Our little Jaden has always shown some developmental delays and when he turned 18 months old our pediatrician referred us to Alta California Regional Center. From there we had a service coordinator come to our home and do a more thorough assessment of Jaden. They determined that he was indeed a little behind and that he qualified for their early intervention program. He was given an unofficial diagnosis of "Unspecified Developmental Delays." They were able to set up services through Easter Seals to come to our home and start working with Jaden. He was assigned a Speech Therapist, Occupational Therapist and a Child Development Specialist. Both Ron and I were so excited to start working with and learning how to help our little guy. Along with his gross and fine motor skills he really struggled with communication. You don't expect a toddler to have a 50 word vocabulary or speak in sentences. But they should be able to at least point to something they want or need and say a few basic words. Jaden wasn't doing either. Often times we were left continually guessing what he was really wanting or needing. That would lead to him getting more frustrated and upset because we weren't understanding him. It's very hard to watch your child meltdown to tears because we are unable to communicate with each other. I often felt helpless because I was unsure of what to do.
Speech was the service that they started with first. I was really excited to start. Jilda was fantastic! In the beginning she taught me a couple basic signs that we would do hand over hand with Jaden until he was able to do them on his own. We would work on basic sounds and things he liked to do at that time. For instance, Jaden didn't really play with toys. But what he would do is a lot of opening and closing of various things. He would sit in a pile of board books and instead of looking at the pictures he would just open and close and open and close, turn it over and open and close. 'Open, close, put in and more' were some of what we started with. After a while Jilda mentioned that she was noticing that Jaden appeared to not like using his cheeks and seemed to hold his cheeks as still as he could when attempting to repeat different sounds. Which can interfere with his speech. She said that it's not that uncommon and sees this often. Sometimes it seems like a sensory thing. It made perfect sense to me as I looked back to when he was an infant. He never had a strong latch while nursing despite all my efforts and when he drank from a bottle he would still suckle so slowly. Getting him to eat solid foods took a long time for him to figure out. He would often just hold his mouth open and keep the food on his tongue and would get very upset and sometimes would vomit everything up. Even pureed food was sometimes a struggle. He never sucked on toys or his hands. So it made sense that maybe he just didn't like the feel of using those muscles in his cheeks and mouth. We started playing some games and other activities to try and wake up his mouth. Most parents do not want their kids to stick out their tongues but with Jaden we encouraged it! We worked on getting him to stick out his tongue which mostly was him opening his mouth really wide instead. But that was okay! We wanted that too. We started a game with the vowel sounds saying each one in a different way and expression to get him to open and use his mouth in different ways. Jilda also brought in and incorporated some things to help with the sensory issues. She had these animal figures that were on top of handles that would vibrate. The idea was to get Jaden to touch them to his chin, cheeks or mouth to help stimulate and wake up those muscles in hopes that he would be more comfortable with using his mouth. It took him a while but he was eventually able to tolerate it. It still wasn't his favorite thing, but he at least did it. We had several other goals that we worked on together. We really wanted to get him to respond to his name by making eye contact or at least turn toward whoever was speaking. Jilda also helped me to recognize his little signals of hearing me whether he looks at me or not. Pointing to or touching common objects/people that are around him or in pictures was something we worked on a lot. Our goal was to get him to point or touch at least 80% or more of the time when we asked him too. Learning different body parts was something we also worked on. We started with helping him identify 2 or 3 and then I think our goal went up to at least five. It took a little while but he was eventually able to touch his head on his own as well as his nose. He was able find his tummy and eventually his eyes. He could find my ears but struggled with finding his own ears. It's possible it was a sensory thing for him because he is always sensitive when anything touches his ears. It also could be that he hadn't made that connection yet in how to find them on his own. But at this point we were happy with him just identifying anything. One of our bigger goals with Jaden was to get him to perform what they called a one step direction or command. Basically it was to ask Jaden to get something like a diaper or something that was close to him and bring it to me. This was one of our long term goals and it was so exciting for me when he did it for the first time. I was so happy and proud of him I almost started to cry. It was so exciting and wonderful to see him grow and learn and start to communicate. We still have a ways to go but life is becoming a little easier for us and our Jaden.
About a month after we began speech therapy we started Occupational Therapy. Sara was his occupational therapist. She was also great! We worked on things that helped him develop and strengthen his fine and gross motor skills as well as his upper body strength. Jaden didn't become mobile until the week he turned one year old. Even then it was just scooting on his bum which eventually led to crawling and then walking. He had only been walking a few months though before we started with therapy. And although he was walking fine he would sometimes have moments where he would suddenly stumble or fall easily. Even the way he would often sit showed that he struggled with a sense of balance and upper body strength. So we would do some activities to help strengthen him. Sometimes Sara would bring in a peanut shaped ball and would have Jaden sit either with her or on his own on top of the ball. Then we would have him bounce or roll on the ball. The same with a larger exercise ball. With the exercise ball we would also have him lay on his tummy and roll forward and see if we could get him to give us a high five or touch or reach for a certain toy. The hope for that was that he would lift himself up in order to get the toy or high five, strengthening his muscles at the same time. Sometimes picking up smaller balls and throwing them. He usually just tolerated this for a few seconds and then he was done. Not being able to balance well on the ball left him feeling unsure and probably a little scared. But eventually he started liking it a little more and more and saw it as a game. We still could only get him to do it a few seconds at a time but he did seem to become more comfortable with it. Jaden preferred some of the other smaller activities that Sara would do with him. Stacking blocks and cups was always a favorite for him. She would bring in sets of different sized blocks and other objects for stacking but we spent a lot of time using smaller sized ones to help him develop his pincer grasp. We would also have Jaden pick up small beads or beans or pipe cleaners with his pincer fingers and place them inside containers with different sized openings. Sometimes the openings would be smaller than the object and he's have to push them in. These would require a lot of hand over hand assistance at first. He didn't get the aspect of pushing down with his hands and fingers at first. But once he did he would sit for several minutes at a time until he went through all his beans or coins or beads and put all of them in the container. This was helpful in developing his fine motor skills as well as his visual skills. I think he liked the repetitive aspect of these kinds of activities because they seemed to be the ones that would capture his attention the most.
Sara and Jilda would often collaborate together and coordinate some of their different activities for Jaden. Jilda would do some sensory things while Sara would do some activities that would encourage Jaden to use his mouth and cheeks. She would bring in bubbles and have him try to blow through the bubble wand. She would also try and get him to stick out his tongue(which he still couldn't do, he just opens his mouth wide to say ah). Sometimes both Jilda and Sara would where blue latex gloves and would brush their fingers and hands with the gloves on against Jaden's cheeks or arms. Sara also had one of those animal figures on a wand that would vibrate and jiggle that she would work with Jaden getting him to touch it to his cheeks or chin. One of the more significant activities she did was to help Jaden drink from a cup or water bottle with no straw and one with a straw. We knew that if we could get him to do that it would really help to strengthen his oral muscles and aid in his speech. I had been trying to get Jaden to use a straw but each time he would just bite down on it instead of suck on it. So Sara brought in this special juice bear cup that uses straws that are surgical tube like. They are a lot firmer and Jaden cannot bite down on them closing the opening. The tube straws also fit perfectly in the cap opening which allowed his milk to flow up the straw when he gave the bears tummy a squeeze. This helped Jaden to connect with the concept that something was supposed to come out of the straw and it actually helped him learn rather quickly how to drink from a cup with a straw instead of a sippy cup. We were so excited when he started doing this. With the juice bear it didn't take him long to start using a straw. The next task became getting him to hold his cup more straight up and down as opposed to lifting it up and tilting his head back like he does with his sippy cup. It took a little time but he eventually got used to holding it so it doesn't spill. We also had Jaden drink from a small water bottle. He would generally take a few sips if we were holding the bottle. Drinking from a cup with no straw proved to be a bit harder for Jaden.
Jaden's sensory side has always been an issue for him from the time he was a newborn. Certain textures, certain tastes, different sounds, the way different things look. Many times these would send him into almost a panic reaction. Sensory activities became an important focus. We would find ways to get him to touch and feel different things. Like play-doe and shaving or whipped cream for instance. We wanted him to be able to just squish the play-doe with his hands and push a car or other small toy through the shaving or whipped cream. He was not always a happy camper with these. Sometimes all we could do was get a quick touch from him and then we'd have to go quickly on to something we know he likes. Several times Jaden would get so upset with Sara for making him do this that he would run across the room and ignore her for the rest of the day. It always made us laugh a little. Another thing we would do is take different soft bristled brushes and brush his arms and legs. This also helped him get used to the feel of other textures on his skin. She would do each arm and leg in a set of 10. At one point she was able to get Jaden to count to 10 with her as she brushed. It was so cute and exciting to hear him using his little voice.
We also had a Child Development Specialist come in to work with Jaden.
Her name was Jennifer and she was also fantastic. She was there to help
with social and some behavioral skills and to help him learn to play.
Pretend play is an important part of development. Jaden never engaged in
pretend play. He was fascinated by opening and closing of things. He
would spend most of his time in a pile of board books flipping through
the pages constantly back and forth. Instead of pushing cars along like
they were in a race he would sit holding it in his hands and turn the
wheel with his finger or he would place the car on the table and look at
it with his peripheral vision. Instead of playing with the farm animals
and making animal sounds he would just sit there and open and close all
the doors on the barn. He would do the same with all the other play
sets as well as the kitchen cupboards. Just open and close the doors
repeatedly. He wasn't interested in taking anything out he just wanted
to open and close the doors. Occasionally he would peak his head into
the cupboard but mainly he was just interested in the opening and
closing of the doors. If we tried to put any of the animals or people in
the play sets he would immediately throw them out. When it came to
other children he didn't know how to react or engage with them. Older
kids he was generally okay with watching them play and run around. But
when it came to kids his own age and babies he seemed so unsure about
what to do. He almost seemed a little scared of them. We definitely have
our work cut out for us!
Jennifer did a lot of the same activities and games as Jilda and Sara
she just had a different focus with them. She would still encourage him
to use his different skills but she would also encourage him to
interact together. They would build towers to knock over and put puzzles
together and practice problem solving skills. One of our goals at first
was to help him establish self awareness and recognize others. We would
begin each session with a hello song that pointed to each one of us.
She encouraged us to play a "Where's........" game. We would have Jaden
sit with one of us and ask him where the other person was and Jaden
would have to point to us or come up to us. This was an important one to
play throughout the week with each member of the family. That way Jaden
could learn to associate our names with us. It was one of the best days
ever when Jaden finally said "Momma" and associated the name with me.
He finally recognized me as Momma! I was so happy I nearly cried. I had
to wait a long time to hear him say that but it was all worth it in the
end. We also worked on learning and recognizing different body parts. This also helped with his speech. He was able to pick up on putting his hands on his head and tummy and eventually his nose, but figuring out how to point to his eyes and ears would be a bit harder for him. Part of me wonders if it's a sensory thing because he does not like his ears to be touched. Or it could be a coordination thing. Maybe a little bit of both. He was able to touch his eyes first and then when we'd ask him to point to his ears he would just go to his eyes again. That's why I wonder if it could be both. It was still fun to see him try though. We worked really hard on getting him to play games with us. Not just peek-a-boo games, although we would do other forms of peek-a-boo occasionally. Pushing cars along the floor or down some kind of ramp or track. Helping him to learn how to play with the cars and trucks other than looking at them with his peripheral vision. Which he started to do and have fun with. But he still isn't fond of having people or animal figures in his cars and trucks. But we're working on that. Bowling games were fun only we ended up having Jaden race with the ball to the pins instead of giving the ball a little push. This skill is still a work in progress. But it was fun and he started to laugh and giggle and want to keep playing instead of hanging out in his corner. It was really exciting when Jaden would look for Jennifer to play one of her hide and seek games that she had done the week before. It was one of those reassurances that what we are doing is making a difference for him. Pretend play was a bigger challenge for us. Jennifer would bring in these animal figures that were different than the ones Jaden had. We would gallop the zebra around and make the lion roar and sometimes we'd have them give a little kiss. Little things to show the animals interacting together. Sometimes he would smile and other times he would completely ignore us. Sometimes all we could do was smile and laugh a little. But there was one day when I came down the stairs in the morning and caught him sitting at the table with two of Jaxen's action figures and he was having them bang into each other like a sword fight! I stopped in my tracks to just watch him for a few minutes. It made my heart happy! He was experimenting with playing pretend! It was so exciting to see. He still didn't play like that very often and would still sometimes fight the activity. But it was starting to become clear that he was opening up to the idea. He has his set favorite stuff animals that he likes to sleep with every night. Usually I would just hand them to him and say their names and he would snuggle up with them. But it was only at bedtime that he would want them. After a while he started accepting little kisses and hugs from his stuffed animal friends and eventually began giving them kisses and hugs too. It was very sweet. There was one thing that we really could not get Jaden to do and that was pretend play with a baby doll. That's actually what first made us realize that babies seem to make him nervous. He couldn't even look at the doll. He would run across to the other side of the room. If we held up the toys that went with the doll like a spoon or a bottle he didn't have any issues. But the doll itself he would get upset. We started to understand why he wouldn't look at pictures of babies either when we'd want him to point to different body parts. Which was another reason we were excited when he started to give kisses to his stuffed animals. We could use them instead. We didn't keep pushing the baby doll play with him but it was an interesting observation and it really helped us to learn more about our little Jaden. And it was really fine because there are many more things we can do with him. He still had his block towers that he absolutely loves!
It's been an amazing journey so far this year. I will be forever grateful to Jilda, Sara and Jennifer. They became some of my heroes! I feel so lucky that we got to have them come into our home and work with Jaden. I loved that it was in home therapy too. I think it helped Jaden being in a familiar environment(even though occasionally I would have to leave the room so I wouldn't be too much of a distraction). But I loved that they really focused on involving me with the therapy. They showed me what I could do with him each day and different things to look out for. I really needed that. When we first met with our service coordinator she asked me what my goal would be, what I wanted from this. For me I wanted to feel like I was working with Jaden and not against him. There was so much guessing and uncertainty and not knowing what to do or how to reach him that sometimes I felt helpless and like I was in a constant struggle. It was such a relief knowing that we were going to have some guidance to help us along the way. It meant the world to all of us.
We still have a ways to go. I think there will always be on going goals to be set. But each day Jaden gets closer and closer to a new goal and it's really exciting for us. He will be in the early intervention program until the age of three and then he will move on to other things. But we're really happy and we're really excited to see what the future brings. He is doing so fantastic!
We love our little Jaden with all our hearts!
