Michael Update

Michael had his cyst removed.  For a while, he had this little lump that we were told could be this big long word.  It was removed about a week ago and we are on our way to his chin healing.  After the surgery was complete, the doctor said that it wasn't what he thought it was, but that it was either a cyst or a lymph node (i didn't know that you had lymph nodes in your chin).  We go for a follow up in about a week and a half and will find out the biopsy of the cyst.

In a week and a half we are also taking Michael for his developmental evaluation.  I have been really concerned about his lack of meeting certain milestones or his lack of communicating.  According to his preschool teachers, he is progressing, but not as fast as they would like to see.  He has been in a a 5 hour preschool program for a year now and is still not really able to talk to us about his day.  Luckily his teacher sends home a little check off on the things that happen during the day so that I can ask him about it.  With lots of prodding he is able to maybe at least acknowledge that he has down certain things at school.  Unlike his younger brother (by 10 1/2 months), Michael can not really communicate about his day even with simple cuing.  I have noticed though, that he is improving over that last couple of weeks.  Before, when you asked him who his teacher was, he would say teacher, now he can say her name and then just this morning, I asked him who was in his class and he actually named the kids without a lot of prodding.  He still likes to play alone and doesn't really even play along side other kids.  His imaginary play is starting, but is still pretty limited.

The one area that he actually excels in is music.  He loves music and can sing many songs.  He was able to sing songs before he could really say a whole lot.  I love listening and watching him sing.  His whole face lights up and you really now that he loves music.

One thing that I do think has helped is his diet.  He has shown to be sensitive to  gluten and dairy.  ever since we have removed these or at least lessened them greatly in his diet, he has been improving.  He is more aware and more vocal.  He sleeps better and doesn't seem to have the skin issue that he was having, especially when he was eating and drinking dairy.

I am looking forward to his developmental evaluation.  Part of me says that he doesn't need it, but another part of me says don't be stupid.  He is four years old and he should be communicating more than he is and he should be playing more with others or at least along side others rather than always wanting to play by himself.  He does well with his brother and sister, but really needs to start playing with other kids.

One other major area that he has greatly improved in is in his behavior.  His impulsivity is much improved.  Before, if you reprimanded him, he would throw something.  Usually this was regarding asking him to put soothing down.  Instead of putting it down, he would throw it and sometimes it was something very fragile.  I do think that you need to talk to him in a certain way, but he is so much better.

I can't wait to either find out that there is no real issue and we don't need to worry, or find out that there is an issue and then we work on helping him with whatever issue he has.  I really just need to know where to go with him and know if I am worrying needlessly or if my instincts were right and I need to do more!

Amy

LIFE!!!!

Lately, there have been lots of ups and downs in our family's life.  Some of the ups include oh so much better sleep.  Pretty much every night between 6:30-6:45 we start our bedtime routine.  At one point, the routine was way too complicated.  I've basically pared it down to either bath time or washing up/brushing teeth, diaper changes/toilet time, 2 books, and maybe a song.  We are usually complete with lights out before 7:15.  Usually, the kids are asleep before 7:30, at least the twins are.  Michael, on the other hand, needs his own wind down time by himself one the twins are asleep.  He is usually asleep by 8:00 sometimes a little later.  This has made life so much easier.  I love bedtime so much more now.

The twins have turned 3 and are no longer eligible for early intervention due to age, but Eva Rose is getting speech once a week for articulation issues.  She amazes me though, and even the speech therapist mentioned it today.  She can say alligator pretty clearly, but she can't pronounce the ending of simple one syllable words like cat or cup.  Thomas is not receiving any services.  He is going to be watched, but he really doesn't need anything.  Michael continues to go to a preschool program for 5 hours.  His behavior seems to be testing limit setting at home and at school.  I think I am going to talk to his doctor about my concerns at his 4 year visit to see if there is anything that we should have him tested for, if not just to ease my own mind.

In the down department, we have had some big issues with a family member who has been living with us.  Life has been really stressful and we finally told him it was time to leave.  There are way to many things to write about why it was so stressful, but I am so looking forward to getting our house and life back in order!  I am not looking forward to the potential backlash from the family, but we needed to do what was right for our family not what was right for this family member.  I am hoping that my kids will be better off and I know that I will be better off!

It has been an extremely mild winter here north of Boston, but I still can't wait for spring.  I can't what to take the kids out and play.  I can't what to go hiking and walk the zoos and farms and ll those types of things.  I can't wait to start our garden again.  This year, I want to start planting our early spring plants on time and not wait til it is too late.

Amy

Pre-School Parent/Teacher Conference

We had Michael's first parent/teacher conference about 2 weeks ago and for the most part it was all good.  Behavior wise, Michael is doing excellent.  Given his fairly severe speech delay, his frustration level is at a pretty good level, but speaking of his speech, he is definitely delayed and I don't know why.  I think the only thing that bothered me about the conference is that when we asked the teacher about about fears of autism, the only thing she could say was that she didn't feel that he was on the spectrum given his ability to be comfortable sitting in her lap and being affectionate.  That was a good sign, but the fact that teachers are not allowed to give their opinion about testing because it may cause issues with parents really frustrates me.  I mean, these are professionals, who in our case, spend 5 hours a day 5 days a week with my son.  I am not frustrated with the teacher, but the system.  Michael's teacher is wonderful.  She is sweet and kind and motherly and I feel very comfortable with her as his teacher.  I just wish I could get a sense if we need to do more.

I have a feeling that going gluten and dairy free is a really good step.  I hate that we have to do this and we were really bad over the holiday, but we are now back on track and no gluten or dairy for Michael (so to be me too).  I really do think that it makes a difference!  It sucks, but I do think it helps!  The other issue that got brought up at the conference (by his teacher), is wether or not to get Michael tested for diabetes.  I am hoping that this isn't an issue.  Michael seems to drink a ton and then pees a ton to the point of having multiple accidents.  It kinds of makes sense that if he drinks a lot then he will pee a lot, but it is the drinking of fluids that makes me wonder, though I have to say, sometimes limit setting helps and his accidents are getting better.  He has even slept with underwear on for the last 2 nights and the first night woke twice to pee, and then last night didn't soak himself.  Maybe going gluten free and dairy free will really help with just more than digestive issues!

The twins are being evaluated for further needs in the school system.  They are going to be 3 in just under 2 months.  I can't believe that I have an almost 4 year old and almost 3 year old twins.  Eva Rose has been in early intervention since the beginning of the fall for a speech delay and has improved immensely (which is another reason I am increasingly concerned with Michael's delay).  She went from barely putting 2 words together and dropping the endings of words  to the point of not understanding what she is saying, to still dropping the endings of words but putting more than 2 words together.  There are still often times that I don't understand her and at 3 I probably should understand almost everything that is said. Thomas just amazes me with his vocabulary! That being said, when I look at friends kids I can't help but compare and still think my kids are behind, but maybe not. Then there are those people in your life who try to tell you that your kids are very behind and that they should be doing certain things, but in reality maybe those people are over estimating kids development.

It will be interesting to see how the kids further develop. Will Michael all of a sudden come out and just start talking? Is there more to his delay? Do Thomas and Eva Rose need more help with their expressive and receptive communication? Only time will tell and will see how things go!

Amy

Public Preschool Eval

Michael turns 3 in about 3 weeks.  This means he'll age out of early intervention.He still has a pretty huge speech delay so we are having him evaluated through the public school system.  I know that he'll qualify for speech therapy, but I am also hoping along with speech, he'll get to go to the public preschool.  I think that he'll benefit from the preschool program for his socialization skills.  He is just starting to parallel play with others.  He is just starting to be social rather than always being on the outskirts of things.  I know that this is most likely just him being more introverted and shy, but I think that he needs to work on this skill and I think our EI group has really helped him with this.  I also think that this will help his speech instead of just having speech therapy a couple of times a week.  In 2 weeks, the school psychologist is coming out to our EI group to evaluate him.  The next Monday, the day before he turns 3 we have his IEP meeting where we will discuss what the public school's assessment is and what the plan is.  Thankfully our EI worker is going to the meeting with me.  My step father is watching the other 2 so I can go to the meeting and hear what they have to say.

I really can't believe that Michael is going to be 3.  It feel like just yesterday I found out I was pregnant with him.  I was just looking at the picture on the top of this blog, for Halloween 2010, and from that short time, it looks as if he has become such a big boy.  I can't believe how much he has changed.  He has done so well in EI, but he really still needs loads of speech therapy.  I really hope that the school feels the same way and he gets to go to preschool with in a week or so after he turns 3.

I am so looking forward to tomorrow, but I am actually a little nervous too.  Any words of advice from others who have been there?

Amy

Updates

On the medical front, we will be spending our morning of the 18th of this month at Children's Hospital Peabody.  Our first appointment is for Eva Rose to evaluate the fluid in her ears.  She has had fluid in her ears for the last 3 months that hasn't changed, if anything, it's gotten worse.  Thankfully, we have not had any resulting ear infections.  I am almost hoping that the doctor recommends tubes because, all the feedback that I have gotten about tubes has been very positive.  I have heard so many people say that their child's speech has improved immensely after having tubes.  I don't know if it will be our case, but the fact that it has made a huge difference in everyone that I have talked to makes me feel really positive about the outcome. 

The next appointment is for Michael.  I have had some concerns about his breathing at night and I have inally done something about it.  For a little while, I thought that maybe I was hearing things, but now my mom and my husband have heard issues with Michaels's breathing.  So, I contacted his doctor and he was seen.  The doctor felt that it would be appropriate to have hime seen by an pediatric ENT. Given that he snores, he sleeps horrible and always has, is a mouth breather and breathes loudly, and I think may even have some issues with apnea, he is being evaluated for enlarged tonsils and adenoids.  The doctor that examined him did notice that, even though it was in the middle of a gag, there was a lot of soft tissue around his tonsils and uvula with little airway.  Michael was not cooperative with the exam at all.  Again, I am almost hoping that there is an issue that can be fixed with surgery.  I am hoping that for his sake and our family, that we can fix his sleep problem.  I'm sure that some of it is behavioral, but until I get him medically cleared, I do not feel comfortable with doing CIO or another form of sleep training.  If there is nothing wrong with his tonsils or adenoids, I will most likely ask for a sleep eval at Children's because Michael has not ever really slept through the night.  We have had short periods where he has, but it has never lasted more than at the most a week.  Also, if he has issues with his tonsils or adenoids and breathing, it may also contribute to his speech delay.

It is so amazing to me that 2 out of our 3 children may have an ENT issue.  I have really only ever had swimmer's ear when it comes to ear infections and ENT issues and I don't think my husband was ever really prone to ear infections or other ENT issues.  My dad did have major issues with his ears and 2 of my sisters have had tubes and one of them has had pretty severe ENT issues.  My niece has also had enlarged tonsils and adenoids and had them removed when she was 5.  I am just waiting for the shoe to drop and to find out that Thomas has some issue.  I really shouldn't complain.  These issues are not all that significant, although Michael's breathing could be.  I really don't have sick kids.  As horrible and scary as the RSV was, and I will probably always be traumatized from having my son rushed to Children's because he was declining so fast as well as watching my daughter on a vent for 6 days, we have been really lucky.  I wouldn't wish RSV on anyone especially when they are so  little, but I have, overall, really healthy kids.  I just want to get to the bottom of these issues and have them finalized and hope that after all is said and done, my kids speech will explode, Michael's sleep will improve as well as his overall breathing, and we will all be healthy again!

Amy

Doctor Visits

In the almost three years that I have had children, except for a yeast issue with Michael right after the twins were born and RSV with the twins and then one related ER trip months later, we have only needed to see the doctor for well baby visits.  I have felt extremely lucky that we have not had more illness requiring doctor visits.  Now I feel that we are having pretty significant issues, though not serious, may be impacting my kids more than I ever realized.

Since all three kids have had a significant speech delay, we have had them evaluated by early intervention.  EI recommended that they all have a hearing test to rule out that hearing loss is an issue for the speech delay.  All three kids speech delay is unrelated to hearing loss.  I've already written about having Eva Rose evaluated for fluid in her ears.  Now, I am thinking that Michael may need to see an ENT.  Michael has never been a good sleeper.  He snores louder than an adult at times.  My husband, my mother, and I have all heard what we think is apnea.  I mentioned this to his EI worker, who is a speech therapist, and she said that if he is having sleep apnea issues, which could be related to his adenoids or his tonsils or both, that could be affecting his speech.  She said that if she knew about this issue early, she would have recommended an ENT eval months ago.  I had no idea that this could be related to his speech.  We are seeing the doctor tomorrow and I hope that she agrees that we should see an ENT.  I absolutely want to rule out that Michael's sleep issues and speech issues aren't related to adenoids or tonsils or both! 

I new that his breathing could be having an impact on his sleeping, but I never even thought about it being related to his speech and it make so much sense that it could.  His EI worker said that every time we talk, we need to stop breathing.  She said in kids with breathing issues, as a means of survival, they don't talk as much.  Where he is so young, he probably isn't able to verbalize the issue.  He certainly also seems congested at times, even during the day, but there is no other evidence of a cold.  Michael is certainly improving with his single words, but has not really put two words together.  If breathing is an issue, then I can certainly see why he is speaking in only one word sentences.  If anyone has any information about sleep apnea in kids or enlarged adenoids and tonsils and how it relates to sleep and speech, I would appreciate it being passed on.

Amy

Good News!

We had EI (early Intervention) today and we talked about the fact that the twins are coming up for their re-evaluation in a couple of months.  Amazingly enough, the EI workers feel that they may not qualify next time.  This is such great news, but it also stink in the fact that I have loved having people to come in and help with the kids speech.  At least, I now know what to do to help them get their vocabulary going.

Michael is coming up for his evaluation at the same time, only the biggest difference is that he is going to age out of EI at his next evaluation.  He will then be evaluated by the school system and I am really hoping that he will get picked up for pre-school through the schools.  He is progressing, but is at at least the same point as the twins and maybe even a little behind them.  Given that he is 10 1/2 months older, I am assuming that he should be further ahead than he is.  EI is going to do an evaluation also prior to the schools evaluation, I think.  They are at least going to do their own evaluation before Michael turns 3.    Hi EI worker doesn't think that he'll qualify for pre-school since he really only has speech delays.  She does think that he may qualify for speech therapy, but that may be it!  It will certainly be interesting to see how things go over the next couple of months!

Amy

If anyone has other suggestions for helping with speech, I'd love to hear them.  Anything else that I can do to continue to get the kids to progress is great!

Early Intervention

We finally have all 3 kids signed up for early intervention and their individual sessions start this week.  Michael starts tomorrow and the twins start on Thursday.  We have been going to group for 2 weeks so far and as great as I think it is, I'm not sure that they are getting anything out of it yet.  It is interesting to watch my 3 interact or not interact with the other kids in the group.  I really feel like my kids need to have more interaction with other kids so that they start to learn social skills. 

I am really looking forward to having the individual sessions start.  I have noticed a big difference with the twins and their immitating skills and Michael has gotten better, but not the the extent that the twins have.  I have hearing test scheduled for all 3 kids and Michael goes this week.  It should be interesting to find out if there is an issue with his hearing that has made him delayed in speech or if it is something else.  I am hoping that he is jsut developing on his own time and that there is not more going on with him or the twins.  I am a little nervous taking Michael for his hearing test, not knowing what to expect.  I may put a message out to the twins group to see if anyone has had experience with hearing tests at this age and what I should be expecting from the visits for the 3 kids.

It's amazing how I was looking for things to do with the kids and now that early intervention is involved 3 of 5 week days, the kids have some sort of intervention happening.  At least Tuesday and Friday are early days, but Thursday is right in the middle so that only leaves the morning to really do anything on that day.  Now that I am working, it makes it a little more difficult, but not impossible and at least I know that we have things going on 3 days a week.  And the best part is that the kids will hopefully start talking more soon.  From what I hear, it happens quickly and EI works wonders.  hopefully it will help with their socialization skills as well as their speech skills.

Amy

Early Intervention Update

Today we had the twins evaluated for EI and like I expected, they qualified for due to a speech delay.  Now all 3 kids are accepted into EI for speech.  I am actually glad that all 3 are involved as I think it will make life easier overall.  We are trying to get them into a group, which I think is beneficial for all of them.  Personally, I think all 3 kids could use some interaction with other people than just me and my husband.  I think they need to be around kids their own age other than each other.  I am hoping that with the fall coming and the weather getting cooler, we'll be back at the park more often.  I plan to look more into other groups, hopefully that are free or really low cost.  I'm really looking forward to getting out IFSP (plan) in place so that we can start working with the kids.  They have already given us a bunch of good suggestions that we have actually started to incorporate into the schedule.  The best part about EI is I am supposed to incorporate thigns into our daily lives not try to find a special time to set aside to work with them. Since I  have 3 under 3,  this makes so much sense.  The thought of trying to remember to set aside time to work specifically on speech is kind of terrifying.  On the other hand, the thought of incorporating it into our daily lives is so freeing.  I am looking forward to getting things started and moving forward with their speech!

Amy

Early Intervention

We have been trying to figure out when and if an early intervention referral needs to be made for any of the kids.  At this point the only issue that we are concerned about is speech.  None of the kids seem to speak at an early age and since my husband and my little sister started speaking at closer to 2 1/2 and 3, we weren't that concerned.  Now that Michael is nearing the 2 1/2 age and is speaking more, but only still saying 1 word at a time, we decided that it would be important to have him evaluated and at the same time have the twins evaluated since they really aren't talking either.  I know a ton of people in my twins group have had EI for quite some time and for all sorts of developmental delays and they have, for the most, part been really satisfied with the service and felt that their kids really benefitted.  Today, I made the referral to our local EI office and will here back from them in 7-10 day regarding an evaluation.

At this point I think things are fine with all 3 kids, just a slight delay in their speech.  I have to admit though, I am a little worried that they will find out that there is something more to be concerned with.  If there is, I know that it is better to know now and get the assistance that is needed, but it is a little scary to think that maybe there is more to the delay than just late speech.  I am also feeling a little guilty since another twin mom pointed out that kids are finished with EI at 3.  That  means that Michael will be in it for all of 6 months if he is found eligible.  I'm sure that there is follow up after EI, I just don't know what.

There are all sorts of questions that I have regarding EI.  I am hoping that my twins group will be a great resource for all of my questions.  I definitely tend to think about the worst possible outcome, I just try not to obsess about it!  I'm sure that I will find support in my twins group for this, as they have been really helpful in the past for me and for others with questions regarding many topics.

Right now, we are just waiting to schedule an evaluation for all 3 kids.  I am going to just wait for that and not think about the worst outcome of the eval.  I will just wait and see where it brings us!

Amy