Getting Speech and Occupational Therapies After Age 3

M2 aged out of early intervention therapy a few months ago. The early intervention provided her with in-home speech and occupational therapy once a week, alternating. Once you hit age 3 though, that all goes away. Boom. Diagnosis or not, needing help or not -- Third birthday? GONE. Then what happens? The child still needs therapy, that need doesn't magically go away. What is next? Where do you turn?

At that point, the therapy goes through the school district. I never even knew that until M2 was going to need the help. The catch is: Getting the therapies isn't automatic. The child has to qualify based on the district's specifications (each does things differently) and it's a long process. It all starts with a call to the school district to tell them your child is aging out of early intervention services. Just because your child may be diagnosed  by a doctor with ASD or he/she has been getting therapy, it doesn't mean the school district will automatically agree that it's needed. They look at things from more of a school functionality aspect. If the issues won't later interfere with schooling, the child won't qualify.

Since August, I've been taking M2 for all kinds of testing to see if she'd qualify to get into the therapy provided by the school district. There were all kinds of hoops to jump through. Speech, cognitive, psychology, behavior, on and on the testing went. Once all the evaluations were finally complete, I met with the team to discuss what they'd determined. Then, we met to discuss what the best next step for her. I spent months worrying about what would happen if the team didn't say she qualified. A and I, along with her early intervention team, knew without a doubt that in order for her to progress she needed to get into the school district's program.

Without it, we didn't now what we would do or what would happen with M2. A private speech therapist and OT alone wouldn't cut it for what her needs are. Plus, those therapies run $150 plus a session and often (like in our case) are not covered by insurance to the extent needed, if at all. Her early intervention team said we had one big thing in our favor: Our school district has the absolute best programs for special needs kids around. It is the most understanding, willing to work with parents and eager to actually help the kids. That didn't stop me from worrying. Every meeting, evaluation, phone call -- anything -- I pleaded M2's case, advocated for her and fought to ensure she'd get the services she needs.

I was lucky that the team working with her saw everything I do and agreed wholeheartedly with everything I said and suggested. In the end, the school district agreed with her autism diagnosis, gave her that diagnosis for school purposes, and agreed that she has a severe speech delay that must be addressed. Her vocabulary, motor planning and clarity simply aren't there. All agreed that she'd need to extra help through the programs the district offers to get her ready for kindergarten. It was all enough to get her into special needs "preschool."

It's called preschool because it goes through the school district, but really, it's speech and occupational therapy twice a week for an hour in a group setting along with one-on-one speech therapy six times a month. The idea is to address the issues she has, expose her to more kids and get her ready to enter kindergarten in a few years.

Her "class" is made up of four or five other special-needs kids. With three teachers and a speech pathologist on hand at all times, it's as close to one-on-one as you can get! During the hour, the teachers work with the kids on things like sitting down to eat, interacting appropriately with peers and adults, sitting in a circle, following directions, playing appropriately -- I honestly don't even know what all she'll be doing yet! With all the time it took to set everything up, M2 has only had two sessions before the holidays started.

Eventually, she'll move up into a larger group then into a group that is a mix of special-needs and typical children. It's a ladder process to slowly get her to where she needs to be, based on her own needs and timeline. As she progresses, more learning and and preschool-type activities are added in addition to the therapies.

We wrapped up her early intervention therapies a day before her birthday and started the preschool therapy two days after. Depending on how she does, I'll most likely be finding a private speech therapist to work with her a few times a month as well. Her previous speech therapist (whom we loved) said she sees the most improvement with kids who have the school district provided therapy and private as well. Setting that up is going to be our next adventure.

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Getting Speech and Occupational Therapies After Age 3

M2 aged out of early intervention therapy a few months ago. The early intervention provided her with in-home speech and occupational therapy once a week, alternating. Once you hit age 3 though, that all goes away. Boom. Diagnosis or not, needing help or not -- Third birthday? GONE. Then what happens? The child still needs therapy, that need doesn't magically go away. What is next? Where do you turn?

At that point, the therapy goes through the school district. I never even knew that until M2 was going to need the help. The catch is: Getting the therapies isn't automatic. The child has to qualify based on the district's specifications (each does things differently) and it's a long process. It all starts with a call to the school district to tell them your child is aging out of early intervention services. Just because your child may be diagnosed  by a doctor with ASD or he/she has been getting therapy, it doesn't mean the school district will automatically agree that it's needed. They look at things from more of a school functionality aspect. If the issues won't later interfere with schooling, the child won't qualify.

Since August, I've been taking M2 for all kinds of testing to see if she'd qualify to get into the therapy provided by the school district. There were all kinds of hoops to jump through. Speech, cognitive, psychology, behavior, on and on the testing went. Once all the evaluations were finally complete, I met with the team to discuss what they'd determined. Then, we met to discuss what the best next step for her. I spent months worrying about what would happen if the team didn't say she qualified. A and I, along with her early intervention team, knew without a doubt that in order for her to progress she needed to get into the school district's program.

Without it, we didn't now what we would do or what would happen with M2. A private speech therapist and OT alone wouldn't cut it for what her needs are. Plus, those therapies run $150 plus a session and often (like in our case) are not covered by insurance to the extent needed, if at all. Her early intervention team said we had one big thing in our favor: Our school district has the absolute best programs for special needs kids around. It is the most understanding, willing to work with parents and eager to actually help the kids. That didn't stop me from worrying. Every meeting, evaluation, phone call -- anything -- I pleaded M2's case, advocated for her and fought to ensure she'd get the services she needs.

I was lucky that the team working with her saw everything I do and agreed wholeheartedly with everything I said and suggested. In the end, the school district agreed with her autism diagnosis, gave her that diagnosis for school purposes, and agreed that she has a severe speech delay that must be addressed. Her vocabulary, motor planning and clarity simply aren't there. All agreed that she'd need to extra help through the programs the district offers to get her ready for kindergarten. It was all enough to get her into special needs "preschool."

It's called preschool because it goes through the school district, but really, it's speech and occupational therapy twice a week for an hour in a group setting along with one-on-one speech therapy six times a month. The idea is to address the issues she has, expose her to more kids and get her ready to enter kindergarten in a few years.

Her "class" is made up of four or five other special-needs kids. With three teachers and a speech pathologist on hand at all times, it's as close to one-on-one as you can get! During the hour, the teachers work with the kids on things like sitting down to eat, interacting appropriately with peers and adults, sitting in a circle, following directions, playing appropriately -- I honestly don't even know what all she'll be doing yet! With all the time it took to set everything up, M2 has only had two sessions before the holidays started.

Eventually, she'll move up into a larger group then into a group that is a mix of special-needs and typical children. It's a ladder process to slowly get her to where she needs to be, based on her own needs and timeline. As she progresses, more learning and and preschool-type activities are added in addition to the therapies.

We wrapped up her early intervention therapies a day before her birthday and started the preschool therapy two days after. Depending on how she does, I'll most likely be finding a private speech therapist to work with her a few times a month as well. Her previous speech therapist (whom we loved) said she sees the most improvement with kids who have the school district provided therapy and private as well. Setting that up is going to be our next adventure.

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Recognizing Autism Spectrum Disorder

Since I've started talking about M2's autism spectrum disorder (ASD) journey (read more here and here) I've had a number of people ask what her specific symptoms are. Even family and friends who don't have experience with autism, or who don't see her often, have asked. I think what the questions stem from is many parents really wondering, "How do you know? What is different so I can see if my kid is on the spectrum, too?" Autism hides from plain view. It isn't easy to spot like some other disabilities. ASD kids look like any other kid on the playground unless you know what you're looking for so it's a normal reaction to want to know how to recognize ASD. With how prevalent it is now, parents want to know how to tell if their own child may have it.

Every single child and case is different. Some kids show symptoms others don't. Some may have many, some may only have a few. Any of the stereotypes you hear about are just that: stereotypes. With ASD, it's really a big picture kind of thing when it comes to autism. Since it's a spectrum, the severity varies greatly as well. Cases toward the high-functioning end may be harder to spot. There is simply no set-in-stone checklist to know for sure if your child has autism spectrum disorder. The best way to find out if your child does have autism spectrum disorder is to take them to see a developmental pediatrician. These are the experts who can give you answers, who know what is neurotypical and what isn't, who know when it's simply a quirk or something more. A and I suspected, but didn't know for sure, until we took M2 to the developmental pediatrician (read about what that was like here).



With M2, we noticed early on that she didn't really play with toys. I always wondered why there are even toys for babies when they do nothing with them and show absolutely no interest. She was also dead focused on learning to do one thing at a time and that is all she'd spend her time doing. Each day, she'd spend almost all her time trying to sit up. Then crawl. Then stand. And so on. Forget helping her with anything, either. Everything had to be done by her, her way, end of story. All of this we pushed aside, figuring she was just determined and independent. Even now, she doesn't play with toys as much as kids usually do. Once we started seeing how different baby B is, we started to wonder.

The big tip off with her is her speech. Her development in this area is far behind what it should be. At first, we thought it was a typical speech delay, which many children have. Then her therapist started pointing out how she doesn't fit in with anything you'd expect with a typical speech delay. As the therapist put it, a whole book could be written just on M2's speech delay. Now we know that the delay stems from the autism.

What sealed it and convinced us something more than M2 just being M2 and having a speech delay was the major changes in behavior. Loud noises bother her. Random noises bother her. She may hear a clock ding the hour proceeds to scream, cry, hold her ears, stomp, kick things, hit and pound the wall. Or, she'll hear the clock and end up in a tight ball on the floor shaking and screaming, "ear ear ear" (well, her sound for ear). Yet another time, she may be fine. The same can happen if she hears traffic, a bird, a dog bark...anything that at that time bothers her. Rain or thunderstorms are sure to set her off. She's not scared of them, it's the sound that is way too much for her to handle. Her senses become over loaded. Similarly, if we're out in public and another child starts throwing a fit, screaming, crying, etc., she'll react to that as well. The noise, plus knowing that something is wrong, overloads her. It's one of the big reasons we so appreciate, and are totally for, people removing misbehaving or upset kids from the situation. When you don't remove your child, mine then ends up terrified and upset so we have to remove her. Our whole day gets ruined when people are inconsiderate like that. The longer the noise lasts, the worse she gets.

Hiding from pictures

Crowds and/or places she doesn't know don't usually go over well in M2's world. To put it simply, she doesn't like them. How she reacts to them are one thing friends and family will point out to try to argue she can't possibly be autistic. People seem to expect an autistic child to have a typical yelling, screaming, kicking, hitting melt down. As I said from the start, each kid is different though. For M2, she shuts down. She does anything she can to get away from the situation. She runs away with no care where we are or where she is going. She won't respond to anyone. She crawls into B's stroller, covers her eyes and hides. If you touch her, she is even more likely to take off. Touch also sends her into a screaming fit. She goes into her own little world, no facial expression, no reaction, no anything.

Once people realize this and actually look at how she's acting next to other kids her age, it's very obvious something is off. As you can imagine, we have to be very careful with where we take her. I also don't take both kids out alone. It's too much of a safety risk when I don't know when or if she'll all of a sudden take off, leaving me having to decide whether to stay with the baby or go after her. I can't be assured that if I look away at something on a self in a store or to help baby B for a second that she'll still be there. She's fast. We always make sure someone is watching JUST her, ready to spring, so that she remains safe.

Upset M2

With other kids, M2 may or may not interact. Most often, she's the one wanting to be alone and do her own thing. A quick hello or a hug, then she's done. I'm not even allowed to play with her most of the time. When I try, she gets mad or upset. Her toys and the decorations in her room are often to be found lined up as well. She'll also be the kid walking on tip toe and toe first.

In M2's case, there are more symptoms than these (such as she hates having her picture taken, is picky with food and has to have things done a certain way). This post would be insanely long if I talked about every one! It's also important to keep in mind that every day with M2 is different, as with most ASD children. Some are good, some are bad, some are very bad. ASD kids don't always show symptoms daily, let alone constantly. It's like Forrest's box of chocolates each day -- you never know what you're going to get. Every day, we start anew and learn more.





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Baby2 and M2 Update

Nursery!
Baby2's room completion is near! A and I cleaned out the closet and rearranged ours to fit some of the stuff in there this past weekend. I then got the nursery closest all organized with the swing, hamper, wipes, diapers, humidifier, etc., that we will be needing to have on hand. A put together M2's cubby storage shelving as well. It's still in the nursery until we swap it with the changing table soon. All the fabric cubes are ready to go on the changing table, I got them organized with wipes, diapers, toys, accouterments, blankets and more. Baby2's hospital bag is ready to go as well. Mine is just a list right now as I realized all the stuff I plan to pack I'm actually using. If I pack it, I wouldn't have what I need now! That'd be rather pointless.

All the extra furniture and lamps have been taken out of the nursery. Some books and random things remain but that'll be easy to clean up. I also painted the anchor wall hanging and Baby2's large initial wall hanging so those are ready to go up. The rest of the room decor arrives tomorrow. This weekend, all of that gets put up and I'll put the finishing touches on the room. That leaves yard work, car maintenance, present wrapping, Christmas decorating, house cleaning and some other random things on my to-do list for next week and the week after. There are only three weeks left. Knock on wood, I think everything might actually get done!

Presents!
M2's Christmas and birthday present situation is all sorted. The last of her gifts arrive tomorrow. I've made a list of what she is getting for each. She'll also be getting a small gift from Baby2 when he comes home from the hospital. It's an adorable Melissa and Doug Christmas tree puzzle I found at Kohl's. It's this one. It looks even nicer in person than on the page. M2 saw it when it first arrived. I had to wrestle it away from her as she wanted it right then. She got the Melissa and Doug advent tree decoration/toy, so that distracted her. That is also adorable! It's better than I expected and M2 is loving decorating and taking apart the tree. The ornaments are all so cute with beautiful designs. It's a good size, too. It should last us for years. It's sold out already. Reading the reviews, it's an item that goes fast each year. I can see why! You can still get it on Amazon for a bit more. Check it out here.

Speech!
The therapy for M2's speech delay was finalized last week. Now, we're just waiting to hear from the speech therapist on setting up her first appointment. She'll be doing twice a month to start. Her coordinator thinks she'll pick up on things and progress fast as she's developing fine everywhere else and shows the signs they look for to know the child will pick up the concepts. We're hoping with hard work from her, A and me that she'll be right on track within a year if not less.

Halloween!

She didn't want to wear her hood inside!

Ready to monkey around.

Halloween was lots of fun. We started out visiting my best friend since high school and his wife. M2 loved that we ordered pizza and she got to watch some cartoons Mama wouldn't usually allow. It was then off to see other good friends and celebrate. One went trick-or-treating with us. M2 got the hang of going door-to-door quickly. She loved knocking and waiting for the door to open. Her costume was a monkey and A was a giant banana. I didn't dress up (hardly any of my clothes fit anymore, let alone a costume!) I did manage to walk around to each house. I'd thought after a few I'd be ready to fall over in pain. Stopping at the end of the drives to take a break while M2 went to the door helped. She was so excited and adorable walking along with her glow sticks and kitty cat candy pail. Sadly, our friends are moving cross country next year so this was our last Halloween with them. It's been a tradition the past 6 years or so to spend it with them so it's like the end of an era. We'll have to find trick-or-treating closer to home instead.


Doctors!
Baby2 has had a few doctor appointments (ok, I had the appointments and he got checked out, with no choice but to come along). He's growing fast. I'm measuring about 3.5-4 weeks ahead, which means right now I feel like I'm at 40 weeks. Driving has gotten hard so A has become my driver. My thyroid is acting up so I saw a specialist for that. He doesn't think Baby2 is being affected and I'm handling the symptoms ok, so we're holding off on meds. I'll be doing blood work often and after Baby2 is born we'll be looking into other testing. It's pretty complicated with many ways it could go as my thyroid is all sorts of screwy. There's a small change it'll go back to normal after Baby2 is born. I'm really hoping it does! There are some other worrisome health issues going on. Those I'm not ready to share yet. I've got more testing for that next week, along with the final ultrasound before Baby2's arrival.

Suspense!
Next week, I'll post pictures of the finished nursery. I was tempted to this week then decided we're so close to it being done I'd rather do a big reveal. You'll have to deal with the suspense until then. I'll also show off the easy painted wall hanging I did and explain it--it's sooo easy! The initial one will have to wait until we reveal his name after birth. I will say I am LOVING how the room looks!

Baby2 Nursery and M2 Weekly Update

The crib is now put together and the rug is out. That's about it for this week. We were too busy going to doctor appointments 1-2 hours away Thursday and Friday, continuing with M2's speech evaluations, Christmas shopping, birthday shopping and I've been tired.

Sales, sales, sales.

At least the Christmas and M2's birthday gift shopping is almost done. Amazon and Kohl's online are a lifesaver this year. Almost everything is coming from there and both already have great deals. Hurray for coupons and discounts! Another hurray for not having to wander stores endlessly while tired looking for gifts!

Almost ready to wrap.

I'll be wrapping all the presents the week before Baby2 is set to arrive. I'm one of those crazy people everyone complains about this year, shopping early and enjoying decorations that are already up. I wish they were all up,really, as we won't get a chance to see much of them since Baby2 will have us hopping. Next year I'll be back on the, "Why are there Christmas items in the stores before Halloween?!" bandwagon.

More doctor appointments?! Yikes.

To add more to the list of already crazy busy and stressful, I found out my thyroid has gone screwy. The ob/gyn did blood tests which came back abnormal. She then did some more and got more not-good results. The endocrinologist said he doesn't think it's pregnancy related. Thyroids just don't do what mine is during pregnancy. The ob/gyn and endocrinologist are both concerned so I'll have an appointment this week (2 hours away again, oh fun!) to start looking into that. It would seem a high heart rate and heat intolerance aren't normal pregnancy symptoms. Instead, it's from the thyroid going wonky. The weight gain, over what is normal for pregnancy, is also probably related. The downside is the options of how to treat it are more limited until after Baby2 is born. None of them are fun options even then.

M2's full speech evaluation went well. The therapists said she's very smart and observant. On everything else the ladies tested her for, including comprehension, she's on track or ahead. We just need to get her to use her words! Even for the speech part, she's not as far behind as we thought, coming in at 15-17 months when she's 22 months old. The speech therapist agreed it's best to intervene now before she gets farther behind. Along with my thyroid and prenatal appointments this upcoming week, we'll be meeting with M2's service coordinator for the final complete evaluation report and to get the speech therapy appointments set up. Ideally, we'll have at least one session before Baby2 arrives. We'll see, since we're insanely busy and the therapist's schedule fills up fast as well.

For M2's fun activity of the week, she and I went to the library's Halloween festival. There were stories, songs, goody bag decorating and trick-or-treating with story book characters. M2 wasn't impressed. She made it through the songs and stories, barely. After that, I asked if she wanted to do the rest or leave. I got my answer as she ran out the door, around the edge of the library, to the front doors, was hunting for the special needs door button, and then ran out to the car saying, "Go! Go! Go!" She even ran past baskets of candy. The kid just did NOT want to be there! She looked darn cute in her monkey costume, though!

Getting ready for trick or treat. (No, this isn't our house. ;) )

With doctor appointments taking up a full day this week, M2's speech appointment, Halloween with friends, pumpkin carving, house cleaning, continuing with Baby2's nursery and more, this next week is going to be another busy one. My goal is to at least give you all a weekly update these next few weeks. There are only 4 to go until Baby2 arrives! Hopefully, there will be enough finished with the nursery next week to make it worth posting update photos.

A Quick Update: M2's Speech and Baby2

This week has been busy with kid-related appointments and having my parents in town visiting. One of the big appointments was to get M2's speech intervention rolling.

M2's Speech Development
M2 isn't quite where she should be speech-wise. She understands everything, has ways to get her points across, she just won't use words most of the time. Except for a select few, the words she does know she refuses to use often. A and I have been working with her doing everything we can think of to no avail. The pediatrician said we could either start looking into therapy now, or wait until she turns 2. However, when she turns 2 is just after Baby2 is born. Taking that into account, we decided to start intervention now.

When asked what the next step is to get her help, the doctor very helpfully only said to "call the county." The county very helpfully only has info on getting assistance with speech for kids 3 and over. After some research and asking around at library time, I found a place not too far away that specializes in therapy for under age 3 only. The nice lady I spoke too arranged an appointment for initial intake at our house. She came over this week, met M2, asked a bunch of questions, and set us up for the next step of a complete evaluation. In a few weeks, M2's going to have "playtime" with a couple ladies who will do a full eval then give us the results. The woman today said she's obviously very intelligent, we just need to get her to start using more words. It's expected that she'll be on track with everything else.

After the evaluation, our intake coordinator sets M2 up with a therapy plan. The good thing about this organization is that they find it important that the child is in their own environment for therapy. The therapist comes out and word with her and show A and I things we can do with her the rest of the time.

The plan right now is to get all this set up and maybe even get a session or two in before Baby2 arrives. At the least, we'll be ready to go as soon as things settle down with him.

Baby2's Room
Last week, we finally narrowed down the choices of paint colors for Baby2's room to four. Once we get those up on the wall we'll (hopefully) be able to pick one. Right now, there's a futon in there so we can't paint the whole room. The futon needs to go in the family room, which has another couch in it. That one needs to go in the living room which--you guessed it-- also has a couch in it. The hospice we're donating one couch to comes next week, then we can play musical couches and start painting. You can read more about the plans for the nursery here.

At my weekly appointment the doctor said Baby2 is on track. The only downside is that he hasn't flipped yet--he's still breech. He's got a few weeks left to make the flip and I'm hoping he does as I don't want a C-section for a number of reasons (the big one being surgery and I don't mix, at all).

A and I checked out the other choice of hospital for labor and delivery finally. M2 got to spend time with Grandma and Grandpa going to the pumpkin patch, animal park and out to dinner while I was busy with the tour and doctor appointment. It's a good thing we did the tour since we've decided we like the hospital better than the one we were thinking of using. As long as Baby2 doesn't come earlier than 38 weeks, we plan to use the one we toured. The big selling point for me was all private rooms and wireless monitors so I won't have to be strapped down uncomfortably to a bed for hours. That part was NOT fun with M2 and I think labor would have gone faster than the 41.5 hours it took had I been able to move around. I also can't get comfortable in beds sitting up or lying on my back--which is the position I got stuck in so the doctors could have the monitors work.

With less than seven weeks to go, there is still plenty to do on our lists!