Mental Father

speech progress

2010-08-08T00:28:00.002-04:00

I'm a bit behind here, but Ella's speech has been improving quite a bit. For about 1-2 months she's been favoring word-approximation type speech over sign, although she still uses sign for complex word.

She's still lacking ability to create r, s, sh, ch, th, f, v and several other sounds, and her use of "t" is absent in many words. However, she is willing to try to approximate most simple words.

Her speech is quite broken, and would not be readily understood by many who aren't familiar with early speech. However she still gets her point across to us. Typical examples of things she says now are "I wah mo coh key" (I want more cookies) "hu guh key key" (hug kity kitty). "uh oh pah pee" (uh oh, potty), and of course lots of "yeah" and "no" (both of which are reasonably well formed and most people should understand her).

Intonation is another area we will eventually have to work on. Her current use of pitch is a little strange, and at times humorous. For the most part, she always pronounces a given word with the same pitch pattern. "ma mi" (for mommy) is always pitched low, then exaggeratedly high. "Wheee" is always pronounced in a flat dead-pan tone (this can be quite funny when she sees a slide, and races over to it saying "Whee" in a robotic monotone..)

While this level of speech may not be much, the frequency of her talking is what's really the big difference. 6 months ago she used words only as a last resort, or when specifically asked. Now she is using spoken word on her own to make requests, answer questions, etc.

She's also starting to speak at a much louder volume. Previously everything spoken was very quiet, but she now occasionally speaks loud enough to be heard clearly in the next room over. (talking loud, but not shouting volume).

Anyway, that's my quick update, hope you all are well.

fall school...

2010-06-15T08:27:00.004-04:00

Ok, I should have posted this last week after Ella's meeting, but oh well, I'm catching up now.

In any event, Ella will be going full-day in the fall. She'll attend an am preschool class, spend lunch with a MINC preschool class, then go into an afternoon pre-k.

In addition to all the extra school time, all of Ella's school-based therapists (PT, OT, SLP) are all increasing the amount of individual therapy time they will be giving to Ella.

This is good, as they're trying to really get her ready to go for kindergarten next year. She seems ready for the extra push, so we'll see how it goes.

2010-05-23T23:15:00.001-04:00

Sorry for the lack of posts lately, but life has been a bit busy, and a lot of Ella's progress has been evolutionary, not revolutionary.

On the speech front, we've seen a lot of little things, but there is real progress there. For example her "no" is cleaned up to a point where most people can understand it, as opposed to the broken "nah ooh" (pronounced as two separate words) that she started with. She is also using a crude "yeah" (eYah!), which is good because she can now answer yes and no questions verbally (this is quite handy when driving... quickly glancing in the mirror at a light to read ASL signs is not exactly efficient.) She's also picked up a few more word approximations and is saying things like "I Wah mo ". She's also gotten a lot more willing to make a real effort at pronouncing new words.

On the motor front, her climbing ability (and confidence to try) is vastly improved. She's now handling moderately complex playground obstacles like rope suspended bridges, rope ladders, vertical ladders of a few rungs, etc. She still doesn't have quite the agility of the average child her age, but she's definitely making good progress in motor skills.

When it comes to food, she's recently gotten out of her absolute refusal to try new foods. She's now eating some soft bread products (not just crackers/cereal), and even eating burgers (with the bun).

We've also got a planning meeting coming up in about two weeks for next year's schooling. I'll definitely have more to post about after that.

Speech, Ella's way...

2010-03-22T22:43:00.003-04:00

Ella continues to make good leaps and bounds lately, as we've seen ever since Ella got her glasses. She's speaking more and her motor skills are making good progress.

On the gross motor front, Ella's learned to make small forward jumps in order to hop her way across the floor. Previously she'd only been jumping straight up-and-down. This is good because it takes a lot more confidence and balance skill to jump forward than it does to jump in place. Her climbing is getting a lot better, but she's still behind in this area, but that will come in time with better balance.

Speech-wise, Ella is now up to using a total of 8-12 spoken words and word approximations, which vocabulary wise is more on par with a 16-month old than a 3.75 year old. Her diction is also pretty crude, again like the younger child.

However, one interesting twist is that Ella is already putting these together to make sentences, and also combining them with ASL signs. This is very amusing, because usually children with such a limited vocabulary only use single words. Hearing Ella very roughly say "Hep Meh" (help me) is an interesting contrast. Her speech ability is really basic, but it contrasts with her more comparatively advanced conceptual language abilities.

Of course, we're used to out-of-order development but it continues to amuse me.

Additional speech therapist...

2010-03-03T23:40:00.002-05:00

Last week we started taking Ella to see a private speech therapist, as a supplement to the school-based therapy she gets right now. So far she's had two visits, but these have mostly focused on evaluating Ella's existing speech in detail (using parts of a Kaufman Speech Praxis test).

This isn't to say the school system isn't doing a good job, but the school environment and private therapy settings offer different advantages. The school environment offers a lot of other kids her age to model from, as well as a mixture of both group and one-on-one speech therapy. However, neither of us are present at school, and we do not have frequent interactions with her therapists. This means that our at-home efforts are a little unguided and only sync-up with the school once a month or so.

The private therapy, on the other hand, is all one-on-one and there's no peers to learn from. However, one of us attends each session, and her therapist intends to start giving us plans for at-home therapy tactics.

Adding another therapist now also seems very appropriate. Since she got her glasses she's made a lot of progress in the "raw fundamentals" of speech. This seems to us (and her school therapists agree) to be a very good time to increase the intensity of her therapy and catch her up a bit now that she's starting to pick things up faster.

As for her speech progress, we've recently seen several new bits of speech progress emerge:

-she combines "hi" with a name to form a two-word greeting. (Hi Dada)

-she uses a lot more different letter combinations than before in her babbling.

-she's started jargoning where she's stringing together a stream of different syllables, rather than just repeating the same one or two. ("nabooka dooga aeee!" instead of "booka booka booka")

Of course, there's lots of things she's still having trouble with, such as sounds that involve bringing the tip of your tongue up (t, l, etc.), sounds using the teeth (f, v, th, s) and most sound combinations that involve going from an open jaw to a mostly closed one. But that's what we're all working on.

catching the blog up...

2010-01-31T23:45:00.005-05:00

Ok, first a little oldish news that I haven't relayed to the blog:

At a meeting with Ella's OT, she suggested that Ella may have depth perception issues, and we might want to take her to a developmental optometrist. We took that as good advice and the results were that Ella is severely farsighted (+7.5 d), and can't focus on things close to her. As a "stepping stone" the optometrist suggested getting glasses at +6.5 see how she does with them, and visit for a follow-up (which is coming up in a week or 2 now).

Now for the rest:

Since getting the glasses, Ella has greatly improved in several areas, particularly in motor ability. The ability to focus on things close to her has given her a better ability to traverse stairs, jump, and the confidence to run around. Her general activity level is also up quite a bit. It has also increased her attention span for hands-on activities etc. We also expect this will have a positive impact on her speech, as she'll be able to see the details of how we move our mouths and tongues while speaking. She still has some motor obstacles to speech (i.e.: she cannot curl her tongue upwards yet), but the glasses at least remove one obstacle.

Of course, we recently had her mid-term IEP meeting with her teachers, where we plan her education goals, therapy levels, etc. Unfortunately, all of the review was written before her glasses arrived, and some of her goals are likely to be rather low now that she can see better. On the upside, we've got another meeting to discuss summer semester soon, and her teacher mentioned we may amend her IEP at that meeting if needed.

brief news bits..

2009-12-16T23:29:00.004-05:00

Just a little quickie here:

Ella's been sick for the past week or so with bronchitis. However, she's finishing up a course of antibiotics, and it is clearing out now.

Ella also seems to be working on a speech approximation for "bye bye", although at this point it is little more than "buh buh". On the plus side, she's continuing with the use of ma ma, da da, and og (frog). She also frequently uses a spoken "I" mixed into her signs, and very rarely she says "Hi". All of this is really good news, as it means her spoken vocabulary is growing. In the past we've seen patterns where a new sound replaces an old one.

Ella has also taken to a lot of play activities that are good for balance and strength. Lots of jumping, bouncing, crab walking, etc. She's even starting to work on a broad jump, not just a vertical hop (I think this is her teachers in action, but I have not directly asked them).

Tech-speak device and speech news.

2009-12-02T22:27:00.003-05:00

Again, I'm a bit behind in updating the blog, but the holidays always make life a bit busy. So, with that asside, here's a quick update of what's been going on.

First, Ella's school has sent home a Tech/Speak device. This is essentially a board of buttons with pictures on them, and when Ella pushes the buttons, it speaks words. The hope is that it will make her realize that spoken-word can help her communicate with more people, thus encourage her to work on transitioning from signing to speaking.

As for speech, Ella's had a few new words/word aproximations emerge over the holiday. In addition to "da da" and "og" (frog), she's now using "ma ma" (which she had a long time ago, but disappeared for a year), and "ah ah ooh" (uh-oh). What seems most positive to me is she very quickly started using these words appropriately, because she already has the concepts of how to use language down from her signing. This makes me very hopeful that once we can break through the physical co-ordination of her mouth, she'll fall rapidly into speaking.

In any event, we all had a great Thanksgiving, and I hope you all did too.

Ella's follow-up appointment.

2009-11-15T22:10:00.005-05:00

This is a bit of old news now, but I'm just now getting around to blogging it. Back on Nov 5th, Ella had her post-op follow-up at Hopkins. They performed a fairly detailed check-up of her heart, and the placement of the device using both echo- and electro-cardiograms. The Amplatzer duct occluder is in-place, it's not moving, and it's not obstructing normal blood flow anywhere. To quote the cardiologist that did the procedure "It's hers now, she can keep it."

At this point, we've been given some very minor restrictions (i.e.: no dental work for 4-5 months due to infection risks.) and we're scheduled to follow-up with our local cardiologist in a year.

In general Ella has been doing really well. The day after the procedure (Thursday) she was still pretty sleepy, but she went back to school the day after that (Friday), and had a more-or-less normal day. She had some minor tenderness for a bit over a week at her hip where they inserted the catheters, but this went really well.

All is well.

2009-10-22T11:33:00.002-04:00

Just to let everyone know, Ella is home and doing very well. She's got a good appetite, when we got home last night she immediately spotted a bowl of goldfish crackers, walked over and stuffed a handful in her mouth. She's been sleeping a lot, but when she's up and about she is acting like her usual happy self. She doesn't seem to be in any serious pain, but was a bit fussy about me changing her bandages this morning. Even that was a fairly mild protest; she was whining about it, not crying or screaming.

At this point, I expect she'll be OK to go to school on Friday, although you never know for sure.

Ok so we are going home

2009-10-21T17:41:00.001-04:00

Things went well and the doctor has decided not to keep ella overnight

-- Posted from my iPhone

Proceedure done

2009-10-21T11:00:00.002-04:00

The proceedure is done and went very well. Still not positive she will stay overnight, but it is likely.

-- Posted from my iPhone

They are using the amplatzer

2009-10-21T10:25:00.001-04:00

They have decided to use an amplatzer, which is the larger device and Ella will likely be staying overnight

-- Posted from my iPhone

The are starting

2009-10-21T09:26:00.001-04:00

Ella is fully under and the catheters are in place. Next step they will inject dye into her heart and take xrays to measure the pda and determine what device to use. This will take about 1 hour.

-- Posted from my iPhone

Waiting waiting waiting

2009-10-21T09:07:00.000-04:00

We are now waiting arround the lobby. The nurse will call us 3 times with status updates as they proceed. I'll be posting those as they come.

-- Posted from my iPhone

In anesthesia

2009-10-21T08:36:00.001-04:00

Ella is currently in anesthesia. She is only mildly sedated and will be slowly taken deeper over the next hour or so.

-- Posted from my iPhone

On our way.

2009-10-21T05:48:00.001-04:00

We are on our way to the hospital. Assuming pre-op doesn't show she is getting sick, the heart proceedure will be today.

-- Posted from my iPhone

Surgery on for Weds.

2009-10-18T08:48:00.001-04:00

As of this morning Ella is healthy and not sick in any way, so we have begun her pre-op asprin therapy (as directed by her surgeon). Assuming she stays cold-free we'll be on for Weds am.

I am also testing the Iphone app I'll be using to post from the hospital.

-- Posted from my iPhone

Surgery delay, potty training, and general updates..

2009-09-20T21:09:00.005-04:00

Ok, first, Ella's surgery (that was supposed to go off last Weds) got rescheduled for October. Earlier last week she came down with a cold, and that added unnecessary risk to the surgery. (mostly because they need to put a tube in her throat during the procedure, and that doesn't mix so well with coughs and inflamed throats).

On the progress front, this weekend Ella spent all of her awake time in regular underwear, and had no accidents all weekend! She's actually very happy to be in underwear now, so it looks we're breaking through the PT barrier that the flu put in our way last winter. (we almost had her daytime PTed, but then a flu or flu-like illness struck, and Ella became afraid of underwear.)

On the speech front, Ella continues to chatter babbles at us, and continues to be quite prolific in it. She'll now say "I" and "Hi", although the distinction between the two is blurred. She'll also occasionally form "Doga" for Dog. Her babbles include "Da", "Dooga", "Tka/Tooka", "Ga", "Ra", "P", "Ba", "Ha", along with all (or nearly all...) the vowel sounds.

Anyway, just wanted to get a little news up on the blog, hope you're all well!

Oh the many sundry things..

2009-09-04T22:22:00.004-04:00

It's been a long time since I've updated how Ella's doing, so here's some quick general bits..

Talking - Ella now occasionally uses a few crudely formed words with purpose. However, she's more inclined to use them as general bables than with any purpose. The most notable exception to this is saying "I" in the middle of signing "may I be excused".

Eating - Ella is doing really good with self feeding, and can now spoon her own cereal out of a bowl. She'll also pick up and bite chunks out of food that she strongly likes, such as fries and nuggets, although less favored foods still need to be cut up for her.

Motor - Ella's gotten pretty good at jumping (over, and over and over again) in-place in little short hops, and getting on and off her tricycle. Her motor is generally doing pretty good, although she is a little bit behind her peers in more ambitious climbing and balance adventures.

School - Ella went back school this past Thursday. She's now in a preschool class instead of a toddler class (higher age group) and is now in a regular early-childhood special ed program, not a MINC (higher development level). The later means that she's not with any of her former classmates, which is unfortunate, but she's doing fine with it.

Potty - Well, we're still working on this one. Ella does pretty well at using the potty, but her enthusiasm for wearing underwear instead of diapers varies wildly (often very resistant to wearing one or the other, usually wanting the exact opposite of what works for the planned day)

Anyway, hope you're all well, I just wanted to get a quick update of how things are going.

Heart procedure - scheduled for Sept.

2009-08-13T20:47:00.003-04:00

MentalMother, in a bit of role reversal, posted a very lengthy and detailed description of all this, so to continue the reversal, I'm going to post a brief note.

Ella is now scheduled for a procedure to correct her PDA. As heart procedures go, this is a relatively minor one, and overall is similar to the way they put in stents for heart disease, but this is closing an artery near the heart rather than opening one.

The whole thing will take place as a non-surgical cardiac catheterization type of procedure on September 16th. She will be under general anesthesia for this (good luck getting a 3 year old to lay still on a table for 3 hours, much less while poking around the heart!). During the procedure they will perform some detailed x-rays with contrast enhancers, and decide what size or type of device to place in her heart to close the ductus. If the ductus is small enough, they will use an embolyzation coil to close it, in which case she will likely go home late the same day as an outpatient. If it is larger they will use an Amplatzer duct occluder, in which case she will say overnight for observation. (note: neat videos on the Amplatzer).

Either way she should be back in action after a couple of days.

Overall, it's good news for us that we can use the catheter procedure, as this eliminates the potential need for conventional heart surgery.

Eating progress..

2009-07-26T23:34:00.002-04:00

Recently, we've had some progress getting Ella to eat new foods. A lot of this has just been overcoming her toddler instinct to reject any food that is unfamiliar to her, which is pretty typical at her age.

However, some of this is due to her texture aversions. Ella really doesn't like to eat bread products very much, but recently she's started eating sandwiches if they're cut up and put on a fork. Her teachers have a theory that the texture aversion is actually not liking the rough feel of bread against her lips, which is what lead them to try putting it on a fork. This weekend, I took that a bit further, and got her to eat the top of a corn muffin by breaking it up into pieces she could pick up and stuff in her mouth.

yay for new frontiers in cuisine for Ella!

Cardiologist results..

2009-07-08T20:51:00.004-04:00

As her mother already mentioned, Ella visited the cardiologist today.

Again they did an EKG (which she screamed at me through because she did not want to lay still) and an echocardiogram (which she was fairly good for). The results are fairly good, or at least as expected. (edit - fixed electrocardiogram to echocardiogram)

Her PDA is still present, but her left ventricle is now a tiny bit enlarged, but there is no damage to her heart or lungs. The enlargement is too slight to be harmful anytime soon, but it is a sign she's going to need a procedure to close the PDA at some point. We've been referred to the doctor that performs the cauterization, and he'll take a look at her. If he deems she's a good candidate for the catheter procedure, she'll have it this year, or the next, depending on how he feels about her size. If she's for some unusual reason not a good candidate, she'll have conventional surgery sometime this year.

This is all pretty much what we expected based on last year's visit.

Anyway, just wanted to share the news that Ella's still doing OK, but will be getting a procedure sometime in the next 18 months or so.

signs and a heart full of love.

2009-07-07T01:17:00.003-04:00

I've updated Ella's list of sign language signs (google docs link in links section), and we're now up to 141 signs that I've documented. She's also getting pretty reasonable at 2 new colors, black and brown.

Also this Wednesday, Ella has a cardiologist visit to check on her PDA, and to see if she's going to need a corrective procedure for that. Last time she saw the cardiologist, they told us it was likely to be necessary at some point, but it wasn't anything significant, but that was a year ago. Fortunately it is likely to be a catheter procedure, not a surgical one, if it is necessary at all.

Regardless, wish us luck.

moving up from the MINC program...

2009-06-13T13:59:00.004-04:00

Originally it was a judgment call between putting Ella into a MINC-T (multiple intense needs class for toddlers), or putting her into the normal special ed toddler class. Ultimately, the MINC was chosen to afford Ella extra therapy time, and a smaller class for her first school.

Recently, the paperwork was done for Ella's school starting this fall. For age reasons, she's going to be moving from toddler class to preschool class. Given how well she's been doing in the classroom, and how well she socializes with other children, the staff recommended that Ella move up from the MINC program to the normal special ed preschool. We've decided to go ahead and do that.

This does mean Ella's one-on-one time with school therapists will be going down, but it also means the class activities will be more challenging for Ella, and provide her with better opportunities to advance on her own or from her peers. With her current progress in motor and social areas, I think this is very important. She's also been babbling back-and-forth with her peers, and this class is also likely to have more students in it for Ella to "talk" to.

This isn't terribly fresh news, as we've known about it for a while, but the paperwork was finalized this past week, so I figured it's past due to put it up on the blog.

Go Ella Go!

Blowing bubbles..

2009-06-11T00:19:00.003-04:00

After recently figuring out how to purse her lips to blow on things with a focused stream (instead of just going "Ha" at them) over the weekend, on Tuesday Ella figured out how to use this skill to dip a bubble wand, pull it out and blow bubbles.

It's not a huge step, but it's progress in her oral motor skills, and her application of them. Since that's an area where she's been progressing very slowly, this makes me very happy.

slow but steady progress

2009-06-02T22:16:00.004-04:00

I haven't posted in a while, mostly because nothing "unusually exciting" has happened with Ella lately.

Of course there's lots of small cute things she does every day, and perhaps I should make a point to post more of those. Thinking of that, here's one now:

A couple of nights ago, when Ella got in bed after her bath, she started giggling and shaking her head all over the place while laying down. This, of course, made a giant mess of her freshly combed hair, and I commented "Oh, you're going to be fuzzy tomorrow". She immediately stopped, looked at me, and started stroking my beard. "Yes, fuzzy, like daddy's beard". It was immensely cute.

As for progress, Color wise, Ella's starting to get the hang of identifying and signing black and brown, although these are still a bit rough and she'll sometimes label black things as being brown.

Motor wise, Ella's continuing to get more confident and bold climbing on play structures, stepping over things, jumping, etc. It's all very gradual, but looking back at even a month ago, her ability to navigate barriers is much smoother now.

On the speech front, Ella's continuing to babble, and it's still mostly "Da". However we are starting to get her to vary the sounds a bit. She's sometimes distinguishing vowel sounds to make word approximations. Most of the time it's all just "da" or "da da", but sometimes she'll intentionally shift towards "eh-da!" (ella), "die" (bye), and rarely she'll even make a little twist towards "Dahn" (done) although it's still more like "Dahd".

We've also recently seen a return of B and R sounds, although these are rare just like "tooka" "Ha" and "Ga" are.

At any rate, I hope you all are well! Hope to see you all soon.

We have jumping!

2009-05-18T14:45:00.005-04:00

This morning Ella jumped for the first time, or at least for the first time with enough vigor to get her feet off the floor. She's been doing a lot of "bouncing" lately, making jumping movements without her feet going anywhere. I guess she was scared of falling and finally got the guts up to try doing it hard enough to actually jump.

This is a good thing, as it shows her gross motor progress is catching up. She's 34 months old now, and jumping is a milestone for 30 months on most charts I've seen. While she's mostly been in the 7-9 month range, this item is only 4 months behind.

Go Ella Go! :)

Now I'm sick.. yay :)

2009-05-16T22:48:00.003-04:00

Well, Ella is pretty much clear of whatever was bothering her. She's got a slight cough now, but it's not terribly persistent.

However, now I've got some kind of head cold with a mildly elevated temperature. It's not so bad, but it's never fun having a cold.

Anyway, hope you're all well!

Something Ella is ahead in..

2009-05-10T23:55:00.002-04:00

Much of the time, I discuss area's ella is behind in. Well, for once, I'd like to mention one she's ahead in.

Colors.

Ella has been obsessed with colors since she was around 24 months old. She's gone through phases of forcing us to work with her book of colors a dozen or more times a day, every day, for weeks straight. Around 27 months or so she started being somewhat accurate at picking out objects of a requested color, at least for red, blue, and green. (Ella, which ball is green? ) At the time, this was largely dismissed as highly unlikely by her special educator.

By 31 months, she could identify red, blue and green objects, and label them expressively with signs. ( Ella, what color is this? )

Ella is currently just under 34 months old, and she can reliably identify and label the colors: red, blue, green, and orange, and usually nails yellow too (sometimes she calls it orange). She can sign brown, but is a bit shaky on identifying objects as being brown. She can also reliably identify purple objects on request, but cannot form the sign.

As milestones go, they say most children should be able to label 1 color by 36 months. In the "what to expect the toddler years" book, identifying 4 colors is in the "may even be able to" section for 34-36 month olds. Ella's reliable with 5 colors, sometimes 6.

Is any of this really that unusual? No, not really. It just goes to show how much a child's interests impact their learning. Children generally learn a lot faster when they're really interested in something. Colors deeply fascinate Ella, so this isn't surprising.

sick again...

2009-05-10T21:22:00.004-04:00

Well, it looks like Ella's going to be missing school tomorrow.

Last night we found she had a 102.7 degree fever. This one reacts very well to ibuprofen or acetaminophen, falling down to normal for the full expected duration of the medicine. It seems to stay reasonable for another hour after that, then starts creeping up again.

So far she hasn't had any significant other symptoms. She's got an occasional cough or two, and I've seen her nose drip once, but nothing that would be unusual for when Ella's not sick. About the only other reaction she's had is being a bit more tired, and snugly, than normal.

Regardless, she's doing well and is full of engergy most of the time. We've just had to limit our playing to the house and our own yard, no visits to the gym daycare today...

And for all the mothers who read this blog, Happy Mother's day!

Still More motor progress

2009-04-25T01:14:00.003-04:00

(ok, this is getting wierd. I swear I published this this earlier this morning.)

Ella's been continuing with more challenging motor tasks. This evening she climbed up a low slide by herself (on the slide part, not the stairs).

In the speech department we're still mostly vowel sounds, "du" "ga" and "tooka", with the occasional "ba" "pa" or "ma" tossed in. However, she's getting more free about echoing sounds back to you.

More motor progress

2009-04-19T21:04:00.004-04:00

This was supposed to be published back on the evening of Sunday the 19th, but for some reason I hit save instead of publish. Ooops.

Well, part motor, part self confidence. Regardless, this weekend we managed to get Ella to do several new gross-motor and balance things we've been trying to get her to do for a while.

First, she stepped over the timbers surrounding the mulch at the nearby tot-lot. The timbers are small, onlt 4" wide, and only sticking up 2" from the ground. However, up until yesterday we'd been unable to get her to take a step over them without holding an adults hand (often making a grossly over-large step and unbalancing herself). Both yesterday and today she stepped over without any help, and kept her balance, with only slight hesitation.

We also got her to run around in our yard without help. Our yard slopes gently, and while we could get her to go across the slope, or up it, she would not even walk down it without holding hands. We had a grilling party yesterday, and towards the end we went and played in the yard. We were mostly playing a game where I'd run away, then sit down and wait for Ella to come tackle us. We had her running all over the yard, uphill, downhill, in circles, whatever, without any problem or hesitation.

I also took her to the "big playground" yesterday, and she actually completed several circuits using the low slide of the gym without any help. She climbed up the steps, across a platform, got on the slide, slid herself down, got off, and ran over to the steps and repeated it all.

I was also impressed with one of her feats of fine motor skill. One of our friends brought over a stomp rocket (link has best picture I could find) and she was readily able to thread the rocket onto the black launch tube (these fit fairly snug), and she was doing it holding the rocket at the middle and the pad was just sitting on the ground. We might have to get one of those (or a jr version) as the stomping part may improve her ballance.

Anyway, hope you're all well.

Back to school, and sign list..

2009-04-16T00:15:00.003-04:00

Well, Ella's back to school following spring break, and she seems quite happy to be back at school. Today she even showed us a new sign related to school. We were at dinner and she signed "learn", and when asked about it she signed "learn - school". I guess our semi-recent addition of signing time vol 13 has a lot to do with that.

In general Ella continues to become more and more sociable, and communicative, and she continues to babble a lot and will repeatedly make specific babble sounds when prompted (Da, Hu, Gu, tooka, dooga). That's good because it demonstrates she has the idea of making specific sounds for a specific purpose. While she does a few other babbles (bu, and rarely pu), the odds of her echoing them back at your request is pretty low (15%?)

I've also converted my list of Ella's signs to a google doc, and I've added a link to it in the links section on the right, or you can just jump from here. I figure that will be useful for anyone interacting with Ella and wanting to know which signs she knows. It also has notes about some of her modifications to various signs.

School..

2009-03-30T20:51:00.004-04:00

Bad blogger, no biscuit!

I mentioned back earlier that Ella would be starting school on the 17th, and it's almost two weeks after that and I've not blogged about it. Tsk. Tsk. Tsk. So, there's no a LOT to blog about, and I apologize in advance if this post is a bit long and desne.

In any event, Ella is taking well to school. During the first week there was definitely some crying, particularly while being dropped off, but she has now acclimated to school as a part of her regular routine. Of course, she's off 7 school days in a row for spring break starting Friday, so we'll see how she does after a longer break than just a weekend.

Ella's class consists of 8 children, a few of whom are typically developing and the rest are other children with delays from a variety of different situations. Being a toddler class, the classes are mostly learning play oriented. The staff consists of a teacher, a few teaching assistants, and 3 therapists. Generally speaking, the therapists rotate in and out of the class, while the rest of the staff is present more-or-less every day. The children spend most of their time in group activities, and some of their time one-on-one with a therapist.

As for communicating home, there are a couple of things that are used to keep us informed. Every day, there's a binder that she takes to school with her, and brings home when she's done. These binders contain a series of laminated pages with pictures of the other children, staff, foods and toys. Near the end of the day, one of the staff places stickers on the pictures of who and what she played with, and what she snacked on at snack time. The binder also allows us to pass notes and references to the school staff, such as the list of Ella's signs we've placed in there.

In addition, Ella's teacher comes to our house once a week. We've only had one of these sessions so far, but these visits mostly focus on passing information back and forth. Her teacher tells us what she's been doing in class, and we tell her about some of her recent developments at home. Of course, Ella participates in the meetings to. This gives her teacher a chance to see some of the things Ella does in a home environment, where she's more comfortable, that she won't do in school.

One thing I have noticed is that she's been *really* excited about babbling lately. Obviously I can't prove the extra social interaction is causing it, but it's certainly not hurting. Also, Mental Mother tells me she's been coming home rather tired and napping quite hard most days. That's also a good sign, as it means the class is successfully stimulating her.

Whew. That's quite a dense post. I'll (hopefully) post more in the next few days.

Better, mostly..

2009-03-14T08:00:00.002-04:00

Well, Ella's virus seems to have toned itself way down. On Friday, she went all day without any fever reducers and only had a mild temperature all day. Even at bedtime her temperature wasn't high enough to warrant a fever reducer under normal circumstances (although we did give her some as she would be only sparsely monitored overnight)

So, the worst seems to have passed for Ella, which is good.

Sick..

2009-03-12T22:20:00.004-04:00

Well, Ella's got some kind of stomach virus.

She had a 102.5+ fever on weds afternoon, and it wouldn't go down very much even with ibuprofen and a tepid bath. Since the fever wouldn't break, Mental Mother made an appointment with a Nighttime Pediatrics and we took her in at 9:20pm. After a long wait, they tested her for flu and strep, but neither came up positive. So we took her home, gave her more ibuprofen, and put her to bed. The fever had broken at 1:30am, but when we checked on her later after the ibuprofen wore off, it had soared back up to 103.2. Today her fever was low, but needed occasional treatment with ibuprofen. Since then she's had one bout of stomach virus symptoms, so it looks like she has some kind of stomach bug that isn't influenza, but behaves similarly.

So Ella's a bit under the weather, and I don't feel 100% myself, but other than that, all's good at our home. Hope you're all well.

Going to school...

2009-03-04T00:30:00.004-05:00

Whew, it has, once again, been a while since I've posted.

Recently it has been time for Ella's progress to be formally reviewed by her therapists, and to revise her education plan. So there's been lots of meetings, testing, planning, etc going on.

As a summary of her evaluation, Ella is more-or-less in the same relative place she was last time she got evaluated. Her motor skills are 7-9 months behind where they "should" be, which is roughly how far behind they were before. Of course, she's older now so that's less of a percentage than before. She is most severely behind in expressive communication skills, as she's still not speaking on any consistent basis. Here she's behind by approximately 18 months, and although that doesn't count her signing, she's still behind even if you were to count them.

And of course, all that evaluation has led to a new education plan for Ella. Currently Ella is in a home based therapy arrangement, where the therapists come to our home for one-on-one sessions with Ella. The plan now is to transition Ella into a group therapy arrangement at a school. This would normally happen anyway when she turns three, but we're doing it a tad bit early. The basic thinking here is the increased exposure to peers will help her model off others, and that's a philosophy that makes sense to both of us as parents.

So, starting in two weeks, Ella is going to be going to a local elementary school for a class called MINC-T (multiple intense needs class - toddler). She'll be going 5 days a week for 2 and a half hours a day. We've already had a chance to go to the school, visit the classroom, meet the teacher, therapists, and most of her fellow students and their parents. So far I'm reasonably impressed with everything.

At any rate, it's getting late (or early) and I best be off to bed.

progress

2009-02-04T00:59:00.002-05:00

It's been a while since I've posted about Ella's progress, so here's a quick post on what she's up to.

In the signs department, Ella's now up to 95 signs I've got documented, but I'm probably missing a few. She now picks them up fairly rapidly if used in context.

In the eating department, Ella still isn't using utensils, but she's very good with an open cup. She can even pick up an open cup one handed now and drink from it (with some chance of spilling). She's starting to be willing to pick up large foods and bite chunks off, as she did with the flatbread, but she still needs many foods cut up for her.

We've also been potty training Ella recently, with fairly good success so far, largely thanks to mentalmother. We've been training for about a week now, and she still has a lot of accidents, and sometimes she gets a bit stubborn about it, but on the whole she's taking fairly well to it.

The past two weeks have also been very talkative for Ella. She's not using words routinely, but we're getting a lot of babbling and a variety of different sounds. In general she seems to be experimenting with her mouth a bit, which is a good thing.

Anyway, I best be going, hope you're all well.

Fruit, shoes, flatbread and pizza..

2009-02-02T05:45:00.002-05:00

I'll post some progress later, but right now I wanted to take a minute to share some short and amusing stories from this weekend.

On Saturday, we were packing up to go out shopping. So I picked up two pairs of Ella's shoes, and asked her "which pair of shoes do you want". She pointed to the pair in my left hand, then signed "pear", "shoes". Very cute, but it raises the question, how do you teach a toddler about homonyms? :-)

On Sunday, we went out to lunch, trying the new Cosi restaurant here. They didn't have Ella's staple chicken on the menu, so we tried ordering her pizza. She would not touch the pizza, but my meal came with a side of a dense, chewy, whole-grain flatbread. That she ate. Even more strange for a child that rarely bites chunks off larger foods, she actually ate it by biting chunks off the big piece.

Just goes to show, there's no predicting what might appeal to a toddler.

General misc news..

2009-01-11T21:42:00.003-05:00

Sorry I haven't posted lately, but with the holidays and all, a lot was going on.

Regardless, on the Ella front the news is mostly small things.

She had a wonderful holiday, and particularly loved the tree. Every morning she'd come out and sign tree, then star. After we took it down, she would ask about it for several days by signing tree.

In the progress department, her signing continues to progress. She's now up to 90 signs, and we're working on colors. At this point, a lot of her signs are distorted to be similar to others she already knows, but in context we can figure them out quickly enough.

Recently she's been on an upswing of babbling again, which is good. She'd slid off her speaking for a while there, devolving at one point to everything being "rah-rah". It's good that the variety of sounds is back again, but this still remains an area of concern for us.

She's also starting to make "play noises", such as "num num num" when pretending to eat off a spoon, and making slurping noises while pretending to drink. This is also a good thing, as it's using a vocalization for a specific purpose, and provides some foundation for us to build on while working on speech.

Gross motor wise I've been off-and-on working with her to try teach her how to jump. I've managed to get her up off her heels, but no real off-the-ground jumping yet. It's more like standing up really fast at this point. Other than that she's doing very well motor wise. I don't know if these have been mentioned before, but she climbs on and off of the couch without any help, crouches down to pick things up without difficulty, etc. I'm overall quite pleased with her gross motor progress.

Anyway, take care all, and I hope your holidays were as bright as ours

Let her eat cake!

2008-12-09T22:23:00.004-05:00

It's been a while since I've made a post (although I did update the "Recent Progress" list earlier this month), so we're more than past due for an update.

This past weekend was Ella's cousin's birthday party. Ella had quite a lot of fun at the party, and managed to do a few new things as far as eating goes. The most notable was that she ate cake without incident. In the past (even as recently as this summer) Ella was not able to eat cake, as the crumbly texture caused her to gag. That is a good thing as far as mouth control and texture tolerance goes.

She also tried a hot dog (well, a pig in a blanket) for the first time, and succeed in biting a chunk off and eating it. It is only very recently that we've been successful in getting Ella to bite chunks off of larger food items, and it's even better that she did it with something "unfamiliar". She's been fairly resistant to eating foods outside her normal day-to-day foods. Fortunately her day-to-day foods comprise a fairly balanced diet with all the major food groups represented, but there's not a lot of variety there.

In general Ella's "safe" foods are:

chicken nuggets of most any sort
turkey meatballs
peanut butter and jelly topped pancakes (a little weird, but she likes them)
Dr. Praeger's spinach pancakes
Dr. Praeger's broccoli pancakes
Earth's best spring vegetables and pasta (yes, it's a baby food, but she loves it and it's vegetables.)
American cheese
yogurt
Cheerios, Kix and Rice Crispies
Any common fruit (esp grapes, blueberries, and canned pineapple)
french fries
a variety of crackers and cookies.

All in all, not too shabby for a fussy two year old. You've got meats, vegetables, dairy, and grains in there. I'd be happier if she was more adventurous in her eating, but at least its a healthy diet, and we're not fighting to find a vegetable she'll eat.

ABC's and more..

2008-11-17T23:42:00.003-05:00

Again, I haven't done this in a while, so sorry about that.

One of our recent discoveries is that Ella can recognize at least half the letters of the alphabet. I've been testing her with the letters from her word whammer, and she's been doing well as long as she can maintain interest in the game. She's had a strong interest in her "alphabet town" toy over the past few months, and it's starting to sink in.

She's also now taking pretty strongly to imitation, which was previously one of our biggest barriers in teaching her.

Other than that, she's got several new signs, including "floss teeth", which she uses often as she actually enjoys having her teeth flossed. (we use a pre-threaded plastic flosser). Why she likes this so much, I don't know, but she actively asks for it. Ahh, the interests of a two year old.

In other news my site has recently gotten a lot hits to older posts from people searching about omega 3's and dyspraxia/DCD. In light of that, I figure I'll refresh my opinions on the matter. If you're not interested in this topic, you can skip the rest of the post. :-)

We've had Ella on 1/4tsp of highly refined Cod liver oil (250mg's of omega-3's, mostly dha) per day since June. After, I really don't think it's directly done much for her motor wise. However, she's had a dramatic change in her motivation levels since we started it, and that's made all the difference. And that dramatic change is still in full force, and that's wonderful for us. In may, Ella was really hitting a deep low in development and was difficult to motivate. About 4 weeks after we started giving her cod liver oil, she really started being motivated to explore and try things.

I still can't say the oil has actually done anything for Ella, as it could all be a coincidence and she was just "ready". However, given the current streak of development, we're not stopping it. If you pressed me, I'd say that it's probably helped her a little bit on an intellectual and behavioral level, which in turn has resulted in motor progress. However, that's really a theory that fits my observations. The scientific evidence to support it exists, but it's a little thin.

There's also a lot of supplemented products with DHA only in them here in the US. Those products didn't seem to do much for Ella. She was on those pretty much since she was 2 months old (formula, then yogurt, and fruit/cereal containers), averaging 40mg a day of DHA. Admittedly the dosage is higher on the fish oil, but it's also got a noticable amount of EPA in it. Givent that going from 40mg DHA alone to 150mg DHA + 100mg EPA made a big difference, I find it hard to believe that DHA alone is the important piece.

A quick update...

2008-10-27T23:34:00.005-04:00

Ok, it's been *way* too long.. sometimes life just gets busy..

In any event, the three of us have been fighting colds for the past week or two. At this point Ella's pretty much over it, and me and mentalmother are on the down-swing of it.

In other recent progress, Ella started standing up on her own, without using anything to pull up on, a little over a week ago. At first it was rare unless you specifically asked her to do it, but she's now doing it quite regularly on her own as a way to get up to standing. Previously she'd have to crawl over to something to hold onto to either pull (tall item) or push (short item) up on.

She's also continuing to develop her signs, and they're now coming fast enough I'm sure I've missed documenting some of them. But she's up to 52 I've documented, and who knows how many more she has. Back in august she had 15 that I posted as a list. Here's her current signs, in more-or-less the order she learned them:

Eat, More, Milk, Light, finished, Dog, Open, Book, Shoes, Daddy,Music, Hug, bird, Drink, cracker, cereal, play, cheese, on ,wash hands, brush teeth, potty, please, sorry, cookie, bath, flower, thank you, time (used to request signing time videos), swing, tree, grapes, slow, car, motorcycle, clothes, silly, rock, game, train, boat, ice cream, socks, cold, like, blanket, hat, excused, break (this one she invented her own sign, and was not taught the ASL version), bed, baby.

That's not a huge vocabulary, but it's enough to express a lot of basic needs and interests.

Anyway, I best get some sleep. Hope you're all well.

A weekend of Ella fun.

2008-10-06T23:40:00.003-04:00

A while ago, a friend had recommended Dutch Wonderland as a good place to take a young child after he took his daughter there. This weekend, we decided to take a long weekend and go up to Lancaster, making Dutch Wonderland one of our stops.

The amusement park was quite good. Ella was only able to ride the smallest group of rides, but there were quite a few for her, and she had a good time on them. She particularly enjoyed a "VR" ride, that was essentially a small movie theater in a bus-shaped capsule that rocked wildly on hydraulics. She laughed hysterically the whole time.

During our trip, we chose to stay at the Willow Valley Resort. This was a really nice place to stay too, and is very child-friendly. The resort has a indoor pool complex that's a lot like a small water park and Ella had a great time there. A lot of the water was shallow enough Ella could walk around in it. Walking in water threw her off for a little bit, but she quickly got the hang of it. We wound up getting a package plan that included breakfast and dinner at the resort. The breakfast smorgasbord is decent, but the dinner one generally left a lot to be desired. We actually wound up using one of our dinners as credit towards their Sunday brunch instead, and that was really very good, bordering on excellent which is really surprising in a buffet-style setup. It was really a day-and-night scenario with no comparison at all.

We wound up staying 3 nights, which was probably more than we needed, but it let us take our time and enjoy ourselves. I think next time we'll go for a shorter stay, and avoid the in-house dinners, but it's certainly worth doing again sometime later on.

Fun at a wedding

2008-09-23T00:31:00.003-04:00

This past weekend was my cousin's wedding, and we went, taking Ella with us. The rehearsal dinner turned out to be a blast for Ella. One of my other cousins has a 4 year old daughter, who was dressed in a bright-pink frilly tutu type dress. Ella thought this was the greatest thing ever, and proceeded to spend most of evening running following her and laughing her head off. When Ella would catch up, the other girl would turn around and poke Ella in the cheeks. This caused Ella to stick out her tongue and laugh even harder.

It was really great to see Ella having such a good time running around and interacting with other children.

Ella has also recently started walking around in grass without having her hand held. Since the surface is uneven this is a bit more difficult for her, and she's been resistant to doing so. However, by Saturday she was chasing her cousin Jake around the yard of the church.

On the language front, Ella is now up to34 signs. The 17 new signs ella has learned since August 12th are: cheese, on, wash hands, brush teeth, potty, please, sorry, cookie, bath, duck, flower, thank you, time, swing, tree, grapes, and slow. So, Ella has doubled her signs in a month and 10 days.. not too shabby.

Ella is also taking much better to the toddler bed. She finally took a nap in the bed. For a while she wasn't napping, then she started napping on the floor in her room, and now she's napping in the bed.

Toddler bed, signs, etc

2008-09-12T07:34:00.004-04:00

Ella did something a little different last night. After we put her in bed and left the room, she stood up in bed and started screaming her head off. Since this was very out of the ordinary and she was completely hysterical, we went in and calmed her down.

After some crackers, water, and more book reading, we put her down again and left the room. Almost immediately she stood up and started screaming again. This time however, she got back down, went to the side of her bed and got out. From there she walked over to her door, touched it, walked back and got back in bed. Then she stopped crying.

Yesterday at her naptime was the first time Ella had gotten out of bed with nobody watching. Apparently she just wanted to prove to herself she could do it again.

In other news, she's up to 27 signs now, and one of her newer signs is "potty", and she's starting to occasionally use the sign to request to use the potty.

She's also starting to be more responsive to our attempts to shape her vocalizations, and I managed to get her to say "duck" last night. This brings her up to 4 spoken words: bubuh (bubble), ella, dada, and duck. However we haven't heard her say bubble in a couple weeks, so she's really only using 3 at the moment.

Regardess, she communicates her needs to us fairly well using the signs, and she's actually very receptive to our requests. Of course, she's two so she might just do what we ask for 2 seconds and then go back to whatever she was doing before, but she nearly always follows simple directions when you ask.

Toddler bed follow-up.

2008-09-06T21:15:00.003-04:00

Well, Ella has taken fairly well to the toddler bed. The first couple nights, she fell out once or twice. Since the bed is so low and we put pillows along side, this didn't really bother her and she just snoozed on the floor till I came in and put her back.

The only "hitch" of the transition was that up until Monday she *refused* to nap in the bed and would cry hysterically if left in the bed at naptime, so we had a couple napless days. However, that passed and now she naps in the bed without fussing about it.

Other than that, things are going well here. This morning we tried Ella in jeans for the first time since she started walking, and the reduced mobility resulted in several falls while trying to run around target. We spent the middle of the day indoors as tropical storm Hanna blew through, but it didn't really do much here but rain and blow down some small branches.

Anyway, I hope you're all well.
Matt

Toddler bed...

2008-08-30T20:44:00.005-04:00

Well, tonight is Ella's first night sleeping in a toddler bed instead of a crib.

We tried to get her to nap in it this afternoon, and she got scared of it, so no nap today. However, at the moment she's actually asleep in the bed. We'll see what happens in the middle of the night :)

More signs, etc.

2008-08-24T22:32:00.003-04:00

since my last post, Ella has added 4 more signs: cheese, on, wash hands, brush teeth.

In other news, while we're not yet working on potty training yet, we have been working on familiarizing Ella with it. At this point she doesn't request to use it, but when she's on it, she knows what it's for and will use it if she has to. This will hopefully make things a lot easier later on.

Ella's also had a lot of instances of waking up in the middle of the night over the past couple of weeks. We may wind up having to adjust her sleep schedule, because after some research, it looks like she's in bed for more hours per day than the average child her age needs.

Ella's signs..

2008-08-12T22:16:00.005-04:00

Well, Ella has 2 new signs today, cereal and dog.

Actually, they're not entirely new signs today, but as of today we now know their meaning.

Ella's first version of a sign can be pretty deformed from the proper sign, so they're tough to correlate with a meaning unless she uses them in the right context. She also doesn't tend to start using them right away in response to being taught them. They tend to lay dormant and then sometime later she'll just randomly start using the sign. It could be hours, days or weeks since we last tried to teach her that sign or she saw a video containing it. (Ella does have a good collection of signing time videos, and has learned several of her signs from them. The videos really are quite good and I highly recommend them to parents who want to teach their child sign.) .

I also realized I've never put up a "list" of all of Ella's signs, so here they are:

Bird, Book, Cereal, Cracker, Daddy, Dog, Drink, Eat, Finished, Hug, Light, Milk, More, Music, Open, Play, and Shoes.

She also has a few common gestures that I'm not sure if they're other signs, or just things that are fun. We'll see.

More walking, signs, etc.

2008-08-09T22:14:00.003-04:00

First, a brief progress update.

Ella walked on her own in the yard for the first time today. She struggled a bit walking up the gentle slope, but seemed to enjoy it.

She also used a new sign today, completely without prompting. I was feeding her lunch, and I started off with a few cracker pieces. After those were gone I gave her veggies, cheese, grapes, etc. About halfway through all this, she spontaneously signed "cracker" at me, not quite perfectly, but quite close. So, I gave her more crackers, showed her the correct sign and she echoed it properly while chewing away happily.

After that was gone, I asked her if she wanted "more cracker", and she signed both words at me. This is the first time Ella's used a two-word phrase.

Not bad for one day.

Finally, something unrelated to Ella but made a rather odd twist to my day

If you encounter one of these (saddleback) caterpillars, don't touch it. I brushed against one today and I can tell you first hand they hurt quite a bit. Very much like a good solid bee sting where they've had time to inject lots of venom. I used the scotch tape trick, washed, and used meat tenderizer to extract the venom. After all that my arm hurt for about 4 hours, and still has a mild tingling sensation 8 hours later.

Leave it to me to find a caterpillar that actually has venomous stings. Apparently that one is quite potent as stinging cate pillars go, but there's one that's clearly more potent (the puss caterpillar, and it can be found in Maryland too.)

Distance record...

2008-08-06T21:23:00.003-04:00

Well, Ella set a new distance record today. Twice today she walked from our bedroom to our kitchen without touching anything, about 48 feet, and also did a similar distance at the food court.

Go Ella go!

May I have a word please?

2008-08-05T21:11:00.003-04:00

Or, well, two actually.

Ella now has two verbalized words! She's finally speaking!

Her first word is "buhbuh", for bubble. Her second word is her own name, Ella, although it sometimes comes out "eya" or "lala". This is a very good thing, and on top of it, Ella has been engaging in a fair amount of imitative behavior lately, which hopefully means we'll be able to teach her more.

We're not really sure what has brought all this progress on, it could be that she was just ready, or it could be some of the changes we've made lately in therapy or diet. But whatever it is, we're going to keep doing it.

One thing we changed in mid June was we started giving Ella a highly purified cod liver oil supplement. Admittedly the best study (Oxford-Durham) I previously found suggested there are no motor benefits, only behavioral. However at least one study that wasn't as well controlled (Stordy 1997, summarized by Richardson) suggests significant motor benefits.

Thus far we've been keeping the dose low, 1/4 tsp a day providing 155mg DHA, and 102mg EPA. Cod liver oil can cause problems with too much Vitamin A, but this dosage is under 20% of her daily vitamin A and has only traces of Vitamin D. Needless to say, it certainly doesn't seem to be hurting, and differs from most of the Omega3's Ella's gotten so far in popular supplemented kids foods which tend to only contain DHA.

Developmental Pediatrician, round 2..

2008-08-04T21:54:00.004-04:00

Today, Ella went to see the developmental pediatrician from UMMC. This is essentially the 6-month follow-up to the previous visit. However, this time Ella saw a different doctor, as the previous has moved on to work for a county government. Actually, she wound up seeing two doctors, as they were running quite behind when they finally got to us and wanted to team up to make the testing parts go faster.

In general, this visit wasn't a whole lot different from the last. One doctor interviewed us while the other gave her a developmental assessment, using the CAT/CLAMS test pair, which showed her to be about 25% delayed (18 months). This is a bit different from what the county school system came up with (12 to 15 months, with one area at 18 months), but they use a different test (ELAP), and the past two weeks have shown a LOT of progress for Ella.

After the developmental assessment, they gave her a physical examination. During this they tested her reflexes noted her muscle tone was slightly low, but not of any great concern. This also matches up with the previous observations of Ella's physical therapist. They examined her eyes, inner ears, mouth, teeth and throat for abnormalities and found none. They also made some observations of Ella's facial and body features and compared them against ours looking for signs of genetic deviation. Ella has a few "off average" features, but she comes by most of them honestly (like my smallish mouth and long toes).

After all that we spent some time talking. They again said there were no signs of autism, just the motor problems we already know about. They said they could refer us to a geneticist, but at this point the only reason to do so would be to find causality (with almost no likelihood of finding anything of therapeutic value) and therefore didn't recommend it. While that might be interesting to know, I tend to agree with them it is not worth subjecting Ella to more tests for something that's merely interesting.

They also suggested a form of speech therapy that works well for children with motor disorders (PROMPT), but after some research, I think our SLP is using some PROMPT techniques.

Finally, they suggested we set up another visit in 6 months to continue to track her progress, this time at a different center as they might want to bring in some other experts.

So, that was basically what happened there.

Revised Therapy services..

2008-08-01T21:55:00.003-04:00

Ok, I'm posting a lot lately, but since Ella turned 2, a lot of her specialists are having their annual reviews or follow-ups.

In any event, the Howard County Infants and Toddlers program which handles the bulk of Ella's therapy recently did their re-evaluation of Ella's progress and planned new services.

Previously at 1 year old, Ella was 50% (6 months equivalent) delayed in gross motor, and 25% delayed in communication (9 months equivalent). During the Evaluations in June she was 35% delayed in gross motor (15 months equivalent of 23) and 45% delayed in communication (12 months equivalent of 22). Those numbers are slightly skewed, as the ELAP really doesn't count use of sign language as expressive vocabulary. However, it's still clear that Ella's area of greatest need is communication. It's even more clear when you account for the gross motor progress ella has made since the evaluation.

In light of that, at the end of August Ella is being switched to a different Special Educator that has a lighter case load and can spend more time on her. This will likely result in Ella getting two special educator visits per week instead of one. This is a good thing, as the Special Educator primarily works with us on activities to increase imitation and use of sounds to express herself. The rest of her team is going to remain the same (she also has a Physical Therapist, Occupational therapist, Speech Pathologist).

Cardiologist visit...

2008-08-01T05:50:00.003-04:00

Ok, I'm actually backfilling news from last Friday, July 25th.

Ella went and saw her cardiologist to check on her PDA with an echocardiogram. This is going reasonably well, but the opening is now larger than expected. It's not causing her any harm, but they're now expecting they will eventually have to close it (via a catheter type procedure). However since it is still fairly small and not causing her any problems, they're going to wait and check on it again when she turns 3.

The cardiologist also told us that they'd be able to see any signs of trouble on the echo long before we'd see any physical symptoms. Apparently the first sign is enlargement of the left ventricle of the heart, which Ella isn't showing in the echo. They also did an EKG and they did not note any irregularities in heart rhythm (another sign), and we've not observed her being unusually short of breath (the first sign we'd be able to see).

More walking..

2008-07-30T00:28:00.006-04:00

In the past week or so Ella has continued to become more outgoing about walking and demonstrating more skill at it than ever before. This is good because for a while she had regressed, at least in what she was willing to do, but as of today she matched her previous distance record. (down the hallway and around the corner to the bathroom, which she last did mid march)

She's now walking without merely concentrating on where she's going and quickly walking there. Instead she's looking around or down at her feet, playing with her hands, etc. She's also picked up the cute habit of walking around with her hands clasped behind her back. I need to get a photo of this because it really is very cute :-)

She's also doing a lot of turning without touching things. When she's walking back and forth between me and Karla, more than half the time she'll come up to you and without touching you (or just poking you on the nose with her fingertip) she'll turn around and head back to the other parent. I can also get her to follow me around corners without touching the walls, at least some of the time.

Recent progress, more walking/babling.

2008-07-18T07:44:00.004-04:00

Ok, I've been *really* busy lately, but I really feel bad about not blogging lately.

In any event, Ella is continuing to progress albeit at her own pace.

In the walking department, Ella is starting to show more bravery about walking on her own. She's still not fully walking independently, but without hesitation she'll take 6' "jumps" between objects. She also tends to not be constantly touching things when walking along them, instead walking with a hand hovering near things, but not on them. Our current gross motor work is focused on developing the ability to stand up in the middle of the floor, and improving her climbing.

In the speech department, Ella has been starting to use vocal sounds in relation to items, like "buh" in relation to bubbles. She doesn't do it all the time, but we do see it occasionally.

In any event, we've got a lot of preparation to do for the weekend, so I best head to work so I can head home sooner.

Progress, etc..

2008-06-01T23:45:00.003-04:00

First, sorry it's been forever since I've posted. Ella's been continuing to make progress, but it's lots of smaller things, with no "big items" since my last posting.

First, her special educator has shifted our activities towards increasing Ella's sensory stimulation. This tactic has been fairly successful. In the past, Ella alternated between making progress in motor and communication, completely stalling progress in one while progressing in the other. With the stimulation exercises, she seems to be progressing in both at the same time.

On the motor front, Ella has progressed in skill, but her courage levels have devolved a bit. Her maximum walking distance is much shorter than it was, only 5 feet or so between parents. However her skills are increasing. She's now readily getting herself down from standing onto her hands-and-feet using inanimate objects to brace herself with one hand. She's also fairly regularly letting go with both hands to play with toys while she stands.

However, she's still not willing to stand without being near a hand-hold, and she's not walking around freely yet.

On the communication front, her sign vocabulary is continuing to grow. She's got 5 signs she uses regularly, and is "close" on another 3 or 4. Her babbling is increasing constantly, but she doesn't yet use any of it with apparent intent.

Anyway, I hope you're all well, and I'll hopefully post again soon.

pinball walking....

2008-03-18T20:07:00.002-04:00

Ok, so last night I had a big update on Ella's walking progress from Sunday night. This morning I got to see another.

Ella is now "pinballing", free walking back and forth between multiple different pieces of furniture, all in rapid succession with little hesitation. From the chair to the couch, from the couch to the ottocube, to the loveseat, couch, chair, tv, ottocube.. boing, boing, boing..

It's all very cool to watch, and she finds it very enjoyable.

Now we've still got plenty of gross-motor skills to to work on, but this is great progress. She still needs to work on stopping, standing around and starting again. She can already do this, but it is really the rare "I got distracted" thing, not something she'd do intentionally.

More walking updates...

2008-03-17T23:01:00.003-04:00

Sunday night me and Karla did more "walking practice" aka "baby tennis" with Ella. This is our usual bit where we sit 5 to 10 feet apart, then have Ella walk back and forth between us.

Sunday I tried something a little different. While Ella was coming down the hall at me, I scootched across the floor so that I was around the corner from her. And to my surprise, she rounded the corner just fine and got me. After a few passes of this, I was able to let Ella go at the bathroom, and she'd take off and round the corner heading for mom without even being able to see her when she took off. For us that's a major advancement in walking bravery, which is very important as her primary obstacle to walking seems to be fear of falling or taking chances.

Her total trip was 16 feet, 5 1/2 feet from the bathroom to the corner and another 9 1/2 feet from the corner to mom. So it's also a new distance record.

We were not able to get her to make the return trip blind. I had to lean my head out around the corner to get her to take off, but it's still a major advancement. With a few more goes at it, I'm sure we can get it going.

Unfortunately, we didn't get any walking practice today, I had to head to work in a hurry when I woke up at 8 this morning, and worked past Ella's bedtime. Hopefully we'll get some in tomorrow morning.

Flu and emergency room update...

2008-03-08T20:01:00.004-05:00

As I mentioned in my last post, late Thursday afternoon we took Ella to the emergency room for hydration. Thursday night was a bit rough, but she's now almost completely better.

Today, two days later, Ella is doing well and no longer shows any major signs of being sick. She had no fever today and didn't vomit at all. She did sleep a lot, ate a little bit less than normal, had one loose stool and a lot of gas, but that's all for signs of sickness.

One thing that did come up in her emergency room visit was her liver enzymes were a little elevated. Nothing serious, and viruses can cause this, but it's a little rare in stomach flu type viruses. In a month we need to take her in for a liver function test, just to make sure there's not an ongoing liver problem.

Stomach Flu again..

2008-03-07T19:27:00.003-05:00

Well, Ella's sick with the stomach flu again (or rotavirus, or whatever else is going around).. She got violently ill yesterday, and couldn't keep anything down, not even water. By late afternoon she was getting listless and shaky, so after my wife called the pediatrician, we took her to the hospital.

Going to the hospital perked her up because it was a new place, and the doctor who saw her wasn't terribly concerned, but ordered and IV of fluids and a little bloodwork as well. Originally they were just going to IV her for an hour (200ml/hr of sodium chloride 0.9% solution), however after the bloodwork came back they upped that to 2 hours and gave her a dose of zofran for nausea.

So, we spent a bit under 4 hours at the hospital last night (from about 5 to about 9), but it turned out to be a good thing. about 75% of the way through treatment Ella felt much better and started drinking water out of a soda bottle (I got it for my wife, but Ella protested vehemently until we gave it to her). She drank about 8oz and kept it down, which was really good.

She's still quite sick, but has been able to keep fluids and simple foods down now without immediately vomiting. She got sick once today, but that's not so bad.

As for the parents, both of us are feeling a bit run down, but it's hard to tell if that's lack of sleep and stress, or if we're coming down with it too...

Hope you're all staying well...

Stair Climbing/crawling..

2008-03-02T21:50:00.005-05:00

Our home has no stairs in it, so Ella gets little exposure to them other than concrete steps outside. So, normally she's only given the opportunity to practice walking up them.

Today we were over visiting the 3 B's and Ella successfully crawled up a short 3 step staircase without any help. Generally speaking that's no major achievement, but it was also the first time she'd ever had a chance to try :)

Also, while she was walking around between adults she did a really nice change of direction. She managed to stop, turn 90 degrees, and start going again without wiping out. While it wasn't the most graceful maneuver, it was impressive none the less. In the past she's managed to stop and resume, and she's managed to turn while walking, but she's never turned in place before.

All in all it was a lot of fun, and only mildly chaotic.

Ok, make it 10 feet...

2008-02-26T19:10:00.004-05:00

Tonight Ella was in a braver mood, and did 10 feet (17 steps) of free walking, shattering this morning's 7 foot record. And she did it repeatedly, at least 5 round-trip laps.

One other thing I neglected to mention.. She steers herself while walking. She might start off headed at a 45 degree angle to where she's going, and she'll properly curve to get where she wants to go.

This is all very good.

Walking progress..

2008-02-26T09:41:00.004-05:00

Well, Ella's still not walking completely on her own, but she's definitely making a lot of improvements. Since Yule we've been having her walk back and forth between us for a few steps at a time, then collapse on the receiving parent. For a while, she regressed and got more hesitant, but recently she's made good progress again.

This morning, Ella will walked a bit over 7 feet ) without touching anything to go between us (10-13 of her steps). We were sitting in the hall and our hands were about 8 1/2 feet apart, but I subtracted a bit for reach-out and push-off. She also no longer needs you to "catch" her. You can simply put one hand up (in a "stop" motion), and she'll walk over, reach out with one of her hands, and grab it for stability while she turns herself around. Most of the time she can turn around with no more stability, but occasionally she gets excited, whips around and falls over.. oops.

We still haven't gotten her to do very much in walking towards inanimate objects, but she will take 3 steps or so to get to something she's really interested in (such as her mother's keyboard so she can bang out some music..). We've had no luck at all getting her to push off from inanimate objects, although we have gotten her to use one of our knees as a push off instead of our hands.

The flu and speech therapist...

2008-02-04T22:10:00.002-05:00

Well, thinking I was "coming down with" the flu was an understatement.. both me and Karla got hit quite severely by the flu on Saturday night. Although my stomach recovered fully by Monday morning, I was still a bit sore and weak as my body was still recovering from the abdominal muscle strain, dehydration and fever. As a result, I took today off work to recuperate.

Flu aside, Ella saw a Speech Pathologist this morning for the first time. That was fairly helpful, and we got some feedback on some of the tactics we've been using, and some tips on recognizing some of her attempts at speaking so we can better encourage them.

It was also recommended we take Ella in for an audiological screen. This is a detailed hearing test, and a test with a device called a tympanometer that bounces sound waves off the eardrum and tests the movement of the eardrum by analyzing the reflected sounds.

Ella's hearing appears to be fine because she's got an excellent receptive vocabulary (she can clearly discern over 100 words that we've counted). However, because she keeps pulling on her left ear they want to screen for fluid trapped in her ear. It's probably just a frustration or boredom habit, but it could be a sign of trouble there.

Biting lemons and the flu..

2008-01-31T21:56:00.000-05:00

Sorry it's been a bit, but life's been busy. Ella's got the flu, and I seem to be coming down with it too.

As for the Lemons...

Last Weekend, Ella got together with JP and his mother. Among other things, we all went out to dinner at Applebees. While at dinner, JP was eating the lemon out of his mother's tea. Apparently he likes them, and is rather insistent upon having them if they're on the table...

So, I decided to try to give Ella a taste of mine.. lo and behold, she likes them too. She does make reel back and twisted faces right after biting it, but then she opens her mouth back up, leans forward and takes another bite.

However, in some of my recent reading, I found that giving a child strong-tasting foods, such as lemons, Tabasco sauce, etc , is actually a therapy method used in aiding children with speech delays. The idea is the alarming tastes cause them to focus on their mouth more, aiding oral motor development. This is, of course, presuming the child doesn't over-react to them.

So, shout-outs to JP's mom.. thanks for the free speech therapy :)

Omega-3's and dyspraxia..

2008-01-26T22:09:00.000-05:00

Recently, there's been a lot of attention of how various omega-3 fatty acids, particularly DHA, affect autism. This has also spawned a lot of research into how various omega-3 and omega-6 fatty acids affect other disorders, including dyspraxia.

Probably the best study on how fatty acids affect dyspraxia is the Oxford-Durham study from 2005. The study used 117 students with DCD, ages 5-12 in a double-blind random study (no crossover). For 3 months they were given a blend of fish oil (EPA and DHA in a 3:1 ratio) and evening primrose oil (provides GLA, which easily converts to ARA) or a placebo of olive oil. At the end of the study they found several improvements cognitive learning rate and behavior, but no motor improvements relative to the placebo group.

So, omega-3's aren't a magic arrow for the motor problems of DCD. That said, there are several DHA supplemented baby foods Ella still strongly enjoys, so her typical daily diet does contain 40mg of DHA and 8-40mg of EPA. (none of the products label their EPA content, but are fish oil based and there's always some EPA. How much varies with blending and processing.)

Dyspraxia/DCD links...

2008-01-26T21:38:00.000-05:00

For those who haven't noticed yet, I added a few links to websites and articles on Developmental Dyspraxia and Developmental Coordination Disorder (DCD). Both are nearly synonymous terms for the disorder that Ella appears to have. Dyspraxia is primarily a term used in the UK, and DCD in America, but there is some crossover.

As for the links, In general, I'd say:

If you want an easy to understand overview, read the NCLD article. For the most part it's very down to earth and practical.

If you want a bit more detailed and technical approach, read the wikipedia article.

If you're a medical professional, or want a lengthy discussion, you might find the DCD primer useful. It's primarily targeted at educating pediatricians, and is 5 1/2 pages of useful text. This article is a little on the older side, 1996, but it's still quite good information.

Teething pains...

2008-01-23T20:50:00.000-05:00

Well, Ella's on another of her "how many teeth can come in at once" phases. Right now she's got 2 that have broken through the skin a little bit, another 2 that are swelling up to break, and 2 more that might be coming in, but it's hard to tell amidst the chaos.

So, Ella's got a good bit of the "teething grumpies", and it's been messing with her sleep. On Sunday and Monday she woke up for the morning at 4:30am and 4am, respectively.

For the most part it's been settling down a little, but she's still having bursts of "I want this, no that, no, wait, I want to stand and sit, and lay down all at once..." interspersed with sessions of "I want to sit on your lap and have you to read to me for 3 hours straight" and "I want you to walk me around the house in laps for 3 hours straight".

Fortunately, it's not really quite as bad as it sounds, but it's certainly bad enough that I feel sorry for my poor wife who has to try to keep her active and happy all day. (dear, you're the best!)

Ahh, the holidays have passed..

2008-01-09T08:29:00.000-05:00

Yes, I know they passed a while ago, but it feels like they just ended recently because everything else has been so busy trying to "catch up".

In any event, Ella is doing well. Over the holidays her number of signs expanded to 3. She now does her own versions of "more" "finished" and "food/eat". Of course her versions are hardly ASL, but we've learned them.

Ella's independent walking continues to improve. She sometimes will shift directions mid-walk without trouble, and she can go up to 10 steps at a time (although usually it's more like 6) before she stumbles or won't try because it's too far. She's also gained enough confidence that she'll sometimes go to an inanimate object instead of another person. (she knows people will catch her if she falls, so she's more comfortable walking towards a person.)

In any event, I hope you all are doing well, and I hope to see all our local friends and family sometime soon.

Hi everyone!

2007-12-24T13:36:00.002-05:00

DSC02049
Originally uploaded by matt

Ella just had to say hello :)

Comments..

2007-12-24T09:01:00.001-05:00

I've relaxed my comment settings a bit to allow anyone to post if you do the "captcha" jumbled-text-box thing. We'll see how this works and if it doesn't cause another deluge of spam posts I'll leave it that way..

Blasted spammers, ruining the world for everyone else who just wants to make information exchange simple.

Steady Progress...

2007-12-20T00:38:00.001-05:00

Well, Ella's still not walking, but she's getting *really* close..

She's now to the point where she'll play the game where one of us helps her walk toward the other, then lets go when she gets close. She'll usually take one or two good steps then loose her balance (at which point we catch her).

This kind of thing has been going on for a while now, but she's really improving at it. Recently we were playing this game and when I let go of her and she stopped, balanced for a second or two, then started walking towards Karla, took 3 steps, then fell into her arms. Being able to start herself moving without throwing her balance off is a very good step.

Also, about a week ago when we were playing that game she tried to stand up without holding onto anything. She got herself on her feet with her hands on my lap, pushed off and stood herself up without touching anything. Of course, she promptly toppled over and I caught her, but that was a "risky" thing to do, and it was very good to see.

Developmental Pediatrician.

2007-12-08T12:12:00.000-05:00

As some of you know, Ella saw a developmental pediatrician from UMMC on Friday (hence forth "the doctor"). She was extrordiarily patient, observant, and made every effort to be helpful. However, in her own words "Well, I'm at a place where I can pretty much only tell you what you already know".

She spent some time discussing with us, as well as observing for her self, Ella's current abilities and behaviors.

On the plus side, she was able to confirm many of our observations, and be a bit more specific than we could be. In general the highlights of discussion where:

Autism - Ella's not showing any signs of Autism at present. Her sociability is too high for that, and we already knew this much. The doctor was also able to point out that her chances of developing autism are quite low. According to her, normally children that are sociable, but develop into autism start off with some signs of abnormal social behavior. During her observation, Ella started off being cautious toward the doctor because she was a stranger. Over a period of a half hour, Ella warmed up a bit to her and started playing near her, letting her hold her hand for walking, etc. According to the doctor, that's very normal, and children "at risk" will tend to have either really short or really long warm-up periods. The doctor still can't be 100% positive that Ella won't develop into Autism, but it's unlikely enough that she admits her gut reaction is "no, not a concern".

Cerebral Palsy - This much we already knew quite solidly, but the doctor did point out that she has no signs of Palsy. Her reflexes and muscle tone are both normal. ( Muscle tone is a reaction thing, not a strength thing, thus related to neurological health. If you suddenly straighten a child's arm, leg, whatever they'll automatically engage their muscles to protect the joint from being jolted. A child without low muscle tone will react slowly or weakly. A high tone child will react much too strongly, or may stiffen immediately.)

Metabolic Disorders - Ella's not really showing any signs of metabolic disorders, no enlarged organs, etc. However, the doctor did say she would have Ella's pediatrician review the metabolic screen she had at birth (ie: the PKU, etc they run on the heel stick), and possibly run some additional screens if some of the ones of interest weren't in her test. This is largely a precautionary measure, and the tests are simple enough to run with a small finger-prick sample of blood.

Assessment - In the process, the doctor also performed a developmental assesment, which was a different assesment tool than the E-LAP that the county used, but I forget which one. In general she came up with Ella's gross motor skills now being around 12-13 months, and her communication is much further behind. That's a bit further along than we thought in gross motor (we've been thinking around 10-11 months), but otherwise no surprise to us. As mentioned above, her social development was age appropriate, as was her cognitive and fine-motor.

Dyspraxia (aka Developmental Coordination Disorder) - This is the "working assumption" of Ella's Physical Therapist, and the doctor agreed this is a reasonable assumption. At this stage she couldn't really rule out any other problems, but that is what is evident at present.

My motor disorder - For those that don't know (which most of you do) I have some form of mild motor disorder. Unfortunately, not a whole lot is known about my disorder, largely because it was detected but deemed to mild to worry about by the neurologist I saw as a child. I can tell you that my disorder primarily affects my fine-motor skills (as anyone who's seen me write or free-hand draw will know), but it does have some lesser impacts on my gross motor and hand-eye co-ordination (as anyone who's seen me try to catch a ball will know). Obviously, since I have some kind of motor disorder, this was a significant topic of discussion since Ella is showing signs of one.

Ella is affected a bit differently than me, as mine is primarily fine motor and Ella's is primarily gross motor. However, my fine motor wasn't really noticeable until I entered school and was doing more complicated things like writing, crafts, etc. Also, I had no obvious gross motor issues at her age, as I was walking at 10 months.

Follow-up - The doctor wants to see her again in 6 months to see how she's progressing.

So, at this point, we only have some confirmation of things we knew, and possibly some additional metabolic screening. But a little confirmation is better than nothing at all.

All kinds of mobile...

2007-11-21T20:55:00.000-05:00

Ella is now 16 months old, as of two days ago (the 19th), and her progress continues to be really good.

As mental mother reported, she's really doing well with walking with only one hand held. This is really less of and achievement in ability and more of one in confidence. Ella's been really good at walking if you hold both of her hands for a while now, so good that she barely puts weight on your hands. However, until recently she's refused to walk more than a few steps without the safety net of you holding both hands. Today, she was a little hesitant, but once you got her going she freely trucked up and down the hallway with only one helping hand.

She's also making a lot more posture transitions. Tonight while making dinner I left her standing at her "busy zoo" toy, when I came back out she was at the dining room table. This may not sound like much, but to do that, she had to get down from standing and crawl over to the table. She's been pretty resistant to getting down from standing without help, but that wasn't and obstacle tonight.

Anyway, there's a new Mythbusters on.. I best go :)

Sick...

2007-11-14T00:21:00.000-05:00

Well, Ella officially has her first cold of the winter season. It's been going around my work, and this past weekend Ella was at the gym daycare and a good-sized birthday party. Lots of opportunity to catch it, and it worked. Now we have a baby with a cold AND teething out a molar at the same time, ahh, what fun!

Actually, it's not too bad given the circumstances. She's grumpy a lot, coughing a lot, and waking up a lot, but that's kinda the way baby and toddler colds go.

Anyway, here's wishing all the little ones a speedy recovery from this round.

A lot can happen in a month..

2007-11-07T22:23:00.000-05:00

It's been over a month since my last update.. wow.. I really need to fill you all in more often..

Ok, so here's where we are now:

Rolling - Ella's now rolling quite a bit, although she rarely rolls completely from back to stomach to get onto her hands and knees, she will do it if there is something really exciting to motivate her. Most of the time she'll roll over onto her stomach, but keep one arm crossed under her chest and use that to flip herself back onto her back after a bit.

Cruising- Ella cruises quite a bit now, going from one piece of furniture to the next, around corners, from high to low surfaces, etc. She's also done some cruising against a sliding glass door with no help, but hasn't done a normal wall yet. (glass is a bit easier since your hands stick to it better when you press them flat to it)

Walk behind - Ella is now using a normal walk-behind toy instead of a chair. We've still got a 3lb weight in it to slow it down some, and she does it a bit hesitantly, but she does it.

Getting to standing - She now "pushes" to standing on objects that are below her shoulder height when she's tall kneeling. She's proficient at it enough now to crawl up to it, get to kneeling, then stand up pushing down on it. She still doesn't have the hang of grabbing onto things over her head and pulling up, but we're working on it.

A recent addition in standing is following this weeks PT session we've been working on having her sit on a bench, with a low table about 6" out of reach. From there, she's now comfortable standing up and thrusting herself forward to catch herself on the table. This little "leap of faith" may not seem like much, but it builds her confidence level so she'll start taking steps on her own. This trick basically took her only a day to master.. Our PT came on Tuesday, and she was doing it without hesitation on Weds..

The other activity the PT has us working on is getting her to bend over and pick things up off the floor while sitting on the bench. This is to help her build balance, and while she's definitely improving and can do it, she's not very comfortable with it yet.

Receptive Vocabulary - (ie: words she understands when you say them to her) I continue to be amazed at all the things Ella can correctly identify when asked. My most recent discovery is she knows what a rhinoceros is, or at least that the gray wooden thing with a horn on her busy zoo is one. (I've asked her on two different occasions "where's the rhinoceros" and she went straight for it..)

Speech - here there's no definitive progress, however our recent vacation has led to her getting back into babbling a lot. There's also been a few times where she might have been saying a word. Over the weekend, she grabbed a ball and made a sound like "ahwl". Which might have been random, or might have been an attempt to say ball. This kind of thing has only happened a few times, so we can't say it isn't coincidence, but we're watching for it.

Gestures and signs - Our special educator currently has us working on teaching Ella basic signs. We've been using a few for quite a number of months now, but now we have some better tactics for teaching them. At present there are few gestures of any sort that Ella does with any meaning. She reaches for things she wants. If you try to give or feed her something she doesn't want she turns her head away and puts her hands up to block you.When she's excited or happy, she claps a lot. Sometimes she does claps when she's bored to entertain herself, but that's less common. She also shakes her head "no" sometimes, but that's always simply because shaking her head is fun. She doesn't associate the gesture with "no".

Well, I best get some sleep, hope you've enjoyed the news..

Progress, Progress, Progress..

2007-10-05T08:22:00.000-04:00

Whew.. it's been a month since my last update! I've definitely been too busy..

Those who have been following mentalmother know that Ella started crawling on September 14th, 3 weeks ago today. Since then, Ella's been an explosion of progress.

So far Ella has picked up the following new motor skills:

Cruising - We've had her cruise short distances on the couch, that was new this past weekend. She doesn't do this often, but if motivated to get a toy she will creep her way sideways to get it without any help other than the couch itself.

Walk-behind - On Tuesday, Ella was walking in straight lines across the kitchen by pushing her music table around. (with nobody touching her or the table) This has a bit more resistance than your normal wheeled walk-behind, which makes it a bit easier.

We're still working on pulling up to standing (although she can pull up to kneeling..), and of course we're now working on refining our walking/cruising skills. She's also very confident walking if you hold both of her hands, but doesn't walk if you hold just one. (She's been doing this kind of for about 2 months now, but we'd been holding off practice to get her to learn crawling and pulling-up.)

On the communication front, Ella still isn't talking, although recently she does seem to point and me and say some variant of "da" which the D is a weird mix of D, T and TH sounds.. However, that's hard to distinguish from her general babbling. She makes da, ta, and ba sounds an awful lot these days.. But it is still quite cute when she looks me in the eye, grabs my nose, promptly says "tha da" and grins.

There are now 31 words that we are sure she knows the meaning of. Most of these are nouns she can point out if you ask her where they are, or verbs that she'll act out. It is likely there are many other words she knows from her books that we've never thought to test her on, but overall this is good.

Of the 31, four of her words are colors that she'll reliably point out something of that color if you ask (red, blue, purple, green). We also think she's gotten the concept of "my ear" versus "your ear", but we're not sure of these so we didn't count them.

Labor day update..

2007-09-03T21:36:00.000-04:00

Whew, we had quite a full long weekend, and Ella got to see many people.

On Saturday friends P & B stopped by with their 23 month-old son and we grilled out some burgers. Ella had lots of fun watching their son use her toys in new ways, and seems to have learned a thing or two from him.

On Sunday we drove off to visit Ella's grand uncle/aunt, along with two of her first cousins once removed (my wife's first cousins) and five of her second cousins (their children). (could you keep track of all that?) That was a great deal of fun, but it was quite a loud scene with 5 children ranging from 12 months to 10 years old running around.

Today we went over to visit Ella's aunt (my sister), uncle and 20 month old cousin. Also lots of fun, and her cousin was very excited to see her. ("Ella... Ella.... Ella...")

Progress-wise we did well this weekend. Today her uncle managed to get her to stand by herself for a new record length of time, about 5 seconds. Her previous record was about a half second long. :) I also helped her "crawl" in the kitchen today by holding her hands to the floor while she dragged herself along on her stomach. We've done this "crawling" before, but in the past she got very upset about it, but today she was content when we started out (she became irritable after a while of working at it).

She was also generally much more active and excitable than normal this weekend. Lots of clambering around on us, splashing around in the tub, etc..

Overall it's been fun. But man am I tired now.. ZZZzzz...

Progress, mostly in food

2007-08-28T01:04:00.000-04:00

As noted over on MentalMother, Ella's been making very good progress at eating solids. In the past we've had a lot of off-again on-again gagging problems, but we've never seen her do as well as she did this past weekend.

Friday, Karla tried giving her some chicken that had been crock-pot cooked, and ella ate it fine.

Saturday, I tried cottage cheese, which has been a long-term problem for her due to its mixed texture. She ate it fine at multiple feedings.

Sunday I had her double-fisting puffs and cheerios in the afternoon, and Sunday night we went out to dinner and she had several different foods off our plates (grilled chicken, broccoli, mashed potatoes, spinach in a cream sauce..)

Overall it was a good weekend, and her eagerness Sunday night to just keep munching down new things was really great.

On the motor front, Ella's continuing to have good progress. She's been continuing to roll without help on occasion, and is also doing a lot of work on climbing onto our laps. She's not very proficient at the climbing, but she tries it a lot.

On the communication front, Ella's doing a fair amount of multi-syllable babbling, and seems to be trying to say "duck" a lot, although it comes out more like "adook". She's also clearly understanding several words and phrases and a few commands, and the list keeps growing. She knows how to "turn the page", and can find a few body parts (although some she always does herself, and others she always does you.. i.e.: it is always her ear, but your nose, no matter which you really asked about.)

We're continuing to work with the PT for her gross motor on a weekly basis. We're also meeting less frequently (monthly or so) with an OT for her eating, and a special educator for her communications and other more general advice.

Dr.'s visit...

2007-08-07T21:44:00.000-04:00

Today Ella had her 1 year Dr.'s visit (yeah, she's almost 13 months..). That all went well, and about the only news from it is that Ella's still almost dead-on 50th percentile in all of the basic measures. Her weight was just a tad over 50th, and is now just a tad under, but given her increased activity level that's not abnormal.

For those who are interested, Ella is now:
29" long
20lbs 12.8oz in weight
and 17 3/4" of head circumference

Thoughts of the day..

2007-08-05T20:48:00.001-04:00

At present, and for the past couple days, all three of us have been suffering through various degrees and stages of the same cold. Ella caught it first, then Kar, and now I seem to be coming down with it too. Yay, rhinovirus!

Today was a good day in general for Ella. Although she has done it a couple times before, today I had her take several steps while all I did was help her keep balance. This is definitely much improved, since a mere 3 weeks ago she had a strong habit of keeping one leg completely stiff while trying to walk. (Which leg she kept stiff would change, but she'd consistently do it with one leg or the other).

Ella also tried experimenting with pulling herself up from being seated flat on the floor, but wasn't successful. That said, it is good she's getting the idea, and we'll have to work on teaching her proper footing.

This whole weekend Ella's been quite vocal and babbling a lot, although it is still single-syllable (ma-ma-ma or ba-ba-ba, etc). Her babbling like this is nothing new, but I would say that she did it substantially more than normal this weekend.

The whole cold thing has been messing with her daytime naps and eating a little bit, but nothing alarming. She was being a bit reluctant with solids that involve chewing, but today she was back to eagerly eating puffs, bits of cheese, etc.

Anyway, I hope you're all doing well.

A starting point...

2007-08-04T21:34:00.001-04:00

For those of you who haven't been following Mental Mother, or speaking to me in person, let me catch you up a bit.

Our daughter Ella is currently 1 year old, and has some developmental delays. A lot of this blog, for the time being, is going to be involved in communicating her progress to friends and family.

She's been evaluated by the local early intervention program sponsored by the school system. The evaluation shoes she has some developmental delays, most significantly in gross motor development (ie: skills involving large movements of the body like crawling, walking, etc). She also has a less substantial delay in communication skills (the ELAP test winds up placing the delays in multiple categories, however the cause of all of them would appear to be communication. See mental mother for more details on this)

Her fine motor development is fine and tested as age appropriate. For her age she has a good "pincer grasp" and hand-eye coordination, etc. Ella also tested fine in cognitive development and problem solving skills. Also, baring being tired, she is quite sociable and enjoys playing with people. There is occasional stranger anxiety, but she generally plays with "strangers" if we're nearby and are calm.

Although not definite, as only time will tell, based on the above Ella's delays are probably not the result of any major disorders. (ie: she's got good cognition and problem solving, so she's probably not mentally retarded, add in her sociable nature and she's not likely on any severe part of the autistic spectrum. Her fine motor development suggests there's no broad palsy or cerebellum issues.)

Thus far she has been responding very well to her current therapy sessions for gross motor development. We've met with a with a physical therapist 3 times, including her assessment visit, but even at the initial assessment the PT left us with some suggested activities to work on.

In general, Ella has good strength development, and to quote the PT "many good building blocks" for gross motor skills, but several other basic skills are missing.

Prior to starting, some of the building blocks Ella already had are: Standing while holding onto things, rolling onto her side to grab toys (but never a full roll, nor a roll off of the stomach), and grabbing onto your hands and using them to pull herself up to sitting.

Right at the start of her eval, but before we'd worked with the PT, she also learned to:
- extend the pulling up on your hands to pull herself up, stiff-legged, into a standing position.
- while sitting, if you put your hands on her shoulder blades and braced her from flipping over backwards she could push herself up to standing with leg power alone. However, even faced with something to grab onto, she'd leave her hands at her sides.

(Neither of those is a useful skill alone, but if you combine them...)

Thus far we have been working on the following things with the PT:

1) Rolling. Ella originally rolled both ways on-time, but stopped shortly after she started. Very quickly she regained the ability to roll if you simply moved one hand into the right place (in front of her, and slightly off-center towards the opposite side.) Recently she started doing this without our help.

2) Deeply bending over to reach toys. We've been teaching Ella how to pull one foot in so she's sitting in a "figure 4" so she can bend deeply to extend her reach from sitting.

3) Tolerating "tummy time" - Ella has always hated being on her stomach. We're now doing things to help her not immediately become upset if placed on her stomach. Little things like always putting her down on her stomach, even if we roll her over right away. This appears to be working well. Even though she still sometimes immediately objects to being on her stomach, she does now generally tolerate it, at least for a little while (ie: 1 minute), and sometimes for more extended periods (ie: 15-20 minutes).

4) Pulling up to standing from an elevated seat. If you sit "Indian style" on the floor and sit Ella on your knee with her feet on the floor, she can grab onto an object nearby and pull herself up to standing. We started off aiding her by bouncing her a bit, but she can now do this with no aid.

5) Kneeling. We're spending time getting her used to playing while kneeling, as this get her used to a position that is important in a lot of transition movements. She seems to do fine with this, although she does eventually tire of it.

6) "plopping" to sit - This is mostly an exercise in getting Ella to realize that not all forms of falling from standing are painful. I've been successful with this a few times, but most attempts result in her resisting by "stiff-boarding" her back or pulling herself back up to stand.

7) shifting from lying down to sitting. This is also one we're still working on. The idea is you tuck one foot up under their butt, and grab their shoulder and sit them up and over it. Today, I was playing around with Ella's feet working on crawling oriented skills. I had pushed her foot up near her butt, intending to put both there and shift her onto her knees. At that point she walked her self up with her hands and got into the sitting position without any help other than my placement of her foot.

Side note for humor: Amidst my research on delays, autism, etc, I found a self-test for Asperger's Syndrome (one of the autism spectrum disorders that is closest to full classic autism). An "average" person scores 16, mathematically inclined folks tend to score a bit over 20, and people with autism tend to score over 32. I scored a 25. I guess that means I'm nerdy, but just an ordinary nerd :)

http://www.okcupid.com/tests/take?testid=1982215450153908026

Anyway, g'nite all.