Autism Testing

So once again life is crazy and I am not keeping up. So much is happening I almost don't know how far I should go back, so for now, I'm not.

We finally were able to have Nathanial and Ethan tested at the Mercy Autism Center a month ago. The good news is that niether one of them was found to have autism. Ethan was iffy anyway and we weren't sure on him, so that was understandable. Nathanial was surprising - and still is. He met criteria for the diagnosis in all areas, except social. When the examiner was speaking with him, he supposedly asked what her children were for Halloween. That showed an interest in her and her family AND him trying to continue the conversation. Otherwise, even socially he met it. Since then we still worry about Nathanial and just have no idea what is going on with him, really. Because although much of it is explained through the other "issues," much of it is not. I suppose time will tell. The three watching the evaluation said they never saw any hand flapping (which is what I reported) and when the examiner came in, they said that to her. She said, oh, no, he did it....he was probably out of range for the window, but it would be on the video. And, sure enough, it was. He also has the very odd speech, high, high pitched voice, echolalia, etc, but he asked that one question.

That, however, does not mean that they do not have a whole host of other issues to work through. They both have a sensory integration disorder. Ethan is incredibly sensory defensive (meaning he seeks sensory input) while Nathanial is more sensory sensitive (he avoids it) most of the time, while others being sensory defensive. I had no idea you could be both, so that was good to know. They also have an auditory processing disorder which is affecting a lot. They both have a "severe and significant" language delay. Finally, they also both have motor delays.

We were told that their issues are being caused by a combination of being preemies (even if they were near term), multiplicity, pregnancy complications and high risk pregnancy, labor/delivery complications, low birth weight (more for Nathanial), severe preeclampsia - and well, you get the idea. All of those things are known factors for many of the things we are dealing with and when you combine them, you rather get an almost perfect storm. But that is also very positive - because it means that much of this, with intensive therapy, they may outgrow.

An auditory processing disorder is that when they are hearing things spoken to them, it gets jumbled and they can't decifer it quickly enough to respond. By the time they do get it, it's too late, the conversation has moved along. They then also have difficulty even expressing what they need or want so all of that adds to the frustration.

Most of Ethan's aggression and anger and extreme OCD tendency's are coming from not understanding and not being understood. He's trying to control whatever part of his world that he can. Ethan's language skills are at a 2 year, 4 month old level and he is only understood by unfamiliar listeners 50% of the time which puts him in the 2nd percentile. No wonder he's frustrated!

Nathanial is understood by an unfamiliar listener 75% of the time, but his overall language skills are much more severe than Ethan. He is only at a 1 year, 5 month level and is lower than the 2nd percentile of his same age peers. They did immediately see and recognize the giggly, out of control behavior as being a stress response and not just something "cute." This has been hard for us because noone else really has and it breaks our hearts when he gets all giggly and squirrely. And he is a very happy little boy, so it can be hard for others to recognize the difference between stressed out giddy and happy. The examiner said she was glad I had warned her, because then she knew to watch for it. When he was trying to do things he couldn't do, he would get a split second panicked look and then just go into his giddy, hyper, running all around response. If you aren't looking at his face for the panic look, you are going to completely miss it.

 Now we move forward. We've been making and putting up story boards all over the house to help them see their schedules and understand the familiar. They need lots of visuals to get through their day. Their teacher is working hard on also doing many visuals at school - more than she already has. We will work hard on them understanding their schedules through visuals until after the holidays and then we will start to change it up a bit (by putting in a "change" card also so they see that). This way, eventually, they will learn to tolerate change a little better. Then we also change the direction of their speech therapy - which is what I have been trying desperately to do for a while. They also have access to the occupational therapist at school and she will be working with their teacher to make things even easier in the classroom.

The best news was that I can homeschool them and this may actually be an excellent option for them. We've prayed about it and are still praying about it. I have been very convicted that I should be homeschooling my children (and am going to be starting Austin in January), so this is positive for me. We are still praying over it and will continue to pray diligently so that we are within the Lord's will and not our own.

Completely Random

So much has been happening and my thoughts are so scattered that I feel I cannot do justice to whatever it is I might want to say. So much has already happened that I feel I have neglected my blog for so long and I'll never catch up; which leads to me putting off posting and then getting further behind. It's an endless cycle. It's gonna stop soon and I'll just post whatever I feel like, but I feel like I should say something in case you've been wondering "where in the world did she go?" I'm still here and I'm determined to just start in and then post about our summer/fall randomly. Just thought I'd warn you....it's probably gonna be scattered! Which is OK, because it'll match my brain!

I do still plan to continue posting about our infertility struggles - I think I just need a tiny break for right now (will probably get back to it next week). I also want to start posting about our mission trip, which will definitely be a multi-part series with all I have to say! And, of course, I want to post about everything that's been happening in our lives at home.

I think that I am feeling so overwhelmed lately due to some major decisions we have made recently. The biggest one is that Nathanial and Ethan are both going to be evaluated for autism in Dubuque at their Autism Center on November 2. I will post soon on all that I've been feeling.

I'm still here, still thinking about this daily, still realizing I need to post more often (this is my only "journal" for these times in our life, so it's important to me to keep up for myself!), still trying!!

Therapy and Decisions

{I know I am way behind on blogs and will update all of that soon, I promise!}

The triplets had therapy this morning. They are still getting development and speech therapy monthly. They are to get each one for ninety minutes per month, but we have found for scheduling purposes it works much better to do all three together and do both therapists on the same day.

I knew that some of the things Julie, our developmental therapist and lead person, was going to be bringing up but today it was very in depth and detailed, so I am just a little overwhelmed with it all.

Ethan is doing fabulous, when he's alone and comfortable. He chatters and even is starting to use some 2-3 word sentences (this week's big one for all three: where aidi??) and he speaks the most clearly. He's very up to trying to say anything you want him to and usually does a great job.

Noah still jabbers on and on the most, but speaks the least understandably. He talks non-stop, but he drops the ends off words, mumbles, stutters, and has a bit of a lisp. But he does love to tell a story. He also loves to sing! He is also putting some 2-3 word sentences together. Noah does the best on names and loves saying everyone's names and uses them the most often.

Nathanial is the slowest to do it, but is still doing incredibly well. He tells me whole sentences, but you can only understand, at best, half of what is said. He also repeats any word you tell him and does a great job with that. He also has a lisp.

All three are definitely, speech-wise, getting there. They are way behind their same-age peers, but I am very happy with the progress we are seeing.

We are having some major issues still with biting, and now pinching. And the pinching is not nice...it's vicious and they leave horrible marks when they do it. Ethan and Nathanial (especially Thano) tend to do the most pinching, but Noah does his fair share also. Noah tends to hit more often when he's upset.

Lately, we've been noticing a lot of autistic-tendencies in Nathanial. I don't even really know if they are autistic tendencies, but there is something very different about Nathanial than the other two. I am convinced at this point he is either autistic or has ADD. As he gets older, it is becoming more and more obvious whereas the other two seem to be mellowing a bit with age. I brought my concerns up to Dr. B at their well baby visit this week (I'll update about that in a different post later), but he seemed to think that we could hold off for a bit and just watch him. His logic is that he is already in therapy, uses a pretty strict schedule, and not a lot would be gained by trying to get him diagnosed with something right now. At first, I was OK with that, but the more Steve and I discussed it the more we thought as long as we have people in place and resources at our disposal, why not use it? So I brought up everything he's been doing to Julie and she agrees it warrants a closer look. She also observed several of the behaviors I was describing in the short amount of time she was here. She wants to bring in the school psychologist who has observed them before again, this time at home during a therapy session, to specifically focus on Nathanial. I am relieved to know we are taking this step now because if he is autistic, then we can start more intense therapy with him immediately. She will observe him at the next visit and then recommend to us if she thinks we should take it a step further or wait.

The other thing that was brought up, which I knew was coming, was preschool. They are "almost three" and will age out of this level of therapy at three. She says at this point, she can guarantee that they are not ready to be done and will all be on an IEP. Which means we need to be making some big decisions in the next little while about what our next step should be. Julie wants them in preschool as soon as they turn three for several reasons. I do not. I did not, ideally, want them to start preschool until they were 4 1/2, but I did know that would probably not really happen. I also wanted them to go to preschool where everyone else has gone. That is now looking more and more like it will not happen at all. We can, of course, object and say no to her recommendations, but honestly, they would be better off in the preschool she is suggesting. She wants them in 4 half days per week and then move to 4-5 whole days per week at 4 1/2. The preschool she wants them in has a special education classroom with a special education teacher. The more that I am praying on this, it seems this is where they really need to be and where they could most flourish. My one problem with it has been that it is not in the same district or town that we are in. And that would mean they would go to kindergarten not knowing a single classmate. Then I realized that Aidan only knows a few of his classmates this year because most of his class went to morning preschool and he went to afternoon. I do feel better once I thought it all through from that angle.

Steve and I will have big decisions to make in the next few months for all of the boys...will you pray with us that we follow God's direction and His will makes it clear which way to go?