Charleston Appointment

Yesterday afternoon we had our appointment in Charleston at Coastal Pediatrics with Dr. Kimberly Caristi. I found her on the SPD website (sensory processing disorder) by searching their treatment directory. Here is her profile there.

Our appointment was for 2pm so we decided to pick Joshua up a little early from preschool so we would have time to have lunch on the way down. 10:40 to 11:10 has been their outside time, they put the kids in a buggy designed for multiple kids and stroll around the Epworth campus. This almost always puts Joshua to sleep which is why he hasn't been sleeping in the car on the way home because they have been going outside lately. Thankfully they were getting started late and had just gotten outside when we got there so he fell asleep promptly in the car. He slept for about an hour and woke up when we were between Orangeburg and Summerville.

We had lunch in Summerville and got to the doctor's office at about 1:45. We then waited until 2:30 to get into the room and then until after 3pm to see the doctor. We were not happy about this but it was our only complaint, the visit was worth it. Joshua was tired by then, really tired. He spent the next half hour or so crying, poor baby. The doctor then went out and got some cheerios and he perked right up, he sure does love to eat!

She took a history from us about him. She also read over the Infant/Toddler Sensory Profile that they had mailed to us, we filled it out and brought it with us. She tried to observe him and get him to do things but up until she brought in the cheerios he was so tired he wouldn't do anything but cry. She is certified in sensory integration as well as being a pediatrician with years of experience dealing with children with all types of special needs. It didn't take her long to see that he is a "sensory" kid. I told her that the PT had been calling him that. It was a pretty whirlwind appointment, Joshua being fussy and we didn't really go into specific detail, I didn't get to ask her all the questions I had but we are going to be e-mailing.

She took down all the numbers of all of the therapists and the EI, she's going to call all of them and formulate a plan of what they can do and what we can do with him. She told us to read The Out Of Sync Child and Raising A Sensory Smart Child. She is going to get him an eye test, we know he can see she wants to know how he sees. We are also going to get him tested for food allergies/sensitivities. I had done some researching and food can play a part if the child has sensitivities. I'm sure there will be more to come as we learn more about it and start working with him. She said that often she doesn't see the kids until they're 3 or 4 so we are really ahead of the game.

Overall we are very pleased we went, the traffic and waiting we could have lived without but we are glad we found her. I feel like now we have a team behind us and that will really help. Looks like we'll be canceling that appointment in July in Greenville.

18 Months!!

Time sure does seem to be flying lately. We are so busy with therapy, preschool, activities and occasional doctor visits or tests. I am so tired by the end of the day. Joshua is doing really well though. The biggest thing is that he is pulling up, standing and even cruising a few steps! The week before we went on vacation his preschool report said he was pulling up and standing. We didn't see it until our last day of vacation. We had put him down for a nap and a half hour later he was still up so we went in there to see why he was still up and he had pulled up in his pack'n'play! We were almost speechless! I didn't find out about him pulling up at preschool until the next week so we didn't even know he'd been practicing it there. His pediatrician was very pleased to her about it today.

His stats are:
32 inches tall (42nd%)
25lbs (40th%) We think he might be a little less since he was fully clothed and wearing shoes when they weighed him, unusual since they usually get him undressed before they weigh him.
48cm head (57th%)
He is in size 4 diapers and mostly 18 month clothes.

He had apparently missed a shot so he was due to get 4 but by doing that he doesn't have to get any shots (except maybe a flu shot once a year) until he's 4!! So we went ahead and did it. He seems fine, he is cutting his upper molars and canines so he's cranky from that but not too bad. He has all his bottom teeth until his 2 year molars come in.

We told her that we are trying to get a sensory evaluation done since the PT thinks he has sensory processing disorder. She didn't say much, I'm not sure she knows much about it. We went over the M-CHAT screening for Autism but she said that even though we answered yes to some of the questions since he is delayed in all areas it wouldn't be right to just put him in that category.

We did make an appointment with a pediatrician in Charleston who is certified in sensory integration. I have left a message for her because I want to be sure she can evaluate him since the test that is usually used is for kids 4-9. We don't want to make a trip down there if she can't evaluate him but I do want another opinion so we will see what she says.

More Questions Than Answers

So we went back to Greenville Developmental Pediatrics today. We met Dr. Shulkin, didn't see the nurse we met with last time but she was in another room observing (you know the one way mirror glass, we saw ourselves in it but she could see us). He told us that he put Joshua at 10-11 month old level but that in communication he was further behind than that, that was his primary concern. He didn't agree with the sensory issues at all that the PT and head teacher at Epworth have discussed with us. They never gave it a name but I looked up and found Sensory Integration Disorder/Sensory Processing Disorder. I printed out a checklist for infants & toddlers and brought it with me. I don't think he'll even look at it, he basically disregarded sensory issues saying that they are part of a broader problem or issue, such as child who was anxious might have sensory issues. He did bring up the Autism Spectrum, saying that it was too early for Joshua to have any sort of diagnosis but if he wasn't making progress (primarily in communication, he doesn't seem concerned or maybe as concerned with gross motor - walking) then we would re-evaluate. We go back July 28th, I wanted an appointment after we saw the geneticist on July 19th. We called back because he said if we thought of anything between now and then we could talk on the phone and of course driving home I had a ton of questions. Mainly about the sensory issues, I'm so confused now. The PT and head teacher at Epworth are sure he has sensory issues, no one has mentioned anything regarding an Autism Spectrum disorder. In fact Joshua's primary pediatrician has specifically said he's not Autistic. He has very good eye contact, something the speech therapist mentions every time she sees him. Also something I told the doctor. We brought Joshua's new braces and shoes, showed them to him and told him about them and he said nothing. He said even if Joshua was walking there would be issues whereas the PT has said that something would click in his brain (some part of his brain that hasn't been turned on yet?) then everything would fall into place. I told this to the doctor and he didn't say anything. I'm not sure if the doctor doesn't believe in sensory issues or what but we will be asking him when we speak to him. The OT had said she could add sensory therapy but I think the doctor wouldn't say to do that.

17 months

I guess I should have seen it coming since Joshua has been less and less interested and nursing for shorter and shorter times but it seems that we are done now. It is very bittersweet for me, another one of those moments to remind me he really isn't a baby anymore. In so many ways he still is but this is one more way that he isn't and I'm adjusting to it, slowly. I was always the one to offer, but then again I'm not sure he's at the point when he could tell me he wanted it yet. He would only nurse for a few minutes so I knew he wasn't getting much but I wasn't ready to give it up yet. Last weekend he bit me and drew blood on one side. Then on Monday it happened again. I tried to pump for the first time in 5 months and got less than an ounce. That's when I knew we were pretty much done. He fell asleep Tuesday night laying in bed with us watching tv, poor baby is dealing with the same allergies we are and has been congested since Sunday. It was so rare for him to fall asleep like that. It was another way I knew we were done. I always wanted to go the baby led weaning route and I think we have to some extent, there has been no trauma to him, it's been harder on me for sure. I'm so proud to have made it this far.

I can remember back to the early days of nursing him as a newborn and not thinking I'd ever make it but I did and wouldn't change it for the world. I know I did my best and gave him the best start. It's hard but worth it. The pride I feel knowing that I nourished him before and after he was born, that he only needed me to survive his first year isn't measurable. There was a study done recently that said that if 90% of US women breastfed thier babies for the first six months it would save $13 billion dollars (not including formula) and 900 lives of babies, I can only hope more women try because it's worth it, our babies are worth it. 75% of women start out breastfeeding at the hospital but only 14% actually make it to 6 months.

Hearing Test etc.

Yesterday was Joshua's hearing test. An Audiology Intern did the test so when we had questions she had to go ask someone else. She also didn't explain what she was doing but she did two tests; a pressure test and another one where she put a probe in his ear (she did one ear at a time) and it was connected to the computer. Not sure exactly what it was but she said his hearing checked out fine except he had some fluid in one ear. Since we weren't satisfied with the results being fine due to our observations of his hearing we are going to their hearing center to have him tested in the sound proof booth. She said she wanted his ear clear of fluid first but when we took him to the pediatrician she said that the little fluid in his ear shouldn't affect his hearing. He doesn't have an ear infection so he is on children's claritin 1/2 tsp. per day for two weeks and then we go back to have it checked.

We briefly discussed the Greenville Developmental Pediatric visit with her and she agreed with the nurse that he doesn't fit the mold of a child with a sensory problem. She was concerned and wants to get to the bottom of what's going on. We told her that we found out it's a 3-4 month wait for a genetics appt and she said that it's the only place in town but they are very good and thorough so we are going to make the appt.

Earlier this week we met with the speech therapist to go over her evaluation and set up goals. It was hard to hear again how he is delayed and she put him at a moderate to severe speech delay (both expressive and receptive). So we have a lot of work to do. I was a little (ok a lot) overwhelmed by this and the dozen goals she has set up for him. She did say that we don't have to work on them all at once although during her sessions with him she will try to work on as many as she can but we should focus on 1 or 2 at a time. He starts next week so I will get more details about how to work on each individual goal and which ones she thinks we should start with.

We are also getting an occupational therapy evaluation but I'm afraid that starting that right now as well will be too much for both of us. It's not yet set up so it's just as well, we have to get adjusted a little to the new schedule before we start something else.

Greenville Developmental Pediatrics

Today was our appointment with the N.P. in Greenville. We really liked her, she made us feel comfortable and complimented us saying we were on the right track and gave me an A+ for all my hard work! It made me feel so good and was something I really needed to hear. She said she wished more parents were as dedicated and doing as much as we were already doing. She couldn't give us a diagnosis, she doesn't know what is causing Joshua's delays. She does not think he is a "sensory kid" like his P.T. says. She said that kids with sensory issues or disorders usually have sleeping problems and eating problems which Joshua definitely does not have, either one. She was very encouraged by his good eating and sleeping. So moving forward we are doing more tests/evaluations: genetics test (they draw blood and do a complete family history), hearing test, occupation therapy evaluation and speech therapy evaluation. He will probably be in both OT & ST so his days will be very busy. We are supposed to go back in May.

Joshua walking in his walker (2)

Joshua walking in his walker (1)

Joshua discovers the cat

More Bathtime Bubbles!

Bathtime Bubbles

Joshua loves Elmo!

Next week Joshua is being fitted for special inserts for his shoes, they are supposed to help him stand and walk better because he still tends to stand on his toes they will get him walking flat footed. We gave back the stander today, that was a rough 2 months using it and I'm so glad it's over. Now our new hurdle will be the walker.

Joshua's 1st Day of Preschool!

I am so pleased to say that Joshua's first day went great! He woke up at 6 but thankfully was back asleep by 6:30 and slept 'till 7:30. We got him dressed and gave him a snack before we left. I got a few pictures but they got some too; I'll scan and upload those when I get them. They said he had a few fussy times but they were short lived. He explored and got into things, had a snack and did circle time. They were feeding him graham crackers and cheerios but were giving another child applesauce and when Joshua saw someone else was having something he wasn't he made it clear that he wanted applesauce too! So he ate very well for him. He must have gotten tired because he took a nap in a little swing/hammock they have for about 40 minutes and was just waking up when I got there. I didn't think he would make it the whole time without getting tired. I'm so happy that he didn't spend the entire time crying, that makes me feel so good. They said he had a great first day! They gave me a cd with all the songs they sing at circle time and a printout of the lyrics. Also there is going to be an article in the newspaper and he might be in it! I hope to get a copy of it and share it on here.

15 Months (2)

I always forget at least one thing. He did very well with his shots today; he got 3 and as usual by the time we were leaving the office he had forgotten all about it. The Pedi said that Joshua doesn't exhibit enough signs of autism for us to be concerned. He isn't speaking but he is very social (a flirt when he wants to be) and didn't object much to her examining him (he usually doesn't). Also she was very encouraged by the fact that he loves to eat and all kinds of food; children with autism sometimes have issues with textures and Joshua doesn't. She said the people at developmental peds will be encouraged by it too.

Something else I forgot, he has pretty much given up the pacifier in favor of his thumb. It started a few weeks ago when I didn't give him the paci fast enough he would use his thumb and we just gradually stopped offering the paci so now he uses his thumb. It's a lot more convenient and the pedi has said before that she'd rather he used it.

15 Months!

Joshua now only has to be in his stander for 20 minutes per day. He got a walker, a brand new one from the PT./K509.html"> He should be in it for a few minutes at a time and just walk a few steps. The PT really thinks it is a reachable goal for him to be walking a few steps by himself by Easter. She was very happy to hear he’s going to Epworth preschool next week. She knew about it but didn’t know it was still open, I guess she hadn’t been there in a long time.

He had his 15 month well visit today. He’s 23lbs (25th%), 30in. (20th%) and his head circ. Is 48cm (70th%). The Pedi was very pleased that he has an appt. next month at developmental peds, we are all surprised the wait was so short. She said the appt. is usually quite long, it’s a play based evaluation; they want to see what he can do. Overall she was happy that he’s improving, she’d never heard of Epworth preschool but is excited about it for us.

I can’t believe he’s starting preschool on Tuesday, that my Mom is moving to Columbia next weekend and she will be 1 mile from the preschool! It really does feel like it was all meant to be, it fell into place so easily. Thank you, G-d!

Joshua Crawling 2/24/10

Joshua Crawling 2/24/10 (1)

Joshua Crawling 2/23/10

Outfit for Joshua's 1st day of Preschool

Horse shirt w/khaki pants

Flying Ace shirt w/khaki pants

Blue bear outfit

Blue whale overalls

Duck oufit

Monkey outfit

Help me pick an outfit for his first day. The one with the most votes wins. The 2nd runner up will be for his 2nd day.