Stats: the 5 year check - up

Keifer had her 5 year check-up with Dr. J. last week and all is looking well with her growth. She is currently coming in at the 93rd percentile for both height and weight:

Weight:  51.8 lbs

Height:  45.5 inches tall

I was quite happy to know she is a "big" girl for her age, but not completely off the charts!  I'm so used to the 100th %ile, that coming down a bit is great news! She is currently in a size 7/8 in shirts and dresses, and bottoms for her are anywhere from a size 6-7.  Her shoe size is around a 12.5 or 13 Wide. 


My babe did very well with her hearing tests, and because we just had her eyes checked (with the FULL work-up) in January (with no issues, whatsoever), she is coming in as  "healthy child".  Of course, no check -up at 5 years would be complete without the Kindergarten shots. Ahh yes. The shots. My poor girl, she was so pumped up and completely READY for the shots: however,  once the needles came out, all 3 of them, she lost her marbles.  

I had to drag her out of the corner, from under the sink and behind the garbage can, and then hold her on my lap, while she revved herself up into a complete tizzy. 

 "Please, Nurse Judy, please STOP, DON'T DO IT, Nurse Judy," she screamed.

Yeah, Mama Bear here had tears of my own.

She managed to handle the 3 shots, got her band aids on, and recuperated enough to pick out a sticker for both herself and her younger sister, who luckily wasn't with us. Whew. Glad that was over.

In other news, we were referred to a Pediatric Developmental Specialist for her anxiety. Yep, the anxiety and sleeping with mom-thing is getting kind of difficult, as usual.  However, after researching the place we were referred to, and then talking at length with a phenomenal co-worker of mine, I made my own executive decision to instead make an appointment with a NeuroPsychologist.   When I looked at the Pediatric place, it talked about more about the child's "behaviors".  I honestly KNOW that K1's "behaviors" are due to an underlying anxiety about things, that are out of her control. Things at our house at night are not due to BEHAVIOR, they are unwinding at night due to some chemical imbalance in her system or something. 

Check out the following info on that:

What is Clinical Neuropsychology?

Clinical neuropsychology is focused on understanding the link between the brain and behavior. For example, how changes in the health of the brain may affect the ability to pay attention, remember, or solve problems. This understanding between how someone thinks and acts and how the brain works is used to diagnosis and treat brain disorders.

What is a Pediatric Neuropsychologist?

Pediatric neuropsychologists are licensed psychologists. They have training in both clinical psychology and neuropsychology. They have special training in how the brain develops. They use this training to evaluate and help manage children with brain disorders. Such disorders may involve brain injury, medical disease, or developmental problems. Pediatric neuropsychologists help parents, teachers, and physicians to:

␣ Understand how problems with the brain may relate to problems seen at school, home, or with peers ␣ Understand how a child learns best ␣ Understand why a child may have behavior problems ␣ Help a child deal with thinking or behavior problems

␣ Identify neurological or psychiatric problems ␣ Help match expectations to a child’s specific strengths and weaknesses ␣ Work with other doctors and teachers to develop the best treatment and school plan for a child

How do I know if my child needs a Neuropsychological Evaluation?

A neuropsychological evaluation may help if your child has: ␣ A neurological disorder such as spina bifida, hydrocephalus, cerebral palsy, epilepsy (seizures),

neurofibromatosis, tuberous sclerosis, or a brain tumor. ␣ A brain injury from a trauma to the head, stroke, lack of oxygen, or an infection. ␣ Other medical problems such as prematurity, diabetes, chronic heart or breathing problems, certain

genetic disorders, or treatment for childhood cancer ␣ Been exposed to lead, street drugs, or inhalants (carbon monoxide) ␣ Been exposed to alcohol, smoking, or certain drugs prior to birth. ␣ A developmental or school problem such as a learning disability, attention-deficit/hyperactivity disorder,

or autism spectrum disorder/pervasive developmental disorder ␣ Had an evaluation by a psychologist or the school, but the treatment following that evaluation has not

helped. Your physician may recommend a neuropsychological assessment to:

␣ Help make or confirm a diagnosis ␣ Get a record of your child’s functioning before treatment with medicine or surgery. ␣ Record a change in your child after a medical treatment (testing can be repeated to see if the treatment

changed your child’s functioning) ␣ Record your child’s development treatments and expectations can be adjusted to your child’s needs.What does a Neuropsychological Evaluation Involve?

A neuropsychological evaluation involves examining thinking, behavior, and social-emotional functioning. The evaluation uses standardized tests and procedures. Examiners work directly with your child. They also talk to you and teachers and other doctors. Tests may be performed using paper and pencil or on the computer. Your child will be asked many questions and to solve different types of problems.. Neuropsychological evaluations typically include tests that measure the following:

␣ Intelligence (IQ) ␣ Problem solving ␣ Planning and organization ␣ Attention and memory ␣ Processing speed ␣ Language ␣ Academic skills ␣ Visual perception ␣ Control over hand movements ␣ Depression and anxiety ␣ Aggression and impulsive behavior ␣ Social skills

The neuropsychologist will also review your child’s medical and school records to help understand how the test results relate to daily life.

How does a neuropsychological evaluation differ from a school evaluation?

Pediatric neuropsychologists and school psychologists often use some of the same tests. However, school evaluations focus on deciding IF a child has a problem with academic skills such as reading, spelling, or math. Pediatric neuropsychologists focus on understanding WHY a child is having problems in school or at home. This is done by examining academic skills but also examining all of the thinking skills needed to perform well in and outside of school – skills like memory, attention, and problem-solving Understanding a child’s specific thinking strengths and weaknesses helps to better focus school plans and medical treatment and understand potential areas of future difficulty. Because neuropsychologists have training in clinical psychology, they are also able to diagnosis emotional problems like depression and anxiety.

I have highlighted IN RED - the issues that are relevant to my Keifer girl. As you know, if you've read my blog long enough, Keifer received a year of Sensory Integration Therapy. That has helped in many areas of her growth, but not in the area of anxiety like it could have. That is why we will be continuing to research for more HELP for her. She is a beautiful, loving, and amazing young girl, but I want to help her before she gets into the school system full-time, and may potentially have things arise that are out of her control.


So that is our 5 year old in a nutshell. Oh, how I love this amazing girl!

She's so SENSORY -Part 1

So, in the past, I've often made comments about Keifer receiving Occupational Therapy for her "sensory" issues. This was a huge part (and still is) of our lives! When she was a baby/toddler, we always commented on how dramatic Keifer was during every situation we were in. Looking back, that drama now makes sense- she was interpreting her world differently than we were through her SENSES, and hopefully- reading the information below will help you understand a little more about what WE have been living. It might also trigger some "aha" moments in your own children, as most kids seem to have SOMETHING that is "sensory" about them.

Also, to add, I'm an Early Childhood Special Education teacher, so by identifying this is my OWN CHILD, it's been helpful for parents to relate with me and for me to RELATE TO OTHER PARENTS, as we have our daily struggles at home with Keifer.

We did receive outside OT services for Sensory Integration (and her funky pencil grasp) for 1 full year. She was discontinued for meeting her goals after one year. It's not that we don't have work to do with her. I'll talk about it more in my next post - the ones with Pictures! :)

Sensory processing disorder is usually recognized in early childhood or adolescence but may be seen throughout the lifespan. These children do not “outgrow” the problem. Difficulties continue into adulthood, although sometimes severity of symptoms may become less apparent as the child learns managing techniques.

Children with sensory processing disorder have difficulty with:

• Managing anxiety

• Handling high stress situations

• Dealing with frustration

• Staying on tasks to finishing point

• Effectively using fine and gross motor skills

When comparing children’s sensory processing problems with coping abilities, the sensory processing problems were mostly related to the child’s difficulty with their ability to:

• Handle new situations

• Change plans / transition

• Appropriately learn new situations

• Understand independence and dependence

• Use self-defense successfully

• Have an proper activity level

• Control impulses

Sensory processing disorder is often associated with other diagnoses such as:

• Pervasive developmental disorder/ autism spectrum

• Learning disabilities/ attention deficit disorder

• Language disorders

• Behavioral disorders

• Anxiety disorder/ depression

Children with sensory processing disorder may display the following behaviors:

• May not like messy things or getting dirty

• May not like to be touched, hugged or cuddled • Likes to touch objects and people to the point of becoming annoying

• May frequently put things in his/her mouth

• Refuses to brushing teeth

• May gag during tooth brushing

Sensory seeking children appear to desire touch because they need sensation that is intense, frequent and/or of long interval. Touch systems around the head and face may contribute to over-sensitive to touch, leading to poor tolerance of anything around the mouth.

Sensory Under-Sensitivity: Children with under sensitivity do not respond to and may seem uninterested or unresponsive to sensory experiences.

These children may exhibit the following traits:

• The child seems weak, slumps, and leans on people or furniture.

• The child has low energy and has a hard time waking up.

• The child gets tired easily, lies around and appears to have little motivation to walk around.

• The child does things very slowly.

• The child seems depressed or neutral.

Sensory Over-Sensitivity: Children with over sensitivity respond to sensations from just one sensory system faster, with more intensity or for a longer period than typical peers.

• The child responds negatively or emotionally to loud people or places.

• The child has trouble concentrating in noisy environments

• The child frequently hums or makes other strange noises.

Some children who are overwhelmed by their environment over-react to sounds or even ‘shut them out’ so that it seems like they are not hearing, while other kids make sounds to block the noises in their environment. These children are sensory seeking and seem to have a craving for strong levels of sensation. Children with over-sensitivity may become uncomfortable with changes to new situations.

Sensory Modulation Disorder: This sensory processing disorder causes problems with modifying responses to sensory inputs resulting in withdrawal or strong negative responses to sensations that do not usually bother typical peers. Problems are often seen in irregular emotions that are made worse by stress, and vary with the situation.

Signs of Sensory Modulation Disorder

• Easily distracted by sounds

• Extremely sensitive to sounds

• Difficulty with falling or staying asleep

• Reacts defensively to being touched lightly or unexpectedly

• Easily distracted by visual stimuli

• Overly active

• Outbursts of anger

Sensory Discrimination Disorder Children with sensory discrimination disorder have trouble in recognizing and interpreting differences or similarities in the nature of stimuli. It is commonly seen with problems in processing sensations from touch, muscles, joints and head movements (vestibular or inner ear sensations).

Signs of Sensory Discrimination Disorder

• The child hits or pushes other people

• The child grips objects too tightly or uses too much strength

• The child frequently drops things or knocks things over

• The child mouths, licks, chews, or sucks on non-food items

• The child craves movement, such as spinning or jumping around

• The child is afraid of heights/ swings or slides

• The child has poor balance

Postural-Ocular Disorder: Postural-Ocular Disorder is a problem with control of posture or quality of movements seen in low muscle tone or joint instability and/or poor functional use of vision. These children have difficulty stabilizing the body while resting/moving and trouble with using both sides of the body together. This disorder is often seen with vestibular (the inner ear) problems.

Signs of Postural-Ocular Disorder

• The child seems weaker than other children

• The child wears out easily

The child often moves around repeatedly

• The child slumps while sitting

• The child has difficulty making eye contact/ following with the eyes, such as reading

• The child seems clumsy he/she may fall and tumble frequently

• The child may seek movements of swinging or spinning

Dyspraxia: Children with dyspraxia have trouble with planning, sequencing & executing unfamiliar actions resulting in awkward & poorly coordinated motor skills typically seen with a sensory processing deficit. It is usually seen with difficulty doing new activities or those that are done infrequently.

Children with dyspraxia may be slow at learning a new sequence of movement. Children who have dyspraxia have difficulty figuring out what movement they need to make, planning how to move and accomplishing a plan. They need to be given more time between transitions.

Signs of Dyspraxia

• Difficulty following multi-step directions

• Strong desire for sameness or routines

• Has an awkward pencil grasp

• Has poor handwriting

• Dislikes or hesitant to participate in sports

• Easily frustrated

• Problems with daily life skills like dressing or using utensils

• Trouble figuring out how to get on swings or slides, play with new toys, get dressed or make certain speech sounds

• Frequently trips, falls, bumps into things and drops toys

• Difficulty imitating simple movements with his hands, arms, legs or mouth

• Difficulty with changes in his routine or schedule

• May show separation anxiety / difficulty separating from caretaker

Treatment

Occupational therapists play a key role in the conventional treatment of SID. By providing sensory integration therapy, occupational therapists are able to supply the vital sensory input and experiences that children with SID need to grow and learn. Also referred to as a "sensory diet," this type of therapy involves a planned and scheduled activity program implemented by an occupational therapist, with each "diet" being designed and developed to meet the needs of the child's nervous system. A sensory diet stimulates the "near" senses (tactile, vestibular, and proprioceptive) with a combination of alerting, organizing, and calming techniques. Motor skills training methods that normally consist of adaptive physical education, movement education, and gymnastics are often used by occupational and physical therapists. While these are important skills to work on, the sensory integrative approach is vital to treating SID. The sensory integrative approach is guided by one important aspect-the child's motivation in selection of the activities.

By allowing them to be actively involved, and explore activities that provide sensory experiences most beneficial to them, children become more mature and efficient at organizing sensory information.

She's so SENSORY Part 2

Why is she wearing those headphones? Well, because there is research that shows that theraputic "listening therapy" can help kids who have different "needs" -such as Keifer's needs with her attention and "need to control" things. (the hot pink tape is just special for helping keep the headphones on her head!)

I'll explain the pictures: 1) swinging helps my girl calm her system and find a place of "calmness". The rope 2)- works on her upper body strength, which in turn gives her core strength, which in turn, allows her to feel more confident and secure about her own body (because stronger = more grounded). 3) The mouth blower if for regulation. It has been proven that blowing (like bubbles or on special blowers or noisemakers) can WORK your lungs out, which in turn causes your system to WORK HARD and in turn, calm down. Make sense?

So yes, our girl received OT Sensory Integration for 1 full year. What finally prompted me to get help? One, I work(ed) with a fabulous OT through my school district who helped cue me into Keifer's needs- in a way that most people aren't even AWARE OF. Two, I was DONE with dealing with things like this:

Children with sensory processing disorder have difficulty with:

• Managing anxiety

• Handling high stress situations

• Dealing with frustration

• Staying on tasks to finishing point

• Effectively using fine and gross motor skills

Dealing with Keifer on a day to day level is hard. She wants your full -on attention all.the.time. I joke about how she has an "umbilical cord" attached to me - but the girl has stress and anxiety like she SHOULDN'T! We are a "safe" "happy" family, you know?

When comparing children’s sensory processing problems with coping abilities, the sensory processing problems were mostly related to the child’s difficulty with their ability to:

• Handle new situations

• Change plans / transition

• Appropriately learn new situations

• Understand independence and dependence

• Use self-defense successfully

• Have an proper activity level

• Control impulses

It came to light when things like this happen(ed): refusals to cut her nails (toes or fingers), refusals for me to even comb her hair, refusals for me to help her do things, her insisting that ,when we took the dogs for walks, we had to do the SAME LOOP every time. On that same loop of a walk, we had to go visit a certain child. If said child wasn't home, melt-downs ensued. There was always NEGOTIATION with her. We've never NOT been able to negotiate moving ahead with our day with Keifer in the house. It also happened at the library: we had our "routine" at the library- and if we didn't 1) push her in a stroller around the edges of the library or 2) let her push a cart, she would have full-on meltdowns. To the point that people would ask me if I needed help. Adding Kyla to the mix only raised MY anxiety with her, and I (to other people ) were told that I "looked" like I was handling it OK. Not inside!

I got the help for Keifer and within months, she was making progress. THe poor girl had a LOT of gravitational insecurity-which was hard to see until you tried to press her into climbing way high without her feet on the ground. I'm so proud to say that by the end she was able to climb like a monkey with no help within lycra "blankets" up high above the ground. I've also found rubbing her feet or rubbing lotion on her arms and legs helps calm her down. It's kind of cute- in a way- when I rub sunscreen on her, she says "rub harder, mommy!". She's now taken MY PLACE on the couch with her feet in her daddy's lap- I don't get my feet rubbed anymore! And- walking by an Asian massage place at the mall, she begged me for a back rub! LOL. I told her for her birthday, we'd get her a massage and she is SO excited to do that! This is the same reason she LOVES to get adjusted at the chiropractor- the pressure! She told the neighbor girl getting an adjustment is like "getting your body massaged!".

I often wondered, did she have another "disability", if you will? Like this:

Sensory processing disorder is often associated with other diagnoses such as:

• Pervasive developmental disorder/ autism spectrum

• Learning disabilities/ attention deficit disorder

• Language disorders

• Behavioral disorders

• Anxiety disorder/ depression

I've come to terms with, most likely, she has some sorts of anxiety and depression, and I think (!) some possibly ADHD or something. She cannot stop. We actually went to counseling last summer for the WHOLE summer plus some time in the Fall - to a fabulous, loving, amazing counselor about her anxieties. We also went because we can't get Keifer out of our bed. IT's turned into her not able to go to bed without me. Do this for over a year, and one will see breakdowns occur. However, after some time with our amazing therapist, it came to light that she is a smart, loving, VERY SOCIAL child and although at first, our therapist thought K1 had anxiety disorders- by the end, she thinks it's more behavioral with underlying issues. The thing with Keifer - you could bribe her or promise the moon to her- but she won't "give in" and promise to do anything unless she really believes she can. Books, bribes, etc. you name it, we've tried it. And I've given into the fact that we all sleep better if she's able to be with me right now. We have come a long way from her screaming outside the shower door as I shower at 6AM because she didn't want me to leave her alone in the bed.

And yes, we got her new bunk bed for her NEW BEDROOM in our new house, that she loves to show off. Daddy gets to enjoy that sleeping room!

So there you have it- so much more to say, but so little time. Let me know if you have any questions or comments, I'm always open and ready to talk! I've found this blog explains a lot of "techniques" that we use at home (and my work) for kids with SID.

This is an example of the lycra blankets that Keifer loved to crawl around in at therapy. Initially, she freaked out if her feet were off the ground - by the end, she was crawling around in there like it was no problem at all!

Hair today; gone tomorrow!

This was Keifer, a few weeks ago, right before we left for a birthday party where she got to dress up like a puppy in her Halloween costume. She let me (I say "let" because it's an unknown each day whether she will let me touch her head of hair or not) put in pony tails- they were her 'puppy ears' for under her hood.

Keifer has the most gorgeous color hair in person- pictures don't do it justice. It's this beautiful mix of auburn, blond, and brown. I adore it. You couldn't pay enough to get hair that color. And when it's clean, and just combed, and fresh - it hangs so beautifully, you just want to sit and admire it; well, I do, as her mom. I love it so much.

I always loved playing with hair. My Barbie dolls had many hairdos before I took scissors to the majority of them, as well as markers, and made them into funky, punk rock Barbies. Having 2 girls made me excited to be able to buy clips,and pony holders, and be able to play with hair, weaving braids and combing it into ponies, and clipping back bangs.


Wouldn't you know it? My Keifer Lynn has a very hard time with us fixing her hair. It's a struggle each and every morning to let us comb her hair, which always looks like a bomb went off (or as it's commonly called: Bed Head (hair)). I usually end up chasing her, screaming and bribing, to let mommy run a comb through it. We debate each morning on one pony or two, because we have to have a pony or a barrette each day, as her bangs would start at the back of her head if we didn't let the top part try to grow longer to eventually flip over to the side.

Usually, a pony is put in, but by the end of the day, she has ripped the pony out, and she looks like a rag-a-muffin. Remember that word? LOL.

So I had an appointment for K1 and I to get our hair cut. Lately, her hair cuts have been my stylist Betsy simply thinning her hair out. Just thinning this girl's thick head of hair, leaves so much hair on the ground, it's unbelievable. Mommy is jealous (being of the fine-haired majority). But this time,Keifer told me she wanted to cut her hair short. She insisted she wanted short hair and told everyone about her upcoming haircut, and that she was going to cut it short (as if they were interested? LOL). So she did. Cut it short.

In the chair, halfway through the hair cut that cost us 10 dum dum suckers just to get it done. My girl has issues with her hair getting cut.

Yep, blue tongue from the blueberry sucker.

Letting Betsy try to hurry and finish the cut before another meltdown ensues.

The finished product: A cute, short bob that suits my girl's sassy personality. Short and sassy.

It is very KEIFER -this hair cut. And we love it on her. It frames her adorable moon-shaped face.

More soon on my girl's sensory issues. She has "issues"with hair cutting, brushing teeth, nail cutting, loud noises, movie theaters, and just regulating her body in general. More soon!