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. 

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

Hungry Boy

Guess who ate only "big boy" food today?! No puréed foods or baby food! 

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!

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.