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 :)
Saturday, August 30, 2008
Sunday, August 24, 2008
More signs, etc.
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.
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.
Tuesday, August 12, 2008
Ella's signs..
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.
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.
Saturday, August 9, 2008
More walking, signs, etc.
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 catepillars go, but there's one that's clearly more potent (the puss caterpillar, and it can be found in Maryland too.)
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 catepillars go, but there's one that's clearly more potent (the puss caterpillar, and it can be found in Maryland too.)
Wednesday, August 6, 2008
Distance record...
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!
Go Ella go!
Tuesday, August 5, 2008
May I have a word please?
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.
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.
Monday, August 4, 2008
Developmental Pediatrician, round 2..
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.
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.
Friday, August 1, 2008
Revised Therapy services..
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).
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...
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).
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).
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