Sunday, June 9, 2013

Rock Star.

When Anderson was diagnosed with ASD in February, one of the first things I wanted to do was have him evaluated for outside therapy--meaning outside of the school system.  If you aren't familiar with how special education/school therapy works, essentially a child with special needs is potentially eligible for all kinds of therapy when they attend public school. The caveat is that the goals of therapy have to be related to the educational impact on the child. So, Anderson has IEP goals that will help him work on fine motor so that his handwriting will improve, speech goals so that he will be able to communicate in the classroom, etc. These are fantastic goals, and as a teacher, of course I want him to be able to work on those things.  The issue is that OT and Speech therapy can address SO many more issues than those that will impact a child in a school setting. That's why I wanted the outside evaluation--so that he can get therapy in school to address areas of academic concern, and outside therapy to address all of the rest.  At his four year check-up, I got the referral from his doctor and made some calls. We decided that Cardinal Hill Pediatric Therapy was where we wanted to start, and I set up evaluations for summer break, when we would all have more time.

Anderson's evaluations were this past Friday. I was both excited and nervous leading up to the date--excited because I am more than ready to get this ball rolling, and nervous because I was afraid Anderson would be uncooperative. I was afraid they would try to assess him individually, without me being there, and I knew without a doubt that he would absolutely not allow himself to be taken away from me willingly.  When he woke up that day, I started prepping him for the experience by telling him that he and I were going to do something special. The word "special" always gets his attention because he knows usually that means something exciting.  I told him we were going to go play with some people (I knew that the evals would involve some playing), and he was game. He was nervous that I was going to take him somewhere and leave him; he kept saying "Mommy isn't going to leave" and "Mommy isn't going to wait in the car". I have no idea where he got that last one; I don't think I've ever waited in the car while anything scary has happened to him, but whatever.  Unfortunately, I kind of got lost trying to find the right building--Cardinal Hill is a sprawling complex of buildings that are attached yet were built at various times over the years, so it's pretty confusing. The longer I was lost, the more anxious he got. Finally I found where we needed to be, and we went in.  I let him take his beloved Tofu, which seemed to help.

The registration process took forever, and he just stood there, smiling and enjoying watching their printer print about a gazillion papers that I had to sign. So far, so good.  We took a seat to wait for his first evaluation, and he was calm, happy, adorable.  Then, I saw a bus pull up outside. I'm not kidding; about 10 kids got off and ran into the building. They were pretty well-behaved, but they were a waiting room...they were loud and all over the place.  Anderson, for whatever reason, thought I was going to leave him with them and he started to get very nervous. I just put him on my lap and kept whispering to him, talking about what the kids were doing, etc., which helped.  About five other families came in to wait for therapy appointments--you all, this waiting room was an absolute ZOO.  I know I was in sensory overload; Anderson was pretty well over the top.  Fortunately, a therapist came out to get him pretty quickly.

His first evaluation was for speech.  The therapist was incredibly nice and told Anderson immediately that Mommy was going to stay with him. He had to be reassured of that oh...about 100 times, but there were no tears. To start the evaluation, I had to answer some questions about Anderson, which gave him the opportunity to settle into the room--a great thing.  Then, she started the assessment. That's when I child is a teacher's WORST NIGHTMARE.  He was compliant, happy even...but he could not attend to a task for any length of time. Teacher friends, you know the type. There was a multiple choice portion of the test, where he had to look at four pictures and pick the one that she was describing. He would point to a picture BEFORE she even finished talking! took everything in me to keep quiet. I just sat back, rolled my eyes (he couldn't see me).  I'm kind of joking here, but I was also a tiny bit frustrated because I knew that he could actually answer some of the questions she was asking but he wasn't attending or even really trying. Ah, well. That's why we were there, I guess.  We only got halfway through the test before she recognized that he needed to be done; we will go back and finish in two weeks, assuming insurance will cover a 2nd day of evaluation.  She actually said he was doing very well (which shocked the crap out of me...I saw what the boy was doing...). I was immensely proud of him because he never cried, he never ignored her completely or said he was done. He didn't even really get frustrated. He worked HARD.  The therapist walked us out to the waiting room to wait for OT.  By this time, it was easily 10:00; we'd been there since 8:15. I was worried about how well he'd do in another lengthy evaluation, but knew we had to give it a shot.

The waiting room was even more of a zoo, if that's even possible. SO. MANY. KIDS. So loud!  We sat down next to a lady who was holding an infant. Anderson is suddenly fascinated by babies, so he was more than happy to stare at the little guy, which was a fabulous way to keep him from getting overwhelmed while we waited.   Thankfully we didn't wait too long for the OT to come and get us--Anderson was okay but I was personally overstimulated in that crazy room.

The OT evaluation was very interesting. I was a little put off at first; the woman didn't seem to know where to start with him, and she balked at my ASD diagnosis that came from the school system, which irritated me because I know all of the assessments that were administered, and they're no different than what would be given by an outside psychologist.  She also immediately started talking about a gluten/casein-free diet, which I was also uncomfortable with; I am not at all sure how I feel about that path, personally, and Anderson is a great eater. I don't want to mess with that unnecessarily because the little dude is tiny as it is. She seemed so scattered...the first thing she asked him to do was copy a shape that she drew on a paper. No getting-to-know-you stuff, nothing. He picked up the pencil and drew an elevator. I told her he only draws elevators. She seemed shocked, took the paper away, and started other testing. I was a bit alarmed because it didn't seem like she was using any specific evaluation--she was just pulling different things out of a box and taking notes. However, it didn't take long to realize she had Anderson's number.  She asked lots of pointed questions about things that Anderson definitely does--looks at things out of the corners of his eyes, likes to watch fast movement, etc.  I felt much better because I knew she was getting a sense of what he was like.

The rest of the testing was positively intriguing.  Anderson's horribly short attention span was once again very evident. If he was "on" when she asked a question, he could do whatever she asked him to do, including building an incredibly complicated bridge out of blocks. If he wasn't attending, though...he couldn't do it. At one point, he almost cried because he couldn't make his block structure look like hers--he tried SO hard, but he could not figure it out.  The other thing that was pretty neat to watch was how using play, song, and rhythm could get his attention long enough to get him to learn something.  He couldn't copy a shape when she just literally asked him to do it, but if she made it into a game, or put it to song, he was all about it.  All of this proves that he IS totally capable of doing anything, but his inattentiveness really hinders his learning. The last thing she did was probably the most interesting part of it. She asked him to come and lay on a mat in the center of the room. She said she wanted to test his reflexes--specifically his primitive reflexes.  Now, I consider myself a fairly well-versed mom; I keep up with different therapies and tests, but I really knew nothing about this.  He was totally cooperative and did everything she asked, and she showed me how he had retained two of his primitive reflexes.  I was caught off-guard with this and therefore didn't have the with-it-ness to ask which ones, but I feel certain that the Galant Spinal reflex was one of them--which would make sense, given that a delayed Galant reflex can lead to inattentiveness and bed-wetting.  Anyway, she did many different things, he continued to be compliant, and then fortunately, we were finished. At this point, the poor kid was starving--he'd usually had several snacks by that point in the day. He asked for a snack; thankfully I had a bag of Chex Mix in my purse from Amelia's doctors appointment earlier in the week. Buddy scarfed them down, then started whining for more.  We wrapped it up with the therapist saying she definitely recommended OT for Anderson, and us scheduling our first visit for week after next.

My boy was a 100% ROCK STAR throughout the whole thing. He never cried, he always tried to do what they were asking, even when it was really difficult for him. He tolerated that insane waiting room, strangers touching him, working through hunger. He was so sweet and cute, both therapists immediately fell in love with him--the OT was dying to be scheduled as his therapist, after working with him. He was amazing, and my heart was so full of love and pride. I know how hard that was for him. I know how hard it was for ME. He kicked ass in a situation that was extremely overwhelming and uncomfortable. He is capable of so much, and after seeing him, I am determined to get him the help he needs to be successful with anything he tries.

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