Tuesday, June 1, 2010

Mystery bug / WF / IEP prelim review

Yesterday (Sunday) we took the kids to Woodfield Mall for lunch and some shopping [for me]. We went to Red Robin, the hamburger joint, because it had an allergy menu. I still gave Ronin chicken nuggets from home, but I was able to get unseasoned fries which the kids love. Nikko had mac cheese, fries and chocolate milk, but halfway through his meal he stopped eating and lay halfway in his chair, much like how he does at home when he's trying to do a #2 but not leave the table. When he didn't finish right away I checked on him and he just didn't want to eat. He remained doubled over and I wondered what the matter was. We left and headed toward Macy's. The boys were both whining to play in the Looney Tunes play area, so we parted. I took Audrey with me to go buy a purse for Mother's Day. It was a hot one outside and the kids went down for naps at home. When I noticed Nikko had been sleeping a while, I woke him up and discovered he was boiling hot. Then I saw a drop of blood trickle from his nose and I intercepted it with tissue. The problem was that the blood was flowing freely, dripping steadily like a faucet and not tapering. Nikko was whining that I had a tissue around his nose, so pinching his nose to stop the bleeding was not very successful. Denis was helping to hold him tightly so I could pinch the bridge of Nikko's nose. Suddenly, the power went out. I had a sinking feeling because here was Nikko, bloody and feverish, and the A/C stopped as well as the ceiling fans. Nikko started wretching and coughed up big globs of blood. I was initially horrified because I thought he was going to keep over, but realized that his bloody nose probably leaked down his throat and made him upchuck. But then he stood and had a bigger vomit fit down his shirt and onto the rubber tiles. With no air circulating, I felt like throwing up myself. Denis put Audrey in the crib, Ronin on his bed (and he stayed, amazingly), and was cleaning up the floor while I took Nikko to the bathtub to clean him up and run him under cool water to bring down his fever. It was an hour before the power came back, as we were sitting and plotting what to do about dinner and where to go because Nikko was feeling ill. He threw up again on the couch, which meant another bath. Before bedtime he had one more small vomit issue after drinking some juice, so I banned the juice for the rest of the night so his tummy would mend. Nikko slept deeply through the night, and this morning he went straight to the kitchen and wanted juice because he was parched. Nikko was back to his old self, a slight temperature that disappeared, and it was as if last night never happened. What caused it? NO IDEA. Food poisoning? Then why the bloody nose and fever? Virus? Possibly. But when?

While Nikko was sleeping, I drove to the Whole Foods in Schaumburg and took time to read labels and get ice cream from Ronin among other things. I got Nikko a probiotic and an enzyme, which I put in his juice today. I wonder if it will help him, but that's what it's supposed to do. Since his stomach was set to zero, I hope getting him some good bacteria will repair any damage and help with his digestive tract. I really want to get Nikko off the MiraLAX because I have no idea what it is doing to him. I am wondering if the probiotic aided Nikko today in passing a really big #2, the size that I would have expected from a suppository session, to be honest. I didn't hear him strain today after he passed it, nor did he try to take off his diaper, so I wonder if it was an easier time for him. My plan is to give him one capsule each, once a day. It's supposed to be akin to eating yogurt every day for the good bacteria. I'll do this for two weeks to see if his poos change. I know it's yucky to talk about poo all the time, but apparently it's really common among parents with autistic kids to discuss their child's bowel movements. His poos are really stinky, and that's indicative of the autism/digestive problems.

Switching gears....
The following were Nikko's IEP goals set last June '09. As of March '10, the ones in bold are the ones he has met/met to some degree. The unbolded ones are the goals he has yet to accomplish:

Nikko will sort a variety of preacademic functional objects (i.e. colors, shapes, familiar objects, animals) into a field of 3, in 4/5 trials by June 2010.

Nikko will participate appropriately in routine structured small group activities with no more than 2 verbal/picture cues, for 6 minutes, in 4/5 trials by June 2010.

Nikko will follow 10 different 1-step directions in 4/5 trials by June 2010. (i.e. wave hi/bye to peers, follow commands like Sit Down, Stop)

In the classroom setting, Nikko will independently use signs, gestures, pictures and/or words to express wants/needs in 8/10 trials by June 2010.

In the classroom setting, when given an individual picture schedule, Nikko will independently transition between activities 75% of the time by June 2010.

In the classroom setting, Nikko will demonstrate the following 2/2 of the following skills 1) respond to his name (turn, look) 2) respond appropriately to greetings from peers or adult independently in 4/5 trials by June 2010.

Upon arrival to the classroom with visual cues as needed, Nikko will take off his coat and backpack and place them in the appropriate locations on 4 out of 5 opportunities by June 2010.

In the classroom at small group center time, Nikko will be able to perform the following skills in 4 out of 5 trials by June 2010: 1) complete a 6 to 8 insert puzzle 2) string 5 beads 3) color with approximation a simple picture with 60% coverage.

So how does that all look? He accomplished 62.5% of his goals. Except for the greetings, it looks like the skills he mastered are ones that don't really involve other peers, like puzzles/coloring, taking off coat, colors, sorting. Without consulting anyone else yet about what to do next, I assume he should continue to work on the goals that weren't achieved, but add in new ones of course. Our meeting is on Friday, so it's possible that he has shown improvement in the areas that are deficient, such as following 10 1-step commands. He's doing this in ABA as well, so maybe Friday will yield slight improvement. I have to find a milestone list to see what skills he should be working on next, like cutting with scissors or using the bathroom, or learning numbers and letters... or is that a kindergarten function? Guess there should be a spread of social and academic goals. It reminds me of when, during Nikko's early intervention years, the developmental therapist (who was very young) asked me what I wanted Nikko to work on, and I felt like she should know what he should be working on since she's the "expert" here. In retrospect, I see now that I could have driven how the sessions would go if I only had a clue what she meant. If I wanted Nikko to improve his skills in cutting with scissors, she would have done activities more craft-based. But I didn't know this back then. That's why I'm trying to review his IEP and look for skills he should strive for, then hopefully take this information into our meeting. I was so glad at our first IEP meeting when the team put out these goals for Nikko, but I would think they might want more input from me now.

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