OT visit

We saw Kira's OT today. It was a great visit and I can't believe we only have 3 more. I'm just going to bullet point, so I won't forget anything.

-I mentioned the suggestion we rec'd from the clinic OT re: pushing golf tees into styrofoam to work on hand strength. She thought it was a good idea and also suggested using playdoh.

-She also suggested hiding small things in balls of playdoh (small pegboard pegs, buttons, etc) and then letting Kira try to dig them out. Jackson played with it while we were working on other stuff and L varied the activity by asking him to do it with his eyes closed. It's an activity that works on both hand strength and cognitive/memory skills - pretty cool.

-We've been working with putting things like crayons, q-tips, etc into a shampoo bottle - to help Kira practice the hand positioning she'll need for writing. L wants to take it further by having Kira pour the items back out in a more controlled fashion and use her opposing hand to catch and then pull the item out, rather than just pouring everything back out onto the floor. She suggested working on this in the bathtub by putting counting bears and water into the bottle and letting Kira pour it back out - catching the bears as they come out.

-She suggested getting some flat stringing beads - or making some out of heavy cardboard or thick foam (I have a salt dough recipe that I think I'm going to try - I'll post if it works). Kira totally gets stringing the bead onto the needle and that she needs to pull the needle through, but she always ends up pulling the needle and the string coming out of the other side of the bead and not the bead itself. L thinks if we have totally different beads she might get past that. She pointed out that stringing beads is a three step process that is similar to the skill set Kira will need for buttoning.

-We need to keep encouraging Kira to do activities with her left hand. I swear she came out of the womb right-handed, she always leads with her right hand and stabilizes things with her left. L wants to make sure that her left hand is doing as well as her right.

I think that's about it. We discussed the clinic and a little bit more about our upcoming transition. Overall, a really enjoyable hour!

Down syndrome clinic

phew - I am worn out! We had Kira's first visit to the Down syndrome clinic today. She's seen our geneticist annually up until now.

This was our schedule:
9:15 arrive
9:30 OT consult
10:00 geneticist
10:30 PT consult
11:00 Hearing eval
11:30 Speech consult
12-1 lunch
1:00 - summary meeting with geneticist

I was so nervous. Kira has always had her therapies once a month and I feel that that is just right for her. But, I was so scared that all of these second opinions would show that maybe I should have pushed for more. I was also so worried about her hearing eval.

I had nothing to be worried about, though! All of the therapists agreed with Kira's current stable of professionals. The PT recommended having her fit for shoe inserts (not the full ankle kind) - more for later development. Her current PT has been on the fence about it. The PT also agreed that at 3 we should get her involved in 1 or 2 community based programs, like tumbling, soccer, or dance. Kira walked up and down the stairs for her and showed off her "blast-off" skills. Jackson was with us and left the PT room saying, "I LOVE the Down syndrome clinic!"

The OT was impressed with her skills and gave me some more ideas on increasing her hand strength. She suggested letting her push golf tees into styrofoam. She also said we could start working with a small pair of tongs - to get started on the motions needed for using scissors.

The Speech path wants us to work on the "guh" and "kuh" sounds - and was really happy with Kira's language development. Interesting factoid - she said that at Kira's age (almost 3) 10% of the child's vocabulary should be verbs. I didn't know that - I need to think through Kira's words and see if she's there.

Kira's current therapists feel that there is a chance that she might not qualify for PPCD (our 3-5 program). She may not be "delayed enough." The therapists at the clinic agreed and offered me lots of suggestions for what we can do if she's not in PPCD. Her geneticist suggested letting her stay up all night, the night before the assessment. ;)

The geneticist also said that if she does qualify for PPCD, she thinks we should do a few months in the program and then transition her into a typical pre-k. I'm not sure what our options are with the school district, so I've got some work to do.

AND Kira totally passed her hearing test!! No fluid in her ears! I was so happy.

Good day all around and I'm so thankful to have access to such great resources. And now I'm going to bed.

OT visit

Kira saw her OT today. We had to skip last month's visit because Kira was sick, so we'll see L twice this month. We didn't receive paperwork; I wanted to get this down before I forget. This will seem kind of random, sorry!

-Work on tasks that require stabilizing with one hand and performing the task with the other - zippers, pouring from a pitcher into a cup, stringing beads, etc. Start working on zippers, buttons, velcro by dressing big dolls with Jackson and Kira's clothes.

-Serving herself during mealtime. We always plate at the stove, so I guess I should start having some things on the table. Jackson could probably use help with this one as well!

-When she's stacking, Kira likes to push down on the block, almost like she's making sure it's stuck on there. Use tasks like putting coins in a piggybank to work on gently releasing.

The visit went really well. L had these stacking cups and she worked with both kids with them forever. L (and the other therapists, too) are always great about including Jackson during therapy, but this time she was really working with Jackson on skills, too. It was so cool. The bottom cup was number 11, so she would ask Jackson which number was next in the countdown. He would figure out the number, find the cup, and hand it to Kira. Then we'd name the color and Kira would stack it. Once they were all stacked, L had the kids take turns kicking it over. The next round, L would ask Jackson what color went next in the sequence.

They worked with the peg board and she was giving me lots of ideas on using the pegboard with both kids. L knows that I'm considering homeschooling and I love that she really takes the time to teach me and Jackson, in addition to Kira. I also think it makes "therapy" seem more like a fun playtime for all of us, and not like we're trying to "fix what's broken" in Kira.

She also had Kira sort the stacking cups by color - two colors at a time. She only put the wrong colors together once! I was really impressed, because we've been working on color identification, but not sorting by color. She also pointed to and said "cheek" - I didn't even know she knew that word or body part! I really think Kira's best teachers are herself and Jackson. She knows things that I know I didn't teach her.

I'm going to be so sad when ECI is over for Kira. (Although I won't miss the getting ready for visits part.) We've been blessed with wonderful therapists who really get how our family operates. I'm so thankful.

ECI - occupational therapy visit

Kira saw her occupational therapist, Laurie, today. We started with Laurie when Kira was 2 months old and have always seen her once a month. When Kira was small, Laurie and Chris, Kira's physical therapist, both focused on many of the same things - head control, trunk control, etc. We saw each of them once a month - so that meant that Kira was seen roughly every two weeks. It was a nice fit for us. We now see Chris quarterly.

Today's report:

What's New/Progress: Put on shorts yesterday, beginning 2 word phrases, puts trash in trash can independently.

Goals/Outcomes Addressed:

1. taking on/taking off simple clothing with minimum assistance


2. open/close zippers with assistance


3. string beads (3)


4. imitates drawing a circle and horizontal line

Routines (summary, observation, assessment, plan): Shirt off if loose, completing a dressing activity if Mom starts. Beginning to pretend play with baby dolls, showing empathy to brother. Working on opening ziploc bags and using zippers - pulls ribbon on zipper pull if hands are placed, opens and removes toy or food, etc.

Recommendations: continue strategies

I think it was a good visit. Last month, Laurie recommended tying a small piece of ribbon in a loop to the zipper pull of a small change purse. Kira can hook her finger through the loop to open and close the zipper, until she builds up enough hand strength to grasp the pull itself. She's doing pretty well with this task. We have to place her hands in the correct spot, but she's doing a good job with the pulling.

The switching hands concept is also something we are working on with the stringing beads. Kira understands to put the wooden needle in the hole and pushes it all the way through. We're working on the next steps of switching the bead to the other hand , then grasping the needle and pulling it the rest of the way through, and finally, pulling the bead on down the thread.

"Showing empathy to brother" - On this one, I have to say how lucky Jackson is to have Kira for a sister. He'll get upset with me and go storming off mad and crying. Kira will go to him and pat his back. She'll say "urt?" (hurt) or "ad?" (sad). She'll give him great big hugs and try to cheer him up. Every now and then, he'll be sitting in time-out because of something he's done to her. And she'll be sitting right there next him, consoling him. All is forgiven in about 2 seconds.

The trash can mention is one of those things that I appreciate Kira doing, that I never took the time to notice when Jackson started doing it. I realized the other day that she's gone from throwing random things into the trash can to actually throwing trash in it. I think one of the positive things of parenting a child with Ds is getting to appreciate those small accomplishments and to recognize how those seemingly tiny things add up to really big deal things, like the hope for independent, successful living later on.

Laurie also mentioned a really cool idea that she saw at a daycare the other day. We're past the baby food stage, but maybe someone else can use this tip. At the daycare, they were using this type of baby food container:

to make blocks with. They would glue little toys inside and then glue the lids on. What a great, thrifty idea for see-through blocks! All I ever thought to do with those was to re-use them for cheerios, etc. in the diaper bag.

Quick Kids' Project

I saw this post on The Write Start awhile back and thought it was a great idea. Jennifer is a pediatric occupational therapist. I love her blog because she has really great ideas for encouraging/developing writing skills in kids AND she points out the fine motor skills involved in the activities.

I was out buying a gift for a birthday party on Sat and Joann's had a bunch of stickers on clearance. I found a cute set of farm-themed stickers with 2 of each sticker for .97. Jackson and I used index cards and in about 5 minutes had our memory game.

Cute, huh?

We've played several times. Kira's not quite ready for the actual memory game, so we've been using it for sorting activities, colors, and of course, two-handed play putting it in/taking it out of the ziploc bag.

I think it's great because I can throw the ziploc in my bag and have a quick activity for waiting rooms, restaurants, etc. And if a piece gets lost or ruined, no biggie, it only cost a buck!