Tuesday 27 March 2012

Swinging!!!!!!


I have said before that fine and gross motor development have been a challenge for Jack.  He walked at 16 months, used to stand at the top of slides and look at me like "lady are you nuts?", and jumping was a really really big deal (and he has never stopped :) ).  We have been working on pumping FOREVER.  It's frustrating for a kid to learn this skill because for the longest time they feel like they are doing nothing, until something finally clicks and they realize they have to lean into it and really work to get moving.  Over the past 2 years, I have tried many motivators, the most popular being "flapping his wings", and being an airplane (legs out= taking off, legs in= coming in for a landing).  This has at least helped him get the concept down, but we have never before had actual movement like this!!!!  I have to try and calm myself down during these developments.  Luckily we do not have the first time he pedaled his tricycle up and down the street on video because it would have consisted of mommy sobbing and screaming "go, go, go" while daddy laughed at me  and said shhhhhh......you're distracting him!

On that note, please put your computer on mute or at least do your best to disregard my shrill voice on this video.  I was too excited not to share!!!!


Saturday 24 March 2012

Snip, Snip

I took the boys for a haircut this morning.  If you have any experience with an autistic child or a child with sensory issues, I need not say more.  I dread this task more than almost any other with the boys.  The day started off well, boys slept till 6am, which is heaven, and we headed out to our weekly OT appt at 8:15a.  We walked in and Jack saw his girlfriend (therapist) and said "good morning Miss Sam".  Stop the presses!!!!!!  He didn't say "have you seen a (hermit crab, killer whale, Wall-E)!  She and I looked at each other and just grinned.....progress!  While the boys are in their sessions mommy gets 50 minutes of time all to herself!  I have made friends with one of the receptionists whose daughter is also on the spectrum, she had several books waiting for me this morning and we had our usual chat.  I am continually astounded by how many kind and generous people I have met on this journey.  The support is just amazing.  About 40 minutes into the session, Natey came rip roaring into the reception area with his therapist chasing him and dove into my bag to grab his cup.  He is obsessed with his juice because it is one of the only sweet things he can have.  Poor Miss Myrna couldn't catch him before he made it!  Too funny.

So after the boys were done, we headed over to Hair Cuttery.  I woke up this morning and just told myself, this morning is going to suck.  And then it will be over.  Easter is coming and it HAS to happen.  It took 10 minutes for anyone to acknowledge our presence, and then I was told there was a 20 minute wait.  It was raining, so we were stuck.  I had the urge to run....but had to get it over with.  The boys were great while we waited.  However, Jack has gone from not talking to many people to talking to EVERYONE.  We were sitting by the door and he had a strong need to show every person who walked in the door the hermit crab that he and Miss Sam made out of a paper plate and pipe cleaners in OT this morning.  And tell them his name.  And show them how the crab moved.  And tell them all about hermit crabs.  ALL about them.  Most people are very sweet with Jack, he's 4, he's cute, and he smiles and makes eye contact.  What's not to love?  But after the first 2 minutes, it's time to move on, and Jack doesn't get this concept.  So he keeps going, and going......that's when it gets awkward.  Luckily he was in a listening mood, and stopped when I reminded him that not everyone loves hermit crabs.  Nate was enthralled with a picture on the wall and pretty much spent the whole wait staring at it.  Did I mention the wait was actually 45 minutes, not 20?  God give me strength.....

Let me explain something about the boys, and most children with autism.  Sounds are very intense to these children, as are vibrations.  Trimmers are OUT.  And their ears are very sensitive to touch.  If it's a night to clean ears I have to take like 15 minutes to prepare myself and then be ready for Jack to try to bite me the entire time.  It's really not his fault.  He does not do this at any other time (oh except nail trimming).  Every time I take the boys for a haircut I explain this to their stylist.  I have tried everything to get him to allow the trimmers (mommy would LOVE to space haircuts out further, believe me), I have tried telling him they are Wall-E's cousin, I have tried rewards, nada.  All of the stylists poo-poo me and then proceed to put the trimmers on his hand and turn them on "just to show him".  And he freaks.  Predictably.  Mommy is not a moron people.  Other than that, and major squirming Jack does pretty well at this point.  But Nathan.....whoa.  He is like a little bucking bronco the minute I put him on the seat.  Today I did the unthinkable just so I wouldn't be asked not to bring him back (ha).  I gave my complex-sugar free kid a freaking lollipop.  And I'm not sorry, so there!  It bought us 10 minutes.  After that it was scream central, with mommy holding his head in a vicelike grip and the stylist moving at the speed of sound.  But we made it.  Probably only 10 people stopped and stared.  Major victory.  So I tipped the stylists GENEROUSLY and we were DONE!!!!!  Very proud of them.

Reward is Chick-filA.  They have grilled chicken nuggets (they both can have them!!!!) and gluten free fries, which Jack can have.  God bless Chick-FilA- the only place mommy can get the boys take out!  Oh, and see Nathan below??  Eye contact!!  Good day


Completely irrelevant to the post (or maybe not), but saw this today and felt like sharing...



 


Thursday 22 March 2012

Big Spender....

I've mentioned before that both of the boys are on special diets.  One word for this---- expensive!!!  Jack is currently on a gluten and casein free diet (he showed sensitivities to both) and has been since September.  We have definitely seen some improvement in his over all behavior and concentration.  This diet is not easy, that's for sure.  Think of almost everything convenient that you feed your kids, and take it away.  Then for about 50% of those items, double the price and make them available only at a grocery store 30 minutes from your home.  Exit yogurt, cheese, milk, anything breaded, regular bread, most cereals, ICE CREAM.  Oh, and family occasions?  Be prepared to make separate holiday dinners for your kids, unless of course you can find a way to work their stuff into the repertoire- see photo from Christmas.  Who knew you could make a gluten and dairy free yule log? 

Birthday parties?  Bring your own cake!  Oh, and pizza, or whatever else they might be having.  How about school parties?  Christmas stockings?  Easter baskets?  Valentine's day?  I may sound like I am complaining, but really I'm just trying to help everyone understand the implications of "simple" dietary changes.  There is no doubt that we are very lucky to be doing this now and not 10 years ago.  The variety and availability of products has increased exponentially and some of the stuff is really good!  Not that I eat it, I can't afford it, haha.  That's the main issue for us....cost.  There are ways to save.....amazon is my friend.  You can buy in bulk AND schedule the items to be shipped every so many months.  Convenient for those things you know your kid likes and will want again.  Other than that.....Whole Foods, and our local organic market.  My sister calls it Whole-Paycheck Foods.  Word. 

Nate's diet was initially the same as Jack's but we weren't really seeing the same improvement despite the fact that his sensitivities were more severe than Jack's.  Look out, a little science lesson coming.....not appetizing. Just sayin'.  One of the tests our pediatrician did on Nate was to check for yeast in his GI tract.  Will not explain this "process", will just say that daddy is very glad that mommy is a nurse, ha.  So his results showed an unusually high amount of yeast in his GI tract, the same organism that causes things like thrush.  This can effect digestion greatly, particularly the body's ability to properly break down nutrients.   The other issue is that yeast feeds on SUGAR.  Not gluten, not dairy, but sugar.  If sugar is not broken down in digestion, it remains in the gut, creating a "happy home" for yeast.  A self-perpetuating problem.  The first intervention we tried was medication- Nystatin to kill the yeast, and multiple probiotics.  3 times a day.  For 8 WEEKS.  I did see some brief improvement, but the symptoms came back rapidly when we stopped treatment AND Nate hated this medication so much that I could not get him to take any other oral meds for months after this.   The diet that we decided to try with Nathan is the specific carbohydrate diet....basic theory is to cut out all sugars other than the most simple, easily digestible sugars.  See the very basic explanation by following this link:
http://pecanbread.com/p/scdscience2.html

So now not only was Nate eliminating gluten and dairy, but all complex carbohydrates as well. One of the symptoms of yeast overgrowth and food sensitivity is the child exhibiting cravings for the things that they should not have.  Nathan was text book, and it all started when I weaned him from breastfeeding.  Not just the cravings, but the autistic behaviors.  It corresponds perfectly in my opinion.  First, Nathan would have bathed in cow's milk if I let him.  When I started giving him milk in his bottles he would drink 14 oz at a time.  And table foods.....carbs, carbs, carbs.  Now I know all little kids are like that to a certain extent, but Nate was extreme.  Think BREAD!  When we removed gluten it didn't matter, the gluten free bread was just as alluring to him.  When I started this diet, Nate was like a child possessed.  He boycotted eating almost everything for the first few days, and had horrible GI upset.  Here is what he could have- chicken (boiled), eggs, ground beef, white grape juice, homemade gelatin (he never accepted this).  For 5 days....this is the intro diet.  Sounds kinda like Atkins right?  After the first 5 days, I slowly added other foods in, cooked fruit, ripe banana, squash, then slowly other fruits and vegetables and nuts and nut products.  He can never have grain on this diet, corn, potatoes, table sugar, etc. 
Here are the stages:
http://pecanbread.com/p/how/stages.html

So this was really really hard!  Nate didn't understand why everything basically tasted like crap all of the sudden, poor baby.  The first time I gave him homemade apple sauce after the intro, you would have thought it was crack.  He has adjusted to a certain extent although he is still very selective about what he will eat and getting vegetables into him is a challenge every day.  He is on so many supplements that I don't worry too much about his actual nutrition, but I do want him to eat a variety.  The average amount of time on this diet is about a year.  Once the yeast have "starved" due to lack of sugar, the GI tract can repair itself and the issues can basically be "fixed".  Not that it couldn't happen again.  Simple things in early childhood for sensitive kids, such as multiple rounds of antibiotics can wipe out the normal flora of the gut and predispose the child to these conditions.  Some say vaccines can also effect the balance.  Many theories swirling around out there.  Right now Nate's favorite food is chicken nuggets.  What, you ask?  They are organic chicken breasts dipped in egg and rolled in almond flour (very finely ground almonds) and spices and sauteed in coconut oil.  I made 4 pounds of them last night and froze them.  This will last about 2 weeks.  Requires a pound of almond flour.....guess how much???  $15 for a pound!!  Ouch.  He loves his applesauce, which I make in the slow-cooker, and the infamous banana pancakes (who woulda thought that mixing 4 eggs and two bananas would yield actual pancake looking and tasting food?), and almond flour "flatbread".  And some fruits and veggies.  And  beef or fish, if he would eat it.  Oh, and almond butter.  Something amazing?  About 3 weeks ago I decided to introduce peanut butter.  He has no sensitivity to peanuts and it was next on the list, so....let me tell you, within about 24 hours, both his father and I were noticing more self-stimulating activity, lack of concentration, etc.  And guess what?  His sitter and teachers did not know we introduced this and THEY mentioned it too!  So I removed it, he wasn't ready, problem solved. 

Has this diet "fixed" the problem?  Not by a long shot.  My feeling on the matter is that it certainly is not doing any harm to the boys.  Other treatments are much more invasive and have side effects, etc.  So why not try this?  What's a little time and money when their health is at stake, right?

Friday 16 March 2012

Sucker Punch

Many of you may think that as a nurse, I didn't have to deliver bad news to patients or families very often, that it would be left to the MDs.  And in an official capacity that may be true.  I worked on an oncology unit and got to know my patients and their families quite well- some relationships lasted for years.  I cannot tell you the number of times I had a patient ask me if they were going to die, or a family member ask if they should move forward with an intervention for their family member or would it be futile.  Or how long did they have left to live?  There is an official way to answer these questions, a therapeutic, unbiased, (or what I call wishy washy) manner in which to respond.  And I did that.  It was very rare that my answer would be completely straight-forward and to the point, because really, does anyone ever know?  So I relied heavily on body language and eye contact to convey my message.  I know that my opinion was communicated very effectively this way, as was my compassion.  The staff and families had to wear masks all winter to protect patients against the flu- about 5 months of the year, our eyes were all they could see of us. 

Why is this relevant to my life right now?  Stay with me here....today was Nathan's 6 month follow up evaluation with the school system.  4 of those months were home visits and for the last 2 months, he has been in the ABA program.  So this was a "touch base", how is he progressing conversation.  Thought I had steeled myself, wrong again.  In some ways Nate is progressing quite nicely, more appropriate play, more purposeful use of objects, definitely comprehending more language.  Still way behind in all of these areas, but progressing.  Language though.....ahhhh language.  When Nathan was initially evaluated, he was 21 months old.  His language was at an 8 month level.  Today I was told that in these past 6 months he has progressed to a 10 month level- sucker punch.  He is using "more" and "go" and a few others, but his case worker agreed with me regarding my recent concern about his use of "I good boy".  He is not saying it because he knows what it means, he is not "using" words, he has memorized the sound.  I came to realize this in the past week as I noted him saying it more and more, and repeating it many times in a row, and out of context.  It's more jargoning.....more purposeful jargoning, but jargoning.  So, I admit it, I did it.  I asked.  I said, is this what you would expect, is this normal for a child with these issues?  And I got the blanket response....every child is different, some take off, some show no progress at all, yada yada.  But I saw it in her eyes.  She is as concerned as I am.  Oh that hurts. 

We got into a discussion about the next steps for Nate.  I asked about several "DAN doctors" and her experiences with them, as they often work together.  I asked her about the doctor closest to us and again thought I saw that covert communication working through her eye contact.  Asked her about a couple others (effusively complimented them).  Then I looked at her, laughed and said, "writing down, Lynn does NOT LIKE Dr ______).  She cracked up and looked down and then said, ya got me.  Just checking.  That's what I thought- in her eyes. 

We will keep plugging along Mr. Nate.  We are moving in the right direction, albeit more slowly that I had hoped.  I don't trust too many people, but I trust Nate's pediatrician, and I have come to trust Lynn (his case worker with the school).  I can see her concern, but she is going to keep on working for you, and so are we.   

Monday 12 March 2012

For Grammy and Grandad



I grew up in a very strict household....anyone who went to high school or college with me is nodding their heads emphatically right now.  Was I grounded for the day if I didn't make my bed?  Sure was.  11 pm curfew when I was home from college on break?  Check.  Car "leased" from my parents for a summer on which I paid mileage?  You betcha.  Job from the time I was 14 plus babysitting every weekend while my friends were at keggers?  That's me!  Grrrrrr.....right?  Yeah, not so much, at least, not anymore.  I recognize that my parents are responsible for my work ethic, my refusal to give up, my belief that I can accomplish whatever I set my mind to.  I pray that I can instill these same values in my boys.

When all of this first came down the pike, I have to admit that I started to question God's plan for my family.  I know that having two boys with special needs is not a tragedy- I love them for who they are and they are of course perfect to me.  That doesn't change the fact that this is hard.  Every day is it's own challenge and this situation has brought many additional trials to our family. 

But then I thought about all of the wonderful things that God has done for my family.  One of the biggest blessings that God has brought into my life is the presence of my parents.  About 2 months before Jack was diagnosed with Aspergers, my parents moved here from California.  They are now about 40 minutes away, and this is the first time in my adult life that I have had members of my family within reasonable driving distance.  At first, it was an adjustment for us all.  My parents had three girls--- I have two boys....worlds apart!  And Jack is not always the most welcoming to new situations....I can still hear "Grammy and Grandad are not here" echoing from about a year ago.  But eventually everyone got to know each other, and at this point a visit from Grammy and Grandad has become a highlight for all of us. 

My parents have proven to me over and over again this year that they are dedicated and loving grandparents.  Not by being there on holidays, or playing with the boys, or buying presents, but by being there when it wasn't easy or convenient for them.  My mom has been nanny for weeks at a time, hurtling herself and Jack in and out of the car at school to prevent being run over while Jack was undoubtedly screaming for his killer whale.  She has been there after Jack had surgery so I could work.  When I first started investigating interventions for the boys and made the decision to change their diet, she was right there with me, researching recipes, experimenting until she found the "perfect" gluten and dairy free cut-out cookie.  She made a fully gluten and dairy free Thanksgiving dinner, and God bless mom and dad, they ATE it!  (ha)

And the sun rises and sets on Grandad!  (and his tractor)  He is a constant subject of discussion (and adoration) around our house.  He is so patient with the boys and always thinks outside the box when it comes to entertaining them.  From driving Jack around in his tractor to pick up rocks and put them in a bucket (who knew how thrilling this was) to catching Nathan's attention (not easy) by doing ridiculous things with his toys, I can tell that my dad is LOVING having some boys to play with! 

Tomorrow my parents are coming to observe a home visit by the educator from Nate's ABA program.  They want to understand more fully what they can do to help him.  I guess I just want them to know that by supporting their daughter so fully they are already doing amazing things for Jack and Nate.  I love you

Thursday 8 March 2012

School Fun

First of all, I just want to thank all of you for the supportive, sweet messages.  Cannot believe how many people I have heard from whether here, on facebook or email.  People from junior high, old jobs, it's great.  I can use all the help I can get!  Any ideas or suggestions for the boys are always greatly appreciated as are your kind words.  My email is jjpnurse@msn.com in case you don't want to contact me through facebook. 

So today I took the day off from that pesky paying job to be mommy all day.  This morning I had a sensory "class" for parents at Nate's school, and this afternoon I volunteered in Jack's class.  The class this morning was run by the occupational therapist that works with Nathan in his ABA program.  It went through many sensory seeking/avoiding behaviors and gave strategies for helping your child cope with their needs.  It was so interesting to hear, but funny in some ways, because for every behavior either Jack or Nate fit the bill.  And never on the same behavior.  Where one seeks, the other avoids.  Nate climbs, Jack is scared, Nate loves to color, Jack puts down his pencil, says "you do it" and makes you work for every letter.  Nate loves to chew on stuff, Jack avoids anything near his mouth.  Same genes right?  So different!  I also had a new experience with another parent.  I consider myself a beginner on this journey and am always seeking resources and looking to other parents for advice.  However, I am also a nurse, and our practice is see one, do one, teach one.  Well today was a teaching day for me apparently.  About half way through the class, a mom asked about gluten, dairy, etc and the effect on behaviors.  Of course the OT works for the school system and wants appear unbiased about things like diet changes and medical therapies, but I could tell that she is definitely pro-diet and just didn't want to say it.  This mom clearly spoke English as a second language and appeared very overwhelmed (we all are right?) by the information being presented.  I ended up sitting with her for awhile after class, telling her what I did with my boys' diets and giving her information about TACA (support group for parents) and the ECI Rolly Pollies.  She sounded so excited to attend these events and was so so grateful.  I know that feeling so well.  It felt wonderful to finally be able to support someone else.  I guess that even though I have a ton to learn, I already have plenty to share myself!

One of the activities the OT suggested for the boys was painting with shaving cream in the bath tub.  So I picked some up for tonight, sounds like fun to me.  Imagine my surprise when I walked into Jack's classroom to volunteer today and the teacher told me the parent "station" would involve squirting shaving cream on the table for the kids to practice writing letters and numbers with their fingers!  Guess everyone thinks it's a good idea!  They put Jack at my station first......LOOK OUT!!!!  He is obsessed!!  The other kids are sitting there spreading their shaving cream around and starting to work on letters.....Jack on the other hand, would dive into the shaving cream if it was possible..  He loves it!  Hard part was getting him to stop!  What a mess! But a fun mess! 

I usually dread volunteering in Jack's classroom, not because I dislike kids, but because Jack (like lots of other kids) acts out whenever I am there.  And since he has issues focusing on tasks to begin with, you can imagine what it is like if he is "distracted".  Today started out that way, he would not leave my side, but would not do what I asked him to do either.  He had a minor meltdown at the end of shaving cream time, and I definitely had my guard up and was waiting for the apocalypse.  It never came.  He moved onto the next station....he gave that teacher a little guff for a minute, but completed his task.  He moved on again, he did his work.  He wrote his name with NO assistance.  He sat on the rug the whole time during the song.  He played on the playground and ate his snack.  Needless to say, I am one proud mama today!!! Go Jack!  He is making great strides!

Wednesday 7 March 2012

Nathan

Dear Nathan,

Here we go again.....4am and mommy is lying here awake worrying about you.  I feel like we are at a crossroads of sorts with you and I am waiting to see if you are going to make a huge leap, or if you are going to remain as limited as you have been.  We have your 6 month progress report coming up with the school next week.  6 months?  Is that really it?  Has it only been 6 months since that excruciating assessment?  Only 6 months since it felt like my heart was being ripped out of my body, stomped on, and then haphazardly shoved back in?  I am up in the middle of the night several nights a week just racking my brain for ways that I can help you.  I am looking for a miracle, I want to fix a problem that very likely is not fixable.  I can't tell you how many nights I have picked you up from your crib, brought you into my bed and just stared at you.  You are PERFECT, and I want everything for you.  I know that you likely don't realize what you're missing, but mommy does.  I want you to be able to enjoy your life, not feel so overwhelmed all the time.  I want you to be able to communicate your needs.  I want you to be able to eat regular food!  But right now mommy just wishes she could make this pain go away.  I want to enjoy your childhood, not spend all of this time agonizing over what I should be doing, what I wish I had done.  I shouldn't have let them put you on antibiotics so many times, when it felt wrong for you to have 6 shots in one sitting, I should have stopped it.  When you started making those monotonous sounds, I should have taken you in right away. 

I know it's pointless for mommy to dwell on these details, I know the point is to do everything I can now.  And I am trying, I am trying so so hard.  And I know you are progressing, people tell me every day that you are progressing so well.  It's not enough.  It will never be enough.  Every parent wants for their child to have an amazing life, wants to protect their child from every hurt.  Right now you are blessedly unaware that you are different, but it won't be like that forever.  I pray that everything that we are doing now will prevent you from having to go through too much later on.  I pray that you get to go to school with other kids your age, ride the bus, play sports, have friends.   I pray that someday you will find love, even have your heart broken.  I want everything for you.  And you deserve it. 

I will keep pushing, I will try everything and anything for you.  I promise that I will not give up, no matter how frustrated or overwhelmed I am.  I see you smile every day, I know that you are happy, that you enjoy things.  I know that you recognize your family, I know that you love me, I can see it written all over your face when I walk into the room.  I know that you are aware of way more than I sometimes give you credit for- you cry when we drive into the OT parking lot- clearly you are aware that you are going to do something that you don't necessarily enjoy.  You run for the bathtub the minute someone mentions it.  You go stand by your highchair when you are hungry and demand "more".  You check in with me on a regular basis, you seek reassurance.  I know these are all great signs of a good outcome.  I will hold onto that.  But for tonight, I guess I just won't sleep....again.  I love you so much buddy.

Monday 5 March 2012

Rolly Pollies

Every Monday we take the boys to Rolly Pollies in Severna Park.  They have an open play from 6:15-7pm for early intervention families only and it has been a great way to connect with other kids and parents in similar situations.  A couple of the kids from Natey's program come from time to time too.  It also feels "safe" to take the kids here- if they have a meltdown it's no big deal, and no shock to the other families.  It's great!

So Jack is obsessed with the water fountain at Rolly Pollies and visits it no less than 10 times in the 45 minutes we are there.  Funny thing is that there are like 3 other kids there with him EVERY TIME!!  I feel like they are looking at each other and thinking, "finally someone gets just how fantastic this is!"  So as always, we redirect him, remind him that the moonbounce and 20 ft long trampoline are also "kinda cool".  Sometimes we even convince him.  One of the symptoms of autism can be an unawareness of one's body in space.  Jack has this in spades.  It makes him look really clumsy at times, but if you watch the pattern....bumping into people frequently, missing steps, fear of climbing, fear of swinging high...you realize that he is unsure of himself and where he is in relation to objects and people.  This is something he works on in OT with "Miss Sam" (who he has an ENORMOUS crush on--- "I love her mommy").  I have noticed a difference in his confidence since we started going to Rolly Pollies though also....he is definitely willing to try more things.  I know I am supposed to discourage my kid from jumping on the bed, but, well, I don't.  I encourage it, I throw him on it (crashing), I roll him up in his blankets like a tamale and pretend to eat him up.  The more tolerant he becomes of this movement, the better.  Nathan on the other hand......well let's just say that the bed could be 10 feet off the ground over concrete and he would not hesitate to jump- the boy is fearless.  He has actually pushed Jack to try new things at times. 

Another really positive aspect of Rolly Pollies for the boys is the social interaction with kids "like them".  Jack is growing by leaps and bounds socially and it is makes me so, so proud.  The other day when I put him in the car after school he grabbed his toy crab (we are back to crabs this week), held it out the window and said "hey guys, look!".  To parents whose children do not have Aspergers, no big deal right?  For me- Jack was considering others, Jack wanted to share.  OK, so he had no idea who those kids were, and they had no interest in a stuffed crab. It's still a step right?  I worked in an outpatient clinic as a nurse for several years and at one point we had a patient with Aspergers who I cared for daily for several months.  I honestly had no idea what Aspergers was when I first received his chart, and read up on it before I met him.  OK, so I was to expect limited eye contact, repetitive behaviors, extreme intelligence and concrete thinking.  Got it.  Ha, not so much.  Every day I drew this man's blood, and it never hit me until I worked with him that one of the main ways I communicated with my patients (and most people) was through humor.  So I would sit with him through the blood draw and assessment every day, inevitably cracking jokes......nothing.  It was so engrained in me that I couldn't stop, and yet every day I felt like a complete failure because his eyes would stay focused on the floor, I would get an ummm,hmm, and that was about it.  Man I wanted to crack him!!!  Never happened.....oh well.

This does not describe my little boy AT ALL.  Maybe it's because he's a child, but I just don't think so.  Sure, he has some trouble with eye contact at times (improving every day).  Sure he's socially inappropriate in some ways.  But Jack is such a loving little boy.....he worries about everyone and everything around him.  He tells me he is "worried at me" when he is upset with me.  At one point I was cutting back on the Starbucks (economically responsible thing to do when you are trying to finance all of these interventions) and would only get my latte occasionally on a Saturday on my way to take the boys to OT.  We pulled into the drive thru and Jack said, "mommy, is a grande skinny caramel macchiato your favorite?".   I said yes....his response?  "I think you should have it anytime you want to".  Now those of you who know me well know how much I adore my coffee....could he endear himself to me any more?  really?  Lately he's also trying to figure out humor- he is cracking himself up all the time.  Every time I say something he doesn't like he asks "mommy is that a joke?"  No such luck, but I love love love that he is exploring this.  He has a little friend at Rolly Pollies whose name is ironically Nathan, he talks about him all week and is so excited to see him on Mondays.  He met another little boy when I had him at the playground last week and when I turned around, they were holding hands.....so sweet!  Seeing my boy this interactive and caring is priceless.