A Tough Day at O.T., but Still Productive and Considering Moving Blog to Tumblr

*UPDATE* Thatcher is officially potty trained! Yeah! It took a lot of intense training and hard work on Thatcher's part, but we finally made it. Now, Thatcher hardly ever has an accident, which is good news for Mom and Dad. However, Thatcher is still learning how to pull his pants up and down, wiping, and proper hand washing. During the day, we set a time, which goes off every hour to alert Thatcher that it is "Potty Time." He sits on the potty for 9 minute intervals (unless he goes sooner) to give him the maximum time to do his business without sitting for too long and we have a middle of the night potty break most nights to avoid night time accidents.

So, now for the real reason for this post: Thatcher's Tough Day at O.T.

Okay, so normally, Thatcher likes going to the therapy, but some days, he just doesn't feel like it. Those are the most difficult days because Thatcher usually screams and it's not easy to calm him and if he isn't calm, it's harder to get any real work done, but today I was impressed. Even though this is the beginning of the week right after Thanksgiving break, Thatcher and his O.T. were able to work together, changing up the activities for today, to get the most out of his O.T. session.

So, here are some pictures:

Thatcher started out jumping on the trampoline. This is a great activity for sensory input, which is vital for Thatcher. This can calm him and make it easier for Thatcher to do better during other tasks. The reason is because Thatcher has sensory processing disorder, so Thatcher has to have extra sensory input in order to cope with the world around him. At home, Thatcher likes to jump on his bed, and off his bed, and jump up and down in front of the television. Simply put, like many children with Autism who like to swing or rock, Thatcher likes to jump.

After some jumping on the trampoline, Thatcher had some fun with Play Dough. This is a more difficult task that is used to build hand strength so that Thatcher can do better with fine motor tasks, like tying shoes, using scissors, and using a pencil. Thatcher does not have a very good grip and has some trouble controlling what his hands are doing. Whereas most children his age are learning to trace letters and numbers and tie their shoes, Thatcher is working on the fundamental building blocks to do these tasks. 

Thatcher got interested in pulling apart the Play Dough before getting frustrated and throwing it across the room.

When Thatcher is frustrated and jumping doesn't help, Thatcher really likes "deep pressure." Thatcher will often seek out hugs for comfort, even from people he doesn't know very well, but he will not a hug a person if he's not in the mood to do so, like many other kids his age.

When Thatcher is seeking deep pressure, it is good for him to have "squeezes," which literally means, squeezing him, a little harder than for a normal hug. This gives him the deep pressure he needs. His O.T. also used "Joint Compressions" today to try and calm Thatcher, which is where the O.T. grabs at both sides of a joint and pushes them together. For example, a wrist joint compression would consist of grabbing the hand and the arm and pushing them together to compress the joint.

Thatcher did a little bit of coloring today, which is useful in teaching the proper grip for handwriting and will later lead to the fine motor skills necessary for writing letters and numbers. Thatcher's O.T. uses stencils and plastic texture cards under the paper to keep Thatcher interested in coloring the paper because it is easier to feel what the crayon is doing with this method, but sometimes, Thatcher likes to look at the texture cards and stencils.

Because Thatcher was having such a tough day today, we ended the day with a light up fidget toy. Fidget toys can help a person with Autism focus better on a task at hand because they are focused on only one or two things, rather than focusing on several different things. We often use fidget toys at Potty Time to keep Thatcher focused so that he will stay on the potty and do what he needs to do without getting up and wandering off too soon. Fidget toys can also be very calming for the same reason that they help a person with Autism be more focused.


So, there's a tough day at O.T. Most days more work gets done, but today, we took it easy, changed up the schedule and got through O.T. without too much fuss from Thatcher, even though he really didn't feel up to being there today.

And last, but not least, I'm considering moving this blog to Tumblr because Tumblr has become a more popular blog host among many people that I know. I really like Blogger and have been with Blogger for various blogs for quite a few years, but to reach the masses, I feel that I must move on. 

The Potty Training Saga Continues!

Well, it's been a long wait and after much paperwork was filed and lots of questions answered, Thatcher is finally receiving potty training intervention provided by a behavioral specialist. As I'd stated before, we've tried everything a person can think of, from rewards to "open door" policy to schedule training, but without any help we were getting nowhere. Thatcher has been going "pee pee" in the potty every morning when he gets up for a very long time now, but we couldn't seem to convince him that going potty is an all day event. We even tried a musical device that would sound when his underpants were wet, but this didn't work because the device was not very loud and nobody could hear it unless they were right next to Thatcher when it went off and then the things stopped working. I called the company and got replacements, but when I mentioned that they weren't loud enough, the person who answered the phone said, "We don't want to scare the children by making the device too loud." What bothers me about that, though, is that the device plays the tune "It's a Small World," which doesn't sound like it would scare a child at all. Anyway, the musical device called Tinkle Toonz was a bust and we ended up calling it quits until the behavioral specialist could come in and save the day.

So, the question now is: If you've tried everything already, what is left to try? Well, do you ever have one of those "Ah ha" moments when it comes to figuring out how to teach your child, or any child for that matter? Our plan of action? Try everything! At the same time! Yup, that should do... try everything at once, but we'll see... *fingers crossed.

Okay, so we knew that schedule training didn't work, but in order to record when Thatcher goes, we printed off the schedule training sheets again. They look like this:

I made these using a MS Excel document. Each page is one document and there were a few tiny errors, but the times go from shortly before Thatcher wakes up (just in case he gets up early) to shortly after Thatcher goes to bed (in case we are up later than usual). On the bottom of the sheets is a legend to tell you what to enter in each box, which looks like this:

And here is one more picture of the schedule which shows a closer look at the top and where we've filled in part of it:

So, there are the pictures of the schedule, but of course, like I said before, schedule training did not work for Thatcher, so in addition to the schedule, we also have an alarm. This is like the Tinkle Toonz in that it is a sensor that goes off when it gets wet, but instead of being a musical tune that is difficult to hear, it is a much louder buzzing sound. Once the child gets used to the alarm, it will theoretically not scare them and it's not so loud that it would cause them any pain. However, the difficult part about this device is that the alarm box (which makes the sound) has to be attached to the child's shirt of outer clothing and it has a cord which goes down and attaches to the underpants where the sensor is located, so the most difficult part about this is the child getting used to wearing the device. With Thatcher this was a very simple process, but the behavioral specialist tells me that many children don't like or are afraid of the device at first and will try to pull it off. Thatcher, on the other hand, was merely curious about the device, but wasn't afraid of it and didn't try to take it off. This alarm can be found at your local medical supply store or on the Sleep Dry website. We ended up giving the behavioral specialist the Tinkle Toonz alarms that were never used (they were replacements), which she plans to use as rewards for other children and she paid for our Sleep Dry alarm. Here is a picture of the box that ours came in:

Of course, schedule training and an alarm doesn't work by themselves. There have to be visual ques and rewards, so when Thatcher is taken to the potty (every 30 minutes [we also check to see if he's dry every 15 minutes]), he is given this picture of the potty, which Thatcher's preschool teacher gave to us for his schedule board:

Thatcher is given a small treat when his pants are dry, like one goldfish cracker or one gummy. You can choose your child's favorite items, but given nothing if he's wet. He is also given lots of praise and a piece of candy if he goes "pee pee" in the potty, which is a bigger treat than what he is given for being dry. If the alarm sounds before he's sitting on the potty and he does not void in the potty, then he is given nothing, but if he finishes voiding in the potty when the alarm sounds he is given a piece of candy and lots of praise. And all of this certainly would not work if it weren't for this little device: 

That's right! It's a kitchen timer, which only costs a couple of dollars at Wal-Mart. We set it to 15 minute intervals for the time being for checking dryness and putting Thatcher on the potty. At 15 minutes we check for dryness and 15 minutes later Thatcher is put on the potty. When Thatcher was much younger we were using a musical potty, which would play music when Thatcher voided in the potty, but this doesn't work for smaller children and it is recommended that children with Autism immediately use the big potty with a seat that snaps in place and a stool. We used the smaller potty before because we didn't know yet that Thatcher has Autism and therefore did not know about the recommendation to put the child on the big potty. This is also useful if your child does not like change. Fortunately, we chose a potty that looked similar to the big potty and had a top that could be removed and snapped to the seat of any toilet. Our potty set up looks like this: 

As you can see, the lid to the small potty snaps on the big potty very easily and can be used with either gender (the pee catcher comes completely off so that it can be used for girls, too). So far, the results are looking good. We are using lots of different tools and our fingers are crossed that Thatcher will be going potty every time very soon. As far as voiding in the potty, Thatcher has done this once (today) during a scheduled "sit on the potty" time... so, updates on Thatcher's progress will come soon. :)

Activity Boxes

So, before I get into the real purpose of this post, I'd like to make some things known. First of all, I have decided that instead of referring to my son as "Monkey" like I have been, I am going to break that barrier with my readers and call my son by his name on here from now on, which is Thatcher. I will continue to allow his last name to remain private as well as our location for the time being. I'd also like to say that the reason I haven't posted in a while is that over the course of the school year, things got really busy around here. I'm about to finish the requirements for my master's degree and needed all the extra time I could get to focus on finishing my thesis and Thatcher was having an issue with the provider of his speech and occupational therapy. Basically, all of those wonderful things I'd said before about how great it was that he was talking; well, he'd reverted back to only saying, "no," which I think had a lot to do with the fact that his therapists kept changing. He had three different speech therapists over the course of less than a year and then his occupational therapist took another job. Of course, I can't fault her for wanting more pay in such a horrible economy, but Thatcher suffered and after she left, my son was assigned an occupational therapist that saw him once and then was on medical leave indefinitely, so it was time for a change. I went back to Thatcher's doctor and requested new providers. In other news, Thatcher was approved for a waiver program in our state which pays for therapies that his medical card doesn't cover so he's now getting community living supports (2 hours a week) and will begin potty training intervention very soon.

Now, on to the purpose of this post: Activity boxes. I've decided that this blog needs more pictures and what a better way to start then with an idea given to me by Thatcher's preschool teacher. At the end of the year, I had been asking about what my son can do in the summer to continue all the progress he's making and his teacher came up with this:

These are numbered activity boxes. His teacher suggested starting with three boxes and building up to more. I have two sets of numbers 1-6, so the most we could do using the numbers is six boxes, which is more than enough for a four; almost five year old. Also, there were a couple of foam puzzles that wouldn't fit in one of these boxes, so his teacher put it in a gallon sized bag. The boxes came from the Dollar Tree, which is one of my all time favorite stores. Everything in the store is $1 or less, so it is a true dollar store, unlike Family Dollar, Dollar General, and most other dollar stores.

So, we have all of this, but then, how do we initiate play with the activity boxes? We use a laminated folder that looks like this:

As you can see, the number of the box we are using goes in the "Time for" slot and the numbers of the boxes that we've finished goes in the "Finished with" slot. The boxes we haven't started go in the other section along with a card for "Choice" which is the one with the hand. After Thatcher has completed using each activity box, he is allowed to choose the activity he'd like, such as iPad or television. This is the reward for completing the activities with minimal meltdowns.

I also like using picture cards with the boxes, instead of number cards, or in addition to number cards, which makes the folder look like this:

 

Since it's difficult to see what the pictures say, I can tell you that it's "Time for" Sensory Box, we are "Finished with" Bubbles and Shaving Cream, and we still have Peg Board and Choice left in this example. This is useful because it gives Thatcher a visual aid rather than an abstract number.

So, now that we've seen how it works, lets take a closer look at each of the activity boxes and we'll start with the one that isn't actually a box, but a bag. Here's a closer look at the Foam Puzzles activity. There is a number puzzle and an alphabet puzzle in this bag and this is also the bag I store the folder and the number and picture labels in when they are not in use:

And here is a closer look at how the tops of the boxes are labeled with picture cards. These are pictures that I made using my computer, which I laminated with laminating sheets I purchased at Wal-Mart. I did have an issue with the cards coming apart, but a little Elmer's glue fixed that w/o making the pictures not visible.
 

These have been attached with Velcro dots. I put the softer ones on the box and the rougher ones on the backs of the pictures, but it doesn't matter how you do it as long as you do it the same way for every box.

And here is a closer view of the numbers on the front of the boxes:

As you can see, they also come off and stick on using Velcro dots. This is great because you can put the number cards on the tops of the boxes or on the front:

And here is what is actually in these activity boxes. This one is full of bristle blocks. Thatcher's teacher had these left over. Most of these boxes were made by her, but there were a few left over boxes that I used to create extra activities:

And here is a box with dinosaurs, animals, numbers and dice. Thatcher's teacher included index cards in some of the boxes which explain the activities.
 

And here are the directions for the previous box. I hope you can read that:

And here's the next box. I put the picture card in the box to make it easier to see what is actually in this box. It's just craft pom-poms (fuzz balls), clothes pins, containers, and some easy grip tongs, which I added to the box since Thatcher still has trouble using the clothes pins to pick up the pom-poms:

And here are the directions for this box:

This is the Alphabet box and it's pretty self explanatory:

Here is the Music Box. It has lip whistles, which don't make a high pitched noise like other whistles, so they aren't as annoying. It also has a Kazoo, Recorder (Flute Toy), Hand Clapper, and some baby spoons which I also purchased at the Dollar Tree. I ordered the lip whistles online on a website where they were on clearance. I highly recommend them if you can find them. I got a set of 12, individually wrapped for about $3 plus shipping. The spoons can be used as drum sticks by emptying the box and turning it upside down:

And here is a favorite; the Sensory Box! You can fill this with pretty much anything, but beans aren't as messy as sand, rice, etc. You can also rotate what is in the sensory box. The cups are baby snack cups from the Dollar Tree and the spoons are just spoons we had when Thatcher was a baby. There are also some magnetic letters and things buried in the beans for Thatcher to find:

And here is the Shapes box. One of the little baggies has shapes that look like buttons and a shoe string for threading. This helps teach the skills needed for tying shoe laces:

And here is the instructional card that was in this box:

Here's a Peg Board. This is good for teaching fine motor skills as well. The pegs can also be stacked into each other and it all fits in this little box, which is a good way to keep all the pieces together:

And here is a box full of Play Dough, Silly Putty, beads, pipe cleaners, cookie cutters and scissors:

And here is the directional card for that box:

And here is a more random box. It has shaving cream, bubbles, makeup brushes (good for sensory), and a sterile brush for the brushing protocol that I've previously discussed on here. We have a dry erase board that easily comes off the wall and we use it as a mat for using the shaving cream, play dough, and putty:

And here is how we transport the boxes to therapy. Thatcher's OT is used to working with adults, so the facility is not already equipped with a lot of these things. Five of the smaller boxes fit in this one tote:

And the ziplock bag with the number puzzles fit on top:

So, here's the tote, all ready to go to OT with Thatcher. We use these boxes at home, too:
 

And all of the boxes store nicely under the coffee table in our living room:

And that's it! All kinds of activities inspired by a teacher and numerous therapists. This is also good for typical children and a great learning experience for all! 

Update on Monkey

The last thing I recall posting about Monkey was that he'd just turned four, so here are a few new updates on my wonderful pride and joy. First of all, Monkey is doing really well in preschool. He loves it and he loves seeing his new friends everyday. He's also talking a lot more than he used to, which is wonderful. He still has obvious delays in his speech, but being able to hear the words, "I love you" from my son is priceless, especially when he randomly says these words on his own without prompting. As for therapy, Monkey is finally in a position where he receiving "co-treats" which means that his speech therapist and his occupational therapist both see him at the same time, which is something we've been trying to work out for a couple of months now. And now, we finally have an I.E.P. (Individualized Educational Plan) for my son. Normally, when a child begins preschool at a public school in our state, the child is either accepted based on low income or disability. I was told by our local board of education that the process of getting Monkey into school would be faster if I chose to enroll Monkey based on our income, so I did, not knowing that it would take until January to even get an I.E.P. meeting. Apparently, the school had so many months from the time I requested an I.E.P. to have the meeting and they took all of the time they could get, but I'm glad that Monkey now has what he needs at school.

So, now the next step in the process for Monkey is potty training intervention. I'm getting nowhere with potty training him, but have been told to use the TEACCH approach. Apparently, this is the best way to teach Monkey that he can use the potty more than just in the morning when I literally have to place him on the potty and give him a distraction toy (the iPod) just to get him to sit there and go. This is the only time of the day that I've been successful in getting him to go potty and for us the TEACCH approach just isn't working. So, the next step is some kind of potty training intervention, which Monkey's medical insurance doesn't pay for, so I applied him for a waiver program in our state. Monkey was approved for the waiver, but we are still in the process of acquiring these funds, so the journey continues. This waiver should cover the cost of a potty training intervention program where I actually get help with teaching Monkey to potty in a way that he can understand. Though I've been told by several people that children with Autism are usually really late to potty train and it's quite impressive that I can get him to go potty almost every single morning. It's a journey, but Monkey is well worth the effort.