The End of an Era

It's becoming very evident that Caleb is moving into a new phase of life. For the last 4.5 years, so much of our weekly schedule has been focused on therapy appointments. Caleb has worked with the same fantastic physical therapist since he was just a few months old. That therapist works part-time, and her schedule won't work with Caleb's new school schedule next month. Our last session with her will be tomorrow, August 3rd. It's crazy to think that we won't see her anymore. She has been such a big part of helping Caleb get stronger and meet so many gross motor milestones. We absolutely love the clinic, so we are going to continue therapy there. I'll take Caleb one day after school each week to work with another therapist. I imagine it'll take him a few weeks to get adjusted to working with someone new, but I'm excited to see how he does with her.

Caleb hasn't been working with his OT for quite as long, but I think he has been seeing her for at least three years (maybe a little longer). She doesn't have any after-school openings, and neither do the other therapists at the clinic. It's a pediatric OT clinic, so most of their patients are school-age and also needing those coveted appointments in the late afternoons. Caleb is on a wait-list, but we don't know how long it'll take for something to open up. We're waiting to hear back from another clinic. For now, he will finish outpatient OT on August 8th. 

We have the world's best speech pathologist. Our schedules fortunately still work, so he will continue seeing her weekly.

Caleb does get PT, OT and Speech at school, and so much of what he does in the classroom helps with his OT goals. I'm not too worried about him no longer doing outpatient OT.

For Tyler's sake, I'm kind of excited about freeing up our schedule a little bit. For 2.5 years, he has tagged along to so many appointments and missed so many good naps. It will be really good for him to have a little more time to do his own thing. I'm off on Tuesdays and Thursdays, so Tyler and I will have six hours together while Caleb's at school. I'm sure we'll find all sorts of fun things to do on those Tuesday and Thursday mornings. He still takes great afternoon naps, so I'm looking forward to a couple quiet hours between lunch and when we leave to pick up Caleb from school. 

Potty Time

I just looked back through recent blog posts and can't believe I never posted anything about potty-training Caleb! Caleb wasn't ready to potty-train at the typical 2-3 year old timeframe, but he started showing a few "readiness" signs right before his fourth birthday. So over fall break in mid-late October, Caleb and I got busy with our own little "potty boot camp". He did great and has been in "undies" ever since. He still has the occasional accident, but I'm so happy with how well he's doing.

Tyler wants to do everything his big brother does, so he has been showing lots of readiness signs ever since Caleb started potty-training. I decided to give it a try with him during Christmas break, but it kept getting put off due to busy schedules and illnesses. I finally got around to devoting some time to do "potty boot camp" with Tyler on New Year's Day. He's only 23 months, so I figured I'd introduce it to him but not push it too hard. He picked up on it all right away and has seriously blown me away! He's having a few accidents each day, but he's having way more successes. I wouldn't be surprised if he's potty-trained (day time... not at night) by his second birthday later this month.

Potty Training Advice?

We've been really casual about Caleb's potty training for the last several months, and the time is coming to get serious about it. My plan is to focus hard on it while Caleb's out of school for fall break next month. Please share any advice or product recommendations! I've read lots of articles and blogs, but I still really have no clue what we're about to get ourselves into! 

IEP

We had Caleb's first IEP meeting yesterday morning. I've heard horror stories about IEP meetings, so I was a little uncertain about what to expect. We knew that Caleb would qualify to participate in the school district's PPCD (preschool program for children with disabilities), and we thought he might get some therapies while at school. We also knew that the school district doesn't have a program for "typically developing" three year olds, so Caleb would be in a class with other kids who have developmental delays.

Now Caleb has been in a Mother's Day Out class for the last two years with typically developing peers that are his age. They're all either three or turning three soon, so the same age as Caleb. And while Caleb's development lags behind in some areas, I know he benefits from the interaction he has with his classmates there and from being challenged by his teachers to do the same things that his peers do.

After much thought, Brad and I came up with a schedule that works for us. We decided that Caleb would go to preschool on Monday, Tuesday and Thursday mornings, and he would go to Mother's Day Out on Wednesdays and Fridays. I suspected this 3/2 schedule wouldn't go over too well with the public school, but I really felt that it was what we needed to do.

So back to the IEP meeting...

We met with the principal, psychologist, special ed teacher, OT and SLP. The PT was at another school that day, so she couldn't be at the meeting. We were told that Caleb qualified to receive PT, OT and speech therapies at school, and he would be pulled out of his classroom for those therapy sessions. The teacher told us about some of the things they'll be doing in class, and we also learned about an adaptive PE class that Caleb will get to participate in. We were excited about everything we were hearing. Everyone seemed happy and excited.

As the meeting was wrapping up, I mentioned that we were only going to send Caleb to preschool three days per week. And instantly the mood in the room changed. They all insisted that attending school five days per week is best. I got a little flustered and didn't explain my reasoning as well as I should have, even though I had rehearsed my response in my head several times.

Believe me, I totally want what's best for Caleb. I want to see him grow, learn and reach his full potential. I would never purposefully do anything to hinder that from happening. I also understand that educators and therapists have extensive education, training and experience and probably have their student's best interests in mind too. I truly value their opinions. But ultimately, I feel that Brad and I know what's best for Caleb more than anyone else. So as we had planned, Caleb will attend the developmental preschool program on Mondays, Tuesdays and Thursdays. He will work with the PT, OT and SLP while at school. And he will attend Mother's Day Out on Wednesdays and Fridays. He will also continue working with his PT, OT and SLP that we've been seeing for the last few years in all that spare time we have. :)

Goodness. Caleb turns three on Monday, and he's suddenly a big boy! I can hardly believe he will start public school in just a few days.

Walking!

When Caleb was a baby, we were told that he probably wouldn't start walking until he was 2-4 years old. He has been working with a physical therapist since he was two months old, and it seems like we've been working on standing up and walking for several months. We are beyond thrilled that, at 2.5 years old, he is walking! He can't go more than about 15 feet without assistance... and really, he usually goes even less than that before either losing his balance or taking a shortcut to grab on to a nearby object/person. But he wants to walk constantly now, and I know that his strength/endurance will improve with time and practice!

24 Month Recap

Well, this post is more than two weeks late... but better late than never, right?  

Weight: 22 lbs, 8 oz

Length: 30.5"

Clothing size: Mostly 18 month, but he does wear a few 24 month shirts. He still wears size 3 infant shoes, and he wears size 4 with his SureSteps.

Diaper size: size 4

Eating: Some of Caleb's favorite foods are blueberry pancakes, raisins, string cheese, mac & cheese, mandarin oranges, grilled cheese sandwiches, pizza, Goldfish crackers, Teddy Grahams, and Annies Bunnies crackers. Caleb drinks all of his milk with the Talk Tools Straw #1 and Take & Toss straw cups. He drinks water from Munchkin Click Lock Insulated Straw Cups

Sleeping: Caleb goes to sleep around 8:00pm and wakes up around 7:00am. He usually takes one nap in the early afternoon. He usually sleeps about 1.5-2 hours. 

His days: Caleb still goes to Mother's Day Out three times each week. He also does several hours of speech, occupational, and physical therapies each week. 

Highlights of the last three months: Caleb is crawling, pulling up, and cruising! He walks while holding onto our hands and occasionally while holding on to a push toy. He says about 25 words (some don't sound quite recognizable to others, but Brad and I know what he's saying), and he signs about 30 words! 

Caleb has twelve teeth now. The only ones he's missing are his four canines and his four two-year molars.

And here are Caleb's final white onesie chair pics...

Goodbye Summer

Several cold fronts have been coming in over the last few days. While not officially fall for another week and a half, it certainly feels like it today. 

Even though Caleb's not in "real" school yet, the new school year brings lots of changes for us. Several of his therapists are either parents (so their schedules change to accommodate their own kids) or they work part-time in the schools. It's always crazy trying to piece together Caleb's schedule into something that works for us. What we've got going now seems pretty good, though we did have to give up some fun stuff like story time at the library. I'm still working part-time while Caleb goes to Mother's Day Out on Mondays, Wednesdays and Fridays. Caleb does speech therapy first thing on Monday mornings, before we go to work and MDO. On Tuesdays, Caleb has PT and OT. We also try to run errands or go to the park on Tuesdays. On Thursdays, Caleb does PT in the morning and then we head to the church so that I can participate in a Bible study. Caleb gets to play with his friends in the nursery while I take a couple hours to study and fellowship with other young moms at my church. Our Thursday afternoons look different from week to week. Sometimes we have an extra session of PT or speech, and sometimes we just enjoy some play time at home. Now that the weather is cooling down, I'm hoping that Thursdays (after nap) will be a good opportunity to go to the zoo.

Brad and I have talked about how we'll have to take a serious look at Caleb's busy therapy schedule (and therefore my busy schedule) as we get closer to Baby #2's arrival. I don't want to cut back on any of the things we're doing, but I know that we will probably need to. Caleb is in what we've been calling a " developmental explosion" lately. For now, I'm going to focus on all the exciting new things he's doing/saying each day, and we'll figure out the rest as we go. 

As for other changes...

Baby #2 is growing and making his presence known. The baby bump is starting to become noticeable to more people than just me. Brad got my maternity clothes out of the attic a few days ago, and I plan to get them washed and ready to wear sometime within the next few weeks. The baby is moving around a lot, and I feel him a little more each day. If this little guy is anything like his older brother, he will soon figure out that it's "fun" to get really active or have hiccups right as I'm ready to go to sleep. 

And my younger brother is gone for at least a year. We spent this past weekend with him in Texas and took him to the airport on Sunday. After a month of training, he will head to east Africa with the Navy Reserve. We're sad to see him go (even though he's excited about it!) and can't wait for his return sometime next fall.

On the Move

It's hard to believe crawling was so hard for Caleb just a few weeks ago! 

Hearing and Speech Update

I recently took Caleb to see his audiologist. After her exam and Caleb's booth test, we were told that his hearing is great and they no longer need to see him for hearing checks! We will continue to follow up with his ENT every six months or so, but that's it! Caleb has been going to that clinic every 1-2 months since he was only 13 days old! We LOVE the audiologist and the speech pathologists we've seen, so I hate to say goodbye... but at the same time, what a wonderful feeling to take one more regular appointment off of our still busy schedule!

His speech development seems to be exploding right now! He's able to say several words, though he sometimes leaves off the last consonant. Caleb's SLP told me that's common for kids who have had fluid in their ears, because people tend to trail off the ends of words. For someone who has trouble hearing, those ending consonants get lost when people don't emphasize them. Here's Caleb's current list of spoken and signed words

Spoken:
Mama
Dada
Nana
Bath
Ball
Book
Tickle
Bye
Eye
Nose
Why
Amber
Water
Papa
O-pa (Grandpa)

Signed:
More
Ball
All done
Milk
Bye
Eat
Tickle
Please
Open
Up
Water
Block

Will Crawl For Kleenex

PT Progress

Caleb had a big day at PT this afternoon! He made some great progress toward learning how to crawl, and he also transitioned from tummy to sitting several times!

Pulling Up

Check out Caleb's newest trick! When sitting on his stool, he can now pull up to his train table!

Another Tooth and a Haircut!

Caleb had a big day on Saturday! He started cutting his third tooth! I was beginning to wonder if he was ever going to get another one, since he got his first tooth at ten months and his second at eleven months. I'm pretty sure his third tooth is the 1st molar (upper right).

Also, Caleb got his first haircut on Saturday afternoon! He did really well for the first couple minutes but then was pretty upset the rest of the time. That hairstylist got a decent tip for all she had to deal with!

Starting to pull up!

Caleb has been trying to pull up for a while, but his arms just haven't been strong enough to do much. On Monday, he made some great progress toward being able to pull up on his own! He was sitting on a block (well, actually it was two phone books duct-taped together), and he reached for me. I held out my fingers, and he grabbed ahold. I didn't pull him at all, but I just gave him a stable place to hang onto. With what seemed like very little effort, he pulled up to standing! I was so surprised and proud! We did it over and over and over. And then we did it again when Brad got home from work, so that he could record it.



As Caleb gets stronger, we are going to have him sit on smaller blocks and then eventually the floor. I should note that on Tuesday afternoon, he did pull up a few times from sitting on the floor... but I could tell that it was pretty hard for him.

15 Month Recap

Weight: 18lb, 14oz

Length: 27.5"

Clothing size: Mostly 12 month, but he does wear a few 12-18 month and 18 month clothes. He still wears size 3 infant shoes.

Diaper size: size 3

Eating: Caleb has definitely found his appetite. It's hard to believe he had a feeding tube this time last year! Caleb loves turkey, cheese, guacamole, Greek yogurt, sweet potatoes, butternut squash and most other fruits and veggies. He hasn't seemed too interested in pasta, but he did gobble up some chicken spaghetti the other day. It was the Pioneer Woman's recipe... who doesn't love it?! Caleb drinks all of his milk and water from his Honey Bear straw cups now! 

Sleeping: Caleb goes to sleep around 7:30-8:00pm and wakes up around 6:30-7:00am. Taking two naps is starting to become rare. When he does, he usually naps 30-60 minutes each time. If he only naps in the afternoon, that nap is usually 1-2 hours. 

His days: Caleb is a busy little guy. He goes to Mother's Day Out three times each week. When he's not there, he stays busy with speech therapy, occupational therapy, physical therapy, story time at the library, play dates, and lots of play time at home.  

Highlights of the last three months: Caleb's speech is getting more clear and intentional. His favorite thing to say is still "Dada"... even when Daddy isn't home. He says "Mama" every now and then. The ladies in the nursery last Sunday evening told me that Caleb said "Bye bye" when his friend left. 

He's starting to sign a few words. He sometimes signs "eat" and "more" before and during meals/snacks. He was signing "celebrate" a lot, but he has switched to clapping lately. 

If we ask him "where's tummy?", he will usually pat his tummy and smile! 

Caleb is trying so hard to figure out how to crawl. He will sometimes rock from side to side and sort of propel himself forward a little bit. By doing this, he can usually move a couple feet. His biggest motivators are toys and Daddy's pizza. Rolling is still his primary mode of independent mobility.

Tripp Trapp

One of the recommendations from the speech-language pathologist in the oral placement therapy program that we do with Caleb is for him to have really good posture when he eats. The chair should be adjustable (to grow with the child) and "should encourage a 90 degree angle in his pelvis, knees, ankles, and chin". The high chair we've been using doesn't really meet any of the criteria dictated by the SLP. And of course, the high chairs that do seem to encourage the best posture are super EXPENSIVE!

Considering that he had a feeding tube this time last year, I'm beyond thrilled that we've packed away the bottles and fully made the transition to straw cups! But there's always room for improvement. After talking with Caleb's two SLPs and some other parents of kids with Down syndrome, I decided a couple weeks ago that it was time to get a new chair. I did a lot of research online, and the ones I thought would work best for Caleb were priced between $200 and $400. I didn't want to spend that much, and my CPA husband really didn't want to spend that much. One afternoon, I decided to check Craigslist and found one of my top choices for sale here in OKC! The Stokke Tripp Trapp! The seller had the chair, the baby set and the cushion for $100. They were about a year old and barely used. If I bought all of that new, it would be $365 plus tax! After a little negotiating and then the seller dropping the price after she had to reschedule the delivery/pick-up, I ended up paying $70!

I haven't noticed a huge difference yet on how Caleb is eating, but I do think he seems a little more focused. I also like that we're able to push the chair right up to our table, so he really can "join" us at the table for dinner. And of course, he looks super cute sitting in the new chair!

iPhone pics... sorry for the poor quality!

First Eye Exam

Caleb had his first eye exam yesterday. Children with Down syndrome often have eye problems, including tear duct abnormalities, strabismus (eye misalignment), early age cataracts, and many other conditions. As with all other health issues, early diagnosis and intervention is best. I didn't suspect any issues with his eyes, but it was still good to get everything checked.

He cried when the nurse put drops in his eyes, but he calmed down and was cooperative for the rest of the appointment. I was thrilled to hear that Caleb's eyes are perfect! No signs of cataracts or astigmatism. His left eye is +2.5, and his right is +2.0. The doctor said they're both right in line with what a typical baby's eyes should be. He told me that babies are born far-sighted, and the eyes gradually adjust to "normal or zero" by about age 16. He'll go back in a year for his next exam.

Oral Motor Therapy

As I mentioned in an earlier post, we recently went to San Antonio and New Braunfels. The New Braunfels portion of our trip was to meet with a speech and language pathologist there. At DSACO's annual conference in April, we met one of the speakers. Renee Roy-Hill is a SLP and a course lecturer for Talk Tools Therapy. She did a presentation at the conference for parents of kids ages 0-3 years, and we were so impressed. We left the conference thinking that we had to get Caleb set up with a speech pathologist. After several unsuccessful attempts at trying to get him in with a therapist at a clinic in OKC, we decided to talk to Renee. She said that she could evaluate Caleb and then write a six-month program for us to carry out at home. We set up a two-hour consult for one afternoon in early July and also scheduled a one-hour therapy session for the next day.

A couple weeks before we went to San Antonio, the local therapy clinic called to schedule a speech evaluation. After weeks of calling and two referrals from the pediatrician, they finally got around to calling us! We went to the evaluation and were pleased with the SLP. We told her about our plans to meet with Renee and that we were going to follow her therapy program. The SLP seemed excited about what we were doing and said that she fully supported our decision and would like to work with us to carry out Renee's program... pending insurance approval, of course!

So fast forward to early July and our first session with Renee. She introduced us to several of the Talk Tooks therapy approaches, including drinking from a straw cup rather than a sippy cup. It turns out Caleb is already a pro at sucking through a straw, but he still needs some work on swallowing all of the liquid he sucks. We also learned how to help him drink from a specially designed open cup. Drinking from the cup will help him learn how to swallow more volume at once. Renee taught us some different ways to feed him purees and soft solids. She also showed us some facial stretches and some tools/toys that will help him build strength and good form. I wish I could go into all that we covered, but it was two hours worth of very detailed info!

The next day we returned to her clinic for a one hour session where we were able to ask questions and get a little extra practice. She recorded both sessions and sent the DVDs to us a few days ago. She will send the program soon.

We're still waiting to see if insurance will approve us to do speech therapy with the local therapist. Whether that happens or not, we're busy practicing all the techniques Renee taught us. I can't wait to get Caleb's program from her and really get started with it!

If you want to learn more about Talk Tools, check out their website. Most of the cups, spoons, and tools we use are available for purchase there.

Back to Tummy and Hand Foot & Mouth

After weeks and weeks (and weeks and weeks...) of practice, Caleb is finally consistently rolling from his back to his tummy! He's been doing this every now and then (like once or twice a week) for a while, but he has rolled over 30+ times today! We are so excited and proud of him!

And Caleb is doing all of that rolling over while dealing with his first virus. He had a low-grade fever a couple days ago (99.6) and was very fussy. I figured that he was probably teething. The fever went away yesterday morning, and I thought we were good. Still no teeth, but at least he was in a good mood. And then as I was changing him out of his pajamas this morning, I discovered a rash covering his body. Fortunately, we already had his nine-month well check scheduled for today. His pedi said that he has "hand foot & mouth disease". For any other first-time mamas out there who don't know what it is, it's just a virus that should go away in a few days. I did cancel his OT and PT appointments for the rest of the week, just in case he's still contagious. 

Nine month recap

Weight: 16lb 3oz (at an appointment last week)

Length: 26.5" (at an appointment last week)

Clothing size: mostly 6 month and some 6-9 month

Diaper size: size 2 (Pampers), size 3 (Luvs)

Eating: Caleb started taking bigger bottles, so we gradually worked his formula down from 27kcal/oz to 22kcal/oz this month. Normal formula is 20kcal/oz, so we're almost there! Also, instead of six bottles each day, he takes five! He eats purees three times/day. In the morning, he eats fruit, yogurt and rice cereal. Either he doesn't like the oat cereal anymore or it doesn't sit well in his tummy, so we're taking a break from it. For lunch, he usually has veggies and/or fruits. And at dinner, he usually eats veggies and pureed chicken. His new foods this month were chicken, whole milk plain yogurt, peaches, honeydew, and shredded pieces of cheddar cheese.

Sleeping: Since we dropped that sixth bottle, Caleb goes to sleep earlier now! He usually sleeps from about 8:30pm until 7:00am. He's still an inconsistent napper. If he naps during the day, it's while I'm holding him or when we're in the car. I usually try to have some "quiet time" with him for a while in the morning and afternoon, so that he can rest even if he doesn't sleep.

Highlight of the month: The highlight of my month was when we were working with the speech pathologist in New Braunfels (I really will blog about that soon... I've just been too busy to take the time and write it all down!). She said "Caleb's a champ at eating!". When she said that, I wanted to cheer and cry and thank God! Caleb has come so far!