Thursday, June 15, 2006

CPSC Evaluation

Here's a play by play of yesterday's events.

Luckily, the morning started with a chipper little dude who had a good night's sleep.

He helped me make eggs, and he ate mounds of them. Joe said it felt like was nice to get a chance to have breakfast together on a week day.

Off we went to Birch, the evaluation site/school. It was happily close to home, the Vernon Jackson stop on the 7, and then right off the train. Knowing that, it became an instant contender for the school he ends up attending. But one thing at a time; we were here for the evaluation to determine if he needed the school in the first place, although we of course knew what the answer would be.

We went to a waiting area where a little girl, exactly Theo's age, was waiting with her anxious mother. I was instantly comforted, knowing we weren't alone. The kids' situations were practically identical. They both didn't talk, but were both very aware and very affectionate. Theo and Cristal, the little girl, were instant friends. They ran around together, and Theo took on the role of leader. Their communication was entirely non verbal, just smiles and sound effects. He would shake his head and jump. She'd imitate, laughing. Watching our children, Cristal's mother and I shared an unspoken, unnerving feeling of, "this is why we're here." For the moment, all that mattered was that the kids were having fun. And while I couldn't help but think of how other kids their age would be relating to each other, it also felt good, that for once we were in a room where Theo was not the least advanced child.

Our first stop was the social worker's office. Theo happily played with legos while she asked me a series of questions that I would answer many more times throughout the day, and that I had already answered a million times throughout the past year. How was your pregancy (perfect) what kind of delivery (vaginal, full term), family history, yadda yadda yadda.

Next stop was the best stop, the psychologist's office. Lillian had been doing this for 30 years, and she clearly loved it. She thought Theo was just the cutest thing and that he was a pleasure to work with. It was still early, Theo was still well-satiated from breakfast, and so he was at his best. When Lillian tested him, I realized just how much Theresa and Lorena, his therapists, had done in preparing him for this day. I tried to hold back tears as he successfully matched objects to corresponding shapes and colors.

Then there were the questions Theo couldn't answer, and I tried to remain calm and remind myself that that's why we were there. For example, she'd show him a group of pictures and ask, what do you wear when it's cold? Where do you go when you're sleepy? He didn't score on any of the function questions. But he did great on his body parts.

I felt good about myself as a mother, knowing my son as well as I did. I knew what he was capable of answering or doing and what he wasn't. Of course, he surprised me a couple of times and knew things I thought he wouldn't, which was even better. And I had feared that he would know more that he would let on, but that only happened a few times throughout the day.

After Lillian evaluated Theo she let him play with the cash register he was desperate to play with for the past hour, while we talked. I told her about the PDD assessment from a year back. She said she had been doing this forever, and that he is NOT NOT NOT autistic. The more Theo flirted with her, or ran out of the room and mischieveously peeked in to see if we were looking, or kissed me, etc... the more she repeated it with certainty. She had no doubt in her mind that he would need special services, and a lot of them. But it was just because of developmental delay, not autism. She recommended a full speech, OT, and PT evaluation, which we had later in the day.

I told Lillian I had an appointment with a neurologist next week with the hopes of them removing the PDD label. I asked if I should even bother going based on our conversation. She recommended going instead to a pediatric development specialist. Aunt Pia had said the same thing, you were right, auntie! This would be a person who would get to know Theo over the next few years and could better determine where he is. I still plan to keep exploring all those other thus-far dead end avenues, ear-fluid, tonsils, etc. The speech pathologist said he had swollen tonsils. But while I'm not ruling any of that out, I am starting to believe that he's overall pretty healthy and simply delayed. That there doesn't need to be a reason for it, he's just got catching up to do. But back to yesterday...

Next stop was classroom observation. Theo joined Grace's classroom. The kids were just finishing up their outside play. Theo went up the ladder, down the slide, up the ladder, down the slide, not paying attention to anyone. Even though I had just assured the psychologist that he loves playing with others at the playground. And he does...when he feels like it.

Grace's class went back to their classroom and were given drinks of water, and took turns going to the bathroom and washing up for lunch. The kids were all introduced to Theo as a visitor, and they were so cute saying hello to him and offering him water. He was very happy to sit with them, drink with them, and even throw his cup away as they did.

The classroom, and the school even, was a very normal place...nothing out of the ordinary. If I didn't know beforehand, I'd never have known the place, or even the children I observed, were different. Again, I was comforted. That's Theo. Normal kid, just slower to develop in language and motor skills.

Theo ate lunch with the kids. I loved seeing their mom's prepared meals layed out. Egg rolls here, rice and beans there, pasta and sauce was an ethnic smorgasboard. Quite lovely to see. As long as all communication is in English, which it is. As they ate Grace walked through a typical day there with me...again, very normal preschool stuff. The only difference being the extra work done with speech, OT and PT.

Went back upstairs to meet with Anthea, the speech pathologist. At this point Theo was exhausted, having skipped his nap and working so hard, and so he gave very lazy, sleepy answers, if any. We decided to hold off and go to the physical therapy portion, where he would wake up again through playing basketball, going on a swing, jumping on a trampoline, etc.

I thought Theo would shine and have no problems at all with PT. But they even found things there that were not up to speed. Jumping, ball throwing, ball kicking...all needed work. The PT was followed by OT, occupational therapy. Michael, the OT teacher, had also observed the PT, and thinks that Theo has low muscle tone. It's why he slaps his feet when he runs, grips with flat fingers and not curved, and locks his limbs. At the time it was all tough stuff to hear, but as I sit here writing this, I realize this is all stuff I worried about being autism related. I can deal with words like low muscle tone, or developmental delays...those words were already pretty much a given anyway. The idea is to work on those delays and get caught up for school. This is the most important developmental time in Theo's life. I feel good that we're taking action now and not when it's too late.

Back to the speech pathology office. Theo was still tired. He refused to label items that I knew he could identify. Luckily, Anthea came with me to watch Theo do the PT and OT, and she learned a lot by observing him there. And so she understood he was just tired. After all, what else can they expect? We got there at 8:30 AM and it was now 3:30 PM. A full day of work for Theo.

From this last series of tests Theo did fairly well in using items properly. He fed a teddy bear with a spoon, gave him a drink with a cup, and made appropriate sound effects. However, he didn't do those things on command, just on his schedule. The exhausting part is, for every single little thing he does, it requires the analysis: Is it because he's 2? Is it because he's tired? Is it something more?" But no matter the reasons, one thing is clear - and this was a unanimous vote - Theo will need to go to one of these schools. Possibly this one.

I liked this school, and hopefully can reserve a spot for them there. Last night, Lorena came over. She spoke very highly of this school, Birch. I told her what an emotional, exhausting day it was for me...she's on the other side, she does evaluations. She told me they are required to take a seminar to deal with what parents are going through. She said some break down, some get angry, some cry.

As for me, I know I cried through happy moments and unhappy moments yesterday. Someone took away the PDD label. Hooray! At times I felt like I was in a separate universe, but then we'd see Cristal and her mommy walk into a room that we just left. And I imagined all the mommies at home making those lunches the way I will be for Theo. I realized how alone we'd been with this up until now. Having the support of loving family and friends has been invaluable, but I'm really looking forward to the new support system for my son and for me that will come in a few months.

Everyone was wonderful. The staff, the kids..especially Theo. He worked so hard yesterday. They all commented on what a good boy he is. Last night, he walked in from the kitchen carrying a whole cake and a fork. I let him go at it.

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