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.
Tuesday, August 5, 2008
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).
Wednesday, July 30, 2008
More walking..
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.
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.
Friday, July 18, 2008
Recent progress, more walking/babling.
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.
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.
Sunday, June 1, 2008
Progress, etc..
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.
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.
Subscribe to:
Posts (Atom)
Posts
