Celebrating Inchstones: IEP

Monday, September 19, 2011

IEP

I had Asa's second ever IEP meeting on Thursday. This time last year I was super prepared and super nervous! This year felt more relaxed! I woke up Thursday morning and still felt short of breath and panicy though.

I see Asa's teacher every day and his therapist weekly. We chat and toss around ideas all the time. I guess the IEP was good to get all of ideas in writing. Last week we were tossing around ideas for PT goals and I was afraid that we had the bar set to low last year. We've had crawling as a PT goal since he was little bitty. And guess what, at 4 years old Asa still isn't close to a crawl! I was very impressed that this years goals include "standing a line for 10 seconds"! WooHoo! I look forward to that day!

His long time OT was very impressed with how far he got in his eval. She said they were scrambling to gather the materials for the next steps of the tests! How fun is that!

And as for speech, Asa has a new SLP. In case you didn't know Asa has no words. Zero! Not even a "mamamama" or "dadadada". And he started speech therapy at 6 months. He's had speech therapy once a week until he was 3. Then last year he had speech twice a week for 30 min each time. Now I'm no expert but if all this work has gotten us nothing then I'm not sure we'll ever get anything. That's why we've started looking at Alternative Adaptive Communication. So far he seems to be doing really well with the PECS cards. One day this week we were in the van on the way home from school when Asa started hugging a card from his set. When I asked him what he had he showed me the "hug" card! How smart! I go in to the school next week for MY PECS training. Seems that there is a set way to use these cards. Asa already gets the idea though so I'm excited!

Oh and Asa won't be moving to another class for a while! Yay! Maybe I should be sad about that but I'm not. Overall, Asa's development was that of a 2 year old at best. And with that in mind I have no problem keeping Asa in his safe, happy class. I feel like he has enough struggles so a happy (happier!) 2 hours a day at school is good enough! And his teacher is by no means just a babysitter! They work on numbers and colors and his PECS and PE and art and music! He has it made, I tell you! We are so blessed!

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Asa's story

Asa is the 4th and youngest in this family. We thought he'd come into this world and our lives would flow right along as it had the other 3 times we brought babies into this world.

We were wrong! After a normal pregnancy and delivery, Asa had to be sent to the NICU because he wasn't sucking, blood sugar dropping, floppy muscles, exaggerated startle reflex and jaundice.

He stayed 5 days were he learned to suck and eat enough to come home. He began nursing well but would scream in pain 30 minutes after each feeding. He had so much mucus and drooled so much. He had a terrible rash on his face. He wasn't making eye contact and was not hitting any milestones.

I kept taking him to the pediatrician but got nowhere until his 2 month checkup when he had only gained one pound since birth. That earned him an appt with a pediatric GI and a change to Neocate formula. Odd gasping spells and eye rolling got him into a pediatric neurologist before the GI appt. The neurologist (he was actually the head of the pediatric neurology dept) personally walked us over to the GI clinic and sat us in an exam room. That kinda makes you worry! That is when we really got the ball rolling. Asa was 3 months old.

At 4 months he was admitted to Vanderbilt Children's Hospital. He stayed 8 days and had a NG tube inserted so we could feed him directly into his stomach. He kept this for 2 months. Also during this time he had an EEG, CT scan, MRI, upper GI endoscopy with biopsy, flex sig, numerous blood tests, a genetics consult, and an ophthalmology consult and many other pokes and prods! So began our relationship with specialist!!

After 2 months on the NG tube, we removed it and tried to get Asa to eat enough to gain weight. He did OK for a little while but by 9 months old, he was fighting each feeding and not gaining weight despite being on Neocate formula at 30cal/oz. The decision was made to have a G-tube put in. The G-tube is a feeding tube that is inserted directly into Asa's belly. He can eat orally but won't so he gets feed into his belly.

Since he was going to have to be sedated for the surgery, it was agreed he should have a muscle biopsy at the same time. By 9 months he had finally began making eye contact. He smiled some but not very social. He was still very hypotonic (floppy) and didn't even have head control. Something was obviously going on with his muscles. All of his brain scans had been normal.

In Nov. 2008, when Asa was 13 months old, we found out the results of the muscle biopsy. Yes, it took 3+ months to get all of the results! He was diagnosed with Mitochondrial Myopathy. He is deficient in Complex IV for all of you medical junkies out there.

What this means is that his cells can't make enough energy to fuel his body....specifically for him, his muscles and GI system, that we know of. If his body has to burn energy to fight off infection, or a stress, then he looses energy in another system. Mito is a progressive disease with no treatment or cure. We try to keep him as healthy and happy as possible. We use the feeding tube to keep him feed so he doesn't have to struggle there. He takes numerous supplements and vitamins in the hope that they will keep him cells healthier. We check his eyes, hearing, heart, kidneys, liver, brain and lots of blood work yearly. Mito can affect any system so it is important to have baseline and watch for changes. He has a GI, neuro, geneticist, optometrist, ophthalmologist, cardiologist, developmental ped, regular ped and a mito specialist.

He gets OT, PT, speech/feeding and a home teacher weekly. He has some sensory issues with touch, sound, taste and texture. This plays into almost all areas of our lives! He is still very hypotonic but gained head control at just over a year (right after we started supplements!). He learned to sit when placed in a sitting position at 18 months. He still can't get into sitting alone. He learned to bottom scoot at just over 2. He does not crawl or walk.

He knows the signs for "moma", "daddy", "more" and "all done". He can show them when prompted but we are still waiting for him to initiate. He waves "bye-bye" and points all the time now. He loves to take a bath and water in general. He has a contagious laugh and can flash the most flirty grin ever!

We learned, with Asa, not take the small things for granted. Each smile, sound, word, bite or even trouble!! You just never know when they might not be so easy to come by or even if you'll have them at all!