Mara’s ABA therapy is all set to start this Wednesday. She will be getting 20 hours a week thanks to the wonderfully generous people at Imagine A Way. 19 of those hours will be at home, 1 hour will be at the clinic. Mara is going to be one busy girl. I wanted to document the skills Mara has now and the progress she’s made up to this point.
Expressive language: This is Mara’s most significant challenge. At this point she has limited verbal language. She has a huge vocabulary but does not use it functionally. She can repeat nearly anything she hears and often “scripts” from movies or books. She has really progressed in the past year with making requests. She will even spontaneously make requests using one or two words every now and then, but she isn’t consistent. She loves music and can sing entire songs. She does not use any signs or pictures to communicate, but that’s fine because we know she can use the words. She often grabs my hand and drags me to what she wants, even puts my hand on a door knob to indicate that she wants it open. Mara doesn’t answer any questions. I would love for her to be able to answer simple questions such as “What do you want?” or “Do you want water?” Right now she answers with “Water” instead of “yes” or “no.” Everything is on Mara’s terms. If she is in the right mood, she will say whatever you ask.
Compliance: Mara’s receptive language has really improved lately. We’ve always known that she understands most of what we say. Her ability to follow directions lately has improved greatly! She is following one step directions regularly. In speech she has even started to give her therapist a requested object when given two choices. I haven’t been able to get her to do this much at home.
Social skills: Mara’s social skills are severely impaired. She does not interact with other children at all. Occasionally she will approach a child to see what he or she is doing. If it is something she is interested in, she will want to do the same thing, but she does not interact. Mara’s engagement with adults is much better. She loves her parents, grandparents and therapists. She really loves to be tickled and genuinely laughs when we play.
Sensory issues: Poor Mara really struggles with her sensory issues. Our biggest issue right now is keeping her pants on! The girl hates pants. Shirts are fine, but she would love to be naked on the bottom half 100% of the time. It turns out that pants are socially expected, so we really need to work on this one. She had a rash on her bottom that we are treating with an anti-fungal medication for 3 weeks. After 2 weeks it is gone and the pants problem is improving. Now it seems like a habit for her to rip her pants off immediately after getting them on. Mara is also constantly rubbing her nose with her shirt and often rubs it until it is red. She also frequently cries for no discernible reason.
OCD concerns: Mara has really started to show some OCD symptoms. When she leaves a room, she steps out, back in and then out again. She wants all of the kitchen cabinets open all the time. She goes to the refrigerator, opens it, and then walks off. She likes to open and close doors on her little jewelry box over and over again. When she accidentally bumps into something, she has to go back and bump into it again.
Potty-training: Mara is urinating in the toilet almost all the time. She does not tell me she needs to go. I either notice her doing a little dance and take her or I take her when it has been a few hours since she has gone. Luckily, she holds it and will not go in her underwear. She was holding it at night, too, but has recently started wetting her bed so we have her in a pull-up at nighttime (unless she takes it off after we leave the room). Bowel movements are a different story. She has had a BM in the toilet 3 times. All 3 of those times I caught her about to go and took her to the toilet. Otherwise she waits until we are not looking and goes on the floor. Of course we’re hoping to work on this one.
So, this is a boring post, but I wanted to write down some specifics so we can have a place to check back. We are expecting and hoping to see a lot of progress very soon!