Improvements

Here are some of Kevin's latest accomplishments:

"Mommy push play" on his movie.
"I want go Grandmama house"
"Shirt off" so he could take a bath

And he retells his entire Cordoroy's Halloween book!! His retelling includes words like
"Puppy is ghost. Bear is witch. Knock Knock. Ding Dong. Candy."

He's using words more consistently when we tell him to use his words. He is able to use words under stress much better than he use to.
And he makes choices about behavior- instead of hitting, he will put his hand on my face and say "That's right. No hitting. Gentle touch." He will also tell us sometimes that he is mad.

Overall, Kevin's language now includes constant labeling, some jargon, frequent requesting, and the occasional showing. He is consistently putting together 2-3 word phrases on his own, using words together that have not previously been modeled for him.

First Typed Document

I left Word open on my computer and came back to find Kevin typing this:

AAAAAAAABBBBCCCDEEEEEEEEEEE

FFFFFFFFFFFFFFFFFGGGGGGGG

HHHHHHHHHHHHHHHHIIIIIIIIIII

IIIIIIIIIIIJJJJJJKLLLPPPQQQQRS

TUUVWWWWWWWXYYYYYYYYY

YYYYYYZZZZZZZZZZZZZZZZZZZ

ZZZZZZZZZZZZZZZZZZZZZZZZZZ

ZZZZZZZZZZZZZZZZZZZZZZZZZZ

ZZZZZZZ

Update

My most recent vocabulary listing shows that Kevin now has 200+ words, mostly nouns but some verbs and a few adjectives and prepositions. He still primarily uses his words to label with occasional spontaneous requesting. Joint attention level is still at "Supported joint engagement" with sporadic "Coordinated Joint Attention" periods. Eye contact remains stagnant at medium quality eye gaze, unless I'm working hard to maintain attention, for example during people games, and eye gaze is good. Verbal communication is still echolalic but is encouraging as he is repeating whole sentences and using some 2 word phrase delayed echolalia. Most language is perseverative and unrelated to the present situation but of the spontaneous appropriate language it is more impressive than previously noted. Play skills have improved and Kevin now demonstrates some symbolic play (specifically "doll as agent") but most play is still at the functional level. He demonstrates some splinter skills in the areas of letter, color, and number recognition and is performing well at table tasks. Overall, his recent progress is promising and reflects our efforts to engage him more often and fulfill sensory needs through frequent swimming and park visits.

Update

Kevin was in a much better mood today, with less crying and perseverations. He was content to play for almost two hours with his new toys at Grandmama's house. He initiated a game of "Five Little Monkeys Jumping On The Bed", and used his Pooh toy as a monkey, making it jump and fall upside down to bump his head. Those were some nice play skills to witness.
He has lost some skills and we continue to work on those. He is now struggling with "I want ___" and I have to draw that sentence out of him. Even with me modeling the sentence he still is reluctant to imitate it. He seemed less motivated during therapy tonight and had a harder time staying focused.

Regression

Has it only been three weeks since my last report of Kevin's new use of language? It seems like it's been so much longer since every day seems like an eternity when it is filled with the repetitive jargon and behaviors that help Kevin keep himself under control. There's no denying that Kevin has regressed yet again. The trigger is what I've been searching to identify. His food habits haven't changed; if anything he's eating less sugar and dairy. I'm excited that he has overcome his fear of the potty and will sit on it while we sing several songs. But aside from this new accomplishment, everything else has backslidden. His language is more echolalic and perseverative. He has been visually stimming and more distant, with less eye contact while speaking to me and in general. He's been hyperactive, and has trouble sleeping. The other night he was so tired he stayed in bed with me but tossed for about two hours before finally giving in to sleep. He seems to be in his usual "regression mood" where he seems so unhappy most of the day, unless he's watching his chosen movie all day. He often just looks at me with sick eyes like he wants to be happy but something inside is keeping him from being himself.

Even more progress!

Kevin continues to make progress towards his goals. He has been using "I want ____" more and often without being prompted. Once he even put two words together on his own and said "Yellow duck". And when you ask him if he wants something like a specific food, he now will say either "no" or "I want (that food)".

More Spontaneous Phrases!

Here's an update on some of Kevin's most recent spontaneous language:

• He brought Grandmama the remote and his Cars toy and said "Cars".
• Next day he told Grandmama "I want Cars" and gave her the remote.
• After a pet store visit, as we walked out of the store he waved and said "Bye animals".
• In the drive-thru he said "hamburger", then repeated "Burger King".
• He said "I want cheese".

He has been very vocal the last two days, repeating more words and saying more spontaneous 2 and 3 word phrases. He has been drinking an average of 4 cups of milk and eating cheese. He has not had a bowel movement in several days, so it seems that the diarrhea/casein link theory is not consistent.

Casein Sensitivity?

Kevin just had two uncharacteristically fussy weeks, where he was more easily frustrated, had a hard time attending or staying focused on any activity, and increased his stimming (he even started something new, wiggling his fingers against his face). These behaviors coincide with an increased consumption of dairy products. His favorite drink lately is chocolate milk, and he's been drinking several glasses a day. Also, after a big meal at Golden Corral where everything Kevin ate was dairy (macaroni and cheese, broccoli and cheese, corn with cheese, ice cream) within an hour he had the worse case of diarrhea he's ever had.

To test our theory about casein as the culprit for his behavior, we partially eliminated dairy for a few days, by cutting chocolate milk, cheese and ice cream. Although the elimination wasn't thorough (some foods could have contained casein), Kevin has gone back to his easy-going self, and has even added language and at his last speech therapy session imitated actions better than ever.

I Want Cheese

Kevin's speech therapist has been working on "I want". Today if he handed her the dog picture she'd say "I want dog" and he'd repeat it back. The whole session centered around "I want". I didn't think it had clicked for him though, because he never said it on his own but only repeated her.

Tonight he brought me a Pringles container so I said "I want chip" and he repeated it. Later he dragged me to the refrigerator, pulled out a block of cheese, and said "I want cheese"!!!

This is one for the baby book...Kevin's first spontaneous sentence!

Kevin's Boo-Boo

Poor kid got hurt...again!

Kevin tripped over the threshold and landed flat on his face. His nose bled for quite a while and his upper lip is still skinned and swollen. He's such a tough little guy though. He only cried a few minutes until Daddy offered him a hushpuppy and he forgot he was hurt.

Picking Strawberries

We joined Kevin's playgroup friends at Garner's Farm to pick strawberries. It had been raining for days so the field was soggy. Kevin enjoyed trudging through the mud so much he abandoned the strawberries for his new-found pleasures- splashing in puddles and climbing the mounds to trample strawberry plants! With Mommy as the discretionary farmer and Kevin as the bucket keeper, we quickly reached our limit and trekked back to the car where Kevin stopped long enough to pose with his bucket of goodies.