We Wish You a Merry Christmas

This Christmas was THE BEST! Bradley was REALLY in the Christmas spirit and enjoyed this year so much!!! His interest in Christmas began in November when he saw a remote controlled, robot spider at Radio Shack and decided that is what he wanted for Christmas.

Bradley and Max saw Santa many times this Christmas season. Each Santa visit Bradley was joyful, polite, and eager to share his robot spider wish with Mr. Claus. Max was not as happy to see Santa...

   

Every Christmas movie that came on was an instant favorite. We watched Rudolph, the original animated Grinch, the Jim Carey remake of How the Grinch Stole Christmas, the Will Ferrell movie Elf, Frosty the Snowman, Here Comes Santa Claus, Mickey's Twice Upon a Christmas (this was Bradley's favorite), and An Elf's Story (the DVD that accompanies the Elf on a Shelf book and doll). Bradley loved our elf on a shelf and named him Jimmy (very similar to the dvd's main character, Chippy). Each morning Brad enjoyed searching for where Jimmy was camped out for the day. If you haven't heard of the Elf on a Shelf, check out: http://www.elfontheshelf.com/

We had fun anticipating Christmas Day. The boys enjoyed their daily piece of chocolate from their advent calendars. We looked at Christmas lights as a family. Bradley played the role of a shepherd in our church's nativity story and really enjoyed the candle light ceremony at church.

Christmas Day finally came and the boys were very excited to see what Santa brought!

The boys were blessed to spend lots of time with family and were showered with presents

Bradley Can Read!!!

Perceived "Inattention" is one of the symptoms children on the autism spectrum may initially present with that leads the parent or teacher to look at a potential ADHD diagnosis, rather than an autism spectrum disorder. According to the Diagnostic and Statistical Manual of Mental Disorders, ADHD criteria for inattention include: being easily distracted, having trouble sustaining attention to tasks that require sustained mental effort, and frequently being forgetful in their daily activities.

For many children on the autism spectrum, inattention is actually a result of being overly absorbed in their "own world." Autistic individuals really aren't "inattentive," from the sense of the clinical standpoint. Instead, they are so overly attentive to something else, that they are in a sense "zoning in" on their area of focus and avoiding and often becoming unaware of other stimuli. That is an AMAZING task and ability that many on the autism spectrum are capable of accomplishing. The question then, is how can parents and teachers help autistic children use that awesome power toward their school work?

I prepared myself for Bradley to struggle with reading. In fact.., I expected reading to be Bradley's most challenging subject area. After all, reading would require sustained, mental effort. However, I am ecstatic to report that I was VERY wrong about Bradley's success with reading so far. Bradley's elementary school uses a reading program called SRA. Bradley's tutor and I introduced SRA reading to Bradley over the summer. I helped him work through about 40 lessons, which didn't take as long as you would think it would... I was pleasantly surprised that Bradley has exceeded my reading expectations.

We have worked hard. Bradley seems to do well with sight words. I think he might be memorizing all of the words he is reading... To try to help Bradley with sight words I started writing his color sight words and numbers on his lunch bags. I'm not sure if Bradley enjoys reading the lunch messages as much as I enjoy preparing them, but hopefully they have helped at some level. I started simple and tried to apply what was taught in his classroom.

Yesterday I filmed Bradley completing his reading homework. This is a pretty accurate representation of Bradley's reading ability. I am so proud of the patience he has gained in taking his time to read and focusing on the work. Unfortunately the audio quality is not quite as loud as I thought it was and my 19-month old son, Max, is sitting next to me talking and "reading" too. For best results in listening to the clip, be prepared to turn up your volume and/or use head phones. I tried viewing the video embedded within the blog from my iPhone and was not able to, so if you're having trouble too you may have to view from a computer.

In the video you will seem him get a little distracted by "movie talking." Bradley watched the Will Ferrell movie, "Elf," that day (and the day before) and was thinking about a scene from the movie in his head. This happens multiple times a day with different movies, including some that we have not seen in a while. I am truly fascinated by Bradley's memory to recall the exact script including diction, pausing, and articulation. It's remarkable. Last night I overheard my husband gently questioning Bradley about his movie talk. He asked if Bradley could see the movie in his head when he movie talked. Bradley said yes. There is so much potential with that type of memory and I continue to look for a way to help Bradley use that super power for good.

What you'll also notice at the end of the video clip is Bradley walking away, on his tip toes. I notice that Bradley does more tippy toe walking when he is barefoot and on our concrete floors. When he wears heavier shoes, specifically his cowboy boots, Bradley walks flat footed. I also think there is a correlation between his excitement level and tippy toe walking. Bradley seems to tip toe walk when he is more excited or anxious when compared to when he is relaxed. This is a form of "stimming" that many other autistic individuals may display.

Speech Delay: Post-Diagnosis

After Bradley's first ARD (at age 3) he began receiving speech therapy from Mr. Clint. I had heard wonderful things about Clint and was excited to begin to see, to actually see (and hear) progress in Bradley's speech.  Bradley met with Clint 1-2 times a week from March through May, but when the school year ended for summer break, Bradley's services were "suspended" (for lack of better terms) because he was making progress and not regressing.  As a college instructor, I totally understand how awesome, amazing, and crucial summer break is for educators and school officials.  On the other hand, we were making progress and I was afraid it would end.  After all, it took Bradley a few weeks to warm up to Clint and I didn't want to have to rebuild  rapport in September when services resumed.

I expressed my concerns with Clint and he shared lots of ideas with me that gave me hope about what I could do for Bradley's speech, as his parent.  Here are some things that Clint suggested I try, that really did help Bradley.  I have to be honest, I hoped for results a lot sooner than I actually noticed improvement, but I stuck with our plan and in (God's) time, Bradley's speech has noticeably improved and is approaching near 100% intelligibility.  Parents- hang in there. I wasn't sure about what progress we'd see in Bradley, but we didn't give up and I don't want you to give up either.  Talk to your child's speech therapist about these intervention ideas:

Practical Speech Therapy Treatment Techniques
1. Model speech for your child in first person. At age 3 Bradley would express needs and desires in one word requests.  Sometimes the word was not clear to strangers, but as parents we knew what Bradley wanted. Here's an example: "whaahhher" was once "water." When Bradley would request water we would model what he should be saying/asking, "Mom, I want a drink of water please." You want to model language in first person, as if you are speaking what your child should be speaking.  We modeled speech for any and every other desire and need Bradley expressed.  When Bradley would get excited about something, like a train on the train tracks we passed while traveling down the road, we would model what we anticipated Bradley would want to say.  "Wow! Look at that train! That's a diesel train."  For months and months and months and months we narrated and commented and modeled and talked and talked and talked the way we wanted to hear Bradley communicate with us.  I had parents in my junior college class with older children with high functioning autism tell me that they did this for their children and that it really did work for them.  You would think that I'd be able to pin point the exact day I finally got the full sentence request from Bradley, but the truth is that Bradley's speech slowly progressed and there was gradual improvement that eventually led to Bradley being able to effectively communicate those needs clearly, meaningfully, and politely.  Now when I ask Bradley what he would like to drink with his meal I clearly hear, "I want a drink of water please" without any modeling from us.

2. Encourage speech through limited options.  We all like choices. We enjoy things even more when we feel like we are in control of the decisions being made.  We like rewards.  Presenting limited options does all of these things as well as encourages speech.  Here's an example, "Bradley- what would you like for breakfast: waffles or pancakes?"  It is important to wait and pause for the child to respond.  If they do not respond you can present the question again.  In the beginning of speech therapy, a communication book may be helpful to offer a visual cue for the choices presented.  *Check out my previous post about the communication book I created for Bradley.  It's important to make this fun for the child while still providing limits and boundaries. Obviously we don't want to give our children french fries for breakfast just because they verbalize that desire.  However, we want to be sure to use an upbeat tone and offer verbal and non-verbal praise when our child responds in a desirable way. Once Bradley responded I would articulate his answer back and cheerfully talk about it with verbal praise. "Pancakes. I want pancakes please mom. Yes sir Bradley. You did a great job asking for pancakes so let's make some pancakes for you." Yes- you start to feel a little silly (or even crazy) answering your own questions, but this really can help.

3. Borrow speech therapy material from your child's therapist.  Mr. Clint was kind enough to loan me decks of speech articulation cards to work on at home.  Bradley wasn't always willing to practice the cards or worksheets, but with adequate reinforcement ("Bradley- do you want to watch television? Then we need to work on these flashcards and do a good job first.")  we were more successful.

4. Encourage and model appropriate non-verbal, expressive communication.  One of the most common social/communication challenges seen in individuals with Autism Spectrum Disorders is poor eye contact.  At age 3 Bradley was making very little eye contact with non-familiar people and inconsistent eye contact with me.  I made it my mission that summer to really work on Bradley's non-verbal communication, specifically his eye contact.  When we would interact I would kindly, verbally request for Bradley to look at me when he spoke to me ("Bradley. Bradley- look at Mommy's eyes please.").  Sometimes I would gently tilt Brad's head up so that his eyes would meet my eyes.  This needs to be done with finesse, because many ASD children have anxiety and poor eye contact might be a coping mechanism.  Another intervention technique to try is encouraging your child to play with other children. I know this may not sound like treatment, but many ASD kids need encouragement to play with children and really engage their peers during playtime.  I set up play dates with my friends who had children close in Bradley's age.  When none of my friends were available for a play date, I took Bradley to public places that were popular for kids his age to try to get him to interact with new children.  By the end of the summer I noticed significant improvement in Bradley's eye contact and interaction with others.

Some of his favorite places include local parks, the Stomping Grounds, and Jumpin Jacks. Check out their websites:
Stomping Grounds: http://stompinggroundsplayland.com/
Jumpin Jacks: http://www.jumpinjacks.org/jumpin_jacks_web_site_001.htm

          

Bradley at age 3 years 3 months at a local park             

5. There's an app for that.  Yes- there are speech therapy apps for your smart phone or tablet.  If your child is tech savvy like Bradley is, they probably swipe your smart phone or tablet every chance they get.  Bradley is now better at Angry Birds than I ever could be.  With fun apps available, speech therapy apps may not seem so cool.  However, we make it a point to do our speech therapy work first and then reward with a train game or another approved activity.

My favorite Speech app is called Articulation Station. We have used it for almost two years now and Bradley really has fun with the flashcards. He calls it "the honey bee game," because a honey bee is the main picture of the app.  The downside to the app is that you have to "purchase" additional sounds, but I think the purchases are worth it. You truly get what you pay for and the free speech therapy apps on iTunes are not as good as this app.  For more information about what the app offers check out:
Articulation Station:  https://itunes.apple.com/us/app/articulation-station/id467415882?mt=8

We also like the "See Touch Learn" app.  It too requires in-app purchases to expand the pool of words, but I think it too is worth the cost.  One word of caution- Bradley is a bit sensory sensitive and in the past he would be anxious about getting an incorrect answer because the app will produce a buzzer sound for incorrect answers.  The buzzer is not terribly loud, but for whatever reason Bradley does not like it.  Still to this day, he is a little anxious about the buzzer, but it actually offers another great teaching opportunity. We work on the speech and comprehension aspect of this app, along with auditory desensitization.
See Touch Learn: https://itunes.apple.com/us/app/see.touch.learn./id406826506?mt=8

Parents Flash Cards is an app that includes learning lessons and quizzes.  It offers verbal and visual positive feedback periodically throughout the lesson and quiz.
Parents Flash Cards: https://itunes.apple.com/us/app/flash-cards-by-parents-magazine/id390789905?mt=8

Fun & Educational Apps we enjoy
Railroad Lite (Bradley likes the Sing Along version of this app): https://itunes.apple.com/us/app/working-on-railroad-train/id431192905?mt=8
Wheels on the Bus: https://itunes.apple.com/us/app/wheels-on-bus-all-in-one-educational/id543545550?mt=8
Amazing Breaker is good for hand eye coordination: https://itunes.apple.com/us/app/amazing-breaker/id421088863?mt=8
Talking Tom: https://play.google.com/store/apps/details?id=com.outfit7.talkingtom&hl=en 

Communication Book

After Bradley was assessed and diagnosed by our school district at age 3, he began working with his new speech therapist, Clint.  As a parent seeking information about how to help my child, Mr. Clint has ALWAYS been wonderful with giving me suggestions on how to work with Bradley at home.  One of the first things he suggested was to create a communication book that would allow Bradley to use pictures to express desires and needs.  Because Bradley had an "expressive speech delay," he had difficulty verbally expressing his desires and needs, but could understand information that was communicated to him (receptive speech).

I spent many, many hours creating these sheets and we found them to be very helpful. Today Bradley continues to enjoy looking at these pictures, but now he names and discusses them, rather than pointing to the pictures.  I have included the pages below to give you an idea of the contents, organization, and format of the book.  If you would like these documents, email me at jodie_hutchinson@hotmail.com and I'll send them to you as a powerpoint you can edit.  All of the illustrated pictures and pictures of name-brand products (Gatorade, Gold Fish Crackers, etc.) were found within a Google Image search or within Microsoft PowerPoint clip art.  I incorporated photographs of Bradley's bed and train table to personalize the book.  I suggest doing the same for your child to make reviewing and utilizing the communication book fun for them.  I had another page that included our personal vehicles, our home, and my mother-in-law's home, but have not included that within these attachments for privacy reasons.

I suggest parents consult with their child's speech pathologist on how they suggest using and setting up a communication booklet.  We used it daily to establish routine, offer "limited" choices, model speech, and expand language.  Bradley's daycare at the time also created their own communication book and personalized the pictures to reflect his classroom and the specific daycare environment.  They laminated the pictures, punched a hole in the top left corner, and bound them with a ring to allow for a portable communication book.  I hope this is helpful and fun for the whole family!

        

        

       

     

         

Speech Progress over 2.5 years

I am looking through old video files on my computer and am amazed at how far Bradley has come with his speech! Bradley has had an amazing speech therapist named Clint and I have worked with Bradley a BUNCH.  However, I know that the continued improvement I see in Bradley is because of the mighty hand of God. My God has used Clint, me, and many others to strengthen Bradley's speech.  When progress is slow, it's difficult to remember how far you've come. These three short clips show undeniable progress. God is SO good!!!

The first video is of Bradley in Walmart at age 2 years, 6 months.  I kept hearing him say something as he was looking up toward the ceiling. I finally figured it out and had to document what I knew was such a smart observation by my little cutie (a triangle). I asked him a few times what he said before I filmed him, so I was lucky to get him to answer me once. After that he wanted to talk about Thomas and then check out my phone to see what I was filming.

The next video is age 3 years, 9 months. It was New Years Eve, 2011 (about to become New Years Day 2012) and Bradley and I were recording a message for my cousin Rachel and sister Jordan. You can't see much of us because we were outside, roasting marshmallows, but you can clearly hear Bradley's speech improvement :)

The 3rd video is Bradley at age 5 years, 0 months explaining why we celebrate Easter ("Jesus died [on the cross] and rose from the grave).  My son loves the Lord and I am so proud of his desire to go to church and his love for Jesus.  When the sun beams down to earth through the clouds Bradley excitedly draws my attention to it and reminds me that it's Jesus shining down on us. God is GREAT!

Speech Delay: Pre-Diagnosis

This is a video of Bradley at Christmas time 2010. Bradley was about 2 years, 9 months. I have included a transcript at the bottom of this post. Watch the video first and see if you can understand what Bradley is saying. Then check out the transcript to see what I now know Bradley was saying. The audio volume is very weak, so you'll need to turn your volume up pretty loud and/or use headphones. If I can figure out how to edit the original movie to enhance the sound I'll re-post with improved sound quality.

"He's not autistic. He just has a speech delay." That's what I remember telling myself and others countless times prior to Bradley's PDD-NOS diagnosis at age 3.  At times I even had a hard time admitting Bradley had a speech delay. I was a talkative child... and I'm a talkative adult. I was an award winning speaker in high school- winning state medals in both cross-examination debate and informative extemporaneous speaking. As a psychology instructor, I speak for a living.  How could my child have a speech delay?  My mother-in-law told me that my husband had a speech delay as a child and didn't consistently use effective, understandable speech until he was two or three. This was comforting to me, but the longer the "speech delay" went on, the more I realized Bradley was falling behind his peers with his speech.

I remember Bradley saying "Momma" and "Dada" before he was one year old. He cooed (produced "aaahhh" and "ooohhh" sounds) as a baby within the average developmental time frame. I think he did a little babbling (vowel-consonant sounds like babababa), but now I realize it was not as much as my younger son babbled. After his first birthday Bradley wasn't adding many new words to his speaking vocabulary. I didn't worry at first, because I knew boys are sometimes slower in adding to their vocabulary than girls.  A few more months went by and at 17 months Bradley entered public daycare in August 2009.  At first Bradley didn't seem significantly behind his peers in the daycare class, but by Christmas time the daycare director suggested I allow an Early Childhood Intervention (ECI) diagnostician assess Bradley's speech.  It hurts to hear someone tell you they think your child is not developing appropriately... really hurts.  I know the suggestion for assessment was made because the daycare director cared for my child. I know that early intervention is the best treatment for just about any and EVERY physical and psychological concern.  Diagnosticians know the benefits of early intervention, but they don't know the hurt.

After an assessment with ECI, Bradley was recommended to participate in speech therapy treatment and began receiving services.  I don't remember the frequency of his initial speech therapy, but I think it was one 30 minute session per week.  Bradley's first speech therapist was a woman named Kori. She was very energetic, nice, and positive. Kori gave me a lot of hope and Bradley seemed to like her.  However, I didn't think I was learning how I could help Bradley.  I guess I was expecting to have a pragmatic treatment plan for me to follow.  Bradley participated in the ECI speech therapy, but I wasn't seeing significant improvement in his speech.  I don't know if my expectations of improvement were too high, but I grew rather impatient with the quality of speech therapy (specifically about the lack of resources and direction given to me as the parent).  While Bradley's two and a half year old class mates were now speaking in sentences and carrying on conversations with their parents, we were getting only 1-2 words at a time with lots of unintelligible talk. Bradley also had excessive saliva that would dribble down his mouth. We would notice this excessive saliva pretty consistently- almost on a daily basis. Meanwhile- speech therapy included blowing bubbles and playing with whistles, and I was growing impatient.

Video Transcript
Mom: Jingle Bells. Jingle Bells. Jingle all the way. Oh what fun it is to ride in a one horse open sleigh.
Bradley: Hey
Mom: Hey- What does Santa Claus say?
Bradley: Clan Saus say (Santa Claus say)
Mom: Ho ho ho
Bradley: Ho Ho. Chris (Ho Ho. Merry Christmas)
Mom: Ho Ho Ho.
Bradley: May mis (Merry Christmas)
Mom: M&Ms??? (at the time I thought he was saying M&Ms)
Bradley: M&Ms
Mom: Can you say Jingle Bells?
Bradley: Ho Ho. Tick a tick. Tick a tick. Tick a tick (Bradley would frequently say "tick a tick" or something along that lines rather than meaningful speech)
Mom: Sing Jingle Bells
Bradley: Tick a tick. Tick a tick. Tick AHH. Tick a tick! (I think he was trying to sing Jingle Bells)
Mom: Jingle Bells. Jingle Bells. Somebody's here. Say, "Who is it?"
Bradley: (whispers) Who's it
Mom: Who is it?
Bradley: Dada
Mom: You think that's Daddy? Let's see. Who is it?
Dad walks in...