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Category Archives: Physical Therapy

Learning How to Play

I recently came across this article, which explains how therapists teach young children how to play and what the benefits of that training can be. Before the Bean came along, it never dawned on me that kids would need to be taught how to play. It just seemed to come naturally for any child I had ever known.  But for the Bean, playing with toys was not a skill that came naturally.  She loved to look at faces and interact socially, but had no idea what to do with the brightly coloured plastic and wooden objects we placed in front of her.  She just ignored them completely.

In the article, Penina Ryback defines play as, “the way children practice and internalize both the rules and roles they see around them. Play helps children make sense of how their world works.” If a child is developmentally delayed or has a condition such as autism that makes it difficult for them to notice the rules and roles they are supposed to be practicing, they need some prodding to play like other kids play.

I notice this when we play with typical kids.  When presented with a new toy or concept, they explore it using what they know, and then quickly branch out into other ideas as they observe others also interacting with the same thing.  But for the Bean, it’s not as smooth or effortless a process.

The Bean is more interested in sucking on her fingers than all the new toys at her birthday party, but her friends are happy to take over.

The Bean is more interested in sucking on her fingers than all the new toys at her birthday party, but her friends are happy to take over.

When other kids the Bean’s age were engaging in parallel play (age one or so), she was still just learning how to sit, so she couldn’t interact with the toys like other kids did.  It didn’t even seem like she was watching them play – she was engaged with me and any other adults who would interact with her and make eye contact.  During this time, we were getting services from Easter Seals.  The wonderful woman who came to our home for an hour each week was teaching the Bean how to interact with toys, and measuring her progress based on whether she could actually grasp a toy and pick it up, or switch a toy from hand to hand.

For her 2nd birthday, I made sure the activities were at her level, and luckily her typical friends thought it was fun too.

For her 2nd birthday, I made sure the activities were at her level, and luckily her typical friends thought it was fun too.

A year later, she was finally engaging with the toys that her friends were playing with a year previous, but they had moved on to more sophisticated activities.  So once again, she was sitting with the adults playing with the toys while the other kids were starting to actually play with each other.  Our Easter Seals therapy was focused on teaching the Bean how to stack blocks, turn the pages of board books, squeeze play doh, and matching wooden puzzle pieces to the right space on the board. She had some success, and was evaluated at about 6 months behind her peers.

At 3 years old, she was able to get around on her own with a walker.  She was thrilled to be able to move around on her feet, but she still couldn't keep up with her friends.

At 3 years old, she was able to get around on her own with a walker. She was thrilled to be able to move around on her feet, but she still couldn’t keep up with her friends.

When she turned three we were still working on stacking, nesting, colouring and wood puzzles, and had also added some imaginitive play, recognizing and matching colours, shapes, and knowing the difference between big and little.  The Bean was finally stacking one block on top of another, recognizing colours with some consistency, and could scribble a little with a crayon, but her speech capabilities were way behind, and her ability to focus on a task for very long was minimal.  Many 3 year olds are happily reciting the alphabet, counting to 10, drawing/colouring with some precision,can write their name, and are totally ready for preschool.  The Bean was being prepared for preschool as well, but it was clear that she was far from ready for integration into a regular preschool, so we enrolled her at Marindale, our County’s special needs preschool.  It was the best thing that had ever happened to our Bean.

At 4.5 years old, the Bean uses her imagination to play.  It's so much fun.

At 4.5 years old, the Bean uses her imagination to play. It’s so much fun.

Without the play therapy we received from Easter Seals, I wouldn’t have had a clue what to expect from the Bean or how to encourage the development of these skills that, in my experience, usually came naturally.  During her two years at preschool so far, she has made huge strides: now stacking large lego blocks into towers, drawing with more variety, playing with her imagination, constructing parts of more complicated puzzles, and imitating others with abandon.  She has gotten to the point where she wants to be able to do what other kids are doing, which shows that she’s paying attention and learning a lot from those kids.  Her speech is still very far behind other kids her age, but that is progressing as well.

We are nearing the time when we have to decide what Kindergarten will look like for our Bean.  We are trying to be realistic and choose the options that will ensure her continued development success without overwhelming her.  Our team of teachers, therapists and administrators are so totally on the Bean’s side, that I have no doubt we’ll make the right decision together.

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Leaps and Bounds

image011 (1)My Bean is growing in every way all of a sudden.  She has moved up a size in clothes, which is super exciting for me because I was getting tired of dressing her in her 12 month stuff.  For those not familiar with the Bean, she’s tiny – 3 3/4 years old and now wearing 18 – 24 month clothes.  What mom doesn’t love new clothes, even if they’re for her child and not for herself?

Walking is the Bean’s favourite hobby.  She toddles around everywhere, dancing if there is music and running (sort of) if she’s super excited.  She sure keeps me hopping when we’re in public – her curiosity knows no bounds, so she’s off the second I put her down. A whole new world has opened up to her and it is so much fun to help her explore and discover new things.

She keeps herself busy while I’m working in the kitchen by removing plastic containers from the cupboard and distributing them around the house.  She loves to “help” me wash dishes, standing on a chair at the second sink with her own bowl of sudsy water.  While it makes a huge puddle on the floor, and she keeps stealing the clean dishes from the rack and putting them back in my dishwater, it can be tremendous fun.  I still eventually get the dishes done.

Laundry is a similarly fascinating chore.  Bean likes to push the buttons on the washer and dryer, so after we load them, she closes the door and gets them started.  She recently started taking clean clothes out of the laundry basket and putting them away in her drawer. As long as I’m one step ahead of her, she manages to put the right things away in the right places and I don’t have to reorganize when she’s done.

023The challenge of communicating with the Bean is starting to get a little easier.  She attempts to copy everything we say, and it’s been a blast finally being able to teach her new words and have her respond.  With Christmas coming up in a few days, we were thrilled that she has learned to recognize and sort of say “Santa”.  We’re still working on “Baby Jesus”.  She had a Santa cupcake at her Christmas party, and since she associates cupcakes with birthdays, she wanted to blow out a candle.  I used that opportunity to remind her that it is Baby Jesus’ birthday, and we sang and pretended to blow out a birthday candle.  So cute.  However, the fact is that Santa is a much more compelling symbol for a toddler – bright colours, concrete concepts, and presents…the importance of the birth of Jesus is a little too abstract for her yet.

My favourite part of parenthood these days is playing with the Bean.  She has a great imagination and loves to make jokes and laugh.  Her jokes usually involve some sort of slap-stick comedy, and she giggles uncontrollably at her own antics.  She loves to be tickled and startled, asking for “moh” (more) over and over again.  At the playground, she enjoys climbing the structure and sliding with me down the big-kid slide.  When we get to the bottom, she pretends to be a chicken as she waddles back to the stairs again, flapping her wings and clucking, “buh, buh, buh”.

128Preschool continues to be an awesome experience for the Bean.  Her teacher is on maternity leave, but they’ve had a string of wonderful substitutes in the meantime, and the teacher’s assistants are a stable presence for the kids in their teacher’s absence.  Bean is apparently the “angel” of the class – the sweetest and least disruptive.  Of course she is – she’s her mother’s daughter!  But seriously, I feel very fortunate that her diagnosis doesn’t come with an expectation of major behavioral challenges.  She certainly gets frustrated and can be persistent about having things her way, but unlike some of the other kids in her class, she doesn’t tend to lash out physically or flop down on the ground in protest.  At her most aggressive, she’s just really loud and squirmy.  I get more resistance from her at home than they do at school, I think, but that’s pretty normal for most kids.

014Mostly, these days, she feels like a delightful 2-year-old.  It seems appropriate to me that her mental age seems to fit her physical age, even if they don’t correspond with her chronological age exactly.  She’s starting to get interested in dolls and playing dress-up.  If they didn’t make her also do other activities, she would be a permanent fixture in the play kitchen at school.  At home she loves to build with and knock down blocks, pull stickers off their sheets and stick them everywhere, have tea parties with Elmo, and get dirty in her sandbox.  When I’m digging around in the garden, she joins me, although a lot of soil still goes in her mouth.

Our biggest challenge with the Bean continues to be her sleep habits.  Currently, she mostly sleeps with us in our bed.  She won’t settle and fall asleep at night time without one of us lying beside her.  If we do put her in her own bed, she wakes up an hour later and we have to do it again.  She still takes naps but if she sleeps for more than an hour in the afternoon, she’s up until 9 or 10 pm, which means that my Sweetie and I don’t get much of an evening together.  We’re working on some strategies to get her sleeping consistently in her own bed.  She is too persistent at this point for the Cry-It-Out method, and frankly, I’m too soft-hearted to be able to stand it.  I think part of it is that she’s just a very physically affectionate child.  She needs the reassurance and comfort of a snuggle – I say there are worse things in this world than that, for sure.

Potty training is in the concept stage right now.  She’s starting to make it known when she needs a diaper change.  We’re working on recognizing when she’s actually going so we can start to preempt it and get her to the toilet.  But she doesn’t like sitting on the potty or on her little toilet seat, so we’re trying to get her used to that first.  As with most things in the Bean’s life, it will take a lot more time than it does for most other kids.  That’s just the way it is for us.  And in the meantime we’re helping to keep Pampers and Tide in business.

image033

I predict that the coming year will be one of even bigger leaps and more impressive bounds.  Our Bean will be turning 4 in March – it’s surreal to think about.  I feel like I’m finally coming into my own as a mother.  The extended infant stage was not my ideal situation…as much as I love babies, having one for 3 years while all the other kids are changing rapidly was a little disheartening and quite difficult for me.  As always, though, when I look for the silver lining it’s there.  Most mothers mourn the speedy passing of the infant stage.  I got to coddle and snuggle and baby my little one a whole lot longer than most moms before she became a wriggly wild thing.  Every milestone reached tastes that much sweeter because of the struggle it took to get there.  I don’t take anything about the Bean for granted.  I marvel at how far she’s come in the last year and I feel grateful for all the help we have along the way.

What a blessed life we live!

Recent Beany Accomplishments

The Bean has been growing in all areas lately.  It’s been so exciting.  Some highlights:

  1. Speech– Her words have been exploding.  She tries to copy most sounds we make, and is learning new words and signs every day.  Recent words include “wah” (walk), “hah” (hat), “ooh ooh” (monkey), “baa baa” (sheep), “nana” (banana), ‘ama” (grandma), “puhpuh” (grandpa), “amauw” (animal – not to be confused with ehmauw, which is Elmo), “wawa” (water), “ow” (out), and “dauw” (down).  Some of these words she’s been able to say for a while, but she’s finally using them to communicate her needs.  It’s so much easier.

    reading a book

    The Bean LOVES to read (courtesy of Naomi Unrau)

  2. Fine Motor– The Bean has gotten very good at manipulating my iPhone.  She can select apps with her pointer finger and touch a tiny arrow to move the story or game forward.  She is starting to be able to feed herself with a spoon.  If I pierce the food with her fork, she can get that in her mouth too.

    tea party

    All dressed up for a tea party (personal photo)

  3. Gross Motor– We’ve been walking around together for a couple of months, with me holding her hands and walking behind her.  She’s started to be able to walk on the treadmill at therapy holding onto a bar without being supported or helped by her therapist.  She can also walk pushing her walker ahead of her.  Standing is now her preferred position and she loves to play, read books or watch TV while cruising up and down the side of the coffee table.  In addition, she has started lying down on her stomach and pushing herself around with her hands and knees.  It’s not quite crawling – more like a frog swimming motion – but it gets closer to crawling every time.

    farmgirl

    Farmer Beany had a cow, EIEIO (personal photo)

  4. Social– The Bean loves to play with other kids.  She has always loved being around other people, but it seems like she’s starting to notice the difference between hanging out with adults and playing with kids.  I’ll be sending her to daycare once a week to have more opportunity to play, and also to give myself a break; we have found a local playgroup, so we’ll be playing there after speech class on Tuesdays;  on Wednesdays, we go to a Mommy and Me music class, which we both enjoy immensely; and we still try to get to playgroup with our Southern Marin Mother’s Club playgroup on Fridays.

    friends

    A little music appreciation with friends (personal photo)

  5. School– on March 21, 2012, the Bean will start prescho0l five mornings a week.  We’re hoping to get her into the Special Needs preschool in San Rafael because they have a lot more resources to help her out.  The default preschool option will be an integrated school in Novato that has typical and special needs kids together in the same class.  That wouldn’t be so bad, except that I think she’s still going to need a lot of physical help, and they don’t really have the resources for that.  So I’ll be advocating to get her into the more extensive program, at least for the first year.I am both anticipating and dreading the start of preschool.  On the one hand, I am very much looking forward to having a few hours to myself every day to get things done without interruption.  On the other hand, I’ve spent 2.5 years spending most waking moments with my daughter, and I think I’m going to feel a little weird (and maybe a  bit lost) without her.  Still, for the most part, preschool spells F-R-E-E-D-O-M for me, and I can’t wait for the opportunity to explore some of my own interests again.

Baby Steps

She's driving already!

I had a dream last week that the Bean suddenly started walking.  The dream was triggered by my excitement about some of her recent new developments.

The most exciting for me was that on Friday, during her physical therapy session, she took her first couple of steps while holding onto her therapist’s fingers.  I was so elated I had to blink back the tears of joy.  My girl hasn’t even wanted to try taking steps until now.  She’s been perfectly happy to stand holding on to something or sit and scoot around.  She can also stand for about 3 seconds without support if she tries really hard, although that’s not consistent yet.  I think the time she spent with other kids (playdates and lots of birthday parties) in the last few weeks may have tipped the balance on her desire to try it.  It’s got to be frustrating to her 2-year-old mind to have all these kids running around when she’s stuck on the ground.  Not a bad use of peer pressure, I’d say. 

The Bean has also been learning a lot more about language lately. 

  • She suddenly started saying “wawa” for water.  I know it’s not just a coincidence, because she already has a sign for water, and she used that right after she said “wawa” and then guzzled a bunch of it down. 
  • I was telling our dog, Sakari, to get off the back of the seat in the car.  The command is “off”, and we have to say it quite loudly and assertively for her to pay any attention.  As I was yelling at the dog and trying to drive, I suddenly heard my daughter say “aw, aw” (sounds like off without the ff).  She’s done that a couple of times now.  So cute.
  • Her new favourite game is to point out the eyes on every person, animal or stuffed toy she can get her hands on.  “Ah, ah” (eye), she says.
  • She spontaneously used the sign for “please” in the appropriate context.  I was ignoring her pleas for “dar” (animated Youtube videos of Twinkle, Twinkle Little Star) because she’d already had too much computer time that morning.  But when I glanced at her, I saw that she was signing “please” (flat hand rubbed in a circular pattern over your chest).  A TWO WORD SENTENCE, albeit in two different languages.  And an understanding that when you want something, you say “Please”!  Wow!  And today, when she was demanding “dar” again, I reminded her that she had to say “please”, and she did it again. 

The third really cool thing that happened in the past couple of weeks is that her ability to copy gestures has suddenly improved.  She waves her arms in circles slowly through the air when watching the ballerinas dance in the Wiggles “Twinkle Twinkle Little Star” video.  Last week she tried to sign “stand” when I showed it to her, and is picking up new signs all the time.  She copies every cute silly thing that her Dada tries to teach her. 

It’s crazy exciting to have our Bean finally learning words at a rate faster than one a month.  It’s so much fun to know that we’re teaching her things daily, and that she understands a whole lot more than we think she does.  We recently split her Oral Motor/Speech therapy session into two separate one-hour sessions so that we’re focusing a lot more on Speech.  I can’t wait to see how the extra therapy time helps to speed up this process.