Occupational Therapy

Last June, I talked to our Services Coordinator about concerns I had with Gulliver's eating, chewing, and swallowing following several incidents of choking on his food. It was a pretty scary experience. I watched other kids his age eat larger and crunchier types of food than I was comfortable giving Gulliver. So we started working with an Occupational Therapist, Stacey, to address these eating concerns.

Initially we focused on stimulating his mouth in a number of different ways: tickling his cheeks; giving him cold drinks before eating; trying intense flavors in food like lemon, vinegar, and spices; using an electric toothbrush; using a Nuk massage brush on his tongue and inside of his mouth. Stacey also gave him different mouth movements to imitate, like puckering and licking. We would practice eating a number of different foods that offered different textures and levels of crunch.

It took over six months to give me an acceptable level of comfort with Gulliver's eating. Today there are still times when we remind him to chew his food. But the majority of the time, I feel like he can handle the things he puts in his mouth. There are still some foods I am hesitant to give him, but there's no rush. Gulliver always has a way of letting us know when he is ready. He has come so far over the past year with his eating. I am so glad we cleared this hurdle.

We also added sensory to the mix when I told Stacey that Gulliver doesn't really enjoy "getting dirty."  Every person has sensory integration issues on some level. It's fairly common for preemies to have sensory issues as a result of their little nervous system not having ample time to develop and being forced to deal with sights, sounds, and smells of the big wide world earlier than usual. I want to make sure Gulliver has every opportunity to be exposed to a variety of things. I knew Stacey would have a different way of playing with Gulliver in "messy" activities than Mark and I do, so I asked her to incorporate some sensory play into our sessions.

We started out with shaving cream. At first Gulliver was hesitant to touch it. When he did, he wanted to wash it off right away. After 45 minutes of playing (it just amazes me that he can sit and focus for this long), he really got into it -- squeezing shaving cream through his fingers and swishing it all over the desk top.

We also use finger painting as another sensory activity. His progression is similar to shaving cream, where he starts off very hesitant, but then becomes more comfortable the longer he does the activity.

Play-doh and sand are two other good sensory activities, both of which Gulliver really enjoys.

Some of the things I learned from Stacey during our sensory play include:
1. Incorporating "props" into play
By using sponges or trucks, Gulliver can engage in the activity without getting it all over himself. As he gets more comfortable, we start doing things like painting the truck and rolling the sponges so that it gives him direct interaction with the shaving cream or paint.

2. Modeling
She continuously emphasizes how important it is for the caregiver to get involved in the play. If I want Gulliver to smear his hands in the paint, then I should already be smearing my hands in the paint. Lead by example.

3. Specific, positive reinforcement
Stacey constantly praises Gulliver on specific actions. "I like the way you are painting with your fingers." "I love how you squeeze the shaving cream with your hand." "Nice using your words."

4. Follow his lead
Rather than forcing Gulliver to do something my way, follow his lead. Build on his ideas. Give him the control. Stacey really has a knack for guiding Gulliver to reach a goal and making it all seem like it was his idea. I've picked up new ways of doing things as a result of watching her interact with Gulliver.

5. Cleaning up is part of the activity
When playing with messy stuff, it's often easier to just clean it up later by myself. But Stacey encourages Gulliver's involvement, since cleaning up plays a part in the sensory activity.  If the child is ready to wrap up, they are motivated by the cleaning up process because it means the end is near. It also changes the focus so that the child does not realize they are getting messy. And it also simply encourages good habits. Now I try to include Gulliver in the clean-up process whenever possible.

All these things sound so simple and logical. But it's surprising how easy it is to overlook any and all of the above.

We still see Stacey every other week to work on fine motor skills. She uses a variety of activities to assist in this area. Some of these include squeezing balls of all different sizes and textures; pulling beads apart that range in size from large to small; stringing beads together; lacing; doing puzzles; opening and closing little plastic clips; grasping objects with tongs; sorting shapes. It's so rewarding to see the progress Gulliver has made. Tasks he used to be unable to accomplish on his own, he now blows right through.

Stacey is also very good at setting boundaries. Following her lead, we try to set a focused stage for Gulliver by giving him a choice of what he wants to play, playing it, finishing, and then cleaning up before moving to the next activity. At first, he resisted this approach (strongly, at times). But now it is second nature. She has helped us establish good habits early on that we continue to foster.

As with PT, there is nothing "wrong" with Gulliver. OT services help us focus on specific areas to make sure Gulliver doesn't fall behind or miss any important developmental milestones. OT has been such a wonderful learning experience for both Gulliver and me. As a stay-at-home mom, I welcome all the new ideas for enriching activities and play.  Gulliver gets so excited when Stacey comes to the door. He gives her big hugs when she leaves.

I love how all our therapists make learning so much fun!

Two and a Half

Two and a Half Years Old. 30 months. Jeepers. Our boy is growing up.  And oh, what a gem he is! Here are some of the things that come to mind when I think about Gulliver at 2 1/2 years old…

His vocabulary increases more and more everyday. I've lost count of how many words he knows... maybe 100 or so? He astonishes Mark and I daily with new words. He gets very frustrated when we don't understand him. We're still working on putting two words together.

He knows black and white. He names primary colors correctly 75% of the time. Red, blue, yellow, orange, green, pink, and purple. Otherwise known as rojo, boo, ye-ow, orge, geen, pink and pur-ple. He stacked up these blocks all on his own and named every color...

He is learning to ride his Strider bike and tricycle.

Over the winter, I would hold Gulliver's hand when we walked through snow and tell him to be careful because it was icy. The snow is all gone now, but every time Gulliver loses his footing or falls down -- indoors or out -- he says "icy" and points to the spot where he fell. Yeah, blame it on the ice.

He gives us big hugs (on both sides) and a kiss before going down for nap or night night. Then he makes sure we know that the music and humidifier need to be on, the lights need to be off, and the tent zipped up. He's got everything under control.

He can open and close doors.

Gulliver is very fond of music. He listens to his CD's before naptime and bedtime. He often tells me the next song before it comes on. He twirls and jumps and marches along with the songs. He sings "E-I-E-I" to get the Old MacDonald song started. Then he fills in the blank after "…and on that farm he had a…" with pig, tractor, dog or duck. I sing "Row, row, row your…" and says "boat." He turns his hands in circles when we sing "Wheels on the Bus." His favorite dance involves bobbing his head back and forth and grinning from ear to ear.

He jumps on our indoor trampoline all by himself. It's amazing how much air he gets on that thing! He loves jumping on friends' big outdoor trampolines even more. He is the king of "butt bounces."

He knows letters A, B, G, T, O, and Y. He knows 1, 2, and 3.

He is very sweet with other kids. He shares toys, waits his turn, and studies their moves to learn new moves of his own.

He loves to watch us blow bubbles. He specifically requests BIG bubbles.

He blows the whistle. Over and over and over again.

He loves playing in his sandbox. We usually have to drag him inside.

We're working on manners. Sometimes he gets a little bossy and needs to be reminded to say "Please." He is very good about signing Thank You after he gets what he wants.

He says his own name. "Gull-i-guh"

He loves to lay in his crib in the morning before getting up to start the day. I often sit in the chair across from his crib and we just chit chat for 20 minutes or so before he finally decides he is ready to get out and start the day.

Favorite TV Show: Dora the Explorer. Hands-down. When we go the the library, the first thing he does is jump up on the kids' computer chair and request the game, "Dora, Dora, Dora".

Love, love, LOVE this little boy!!!

Happy Half Birthday, Gulliver!

Physical Therapy

As part of Colorado's Early Intervention program, we started receiving a variety  of services when Gulliver was only 3 months old. Looking back over the blog, I realize I have not spent much time discussing these services, even though they have played a significant role in Gulliver's development. So I want to include an update on the various services we have been receiving, starting with Physical Therapy.

Gulliver started Physical Therapy in June, 2010 to address low muscle tone. We had weekly visits for the first six months then switched to two 1-hour visits per month. We have been fortunate to work with the same PT during that time. We just love Kaylynne!

Most of the time, Kaylynne comes to our house. But sometimes we venture out to other locations to mix things up a bit and get Gulliver away from his comfortable home environment. We have gone to the playground, the gym in town, Kaylynne's house, her office PT facility, and the Trailhead Museum. Gulliver does a variety of different activities with Kaylynne, all of which involve play and fun.

Gulliver's history includes reaching all of his gross and fine motor developmental milestones, although he usually reaches them later than average (even for his adjusted age). It's great that he does not skip over things, as that could cause problems later (the ol' "crawl before you walk" saying).

I've learned so much more in this area than I ever would have without PT services. There are many subtle things that indicate low muscle tone. For instance, the sway in his back when he crawled, or holding one hand up in the air while learning to walk, or grasping objects with just his thumb and index finger instead of his whole hand.

When Gulliver was learning to crawl, Kaylynne would hold a towel under his hips to help him along. When he was learning to walk, she would have him hold on to a bar to help keep him balanced and centered. We worked on throwing for a long time. When he mastered that, we worked on throwing at an object to develop aim and intent. We spent a lot of time going up and down stairs and throwing objects up and down the stairway. She likes to have him jump off things. They read books that involve different actions (rub your head, kick up your heels...). She focuses on building core muscle strength through activities like wheelbarrows, riding Rody, and leaning him over an object so he has to pull himself up using abs and back.

A favorite activity of late is the tunnel. You have no idea how many ways you can play with a tunnel! Climb through it, stand in it, step over it, put a 180 degree turn and crawl through it, roll balls from one end to the other, hold one end up so the ball rolls down, roll over in the tunnel, rub the tunnel to make funny sounds... the list goes on and on.

Watching them play with the tunnel reminded me of when we were in St. Louis last fall and Harper and I came up with a list of "101 games to play with a superball."

I could tell Kaylynne was excited about how engaged Gulliver was with the tunnel and how many different things they were doing. She commented several times, "This is good in so many ways!"  I asked her to explain that to me. Aside from the physical acts of crawling and moving around, she talked about how it is such a good sensory activity and great to be able to play with a toy in unconventional ways. Being able to get past the intended use and find other ways to use it. There is also the problem-solving aspect of indirectly using an object (lifting one end of the tunnel) to manipulate another object (the ball rolling down).

PT has been such a positive experience. I used to focus on when we would be "done" with PT. I thought that would mean everything was OK.

Now I realize that everything is OK with Gulliver. PT just provides extra attention to ensure that everything remains fine. It's more of a journey than a destination. We all have things we can improve upon, and PT helps us identify specific areas for focus. And for Gulliver, it's lots of fun!

Love. Spring.

What a lovely spring it has been so far! We've been going to the park on a regular basis. Boy, how I've missed the park these past few months. We grill out on the deck and enjoy the mild evenings. And it just seems like the spring weather puts everyone in a delightful mood.

Playing mailbox with dad….

Goodbye, boots -- hello, shoes! Size 8 already, my goodness how this boy grows!

CB South playground…

Deck entertainment…

The shell and spool game…

Peek-a-boo!

Getting artsy with dad...

Jorgensen Park in Gunnison

Happy Easter!

It's a beautiful, warm and sunny Easter in Crested Butte this year. It's also the last day of the ski season -- and not a day too soon. The snow is melting fast. We saw lots of skiers and boarders dressed in costume and shorts.

We had fun dying Easter eggs yesterday. It didn't take very long at all to color the dozen hard-boiled eggs. Gulliver zoomed right through them.

This morning we headed up to the mountain to enjoy the Easter festivities. Gulliver was not too fond of the Easter Bunny, but he really enjoyed the other activities.

In the car getting ready to go…

Painting an egg…

Waiting for the egg hunt to begin (Gulliver was pretty eager to get hunting, along with all the other kiddos)…

The hunt is on!

Riding the bus back to town…