Wednesday, January 18, 2012

Art Show!?

I hope Sunshine's SLP knows how lucky she is.

I made the huge mistake this morning, at 8am, of telling Sunshine that her SLP, Michelle, would be here today. What I didn't tell her, as she's only 2 and has no way of understanding, is that M wouldn't be here until 1045am, so instead of thoughtfully giving my child a preview of her day, I caused endless stress and anxiety, because, no, she's not here yet.

"Artshow?" It only took an hour to figure out that she didn't mean she wanted to watch Yo Gabba Gabba's "Art Show" episode, which she did get to watch because "artshow" only sounds like "Michelle" if you're a really drunk, which I was not.

"Ohhhhh! Michelle?! You want Michelle?!"
(This is a Big Deal, as she doesn't really ask for anyone, ever.)
"Artshow! Toys!"
"Yes, Michelle brings toys to play with you!"
"Elmos!" (She gets plurals. It's really cute.)
"Yep, she'll have Elmos for you to play with!"
"Yes! Michelle will bring puzzles!"
"Umm-hmm. Michelle is coming to play with you!"
"Yes, Michelle is coming to play with Sunshine. Very good."
"Fah? Floor! Yes, Sunshine and Michelle are going to play on the floor!"
Lather, rinse, repeat, for nearly three hours.

Michelle came and went. Sunshine played very happily, and only shut down for a tiny bit about halfway through the hour. She really doesn't like being pushed to talk. It's only her third session, but she's starting to grow bored of the toys already, and is getting a little resistant to constantly having to "put your lips together!" to produce p/b/m sounds.

She has p/b/m, which are very early sounds, but only in certain contexts. She can say "mama," "poop," and "boo-boo" as clear as a bell, but whenever there's a long a, e, or i after the p/b/m, she usually switches to a d/g/k sound, but sometimes to a "shu" or other sound. So "pee-pee" is "kee-kee," "baby" is (currently- "baby" changes a *lot*- it was "ashee" for the longest time) "aye-kee," and "me" is "nee."

*I* suspect apraxia, which is why we got the neurology referral. I mean, my doctorate is from Google U, so I have no idea what I'm talking about 99% of the time, but from what I can see, she has a lot of red flags for childhood apraxia of speech. In a nutshell, CAS is neurologically based- the brain knows what it wants to say but can't correctly tell the mouth what to do. It's a motor-planning problem, kind of like dyslexia of the mouth area. (There exist both oral apraxia and apraxia of speech- usually you can have just verbal apraxia and not oral, but if you have oral, you almost always have verbal apraxia, too.) See, my kid's so special and perfect that she can't *possibly* just have a general speech issue; she has to have a fancy rare thing, because she is such a special, unique snowflake. Yes, you can all roll your eyes in my general direction. I'm pretty insufferable.

She was a late babbler, and was never chatty once she started- "quiet baby" is an understatement for her infancy. She often says words seemingly inside-out: "dada" first was "ahda," and "flower" was "uhfuh." She has really inconsistent consonants and vowels- "nose" is anything from "nose" to "news" to "nuhse," all in the same day, and car will be anything from "cah" to "fah," to, as it is today, "fuhm." She can't imitate facial expressions, lick her lips, pucker her lips, puff her cheeks, wiggle her tongue, or bite her lip (though these could all be due to oral-motor weakness, which is different than motor-planning.) She had a lousy latch all through her 11.5 months of breastfeeding and only just learned to drink from a straw last week. She has very limited facial expressions in general. She pauses a lot between words, and her pronunciations break down dramatically when she tries to string more and/or longer words together. The phrases she has solid, like "all done," or "it's okay," come out quickly and smoothly, but newer phrases are very stilted. "Mama. (pause) Help. (pause) Sunshine." She's still really echoy, and new things she overhears and repeats tend to come out clearly, but when she uses them again on her own, they're often muddled.

Michelle thinks it's more of a motor weakness issue, so we did a really half-assed little test to see if she'd allow us to bribe her into making some nice mouth movements. Nope. She wanted that lollipop alright, but still couldn't pucker her lips, lick her lips, or wiggle her tongue. It wasn't surprising, but it wasn't terribly good science. Sunshine drools a little bit more than she should at her age, and has an open bite, probably due to her heavy pacifier use at bedtime and naps. Those things are usually more indicative of motor weakness than motor planning, but, my Google U degree and $5 will get me a cup of coffee.

We really don't know what's causing her speech issues. It could be any number of things, and it could very easily be something that we'll never know. Artshow will need to spend more sessions with her to see what works and what doesn't. She's already picked up on the lack of face-checking Sunshine does, and has adjusted her play style accordingly, bringing desired toys up to her mouth to get Sunshine to look at the way her mouth is shaped.

Aaanyhow, she gets fed up working those bilabial sounds (b/p/m, for those of you just joining us) and quits quickly when she's asked to say a CV (consonant-vowel) combo that she doesn't have. "Ba-ba-boo" is fine. She'll say that all day. "Ba-ba-bee" is met with a very firm "ALL DONE."

Overall, she's doing great, though. She's cheerful, cooperative, and tries very hard. Artshow says she's at the top of her caseload in terms of overall speech, though, which is wonderful. I mean, someone's got the kid who isn't doing well, and as dickish as it is, I'm glad it's not me.

So Sunshine enjoyed her 60 minutes with Artshow today, and I thought that would be the end of it. But, no. She woke up from her nap asking for Artshow, with her precious Elmos and Pig and Pegs ("Elmos," "Tig," and "Tigs," of course.) By bedtime, she would ask for Michelle, then pause, and you could see the little lightbulb start to glow- "keek!"

"Yes, Michelle will be here next week."



Tuesday, January 17, 2012

Zoloft and Me

I've been on Zoloft for nearly 3 months now. I started taking a tiiiiny dose when Snowflake was a few weeks old, as I was feeling a little post-partum depression-y. Not like depressed, but just angsty and moody and yelly and anxious.

I started on 12.5 mgs a day, which is a really small dose. I'd read a lot of stuff that suggests that for people with obsessiveness, compulsiveness, anxiety, and mild ASDs that micro-doses of SSRIs can be of great help. Zoloft is the only SSRI that's really safe to take while nursing, so I gave it a try. It really helped level me out just a little.

I bumped up to 25 mgs a day a month or so ago. It's not considered a therapeutic dose, but it's had a remarkable effect in curbing my obsessiveness. I no longer feel driven by an outside (inside, I guess) force to research, study, or build things. It's nice to have a quiet brain, and it's nice to not feel compelled to do things I don't want to, but it does feel very strange. I don't feel flat or like a zombie- I just feel like me without the noise.

It's unsettling to not have a project. I get stuff done, and can focus on necessary and/or enjoyable things, but I miss my busy mind. I don't like that I actually have the mental energy to think about my emotions. For example, Mr. Dad and I are getting divorced. I'm fine, and the girls are fine, and he's fine, and we're starting all this on the best possible footing. Usually, though, I'd have some project going on in the background, taking up my time and energy. Without that, I actually have time to feel things, and I don't like it. I'm not used to dwelling on my feelings- ordinarily, I can acknowledge my emotions and move on, but now, with all this surplus room in my head, they stick around a little bit longer than I'm used to.

I'm still an emotional weirdo (hence the divorce- I'm just not cut from marrying cloth) and I'm still doing everything I usually do, but I feel lost without my projects. I have become more introspective and have been trying to determine what's at the root of my emotional stuntedness. Is it really Asperger's? Is it a really odd manifestation of childhood trauma? I really don't know.

If I can get "better," and want to form meaningful relationships, that's something I want to pursue. I don't want wine, men, and song for myself, though, but for my kids. If I can learn to be more "normal" for them, I will. If it's really neurological, then there's not much I can do besides learn more healthy coping mechanisms for navigating a social world.

All in all, I'm glad I started the Zoloft. I haven't had any side effects that aren't welcome (goodbye, libido, please, never come back) and it's helped hush up my head. I'd recommend it to others with OCD/ anxiety/ ASD/ spectrumy stuff for sure, but it's not magic, and it's not a cure for much. Quiet is nice, and I'm trying to get used to it..

We'll see.

Also: Sunshine's speech is coming along beautifully and she's enjoying her weekly speech therapy sessions. Her neuro appointment has been set up for the end of Feburary. Snowflake is being a very excellent 4-month-old, even if she wants to wake up at 7am just to yammer at me.

Sunday, January 1, 2012

Things To Teach My Daughters, List #1

In no particular order:

1) It's okay to be lonely sometimes. Everyone feels lonely sometimes. It's normal. When you feel lonely, tell your brain, "It's okay that I'm lonely right now. It doesn't mean that I'm sad or lacking, it just means I feel lonely right now." Don't worry about it. It won't last.

2) It's okay to be alone. Try not to be alone all the time, though. People are pretty nice and good people.

3) Boys are more trouble than they're worth when you're young. Study hard, use all that great young brainpower, and worry about boys after college. You've got loads of time, and it'll be worse for you in the long run to start with boys too soon- there's no such thing as starting "too late." There's *always* time.

4) Only wear comfortable shoes.

5) You can tell people to clarify when you don't understand something. They won't think you're stupid, and once they explain it, you'll understand it forever. If you pretend you get it, but don't, it becomes harder and harder to learn it *cough* multiplication tables *cough* as you get older. I promise, they won't think you're dumb. Just ask.

6) You don't have to be good at everything right away. Seriously. It's totally normal to be actually quite lousy at lots of things. Every single person has at least one thing they're terrible at, one subject that they're utterly clueless about- really, honest, and truly- everyone is awful at loads of things, and it's okay. Trying your best is way more important. Try really hard and stick with it. Even if you still aren't a good dancer, artist, or whatever, that's okay. Don't just give up when it gets hard, but don't beat yourself up if it's never perfect.

7) You don't have to be an expert on everything. Really, people don't care if you don't have an opinion on something. If everyone's talking about, say, Middle Eastern politics, and you're not up on them, it really is okay to say, "This is interesting! I'm not so up on this- could you tell me more?" You don't have to speedy-quick think of all the things you know about the Middle East and formulate a very firm stance then and there. I promise. No one will think ill of you.

8) Inside your head, *feel* like you don't care what anyone thinks, but don't *act* like you don't care what anyone thinks. If someone thinks you're dressed funny, boo on them, but don't dress in a way that would cause the average person to think you're rude and disrespectful. Don't roll your eyes at people behind their backs or in front of their backs- no eyerolling, period. Well, okay, just a little. Don't tell people off, even if they've slighted you. Always be polite and carry yourself well. Don't say mean things about people. You're going to be tall, so stand up straight. People will treat you well if you act like you care what they think of you- show them that you want to be taken seriously, and you will be far more well treated than if you carry yourself like a thoughtless jerk. (You can still always wear sneakers, though. I'm okay with that.)

9) You can read books all day, but not every day. Lots and lots of days, though.

10) You don't *have* to like to read. I hope you will, but if you don't, it's okay. Perfectly smart, amazing, educated people don't really love reading for fun.

11) Most people really are pretty okay. Give them latitude before you judge them- people usually don't *intend* to be unkind.

12) I love you more than anything, and no matter what happens in your lives, you can come to me. I'm a pretty okay kinda guy, for a mom, and you can trust me.

postscript: This obviously should actually be titled Some Things I Wish My Parents Had Taught Me, or, let's be honest, Some Things My Parents Tried To Teach Me But I Was Arrogant And Foolish Thus Ignored And Also Some Things No One Ever Taught Me.