Showing posts with label evaluations. Show all posts
Showing posts with label evaluations. Show all posts

Saturday, August 3, 2013

Perceptions Drives . . . Everything

from the smart people at www.praacticalAAC.org

Perception
Maya loses her balance and falls regularly. She walks the way a bowling ball rolls down a lane with bumpers---diagonally, occasionally veering into a wall and bouncing back to continue crookedly the other way. She seems unaware that her mouth often hangs open, which leads to drooling issues. She often has a hand or fingers in her mouth. When you speak to her, she may or may not look at you, or in your direction. If you talk to her when she is involved with something else it’s quite possible that she won’t even look up, and you’ll wonder if she’s hearing, or able to process, anything that you’re saying.  She may or may not answer yes/no questions reliably (favoring “yeah”) and so when you speak to her you wonder if she’s able to understand what you’re saying or just answering automatically.  You may know her (alleged, per her mom) favorite topics, and try to engage her in conversation, only to be met with blank, open-mouthed silence.  You may have heard that she can (allegedly, per her mom) use a fancy communication device, and you turn it on (thinking “this is way too complicated, with far too many buttons”) and put it in front of her and she looks away, and you say “tell me something with your talker” and she stares at you or slumps in her chair and smiles, teetering too close to the edge and looking sure to fall.

-----------

When Maya is excited, she can move with speed that I never would have imagined a few years ago. I hold my breath when she runs, each unsteady step seeming sure to lead to a vicious fall, but I am impressed with the way that she usually manages to steady herself. The surge in speaking that has happened over the past 10 months tells me that she’s starting to coordinate her mouth muscles in new, wonderful ways. Maya is clever and surprisingly funny. She likes to laugh and to make people laugh and will tell “jokes” that are only funny to preschoolers (like telling us that it’s rainy on a sunny day, or telling us that she wants an alligator for dinner---each followed by a cackle). She is creative, pretending that she’s taking her dolls for a walk not to the grocery store or the doctors, but to the amusement park where they all ride roller coasters. She has a memory that consistently surprises me (if I tell her before school that she can have a cookie after school, you better believe that her first words off the bus in the afternoon are “cookie, please”). I wish I knew how her brain processes things----all too often I see her focused on something so intently that I’m nearly sure she can’t hear me at all, only to have her suddenly turn and answer my question a minute or two later  . . .  as if I were rudely interrupting earlier and now that I’ve given her some space she’ll comply and answer my question.  She has reminded me about numerous appointments that I would have forgotten (“Monday! Speech therapy!”).  She is a master manipulator, and has learned to avoid questions and demands by creating a situation that requires the adult to abandon their request and responded to her instead----like threatening to drop something important, or dangling off furniture so that she needs to be repositioned, or putting her head down and acting as if she’s so tired that she couldn’t possibly continue. She keeps us on our toes. 


Perception drives expectation
When Maya was two and a half she was evaluated by the preschool section of the DOE (among other things, these evaluations determine whether children have impairments significant enough to qualify for a center-based preschool, where all therapies would be provided on site).  Her scores qualified her for services across all domains (speech, physical therapy, etc) but one number stood out: her cognitive functioning was in the 0.04th percentile for her age. This meant that out of all 2.5 year olds, Maya was in the lowest half of a percent, cognitively speaking. Based on the data from these evaluations, it seemed that Maya was severely, severely impaired . . . a reader of these reports could expect a child that was close to vegetative. Unable to walk, unable to speak, with almost no receptive language (about 2 words), leaving her unable to understand anything said to her. The lowest of the low. She needed a therapeutic preschool, where they will hopefully be able to make some kind, any kind, of progress.

-----------

When Maya was two and a half she was evaluated by the preschool section of the DOE, strangers who arrived with a flourish, loudly asked many questions, and then disappeared. She was shy, and her responses ranged from nervous to puzzled to noncompliant. The woman who would go on to determine her “cognitive functioning” was late, unengaging, and, well, not very good. The results come in the mail a month later, and while it’s never fun to get crappy test results, we see them for what they are (biased, ridiculous, a means to an end and nothing more).  Maya is signing, making animal sounds, playing in an imaginative way (little animals go in the barn, little people sit in chairs for a pretend birthday party, etc), and shows clear understanding of a million little things all day long. She’s got preferences and opinions, and she is determined.  She needs to go to a therapeutic preschool, where they will hopefully be able to recognize her amazing potential, and have the skills to work with a child with a sharp brain but an uncooperative body, to help her gain movement, knowledge, and the ability to communicate what’s going on in her head.


Expectation drives opportunity
Before Maya met her preschool teacher, the teacher had already met Maya. Although we didn’t have the concise, powerful sound bite that “expectation drives opportunity,” we had that understanding (Dave and I were both teachers, and we watched students rise to high expectations year after year) and we were certain to help Maya’s staff set the bar high for her. Prior to the first day of school, they received a packet of information about her, and video clips that showed some of her skills and translated her signs. We had already exchanged emails about her, and the main messages were “don’t let her trick you into thinking she doesn’t understand you---she always does” and “push her---she will keep impressing you if you keep pushing her.”  Maya had been assigned to the smallest class, the class of kids who are, by and large, the neediest of the school (that’s where those evaluations put her, and it turned out to be fortuitous, because the staff in that room was fantastic). Her teacher saw the strengths in all of the kids, and pushed. When she showed me ideas for a communication board, we ran with it at home, and turned it into a word book. The teacher embraced the word book and then supported our quest for assistive tech, despite never before having used a full, dynamic communication system in the classroom.

-----------

When the assistive tech evaluator (L) met Maya, she didn’t expect much at all. L assigned her a low tech device, despite our insistence (and Maya’s demonstration) that she needed so much more. L said “I only give these devices to students who can show me during the course of the evaluation that they are able to use it to make sentences.” This boggled my mind, as I couldn’t imagine preschoolers picking a system up so quickly---yet I was sure that Maya could do it eventually. “How old are the kids you typically give it to?” I asked, and she replied “9 or 10, usually.  Some are a little younger.” 

-----------

We were not willing to let L’s expectations control Maya’s opportunities, and fortunately, Maya’s teacher agreed. She kept her expectations high (and we hoisted the bar up a giant notch when we came into school with a new, huge AAC app, set the iPad on the table, and said “Yeah, we’re sure she can do this.”) . . . and because of this, we laid resources in front of Maya and let her try it all.  She had opportunities, particularly the opportunity to be pushed and supported into a large AAC system, that the majority of 3 year olds simply do not have (although I’d like to change that).   


Opportunity drives achievement
L, the assistive tech evaluator who determined that Maya should only use a simple device, had a plan for Maya. She explained that we shouldn’t overwhelm her with a system that would be too big, or too complicated . . . it would only lead to frustration for Maya, who then might reject the system and cease trying to communicate with it at all. We should start small. Maya would have a device that gave her access to 32 words at a time, a number that was small and manageable. Because the teacher could create 8 sets of 32 words, she could have a set for art, a set for lunch, etc. It might take time, but over the next year Maya would learn how to access the words, possibly even achieving some success with creating simple phrases and sentences.



-----------

We downloaded the big, full AAC app, and we had a plan for Maya. We would present words slowly, but (because of the very smart design of the app) she would always be able to touch a button that made every single word available to her. We would model as much as we could. We wouldn’t force anything, but we would become AAC users ourselves, immersing her in it, and we would leave the door open for her to follow us through (and maybe we would nudge her along a bit, too).  Grammar, mistakes, times when she pushed the talker away, a favorite word pressed ad nauseam . . . none of it mattered if she would be able to say things that were on her mind. We so wanted to know what was on her mind. If we were painting, we wanted her to be able to say “grandpa” if she wanted to paint grandpa---not to be limited to a predetermined set of 32-words-that-someone-else-thinks-Maya-might-want-to-say-when-she’s-painting. We wanted her to have all of the words, to be able to choose her words at any moment, the same way that any other 3/4/5 year old speaking child can . . . and she did.

She told us about the weather, she counted, she spelled her name. She told us her ideas about what we should do on a given afternoon, what we should eat for dinner, what song we should sing. She told us that she loved us, and who she played with at school, and that her ear hurt (it was an ear infection), and who she wanted to Skype with.  She showed creativity, the ability to analyze information, the ability to make connections, (kind of impressive) memory, wittiness, kindness, and sarcasm.  She could communicate, truly.


Achievement drives perception
In the fall, Maya will start kindergarten and leave the security of preschool behind. To find the classroom that will be the best possible fit for her next year (the most perceptive leading to the highest expectations and granting the greatest opportunities, so to speak) we have been assessed, evaluated, and interviewed within an inch of our lives.  In recent months we were asked (by the DOE) to tour certain schools, and several requested that I bring Maya for the tour/interview.  We toured the facilities, heard about class sizes, visited potential classrooms (with Maya wandering right into the middle of the action, of course).  The school personnel had looked over her case, watched Maya boldly step into the classrooms, and smiled in a satisfied way that said yes-this-will-be-a-good-fit.  Until we returned to their offices, and I put the talker in front of Maya, then ignored her and spoke with the other adults. It only takes a minute or two of ignoring before she starts speaking up (although if you try to interrogate her she can hold onto a stubborn silence for.ev.er.) . As she tapped out a full sentence to request a snack or a drink, I could see a flicker---“oh, wait a second . . . “---and as I gently led her into more creative territory (what do you want to do today, who should go with us, what do you think we’ll see there, hold on---what day is tomorrow, again?) the flicker grew, and they were wide-eyed, surprised by this quiet girl who had tricked them.  And maybe (hopefully), surprised by their misassessment.

And, in a mere minute, a huge perception shift. In the following minutes, the comments that Maya “was too advanced” and “wouldn’t be a good cognitive fit here” and “clearly needs to be somewhere where she will be challenged” and “is full of potential, wow!”

In the space of only three minutes Maya’s achievement with AAC reshaped their perception of her as a learner which raised their expectations for her academic potential and offered her the opportunity to not be relegated to an ill-fitting, limiting classroom . . .

In a month-ish, she’ll start in a new school, with a new staff and new classmates and not a single person that she knows. And so the cycle starts again . . . and I’ll be sending over a new packet . . . because I know that my girl isn’t easy to read, and I’m going to try to shape their perception, to show them Maya that I see---manipulative, sassy, stubborn, clever, and full of potential.  



Wednesday, February 20, 2013

A Tale of Two Evaluations

As we trudge through the process of figuring out the best kindergarten fit for Maya, we are once again back in the world of evaluations and reports.  This is not a fun place to be, as any parent of a child with special needs can attest to.

First, I will concede that these reports are necessary.  It’s important to identify areas of strength and weakness, to determine whether a child qualifies for services, and which skills should be targeted in the future.  That all makes sense.  But then things start to break down.

Evaluations are often conducted by people who have never met Maya prior to said evaluation.  These well-meaning people tend to greet her enthusiastically, which makes her clam up and withdraw a bit, smiling shyly.  In turn, the evaluator lays it on a bit more thickly, lots of cheerfulness and toys laid out and “show me your talker!” and “maya-do-you-want-to-play-with-blocks-or-maybe-a-doll-or-maybe-this-school-bus-or-maybe-do-you-like-crayons-better-do-you-know-your-colors-maya-do-you-like-pink-do-you-want-this-pink-crayon-maya-maybe-can-you-say-crayon-with-your-talker-no?-yes?-well-maybe-you-can-say-pink-or-if-you-don’t-have-pink-you-could-say-red-I-guess-maya-do-you-know-how-to-turn-your-talker-on-is-it-with-this-button-here-hmm”.  And Maya just smiles.  Or maybe tries to hide her face with her coat. And maybe sits on the floor.  And maybe knocks over a toy or giggles and tries to swipe a crayon. 

If the adult is putting on a show, Maya is generally content to watch. 

I know this, but can’t get over the awkwardness of saying what I really think needs to be said . . . “Hi, I’m Dana.  If you want her to pay any attention to you, your best bet is to start talking to me and ignore her for a few minutes.”  (because then she’ll act like a typical preschooler . . . hey, what about me? Don’t you want to see my talker? Hey---is that a school bus?!?!  I want it!)

Typically, I sit back. It’s the scientist in me.  I don’t know what protocol evaluators are following and I don’t want to skew results.  I imagine that they, as professionals, have a big bag of figurative (and literal) tricks, and that they will present them in some sort of interventional and motivational hierarchy.  I imagine that they are masters of body language and social intelligence, and will push in and pull back until they have figured out how to dance with Maya through the evaluation.  I imagine that they are skilled experts. 

As it turns out, sometimes they are.  Sometimes they are decidedly not.

In the category of decidedly are not, let’s revisit Maya’s psychological evaluation from 2010.  This evaluation, required for determining whether she qualified for a therapeutic preschool, was also our first attempt at cognitive testing.  This evaluation, and the report that came as a result of it, had been so abysmal that I wrote a longer piece about it---here’s an excerpt, so that you can get a look inside the appointment:


I think back to the afternoon of Maya’s psych evaluation.  Oh wait, I mean the evening of the eval, as the psychologist arrived 45 minutes late, only getting down to business at 6:15, thirty short minutes before the girl’s bedtime.   I eyed her suspiciously, as she looked to be about sixteen and appeared to have never interacted with a young child.  She handed me a survey to complete and I sat off to the side, dutifully penciling in bubbles, as Maya laid face down on the floor and eyed the psychologist suspiciously through one eye. 

Maya!  Do you want to play with the DOLL?  Which toy is the DOLL, Maya?

(Maya made no motion.  I think she even willed herself not to blink.)

Here-can you see them, Maya?  She carefully moved her line up of toys closer, now an inch from her nose.  Which one is the DOLL?  Do you want to play with the pretty DOLL, Maya?!

Maya turned her head away, saw me sitting across the room and smiled at me.  I stifled a laugh.  I wouldn’t want to play with that crazy lady either, silly girl. 

And so it went for the next forty-five minutes.  Toys were presented and ignored.  Requests were made and ignored.  At some point it struck me that this woman might end up writing that Maya was catatonic unless I intervened, so I made her sit up and engaged her in some play with a few blocks.  See, she listens, I thought, you are just very boring and now it’s bedtime.  When she left I joked to Dave “Well, it shouldn’t be a problem getting into a specialized preschool.  That lady most likely thinks that Maya is a vegetable.”

But now, on paper, it didn’t seem funny anymore.  The typed words looked official, the opinion of a professional, and this professional said that Maya’s cognitive functioning was abysmal.  I skimmed her observations and then this gem jumped out at me: Alexandra was not able to stack blocks. 

Who the hell is Alexandra? 

You mean to tell me that the late, unengaging psychologist was also not yet proficient at copying & pasting?  Really, lady?  Your report is bringing me the news that my child is severely impaired, and you can’t even do a quick proofread?  I imagined her quickly printing off the report and running out to the bar with her young, unburdened friends.  I hated her.

Further on, she wrote that Maya’s “expressive language skills were slightly stronger than her receptive language”.  Translated, this meant that she could speak more words than she understood.   Since she could only say one word (bye!), this meant that the psychologist assessed her to understand zero words.  Zero.  How would she explain what I saw as I peeked into the living room, where her OT was saying “Maya, pick up the yellow duck and put it in the box”   . . . and Maya did, of course. 

That psychologist didn’t know Maya.  Not at all.


That psychologist was not a skilled professional (professional, yes, skilled . . . eh).  She did not have a big bag of tricks, figuratively or literally or even imaginarily.  And lest you think that I am unfairly bashing the therapist, let me say this: I know Maya can be a challenge, a little puzzle.  But she was 2.5, and toddlers are tricky---she should have been prepared to coax her out of her shell.  And if she couldn’t---no worries! I was sitting right there, and would have happily, accurately, unbiased-ly answered questions about what she could and could not do. But she didn’t ask.  And so I fault her, fair and square.

The report from this evaluation contained one sentence that gave me pause:  Maya’s cognitive functioning is in the Extremely Low Range as compared to her same age peers.  This score is in the 0.4th percentile, meaning that she performed as well as or better than 0.4% of children her age.

Given the inaccuracy of the observations about her receptive language, I should have dismissed it outright.  And eventually, I did, but for the first hour or so after I read it, it stung.   And I doubted Maya, and I doubted myself, and I wondered if this lady could have seen something that I haven’t been seeing.  And then I shook it off, but a little dark shadow lingered . . . because no matter how sure of yourself and your child you are, when you see terrible things written about them on official letterhead from an official professional a dark shadow of doubt lingers, at least temporarily.

And that brings us to December 2012.  Two years later.  A new evaluation team (2 people instead of one), a new psychological evaluation (this time for kindergarten), a new report.  This time, with truly skilled professionals---two women who were ready for a challenge, who sat on the floor when Maya sat on the floor, and climbed up to the table when Maya wiggled into a chair.  Women who turned to me when Maya was shy, giving her a break.  When they weren’t getting far they asked me what I thought might work, welcoming my input and encouraging me to pull things out of my own perpetually stocked bag of tricks . . . m&ms and stickers and a juice box, oh my!  And Maya worked for them, answering questions and taking breaks and playing games, and 90 minutes later we had more accurate data than anyone had ever collected about Maya, ever.

I waited anxiously for the report.  Weeks went by.  I was nervous, and mad at myself for being nervous.  My hopes were up and I hate getting my hopes up.  I have a file full of reports that have taught me that they will not be accurate (in my opinion) and I will be agitated by the results.  And I’ll end up with lingering shadows that take weeks to clear away.

The report arrived, via email.  I saw it on my phone.  We did dinner and bedtime and I sat at my computer to open the file and read it, 10 pages of details and data and recommendations.  I skimmed it first, to see if it was worth reading, and then went back to read it carefully.  And finally, someone got it right.

I don’t generally talk about the numerical details of Maya’s reports, because –quite frankly- they are nobody’s business but our own.  However, I share the details below to boost the confidence of others who are receiving reports during this evaluation season and deflating.   I deflated a little when I got the 2010 report, even though I was pretty sure it was inaccurate.  The numbers made me scared and sad for Maya: 0.4th percentile, 1st percentile, 0.3rd percentile.  These are not good numbers. 

The new report has better numbers, but it has bad numbers too.  The bad numbers roll off my back now, as we’ve seen them before. The good numbers, though, those are new . . . and even more important than the numbers are the qualitative observations that are embedded throughout the report.

75th percentile:  Her receptive language is “high average” among her same-aged peers. (yes)
50th percentile:  Her academic readiness is “average” among her same-aged peers. (yes)
While certain tasks were attempted, it is felt that scores are likely an underestimation of her capabilities and potential. (yes)
Her performance on the current evaluation should be considered as a baseline of her functioning at this point in time, but should not be used as a long-term prognostic indicator. (yes)

It’s been almost 4 years since we entered the special needs world, creeping nervously into Early Intervention.  I was scared in the beginning, and worried too much about assessments and milestones and where we were and the future.  As time passed, I understood Maya more and more, and I saw her strengths and her cleverness and I believed in her, so much so that I knew the reports were not gospel .  I’ve listened to many scared moms tearfully speak about bad reports and I want to tell them---don’t worry, your child is the same child that they were before you opened that envelope.  That report might not be accurate.  Keep the faith. 

Until now, I had no data to back up my “keep the faith, ignore the reports” general stance . . . I could have just been a biased, delusional mom.  But now I have a report that confirms that the other reports were clearly inaccurate.  I have a report that says that she is smart and she understands, as much as an “average” kid her age does.  I have a report that says that I was right to trust my gut.  And with this report in my corner, I’ll say now what I wish someone could have said to me back in 2010:

The truth of the matter is that reports are just opinions on letterhead. Some reports are informed, thorough, intelligent, professional opinions on letterhead, that should be valued and reflected upon and future decisions should take their findings into account.  Some reports are mis-informed, inaccurate, not-correctly-spell-checked, best-used-for-sticking-in-a-file-and-forgetting-about opinions on letterhead. 

Reports are a means to an end.  You need them to get services,  and you should read them to get details that you might need to use to fight for services, but read it as if it’s written about a stranger. Don’t take it personally.  Bad things in reports are actually good, as they’ll help you to get additionally therapies/interventions/support for your child. Note any weaknesses that you actually agree with, so that you can target them with your child in the future.  After you highlight what you need, file it and forget about it.  Your child is the same person as they were before you opened the envelope.  You know your child better than the evaluator.  This evaluation does not have any power to predict your child’s future . . . and it shouldn’t have any power over you. 

Breathe.  Cry about it or laugh about it or do both.  If it helps, make a photocopy and shred it up, or burn it.  Then do something special for yourself (because if you have to read these reports, you deserve something special for yourself).  Then, move on.  And keep the faith.  


 
 

Saturday, December 3, 2011

Pull up a chair . . .

As many of you know, we had our Assistive Technology re-evaluation with the DOE yesterday. The point of this meeting was to determine, after a 6 week trial with a TechSpeak, whether she should stay with the TechSpeak or possibly move to a high tech device.

I couldn't figure out the best way to post an update about it.  I think people often say "The meeting was a fight", but unless you've ever been in one of these DOE meetings, it's hard to understand what that looks and feels like.  And if you have been through one of them, you know that it often is so long and twisty that afterwards it just feels like a blur and is difficult to re-tell.  So the best way I could think of to tell you about the meeting was to try to take you inside and show you, so you can see for yourself, rather than just summing it up.  Here it is, in all of its disjointedness . . . scenes from inside the meeting.


Maya sits in a little chair with the TechSpeak in front of her on a table.  Sarah, her lovely speech therapist, sits next to her in another tiny wooden preschool chair, holding a big bag of farm toys (barn, tractor, animals, etc).  Britney, the DOE-assigned assistive tech evaluator, sits behind Maya, peering over her shoulder, watching to see what buttons she’ll tap on the TechSpeak, notepad poised on her lap.  I stand in the doorway with Maya’s teacher, surveying the scene, trying to watch through both my eyes and Britney’s eyes . . . and realizing that those two sets of eyes are seeing very different things.
“I want to see her choose between three items,” Britney says, pen in hand.
“Ok,” says Sarah, “Maya, do you want the sheep, the cow or the pig?”  She holds up the three plastic toys.  I hold my breath.
Britney watches the back of Maya’s head turn slowly from side to side as she scans the TechSpeak, conceivably looking for the sheep, cow or pig.  Her head stops moving and she makes a small nonsensical sound.  Her finger reaches for a button—zebra!   He hand starts moving faster, tapping out- zebrazebrazebragiraffe.   Britney takes notes.
I can see the front of Maya’s face, so I could see her look at the cow and the sheep and turn away, looking for something more interesting.  I understand Maya’s sounds, so I knew that the little “hmph!” noise that she made meant something silly was coming.  That’s the noise that she makes when she’s kind of delighted by something.  And I could see her watch Sarah for a reaction when she said zebra . . . and then smile sneakily as she said zebrazebrazebragiraffe.
I see a silly, naughty, clever girl.  Britney sees a girl who didn’t understand the question.


-----------------------------

Britney makes the case for keeping the TechSpeak.  She makes good points, her arguments are strong.  She says that Maya isn’t yet using the device to the fullest of its capabilities, and that’s true.  For example, she’s not making spontaneous observations (like I see-Billy, a two button combination) during morning circle.  This is where Maya’s teacher jumps in and said “But the thing is, no three year old would really say that, you know?  If we ask who is sitting in the circle, Maya will just say Billy, not I see-Billy. 

Britney talks about different ways the TechSpeak can be programmed, different uses for it in the classroom.  She tries to spin the limitations of the device as simply poor programming choices---insisting that if it was just programmed differently, there would be different, possibly more useful, sentence making possibilities.   She has a lot of pro-TechSpeak arguments.  I zone out.  It all sounds like I’m-in-charge-I’m-making-this-decision-I-know-what-is-best-you’re-keeping-the-TechSpeak-and-here’s-why.

Then she changes tactics and speaks about the challenges of using the Dynavox Maestro (the high tech device that would be the next step if she decides the TechSpeak is too limiting).  She speaks (at length) about the cognitive skills needed to work a high tech device like a Dynavox.   “To use this, a child needs to be able to understand categories.  If they want milk, for example, they have to be able to tap I want, then remember that milk is in the drink folder and tap drink, then scan the page to find milk, then tap the top bar to hear I want to drink milk and then tap the home button to get back to the main screen,”  she was holding up her hand, ticking one manicured finger off for each button tap.  “That’s a 5 button sequence, and the child needs to remember where the different categories are.”

“She could do that,” I say, without hesitation.  I mean, I think she can . . . I’m pretty sure,” I add, in my head.

Britney sighs and looks to the teacher and the speech therapist.    The teacher nods, yes, Maya is smart.  I barely resist the urge to hug her.

Britney takes out the Maestro that she’s brought with her and starts to fiddle with buttons, turning it on and setting some things up for Maya to see.  In a very prove-it-to-me tone, she tells me that she wants to see Maya form a 3 button sentence--- I want- to drink- milk.

I show it to Maya, who is only slightly, cautiously interested.  Mostly, at this point, she’s trying to get past me and into the hallway.  We’ve been in the room for over an hour.  We all want to escape, I think, but Maya is the only one actually trying to put that plan into action. 

Tears fill my eyes.  I force them back.  I will not cry during this meeting.  I will not.

“She’s not going to do it,” I say.

My frustration during this meeting is that, more than anything, I feel like we are assessing Maya’s obedience, rather than her ability.  No, she will not tap that I want-to drink-milk because, well, she doesn’t want to.  She doesn’t want to drink milk and she doesn’t want to tap a sentence and she doesn’t want to be in this room anymore.  She is 3 and she is stubborn and she is done and she doesn’t want to.

Britney is insistent that she only gives the Maestro to children who demonstrate that they are capable.  Children who are able to sit in the evaluation, watch someone model a sequence a few times and then demonstrate that they can do it.  That shows that they understand and are capable of managing the device. 

I get the feeling that she doesn’t give these to many 3 year olds.   But I don’t really care.

I want it.  I want to see Maya with it and I want to decide for myself if it’s a fit, with the help of her teacher and therapists, who believe in her and will put in the time and effort to give this a fair chance.  I want it in Maya’s hands, and I want to see if she has the motivation and ability to learn how to use it.  I want to see if this can be her voice.

No offense, Britney, but over my dead body are you going to be the one to make that decision, unchallenged, after a few hours in a hot, overcrowded office with my kid.    That’s not how this is going to go down.

---------------------

The meeting is long.  Time is spent observing Maya and debating-more debate than observation.  Britney talks the most and I talk the second most and the teacher and therapist and mostly quiet, which is good because their words seem more powerful, since they are so few.  They request a six week trial with a Maestro.  If it’s not a fit, we can give it back at the end of the trial period and switch back to the TechSpeak-no harm, no foul, at least we’ll know for sure. 
Britney does not love this idea, and says that we’re trying to move too fast---the Word Book is relatively new, the TechSpeak is relatively new, we should just stay focused and stay where we are.  I argue with her about vocabulary size and limitations and not meeting needs.  She understands my points, but disagrees.  I understand her points, but disagree.  Maya’s teacher mentions, again, a trial period with a Maestro.  We go round and round and then Britney says . . .
“Well, if I did agree to a trial with the Dynavox . . . “ and I don’t hear the end of the sentence because I know that she will give it to us and the relief is immediate and overwhelming.  I nod along with whatever conditions she is laying out.  Tears are in my eyes again and I remind myself that I will not cry here. 

----------------


The details are arranged, date for delivery of the device, date for re-evaluation.  We do paperwork and print things and wait for faxes to go through and clean up toys.  Now that we aren’t arguing anymore, we are pleasant.  Britney offers, “You know, we all want the same thing.  We all want something that will work for her,” and I know that she means it and she’s a nice person.   But I still resent the fact that she has the power to make these decisions, and that I’ve spent two mornings this fall trying to prove to her that my kid is smart and deserves a chance with a device.  

-----------------

I am crying before I get to my car.  The silent type of tears that fill up my eyes and overflow and spill down my cheeks without any effort or noise, they just come and I can’t hold them back any more.  The beauty of the sidewalks of NYC is that so many people are moving so fast that no one notices a crying lady walking down the block—and if they do, they keep to themselves anyway.  Tears of relief that the meeting is done mingle with tears of anger that I had to fight so hard and tears of anxiety at now having to teach Maya this device only to re-live this meeting at the end of January. 

    

Saturday, July 23, 2011

Letter hunting . . .





This video kind of makes me think back to those grossly misrepresentative evaluation results that we got a few months ago. 

Um, 0.4th percentile for cognitive development? 

Ha. 

It's a shame that the person who did the evaluating wasn't smart enough to understand Maya . . .  because Maya was certainly smart enough to understand her.

Tuesday, February 8, 2011

Show and tell

Maya wants to show you . . . . . . .that she is not to be underestimated :)

She was eating a waffle and looking at a zoo book.  I randomly started asking her to point to animals and was floored to see how many she knows.  When did she learn these things?




Ironically, her psych evaluation says that her receptive language---words she understands---  is actually less than her expressive language---words she can say.  She can only kind of say 1 word (bye bye- "ba ba") . . . so we can infer what they're implying about her receptive abilities.  Take that, psychologist-who-was-late-and-not-engaging-at-all.  (Oh, and her special instructor knows all of the names of the Little People---the only one that I know is Maggie)

Parker wants to show you . . . his new shoes.


(How embarrassing)

They're for function, not fashion. He was so psyched to have his stitches out (post-neuter) and be free to run, but quickly cut open 2 of his paw pads on ice :( So now he has rubber booties to protect his feet.

And, just for fun, here's some video of Parker running at the dog park this morning :)
(If you watch closely, at 0:05 and 0:21 you can see my boot pop into the screen as I kick the ball. I am a master high-kicker.)



(As always, if you don't see the videos, just click the play buttons and they will appear)

Sunday, November 28, 2010

Under Pressure*

Why are we having evaluations this week?  What the heck is CPSE?  Here's my understanding of the situation, in a nutshell:

In the state of NY, therapies for children are provided through EI (Early Intervention) from birth until their third birthday. We’re starting to prepare for Maya’s transition out of EI and into CPSE(Committee on Preschool Special Education) which is run by the DOE (Department of Education, aka Board of Ed.). In general, the DOE is known for being extremely stingy with services, and very difficult to work with (placing children in “special needs” schools that are across the city from where they live, drastically cutting therapies, not providing one-on-one aides without a huge fight, etc.). 

By the way, this all ties in really well to the learned helplessness model again---it's us parents vs. the DOE, very David vs. Goliath-esque-----and they know all of the rules and hold all of the power, while we're scrounging around trying to gather as much infomation as possible to fight back with.


So this week we have a group of evaluators coming to, well, evaluate Maya. This morning we had the PT evaluation---later this week we’ll have OT, Speech/Feeding, and Psychological evaluations. Each evaluator will ask me some questions, watch Maya, interact with her, and administer some type of standardized assessment. The scores of each assessment will say how delayed she is in each area of development, and those scores will be used at the big meeting with the DOE in which we try to find an appropriate preschool setting (and whether she’ll be at a therapeutic—aka “special needs”—preschool, or whether she would be in a mainstream preschool and get therapies at home).

Also, I’m calling preschools, setting up tours, trying to find schools in the area. Trying to figure out what would be best for Maya, when really I have no idea. How can anyone know this stuff? I’ve gotten the name of a place to call this week that is supposed to help parents navigate all of this a little bit easier . . . I’ll be interested to see if I can find some guidance.

This stuff is all so stressful. I feel like a few months from now, my hair will fall out again.

I'm not joking.

I have felt my base stress/anxiety level increase, and I can’t really figure out how to best combat that. If you saw my last post, you saw what our schedule looks like . . . granted, this week is busier than usual, but even on a “normal” week, all of those therapies are there. We’re busy. There’s not a lot of time for relaxation or unwinding.  There's a lot of worrying.  A lot of "what if there's something I'm missing" and "what if there's some school that is only doing tours right now but I don't find out about it for a few months".

(sigh)

December is my favorite month, and I don't want it to get lost in this.  I've been addressing our holiday cards :)  I'm going to start decorating this week, and wrap presents.  We made reservations to go out to dinner for my birthday.  I'm going to make shopping lists.  I'm trying to figure out how to Maya & Parker proof our future Christmas tree, since they are getting more and more mischievous.  Like this:



That's Parker in the bottom corner, saying good morning to Maya.  And that's Maya, who somehow was trying to undress herself in the crib, apparently.

I'm going to try not to let this giant dark evaluation/CPSE/DOE/preschool placement cloud overwhelm my favortie month.  But I hate the fact that it feels like it will take effort.

Friday, November 26, 2010

Time slips away, and leaves you with nothing, mister . . . *

I haven't written since Monday?  Really?  Well, that's what happens.  Dave gets a week off from work, projects take over, time slips away, and the blog gets bumped down on the list of priorities.

We've been having a great week :)

We had some therapies on Monday and Tuesday, but canceled them all for Weds-Thurs-Fri.  3 days of blissful unscheduledness.  I'm sure that Maya misses her buddies, but it's nice to have the time off.    We've hung out with family (both sides), Maya's gotten to play with both sets of grandparents, 3/4 of her aunts & uncles, and 5 out of 7 cousins.  We've played, ran errands, and created another fantastic holiday card---coming soon to mailboxes nationwide :)

Oh, and we picked up these:


AHHHHHH!  (that's the angels singing) 

If your a real life friend of mine, or a regular reader, you might know that I have a thing with iced coffee.  I have 2 per day (ok, occasionally 3).  It has to be iced, has to be strong, has to be in a large (venti, whatver) cup.   A few years back Starbucks made these reusable iced coffee cups, which flew off the Starbucks shelves----and unfortunately, flew off of my desk at school, cracking mine straight down the side.  (Dave ordered a replacement for me from Thailand.  Seriously.)  Since then, we try to have a few back-ups on hand.  They only come out twice a year (holidays and summer) and don't last long.  So we grabbed 2 new ones this week.


And then, my fabulous sister-in-law brought me a blue one!  Blue! Someday I'll have all the colors of the rainbow.


And we even got this teeny tiny Christmas tree ornament cup :)  It's too cute (and perfect)!

(If you like iced coffee, a cup like this is really worth getting---it's double walled, so no water beads up on the outside of it.  More importantly, it's reusable (good for the planet).  AND, I just make a pot of coffee and then keep it in the fridge (in a Tupperware style pitcher) so it's cheap and always on hand.)

On the other end of the relaxed spectrum, this week we will be SERIOUSLY OVERBOOKED.  (That's in all caps because it's a scary, intimidating week.)  Maya will have her full schedule of therapies, plus a pediatrician appointment (2.5 year check-up) plus 3 evaluations for CPSE.   I'll explain what that means some time this week, but for now just know that it's stressing me out.

So we will be completely booked, from breakfast until dinner, nearly every day this week. 

Monday: (breakfast/walk Parker) Therapy A: 8:30-9:30,  (walk or dog park, lunch) Therapy B:11:30-12:10, (nap) Therapy C: 3:15-4, (snack) Therapy D: 4:30-5:15 (dinner, play, bed)

Tuesday: (breakfast, dog park) Therapy A in Manhattan with travel time 9:45-12, (nap), Therapy B: 3:15-4, (snack, walk in lobby) Therapy C: 4:45-5:30  (dinner, play, bed)

Wednesday: (breakfast, dog park) Therapy A in Manhattan with travel time 9:45-12, (nap), Therapy B: 3:15-4, (snack) Psychological Evaluation 4:30-?  (eat, play, bed)

Thursday: (breakfast, walk Parker) Music class: 9:30-10:15 (walk home, snack, play) Therapy A: 11:30-12:15, Pediatrician 12:30, (nap, walk Parker) Speech/feeding evaluation 4-? (eat, play, bed)

Friday: (breakfast, walk Parker) Therapy A: 8:30-9:30, Psychological evaluation 10:30-? (lunch, nap) Freedom!

I'm sure that I'm not alone on this front---sometimes it's really hard to explain to people how we "don't have any free time" even though Maya's little and I'm a stay at home mom.  Our free time really exists in 30-60 min blocks, which isn't quite long enough for a play date or lunch or whatever.  It can be really isolating.

So those are all of my random, strung together thoughts on the past week.  Oh, and I should include this, which was our Facebook status on Thanksgiving Eve, in case you didn't see it:

A year ago today we were having Maya's brain MRI done. This year we had breakfast and dinner with family, ran some errands, and enjoyed a therapy free day. Sometimes a year makes a big difference :) Happy thanksgiving, everyone.


:)
Hope you all had great Thanksgivings!