Our first occupational therapy session

Last week I made an appointment with an occupational therapist because I wanted to get AngelicA assessed on her fine motor skills development and areas we need to work on. Besides, the developmental pediatrician who had done her developmental assessment had suggested that we start Angel on occupational therapy. So yesterday, we made the short trip to the early intervention center to meet the occupational therapist.

Initially, when we got there Angel started fretting a bit and was clinging to me. She does this quite often now. But once the therapist gave her some beads, blocks and other stuff to play with, she got comfortable and played while we chatted about her.

He told me to show her how to string some beads and Angel caught on quite quickly. After a while, he told her to put the blocks back into the box and she did as she was told. He told her to stack some cups and she did that too. But after a bit Angel was distracted and wanted to play with Elle, somehow whatever her sister's doing always seems more interesting so she scampered over to Ellie.

All the while, this therapist kept observing her and making notes. I wasn't sure what he was making of it. Until all of a sudden he asked me - Is she always like this? And I was a bit puzzled. Like this? Excuse me, like what? And then he asked me again, is she always hyperactive? I just didn't get it. Among all the kids in our extended family, Angel is the most placid and amiable. Yes, she has started jumping around like a little monkey now that she can stand without support and climb pretty well, but don't all children do that? I told him so but he still insisted that OT will help us to address her hyperactivity!!! Can you believe that? So that remained a moot point in the course of the assessment.

At the end of the assessment, he said that he doesn't see too many issues with her but because she has 'a condition' it would help to get her started on OT so that she is able to reach her milestones more or less in line with typical kids. He suggested that we do some of the exercises at home with her. I had already started getting her to do a few things like coloring with crayons and playing with beads. I've been showing Angel how to unzip and zip up the zippers on cushions to help her develop a more mature pincer grasp. And sometimes she pulls down the cushions so she could go at it herself. Now I'm looking for some peg boards that could possibly be as useful.

I've picked up some suggestions from About Down Syndrome and listed them here.

- Picking up small items (i.e. uncooked macaroni, cheerios, etc. and putting in cups or bowls.)Always, always stay with your child when doing this and make sure he does not put these items into his mouth.
- Putting together snap lock beads
- Manipulating puzzle pieces ( the kind with the pegs for picking up the pieces)
- Brushing or combing his hair (or yours, but beware, he might get overzealous!)
- You can give your child a crayon and piece of paper and let him go at it (make sure to supervise this activity)
- Alternatively, a magna doodle might do the trick
- Peg boards

Another interesting article on Bright Hub recommends that toddlers should be encouraged to use the index finger and grasp tiny objects as they engage in the following daily activities:
- Point during finger play songs
- “Paint” with the index finger in whip cream
- Put small pieces of crackers inside large container openings
- Stack blocks
- Put large pegs in or out of a board

The article goes on to say that two-year-old children are ready to practice the following fine-motor activities that will develop these skills:
· Stringing large beads
· Putting objects inside containers/ dumping them out
· Opening food wrappers
· Opening and closing lids such as the top of a band-aid box


Pic source: Brighthub.com

Suggested activities for three and four year old children include:
· Opening and closing squeeze clothespins
· Using toy pliers to move around objects
· Opening or closing screw caps
· Winding up toys

I would love to hear from you about all that you have been doing at home to develop your child's fine motor skills. Please do write in to littlemommysunshine@gmail.com.

Thanks for reading,
JD

Baby talk

We've finally started Angel on speech therapy. Yesterday, we met a therapist who was recommended to us by the pediatrician at Ummeed. And I'm happy to say that it was a nice, positive experience.

I was initially apprehensive that we were probably very late in starting Angel on speech therapy considering she is already 15 months old. Thankfully, Palak (the speech therapist) reassured me that it was fine to start now.

She did an assessment of Angel's speech even as the two of them carried on a conversation. It was great to watch them both talking. I could see Angel was in a happy place, what with the new toys and someone actually 'understanding' what she was saying. That itself was a big learning for me.

Palak drew up an therapy action plan for us to work on with a two month timeline. What I really liked was that all of it can be done easily at home. The key actions that we have to incorporate in our daily routine are:
- We have to use short sentences, stretch words and use a lot of gestures while speaking with Angel.
- She has to learn to sign 'eat' and 'finished'.
- We have to incorporate doll play into our routine. We have to take the doll everywhere and make the doll do whatever Angel is doing.
- For oro-motor stimulation, Palak recommended we buy a set of training toothbrushes and use the beginner brush - which looks more like mini paddle - and roll it around her mouth five times each day. The brush has to be dipped alternately in honey and lemon juice and we need to do five repetitions each time.
- We have to record Angel's vocalizations and play it back to her.
- We have to imitate her vocalizations and do vocal play with her.
- We also have to talk for her. So when she says boo....we say boo...book? Do you want your book?
- Within the next two months Angel must be able to recognize 20 commonly used objects.
- We need to buy her some cause-effect toys. If you'd like to pick up such toys make sure you have the time to look around all the stuff before you pick what will really benefit your child.
- We have read the book 'The new language of toys'
- Palak also suggested that we play a DVD on signing for her. It's called - My baby can sign. We haven't managed to locate this and the book yet but as soon as I get them, I'll add the details to this post.

I left Palak's clinic happy and with a sense of having achieved a milestone even though it was just the first step. I guess you, dear parent, will know what I'm talking about.

We'll keep you posted on how the talk therapy is going with us.

Thanks for reading,
JD

Seeking Pollyanna in our education system

Ms Elle is all set to enter the hallowed portals of The Big School. The key question for us is "Which one should she go to?" Early on, one of my main criteria for shortlisting a school for Princess was that it should be one where Angel could also go.

As someone who has written on education for many years, especially on the changing landscape of education and schooling across the country, I was somewhat hopeful that more educational institutions in India might have made progress on the inclusion front.

And recently, I came across this interesting article in the Hindustan Times which got my hopes up even more. This story is about institutes that provide a welcome alternative to conventional schools. These are just the kind of schools where Angel can truly learn and any one of them schools would be perfect for her, I thought.

Unfortunately, what followed is not what I hoped would happen. I chose two city schools from the ones listed in the story and called them only to be told that they don't take children with special needs because they are not equipped to address their needs. It would be an understatement to say I was disappointed with the response. Dismayed is more like it.

As everyone living in Mumbai knows, this city has a dearth of quality schools because of which even average schools have a long list of applicants. I'm pretty much sure that the situation is no different in other parts of the country. It's no surprise then that many schools, especially those that are considered top schools, shun children with special needs.

I have not asked any particular school the reasons for rejecting these kids, but after reading up on the subject, here's what I have arrived at - Schools fear that taking in children with special needs will put additional strain on their already overstretched staff and resources. They also fear that when these students get to the point of appearing for a public examination, they might not succeed impacting the overall performance (and therefore image) of the school.

Ironically, much of the research on inclusion (see here) has found out that having an equal opportunities policy has a positive impact on the school and the community. Special needs students benefit from being considered as equal members of a community and other students benefit by learning to be empathetic. Fr Agnel School, Vashi, Navi Mumbai, is among the few schools here that understand this, as indicated in this story in the Hindustan Times.

I've would like to make a concerted effort to find good regular schools in India that even children with special needs can aspire to go to. And I hope to list them here as and when I get any information.

Here are a couple to start with:
Billabong High International Schools, which has an explicit inclusion policy.
Fr Agnel School, Vashi, Navi Mumbai

If you know of any inclusive schools, please do let me know and I'll add them to the list. My goal is to have a comprehensive list of such schools from across the country. After all, our kids deserve quality education too.

Thanks for reading,
JD

You've come a long way baby!

Angel does the cutest things these days. She loves to pick up any phone that she finds near her, hold it to her ear and yell out "Yeah" :) She loves to explore the world around her, cruising along furniture and walls quite comfortably. And she's also very quick - she climbs beds and sofas in seconds. And boy does it make me happy. Especially since some experts had us believe that we would have to wait a long time before she achieved these milestones. Yet at one, she's showing just minimal delays much to everyone's surprise.
We recently got Angel's developmental assessment done at Umeed, an organization that helps children with developmental disabilities. This could easily be one of the most important things we have done in the recent past. It not only gave us an idea of where Angel is, it also helped to identify areas that we need to work on.
Angel started on early intervention (only physiotherapy) when she was two months old but we had never got a developmental assessment done and we were not even aware about it. Our serendipitous discovery of Umeed led to us making an appointment for the assessment. I know for a fact that many children here (in India) have no access to such facilities so if you are a parent of a child with special needs and you live in India I would suggest that you find out options through your pediatrician to determine your child's progress. This would be very helpful in designing a development program for your child.
Coming back to Angel, the developmental pediatrician told us that she's showing good potential in many areas. We do have areas that need working on - the main ones are speech and language. So that's going to be key over the next few months. I'll be making an appointment shortly with a speech therapist who offers an at-home programme. In the meantime, I'm trying to implement some of the recommendations made by the developmental pediatrician at Umeed. Will keep you posted on how this goes.

Thanks for reading,
JD