Saturday, December 28, 2013

Finally communicating his thoughts

For those that have been following Kreed's progress, I've been trying to figure out how to unlock what's inside of his head forever. Years ago I figured out he knew more than what he was showing us and began raising the bar- that's how we figured out he could read and use a device. Even with using the device for the last year and a half, I knew there were still some things missing! Kreed could absolutely ask for his wants and needs with generally one key hits- whatever the object was. But we could never get him past the hump of only using nouns and not any kind of phrase or typing or telling us his thoughts etc. We tried everything- PRC, prolo2quo, different apps on the ipad, and his favorite among them- Dynavox Maestro. He was tapped out on all of them. None could take his language to the next level.

Then he got the newest Dynavox, first the app on the ipad- Dynavox Compass and then the dedicated device called the Dynavox T10. It was like a switch flipped in his brain. The first time he played with the T10 he giggled. No joke it's on camera!

And he started using phrases almost immediately. Kreed uses the NavBar page set and it is super set up for him to communicate his thoughts in phrases and comments and questions rather than just one hit keys of nouns. It's amazing. Changed the quality of his language immensely. He was communicating more fully and he wanted to communicate more. I will write more on this later, but on with his progress.

Then one day I was going through Facebook pages and I noticed a picture of a woman holding like a wooden spatchula for a child to use their device. I thought that was clever- Kreed has always had tremors in his hands and trouble with motor planning. The next day we went to Home Depot and picked up a couple to try. What happens next is magic. Here are two videos.

Kreed has known how to spell- we knew this to some degree, but not to this degree! He can tell us exactly what he thinks!!! This was so incredible to us and a miracle. It really all started with a shopping trip to buy a present for his mom- completely his idea. Here is the main video of this:

And then a few days later on Christmas Eve he spelled out Target when I asked him where he wanted to go. When we got there he wanted to buy gifts for his favorite cousin and his two older brothers! Again astounding he knew to get them gifts and wanted to AND things they like!! His brother Kyler loves Disney movies and collects them always and his other brother Kaden has always loved Star Wars. Again amazing for us. Here is the video.

We continue to film daily his progress. While it was not an all at once occurence, he is certainly showing us what's in his mind and what he's thinking and we couldn't be more thrilled to finally know what he is thinking. His behavior has improved dramatically as well now that he is communicating. While he gets frustrated, his frustration is generally if he can't do something or wants something he can't have. But this too is improving and he is learning to accept no better and choose another activity.

People have always assumed Kreed's behavior was for this reason or that reason (you know, desire for item or activity, sensory, attention, escape/avoidance), but really at the heart of all of it was communication. I can look back on many things in the past and kick myself for not seeing it. And then the absolute chance that I saw that facebook picture- it changed his life. I don't even know the page that had it- so if you know of the page that has a picture like that please tell me. I owe them my life, and Kreed's. I'm still in shock at the difference. He just needed more arm support. This quote:
reminds me of what its been like for Kreed. It's not that he didn't want to communicate. It's that he actually physically had trouble with his hand and arm and moving it correctly and steady to type what he wanted. And with his Dynavox T10, a whole new world of things were at his fingertips and he was able to more fully communicate, including mastering yes/no in relation to questions- which gives him a huge world he can communicate with and tell us exactly what he wants. It's all amazing to us and we have to go back to the drawing board on teaching him! We are so thrilled and I am so proud of him for sharing his thoughts with us. It's an amazing journey right now and we film all of it to show others what it can be like with persistence and determination and not quitting on your child. Six months ago Kreed was raging so bad he had bruises all over his body, as did I, he stopped using his communication device, he was hurting himself dozens of times a day and had to be restrained much of the day which was physically exhausting. I didn't take him in public anymore because he would just rage. Fast forward six months later, he went to Best Buy with me for two hours- no shopping of his own, but talked to me the whole time about what he was thinking with his device, he goes out with me every day for anything, he communicates all day long and rarely hurts himself and there are always clear cut reasons. Amazing. He gives me so much hope.

Saturday, December 21, 2013

Communicating with device while watching movies!

Every so often I like to post tips on how to communicate with your kiddo while they are doing an activity. Today's is while watching a movie! Kreed is in therapy and makes a lot of progress, but he makes the most progress at home, taking what therapists have shown him or taught him and integrating it completely into his life. We expand on Kreed's language with his device at home in a variety of ways- such as watching a movie! 

Kreed has been nonverbal since he was three years old, so we've all gotten pretty good at reading the signs of what Kreed wants etc. But since he has had a device we "play dumb" in a way and instead of just instinctually knowing what Kreed wants, he has to use his device to tell us. So that means telling us what movie he wants to watch and then telling us about it.

There are some really quick and easy ways to get kids like Kreed (or even verbal kids!!) to communicate and learn language for a given activity that you often find at home, such as watching movies. With Kreed, he has to tell me to turn the TV on (or ipad) etc. Then he has to use a sentence or phrase and tell me WHAT movie he wants to watch. Generally after that it goes on etc. However, at some point I will normally ask him other questions such as WHO his favorite character is, how they FEEL or if he LIKES the movie or not. These are such fast and easy ways to get your child to undrestand concepts such as like/dislike or picking out the emotions in other people or characters. Most people think it takes hours for you to sit with your child with their device, but really, all of these clips below took three minutes or less! It's that fast and makes such a lasting impression.

Kreed used to be a child who threw massive tantrums, bite himself, hit everything and everyone, throw everything (literally- everything!) and everyone walked around on egg shells around him. While he still has his moments, for the most part he is super awesome, very communicative and his goal is no longer destruction and  chaos, but simple to learn to communicate his wants and needs with his device, and lately, more conversational language with it. And most of this has been accomplished with just a minute here or there- not hours upon hours sitting in front of Kreed with his device. We have a life and we fit how to use his device within that life.

Here are a few clips showing what I mean!

Tuesday, December 17, 2013

Strategies for Conversation at the Grocery Store

All over the internet I see different therapy strategies to get kids to communicate. However, what I see less of is telling parents how then to naturally incorporate it into their child's life. We do this with Kreed every single day. Probably an advantage of living with a behavior therapist! We use every moment we can as a teachable moment. As I said in my last post- sometimes all you need is 1 minute to do this! Here are some very basic strategies to  generalize language for your child. Although this is tailored to kids and adults using an AAC device, this can work for verbal kids to as a way to increase their language and answering questions.

1. Ask the child WHERE you are going

2. Use a visual grocery list and ask the child WHAT you are going to get

3. Ask WHO is going on the trip

4. Allow your child to also help retrieve items so there is also RECEPTIVE understanding.

These are fast an easy ways to reinforce basic WH questions your child may learn in therapy and begin to understand real life aspects of going to the grocery store.

We do this often for Kreed in different ways. Here are some videos highlighting this, although not always specific to grocery store- sometimes I'm asking a WH question about other places as well, but you get the general idea. Each of these moments takes maybe a minute or two! Thinking about implementing all of this does not take much time at all. Normally I'm asking him these questions right before we leave and I might re-ask just as we arrive at the store and maybe some time during the store. But again, these are not ten minute lessons. Most of this is LESS than a minute long!

I really hope this helps to illustrate how to carry over things your  child may learn in therapy but even more, how you can just use a device or language in any way at home with your kiddo. These are short and fast ways to increase your child's language and ability to answer questions!


Thursday, December 12, 2013

Saying more with less time...

When I talk to other families, I find that most don't know how easy it is to implement devices at home in most situations. Especially families who are getting a device for the first time- it seems overwhelming at first. That's why I started shooting videos of Kreed that are a minute or less- showing how fast you can have an interaction in just a minute! Take this 45 second video:
 A lot of what we do with Kreed is in short bursts. We take opportunities as they come. Everyone has so much to take care of day in and day out, but these short couple of seconds or few minutes can be worth so much to your son or daughters life when they are using AAC to communicate. Unlike you and I who can always say what we want and when we want it, our kiddo's are forced to wait for the right time or have to be taught what language to use in what situations.
This is perhaps the main reason we use Kreed's device in every situation- he has to be taught how to use the language on the Dynavox in any given situation- from asking when the cookies are done (instead of opening and closing the oven a billion times) to requesting for me to go get his Ruffles and water versus handing me a plate and a cup. I have to teach Kreed to have purposeful language.

So I try to tell families, just take these thirty second bursts ot a minute to have these nano conversations. Our kids rely on us 100% to communicate and I find it only fair that I try to expose Kreed to as much language as possible with his device. This is why I love the Dynavox T10- his device- it has so many phrases pre-programmed, I have to do very little programming outside of what they have which has been wonderful. And if I do have to program anything, it takes like half a second, so we aren't losing valuable time having to program the darn thing! And the phrases they selected for them to use is un-matched. It has catapulted Kreed's language way ahead. All of this progress! And it makes these mini conversations super possible! For more video's on Kreed using a device, head to his youtube- . Here are a few more snapshots of short clips that are easy to incoprorate at home. 

What are ways famlies can integrate devices in their every day life?
- During meal time- asking for more, saying all done, telling what they want to eat
- During car rides- what song they like, if they want the window up or down, answering wh questions about where you are going and what you are doing
- At stores- using a grocery list, talking about what you are going to buy, what they want to buy, where to go in the store
- At a department store- where they want to look or go, what they want, using a store list, talking about things you see at the store
- At the park- requesting where to go, what to do, commenting about activities at the park
- Watching videos- Wh questions about what they are watching, requesting movies, requesting to stop, play, eject, a different movie or episode, if they like the movie or don't like the movie

I will continue to add tips!!

Tuesday, December 10, 2013

First time initiating conversation in 16 years

Kreed has been using a device for about two years now. In that two years he has made incredible progress. We now know pretty much at all times what he wants and what he needs. That is a huge step in the right direction. However, we wanted to move beyond simple requesting. Kreed has always been expressive with his body language and facial expressions, however, this has not translated into actual conversation before. 

Since he has had his Dynavox T10, for about a month now, his language and communication ability has had an incredible leap. He has told us what his favorite song is, things he likes to do, if he wants us to change a movie and even use more language to ask for the things he wants. However, he really still wasn't asking questions or having a conversation with a communication partner. His language was ME focused. There wasn't a whole lot of other people factored in, except to get him stuff!

Until last Sunday. When for the first time in 16 years Kreed wanted to ask another child if they saw a particular movie. Kreed was at the park with his speech therapist and two daughters. She brought them along to see if we could start some social. For the most part he ignored them. Then at the end of the session he stopped in front of the cars and turned toward Haley, the youngest daughter. He lifted up his device, went to his movie section and hit a movie and then stared at her. We were caught off guard! I quickly went to see what question he could ask her and so I prompted him to add "did you see that." She took the ipad with the companion Compass app and replied to him. He grinned so huge and quickly went to look for another movie to ask. This went on for about fifteen minutes. He would find a movie, I would prompt him to ask the question and she would respond. It was beautiful. And Kreed couldn't have been more thrilled.
Kreed is proof positive that learning never stops no matter how old. We have worked for a long time to incorporate more language, but it wasn't until he had the right communication software and the want to communicate more. Persistence pays off.

Here is a video that was clipped together of what happened.

In fact, today Kreed opened the oven to look at his sugar cookies and asked me "Is it done yet?"!!! Then when his buddy Bill came over, he looked at him and said with his device "can we go bowling today?" How amazing is this? It's like he finally realized conversation could be a two way street! I can't wait to see what else he has in store for us!
Here is the video of Kreed asking about the cookies!

Friday, December 6, 2013

Kreed these days...

Well, I've done a very bad job of keeping up with Kreed's blog. I am going to try and change that and make Kreed's blog central station. Just a few months ago I created Kreed's World and all it's various social media, never knowing it would become a thing. A lot has happened in Kreed's World in the last few months as well. I started all of this also when he was nearing the end of a medical journey. Which basically took a kid from looking like this:

To looking like this:

What an incredibly journey. I write about it more in past posts where we first figured out it was no just behavioral, that maybe it was seizures. Then we saw it wasn't just seizures and we thought maybe it was low blood sugar. We were correct on his plunging blood sugar levels but not the reason. Here were a few of his levels:

First everyone thought seizures. Then we went to his genetic doctor (for his various issues plus metabolic disorder) and Endocronologist (due to his hypothyroidism) to try and find answers. Both were intrigued and wanted to run a bunch of tests. Basically looking for a shot in the dark. His Endo came up with the winning goal. His cortisol level was wicked low. No where near where it should have been. Alas we had an answer- cortisol does a lot for your body including keeping blood sugar fine, as well as helping your body manage stress. So for who knows how long Kreed was not able to deal with stressors like you and I and he had plunging blood sugars. The whole thing breaks my heart. Anyhow...he is diagnosed with an ACTH Deficiency, which basically means his body does not make cortisol correctly or in enough amounts. Very similar to Addison's Disease. The cause is not sure as of yet. There also still may be both underlying mitochondrial issues and nerve damage. We are still searching for all the answers.

All we know is that once Kreed started cortisol replacement with hydrocortisol...he was a different kid. Back to being happy. Back to learning. Back to communicating. And his communication is where I will go next.

Kreed first got the new Dynavox Compass app and within the first week he was already saying more than he had in the past. With his previous Dynavox Maestro and his other devices (PRC and others, you name it, we've tried it), the most he really ever did was request what he wanted- which left out pretty much responding to questions, making comments, asking questions and helping breakdown's in communication. The very first night we showed him the new app he giggled like a little school girl. I'm not kidding. I even have it on film. It was amazing. The Dynavox Compass software has more vocabulary and language than all the other devices combined. I'm not kidding either. Devices is also my life's work and I'm saying this. It easily takes Kreed from just requesting to commenting. I've never seen anything like it. Plus, it has all the behavioral supports built in such as schedules, timers, first/then charts and all kinds of stuff that's for another post. Kreed knew it too!

Now we've seen him comment on songs and movies he's watching. He is much more specific in asking for what he wants. But probably the most profound aspect of the new device- which he was able to get a Dynavox T10 which is their tablet stand alone device with Compass- was his ability to now cope with us telling him no or wait. Prior to his device, I would get boxing gloves ready and pretty much get ready for a fight anytime I would have to tell Kreed no. I'm not joking either- I have pictures and movies to prove it!

Now when I tell him no- he negotiates with me. He will first ask me in every way possible for what he wants and let me tell you, he can get very creative ha. Then after that I always remind him and ask him "what was my answer" and he goes and hits no. Then we will negotiate for a bit- he will ask for something and I will tell him something until we have a mutually agreed upon activity. Do you know how profound this is?? I don't think peopl realize. I could never tell him no before without a major production. Now he has a huge amount of language and actually goes back and forth with me like a regular teenager. I wish I could shout this from the rooftops because it's amazing to me.

So many things have been amazing to me, from him telling me what his favorite song is, to what he wants to eat, to how he feels at a given moment to accepting no for an answer. For some reason the software is very easy to navigate and Kreed does not have to build every single part of his sentence so very quickly he can speak to me, as if he was using his voice. So instead of saying "I want you to bake cookies" Kreed will say "cookies, you bake it." Not as grammatically correct but Kreed likes to use nouns first and then qualify it. Just like with songs he will say "Part of your world, that's my favorite." do you know how many key strokes that took? TWO. Before it would have been word for word- 7- or at least 3 (assuming one key was the whole song and the other two might have been my and favorite). I will have to make more videos showing this.

Kreed is now using his device in every aspect of his life. It's amazing. And more amazing things I think will come. For now it's late ha and I need to go talk to him about bedtime. Yes, I can actually talk to Kreed about bed time now. In the one month since he started the hydrocortisone he is now having mini conversations with us. I'm still amazed by this. I leave you with my favorite picture right now. It always brings me to tears and I can't explain why. But it's simply beautiful to me. As is he.