Kevin and Ryan Updates

Kevin's Psychological Assessment

Kevin went for his psychological assessment on Wednesday and Thursday morning this week.  (Daddy took him in because he had some vacation days, and I was just starting back to work this week.) On the first day, they did cognitive testing portion with Kevin. The child psychologist came in and introduced herself to Kevin, and explained the procedure to Daddy.  Then, she took Kevin into a separate room, where they sat across from each other at a little table. She asked Kevin questions about pictures, gave him puzzles to work on, tested him on following instructions/language comprehension, etc.  Daddy was in a room next door that had that two-way glass, so he could observe, but Kevin couldn't see him. Our Children First Resource Consultant (RC) sat with Daddy and explained things/took notes. Kevin responded well to the questions and seemed comfortable with the process.

On the second day, they did more assessment of the social/play areas of Kevin's development. Daddy and our RC were in the room, but off to the side, and were not to get involved unless Kevin made a specific request of them.  This time, a student was using a family of dolls to try and engage Kevin in social play, like encouraging him to use the doll to kick a ball back and forth to another doll, etc.  Kevin quickly lost interest in this.  In the variety of toys they provided, he zeroed in on the one car and one space ship available, and only wanted to play with those.  The child psychologist stepped in and tried to engage Kevin using those toys he was interested in, with mixed results.  By about halfway through the appointment, Kevin was telling everyone, "I liked yesterday better," "I don't like this appointment today," and "I want to go home now."

We'll get an official report with the child psychologist's observations and recommendations in about 2-3 weeks.  Daddy said they didn't say too much else, except how surprised they were that Kevin responded so well on the first day, and showed  boredom and irritation on the second day.  They said most kids like the play assessment better, which I suppose would make sense.  But since when have my kids followed other kids' trends?!

Kevin's Sensory Profile Assessment

We finally got the formal reports for the boys' sensory assessments. Here's a summary of Kevin's results.  He does have "sensory differences" in some areas.

• Kevin may miss sensory input needed for participation. He has difficulty organizing input related to his endurance/tone. Therefore, he may have difficulty sitting for long periods of time, remaining alert, and maintaining participation with peers.
• Kevin seeks/obtains sensory input at a level similar to others.
• Kevin is bothered by sensory input much more than others.  He may become so overwhelmed by sensory input that it interferes with participation. He can become either too excited, or too withdrawn, to respond appropriately or complete some tasks. He becomes frustrated or upset easily when his nervous system is not interpreting input in a helpful way.
• Kevin detects sensory input to a degree that is similar to others.

Therefore, Kevin will need classroom modifications to his seating and school supplies (scissors, pencils, etc.) to ensure he does not tire too easily.  He may also need a quiet space or some coping strategies to help him when sensory input becomes overwhelming.  The big message we need to get to his future teachers is that if Kevin appears restless, or is having difficult behavioural responses, it could very likely be due to his sensory differences, and should be handled in a manner appropriate to his needs.

Ryan's Sensory Profile Assessment

Here's a summary of Ryan's report. 

• He has a "particularly low threshold for sensory input," meaning, "it takes a very small amount of sensory stimulation for him to become overwhelmed and he is not able to attend to or understand the important information in the environment." 
•  Ryan's differences in integrating sensory input "are affecting his participation in his daily activities (i.e. not yet feeding self, not yet transitioning to solid foods, avoiding playing with others . . .)." 
• Ryan tries to "gain control of his environment by moving away from uncomfortable stimulation and/or showing distress (crying, turning away)."
• Ryan does not seek enough sensory input to sustain successful participation.
• He may become so overwhelmed by sensory input that it interferes with participation.
• Ryan detects sensory input more than others. He may be so distracted by sensory input from his environment that it interferes with his daily functions.

At this point, we are already aware of these issues, and this just put it into a clinical summary for us.  We are continuing to work with Ryan's Occupational Therapist (OT) to "explore sensory and self-regulation strategies to support his ability to function within his various environments." 

Ryan's 18-Month Check-Up

This week, we also took Ryan to the pediatrician for his 18-month check-up and immunizations.  (Ryan is 19 months old this week, but the pediatrician wanted to do it by corrected age since Ryan was born about 5 weeks early.) Our doctor has been following all the reports from Children First and all the other specialists Ryan has been seeing, so he's very much aware of Ryan's developmental delays and sensory issues. Anyway, here's a summary of information from our visit to the pediatrician:

• Ryan is almost 27 pounds, and 33.5 inches long.  He's a big, healthy boy, in that sense!
• I asked about the sore he's had on his cheek for 8 weeks. I have tried putting polysporin on it, but it comes and goes. The doctor said, "Put Polysporin on it." I told him we already did. He said, "Put some more on, and put a bandage on it." Whatever.
• I asked about Ryan's constant grabbing/scratching of his private areas.  The doctor's response: "Oh, that's normal." Whatever. (It's not normal that he's giving himself a constant rash.)
• The doctor told me Ryan should not be drinking more than 12 ozs. of milk a day because it will make him severely anemic.  I think he saw the look I gave him, because he quickly added, "Of course, with his food-sensory issues, it may take time to adjust this . . ." Um, ya. The only liquid he will tolerate is milk. (I tried water yesterday and he looked like he had sucked a lemon.  He also took about 3 sips of apple juice, and then tossed the bottle across the room.)
• GOOD NEWS: Ryan's MRI results are completely clear. Like it was with Kevin, we don't know what's causing all his developmental delays. However, this time, we do know the sensory issues are negatively affecting his development.

Of course, the big "A" popped up again at the end of the appointment. The doctor asked, "Have you considered an investigation into a diagnosis of Autism for Ryan?" to which I responded, "Yes. He's on the waiting list for a psychological assessment from Children First within the next 6 months or so." The doctor agreed that they usually start testing for autism around age two or later.

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Despite all the medical concerns, we still have our lighter moments. A few nights ago, Ryan was laughing like crazy at a Pampers commercial that has babies crawling, scooting, and walking to some up-beat classical music. He especially enjoyed the baby at the end.  Since we have the DVR, we were able to rewind and play the commercial over and over, for about 20 minutes straight.  The more we played it, the harder Ryan laughed!