the teacher, they're going to put him into the class to see how he adjusts to the new teacher, new surroundings, older kids, etc. He hasn't had a hard time adjusting to new things lately but he's become quiet comfortable with his school schedule and this will help prepare him for his change to kindergarten next year. And speaking of kindergarten, he'll be attending an all day REGULAR kindergarten class next year. The teachers/therapists think he will do great. There are areas that he'll need some extra help in but overall, he should do fine. One of the biggest things is he's continuing to initiate conversations and play with the other kids. Because his speech is limited, it's difficult but at least he's trying despite his lack of speech.

That about wraps up my Natey update. I will conclude by saying that we have an appointment with the developmental pediatrician in March. We haven't seen him since Nate's diagnosis was changed from developmental delay to PDD-NOS so I'm anxious to hear what he has to say about Nate's progress and Nate's future. The last time he saw Nate, he only said 2-3 words, didn't make eye contact at all, etc. and he's improved SO much since then. I'll be sure to update once we've had that appointment.