Tag Archives: literacy

Every Moment Can Be a Teachable One

This morning Emma asked to make pancakes.  Emma knows how to make pancakes, she’s been perfecting her technique for years.  So I said, “Sure.  Let’s have pancakes.”  Then I stood back as Emma proceeded to get out the bowl, whisk, measuring cup, pancake mix, milk and chocolate chips.  As she poured the mix into the bowl and then the milk, she said, “Pour milk.”  I stopped her and pointed to her.  ”I have to pour in the milk,” she amended.  She used the whisk to mix the batter with the milk.

“Hmmm.  You could add a little more milk,” I said.

Emma poured more milk into the batter.

A bit later Emma added the chocolate chips.  ”Are you finished with the chocolate chips?” I asked her.

“Yeah.”  I stopped her and repeated the question.

“Yes.  I am finished with the chocolate chips,” she answered.

“Then they can be put away,” I said.  Emma dutifully put the chocolate chips back in the cupboard.  After we’d poured the batter onto the grill I said, “Are the pancakes ready to be flipped?”

“Yeah,” Emma answered.

I repeated the question.

“Yes, the pancakes are ready to be flipped,” Emma said.

“Oh good.  If you want you can flip them.”  Emma picked up the spatula and flipped the pancakes.  ”You’ll need a fork and knife to eat them with,” I said, holding the plate with her pancakes.  Emma ran to the utensil drawer, got herself a fork and knife and returned to the table.

“Do you have everything you need?”  I asked.

“Syrup!”  Emma cried.  But again I held her back and didn’t let her run to get the maple syrup.  I waited.  ”The maple syrup is missing,” she said.  ”I need to get the maple syrup!”  She ran off to get what Joe calls “liquid gold” because here in Aspen, maple syrup is more than twice the cost of maple syrup in New York city.

We have been working with Dr. Marion Blank for almost a year now.  The literacy program Dr. Blank created specifically for children on the spectrum is but one part of a larger piece, which includes helping Emma navigate the rocky terrain of language and speech, something that is often difficult for children with autism.  The above is an example of insisting Emma use the “rules” Dr. Blank has been trying to teach us to use with her at all times.  I forget to insist on this, but it is imperative that we do so for optimum progress.

For more on Emma’s journey through a childhood of autism, go to:   Emma’s Hope Book

An Epiphany

I was thinking about progress, Emma’s specifically.  Through the literacy program we embarked on just exactly a year ago now, Emma is reading and writing in full sentences, we are also working on comprehension.  Her language is beginning to change as a direct result of all of this work.  As I was thinking about this yesterday, I realized something that probably seems obvious.

Drum roll please.

If Emma continues to make the sort of progress she’s made in the past year, we have nothing to worry about.

(Richard is yawning right about now.  He has maintained this for years and continually reminds me of it, but when he says it, it seems hard to believe.  Okay, now he’s rolling his eyes and probably has walked away.)

I know this may seem like less an epiphany and more a random thought that anyone who’s been reading this blog will have come to, and probably quite a bit sooner than I have.  But here’s the thing.  Sometimes I am just too close to it all.  I’m in the trenches, working with her, everyday, observing and noting.  But pulling back, taking the longer view, seeing Emma from a distance, well, it’s just much harder for me to gain that perspective.  Whenever I am able to and do though, I can see how far she’s come.  I am filled with excitement with her progress.  And yes, it feels as though I’ve had an epiphany.

Unfortunately I have a short memory.  So it’s important I write this down.  Maybe I’ll even remember to reread this post some day when I have forgotten and am feeling discouraged again.

On April 9th, 2011 we began her first literacy session.  We began with the word “sit.”  Prior to that we had worked on letter formation and sequencing with colored tiles.  From that day in April, Emma is now writing sentences in answer to questions such as – “What is this?”  ”What is she doing?”  ”What does she want to do?”

This is a sample of Emma’s writing answering those questions from this morning’s “literacy session.”

For more on Emma’s journey through a childhood of autism, go to:   www.Emma’s Hope Book.com

Emma’s Literacy

Today Emma wrote the following sentences:

It is a good visual reminder of how nicely she is progressing.  After she wrote these sentences she became frustrated with two longer sentences she was suppose to remember and write.  I finally had to break them down into smaller pieces.  We then worked on reading comprehension.  The idea being – it won’t matter how well she reads if she cannot understand what it is she’s just read.  Like many children on the spectrum, Emma has a tough time saying what a story is about.  So we are slowly trying to build a foundation for her to be able to do so with increasing ease.  At the moment it remains very difficult for her.

Yesterday and this morning have been hard for Emma.  Her routine was interrupted, I spent a good part of yesterday cooking, we had guests for Thanksgiving and though Emma loved having family and friends over and sitting with us at the dinner table, I think the disruption proved tough.  She’s been out of sorts, a little crankier than usual.  This morning she kept insisting she go to the Central Park zoo and the big carousel; all things Richard did with her yesterday.

I never know what the reason is for her steps backwards, particularly when we can also see her many steps forward.  I keep hoping things will just move forward with no steps back, but this is unrealistic.  I know.  I have to keep my eye on the bigger picture and not get weighed down with the little daily upsets.  As we worked together this morning we had to stop several times as she became too upset to continue.  Her frustration is in glaring evidence during these moments.  She clenches her fist, hits her legs or pinches herself, so we had to stop each time and wait.  I understand how frustrating it must be to not be able to make the words come out right, to not be able to retain a seven or eight word sentence, to want to give up.

“We have to keep trying, Em.  I know it’s hard, but you can’t give up.”

“I know,” she said, nodding her head and looking sad.  ”I know.  We have to do it again.”

“That’s right, Em.  You’re doing great.”

“Last time.”

“We’ll do it until you get it.”

“Okay.  Last time.”

And then she did it perfectly.

For more on Emma’s journey through a childhood of autism, go to:   www.Emma’s Hope Book.com

Words

Yesterday morning while I was setting up my materials for Emma’s literacy session, she looked over and said, “Today we do the word see.”

“Yes, Em.  That’s right!” I said.

She came over and pointed to the word “see” and said, “Yeah.  This says see.”

She was absolutely right.  The word on the page did indeed say “see.”  However the truly surprising thing was we have never worked on this word before nor to my knowledge has Emma been shown the word prior to yesterday.  Dr. Blank has maintained on a number of occasions that Emma knows much more than she lets on and while my heart soars whenever Dr. Blank has said this, I am also aware of a tiny doubting voice questioning it.  I try hard not to give that little voice much credence and am usually successful in not paying attention to it.  Still it’s always lurking somewhere in the background, no matter how often I try to shut it up.

During her literacy session Emma stumbled over the words “who” and “what”.  These are both, what Dr. Marion Blank describes as “noncontent” words (all the words that are not nouns, main verbs, adjectives and adverbs) and both are words we have worked on before.  Dr. Blank, in her book – The Reading Remedy: Six Essential Skills That Will Turn Your Child Into a Reader – writes, “Noncontent words are all the little words of our language that do not appear to have any direct meaning unto themselves.” She goes on to explain, “Although they may be difficult to define, the noncontent words are the glue that binds the content words together.”  Without these words we cannot effectively communicate.

Emma shows knowledge of things that surprise me and then doesn’t seem to remember other things we have studied, so it is inconsistent.  But what I keep coming back to is – it is much better for me to approach my interactions with Emma assuming she does know and can understand than to underestimate her abilities and therefore limit her with my own preconceived notions of what she cannot do.

For more on Emma’s journey through a childhood of autism, go to:   www.Emma’s Hope Book.com

Literacy, Diets, Progress

Dr. Marion Blank has written a terrific piece for the Huffington Post regarding the 60 minutes segment on APPs for autism and the current ways in which language is taught.  For anyone with even a passing interest in language or autism, I encourage the reading of it.

An update on Emma, her diet, her progress:

Emma ate about three tablespoons of chicken and brown rice two nights ago and tasted the pumpkin mousse I made.  I will attempt to make coconut milk whipped cream this evening in preparation for our Thanksgiving feast.  I want to have several things Emma might like, so I am planning to prepare Maple Syrup glazed Turkey, roasted carrots and sweet potatoes and some kind of desert she might enjoy (she didn’t love the pumpkin mousse or pumpkin scones, so I’ll try some other recipes) as well as things the rest of us will enjoy – we are having between 12 – 15 people, many of whom are bringing things!  I am thinking of writing a cookbook entitled All The Delicious Things I’ve Made That Emma Won’t Eat.

I worried the other day (someone pointed out that I am always worrying about something – I blame my mother for this – she is a known worrier, plus I’m a New Yorker so there’s no hope for me) that Emma is just as rigid now as she was before the diet.  Instead of only eating six things, all of which were dairy or wheat, she now eats six other things, but as Richard pointed out, at least they aren’t dairy and wheat.  I think my expectations were high (they tend to be) when we began the diet; I had read in many cases the child, once off dairy and wheat, expanded their diet dramatically.  Don’t get me wrong, it is wonderful to see Emma eating brown rice and roasted chicken.  In fact it’s a huge achievement on her part.  I’m taking a deep breath now and will bask in the glow of brown rice and chicken.

Okay.  Now that I am filled with gratitude, to continue -

To date we have seen no identifiable cognitive or behavioral progress as a result of this diet.  We see her doctor in another three weeks.  I am still hopeful we might see something by then.

We received a report from her school that Emma threw a chair across the room on at least two occasions and pulled one of the TAs hair.  Obviously this is not good news.

Another deep breath, focusing on the joys of brown rice and roasted chicken.

For more on Emma’s journey through a childhood of autism, go to:   www.Emma’s Hope Book.com

The Diet

It’s been a month.  Last Monday I wrote that it had been four weeks and two days, I was wrong.  It just felt like it had been a month.

One month ago, on October 16th we began Emma on a GF/(modified) CF/ soy free and a great many other free diet.  This is our second go around with this diet.  The GFCF diet was the first thing I did when Emma was still two years old, to no noticeable change.  However, that first time she began eating a great deal of soy – soy yogurt being her favorite.  I was working with a DAN doctor at the time who tested her for hundreds of foods but never said anything about all the soy she was eating.  So after three months we took her off the diet and again saw no change.  This time I’m working with a naturepath/physician who also tested her for hundreds of foods.  This time, the list of foods to avoid was much longer than the first: cocoa, corn, potatoes, chicken egg whites, all red skinned fruits and vegetables, bananas, peanuts, onions and garlic.   Emma did not test negatively for wheat, but he advised we take her off it anyway, just to be safe.  Oddly, she also didn’t test negatively for sheep and goat’s milk, so we’ve allowed her to have sheep’s milk cheese, sheep’s milk yogurt and duck eggs.

Still we have witnessed very little change in Emma.  We’ve grown used to this.

I keep thinking I’m going to find something, something that other families have tried with significant results, but so far, other than Emma’s literacy program, we have not.  It’s frustrating to try various things and see little, if any, change.  As I’ve written before, we think we are seeing an increase in physical affection, but it’s hard to say this with certainty.  We have definitely not seen a profound change of any kind causing us to feel without a doubt that this diet has done anything.  Still I will give it more time.

Why some of these interventions work for some children and not others is something that’s been debated for awhile.  Why is it some children are mainstreamed after a few years of intensive 40 hour a week ABA, yet for children like Emma, they were not helped?  How is it that some children go on a GFCF diet and within days are transformed from a screaming, frustrated, incoherent child to one who is speaking in full sentences, playing with toys in an “appropriate” manner and displaying a never before seen curiosity of those around them?

It is easy to blame oneself, but I don’t believe that is the answer.  I know of too many cases where the parent has tried a great many things only to find their child did not respond.  I wonder whether it is the children who do respond, who are the exception.  While this thought depresses me, I have to wonder whether it isn’t more accurate.

For more on Emma’s journey through a childhood of autism, go to – www.Emma’s Hope Book.com

Preventative Measures

The New York Times published a piece in August of this year about the role the environment plays in the rise of autism.  It begins with the question asked by many people who are hoping to become parents  - What can we do to decrease the risk?

I have often thought about what I would have done differently, knowing what I now know.  There are a number of things, things I didn’t know to do or not do when I was pregnant with Emma.  There are a few things that appear to have some scientific basis to them, such as taking prenatal vitamins at least three months before getting pregnant and continuing to take them for the duration of the pregnancy.  I began taking them when I learned I was pregnant with Nic, though interestingly, with Emma I was taking them before I became pregnant with her and continued throughout the duration of my pregnancy.  I would not have eaten any fish of any kind during any part of my pregnancy.  I ate grilled swordfish a couple of times in my second trimester with Emma.  I also used fingernail polish remover a couple of times and had my hair highlighted once during my third trimester.   I would have stopped using all artificial sweeteners and I would have been more careful after the 9/11 attacks by not going downtown to Richard’s office in Soho to work.  Beyond those incidences, I did not take any drugs of any kind, not even aspirin, I didn’t consume caffeine or alcohol, I did not have an amniocentesis, avoided all and any invasive procedures, had two sonograms and gave birth naturally in a birthing center.  It seems unlikely that anything I did while pregnant contributed to her autism, but who knows?

After giving birth I would have done a number of things differently.  From the moment she took her first breath I would have eliminated all onion, garlic, dairy and wheat from my diet while I was breast feeding.  During those first few months when she was so uncomfortable and “colicky” I would have kept a food journal to see if there were other foods I was consuming that upset her and then eliminated those.  Since Emma seemed so uncomfortable when I breast fed and much preferred drinking breast milk from the bottle, I would have tried different techniques in swaddling her or having some sort of soft cloth between us so our skin to skin contact wasn’t so uncomfortable for her.  I would have started brushing therapy (click link for more detailed information on brushing) with joint compressions (see link for a detailed description of joint compression exercises) during this period as well.

Then there are the things I wish I had done much sooner such as  Dr. Marion Blank‘s literacy program instead of all those hours spent doing ABA.  I wish I had discouraged Emma from sucking her thumb.  I would not have introduced corn, soy, wheat, dairy or any foods that are thought to be problematic for some children.  I would have obtained an evaluation much sooner as well as taken her to a neurologist and had an MRI done before she was 18 months old.

Had I done all of those things, would any of it made a difference?  Except for introducing Dr. Blank’s program right away, which I am convinced would have made an enormous difference, who knows?  How much of a role does the environment play?  How much is due to genetics?  I have questions, lots of questions.  None of which will likely be answered any time soon.

For more on Emma’s journey through a childhood of autism, go to:   www.Emma’s Hope Book.com

Emma’s Story

This is the story Emma made up and wrote this morning before she went to school.

I had to give her support a couple of times when she would say a word, such as “the” or “to” but then would forget to actually write it and wrote the next word (always a noun or verb) instead.  According to Dr. Marion Blank, the woman who created the literacy program we have been using with Emma for the past nine months, children on the spectrum dislike non-content words.

Emma then took her story over to her dad and read it to him!

We first met Dr. Blank almost a year ago now.  Before that first meeting we both read her book “The Reading Remedy” and were impressed by it.  In January of 2011 we began implementing her program with Emma.  During those first few months we worked on the beginning of letter formations and sequencing.  In April Emma was able to form all the letters of the alphabet and we began the first level of the literacy program.  Over the last seven months Dr. Blank has added other elements to the program, specifically designed for Emma so that we now are working on a spoken language program in conjunction with the literacy piece as well as the Phonics Plus Five and Reading Kingdom programs.

For more on Emma’s journey through a childhood of autism, go to:   www.Emma’s Hope Book.com

Amanda Boxtel

Last night Richard and I went to a launch party here in New York City of Ekso Bionics with a live demonstration by Amanda Boxtel.  Amanda was in a skiing accident over 20 years ago, which left her a paraplegic.  For more than two decades Amanda has lived her life from a wheel chair.

This photo is out of focus and does not do Amanda justice.

Amanda demonstrates the power of Ekso Bionics

This quote is from Amanda’s website.

“Imagine wanting something so badly for years and years—fluctuating between acceptance of what is and hope for something better.  Imagine if that one thing you longed for is to stand tall with your legs supporting your full body weight, and then taking your first step.”

When we took Emma to Costa Rica for her first stem cell treatment, fluid seeped from her spine into her blood stream.  Suddenly she was in excruciating pain and Richard and I were terrified.  Amanda wrote me and her letter, one of many I have kept, was a calm voice of strength and reassurance.  Amanda has been to India six times for stem cell treatments.  She is an inspiration and source of hope for all.

Watching Amanda stand and then walk last night was a visual confirmation of what is possible in this world, if we never give up.  I think of Amanda often as I work with my daughter, Emma. Writing is difficult for Emma, it does not come easily.  But then walking does not come easily to Amanda either and yet she has never allowed that to slow her down.

Emma’s writing from this morning

For more on Emma’s journey through a childhood of autism, go to:   www.EmmasHopeBook.com

On the Spectrum

I was asked recently why I am trying so desperately to overcome autism.  It’s a valid question and it made me think about the challenge of writing about one’s child in a way that honestly captures that child with all their complexities.  A week or so ago I wrote in my post entitled A Cure – “Emma cannot function in our world, she is not mainstreamed, she cannot take a shower, wash her hair and dry herself off without support.  We are not discussing nuances here.  We are talking about a child who is more than “quirky”.  My husband, Richard and I love quirky.  Quirky is GREAT!  We’ll take quirky.  But that’s not what Emma is.”

To me, that summed up why we continue to search, why we continue to try various things, but it does not adequately describe Emma.  Emma cannot function in our world without hands on support.  We cannot have a conversation with her or ask her questions.  I am still trying to capture Emma on video and post some clips on here, but haven’t had the time to do that yet.  The question I began this post with, made me realize that for someone reading this blog they cannot know her through my writing.  Perhaps one gets a sense of her, but there’s too much left out, too much I don’t think to mention, the cadence and inflections of her speech, the words, which I can understand, but which may not be understood by someone else.  I try to give an accurate portrait of her, but in the end, it is just that, an interpretation and not representative of the whole.

When we first received Emma’s diagnosis I was determined to find a “cure”.  I felt sure that I would find one too.  (Hubris?   Arrogance?  Ignorance?  Stupidity? Denial?  All of the above?)

After those first few years I realized I might not find a cure for what ailed Emma.  And after another few years and three trips to Central America for stem cell treatments under our belt, a “cure” seemed more and more elusive.  I have come to accept that.  Perhaps more importantly, I am less focused on the miracle of a cure and more focused on pushing Emma to expand her world.  There’s a balance we have tried to achieve with Emma.  We try to follow her lead whenever possible, but we also encourage her to stretch and do things beyond her comfort zone.  Our most recent attempts to expand her diet is a case in point, her literacy and math program are another.

Which isn’t to say that I don’t continue to research and do everything in my power to find treatments to help her.  I am convinced Emma’s digestive issues are exacerbated by her environment – the foods she ingests, the air she breathes, the water she drinks.  This Friday I am taking Emma to a doctor who has worked with hundreds of children on the spectrum.  He and I spoke on the phone yesterday for over an hour, going over her history, her GI issues (inflammations and ulcerations), chronic constipation, recurring strep throat, porous teeth, cracked heels and limited diet.  While a few years ago, I would have eagerly anticipated this appointment with the same degree of excitement the devoted view a visit from the Pope, I no longer do.  I have come to see all of these people, no matter what letters may follow their name, with tempered interest.

Last week Emma’s school bus matron told us Emma refused to buckle her seat belt and when the bus matron tried to help her, Emma kicked her hard in the chest.  We immediately went over with Emma the behavior we expected from her.  We rehearsed buckling her seat belt and made sure she had her ipod and ear buds with her so she could amuse herself once she was seated.  We went over the importance of not hurting another person.  We tried to consider what sort of support she might need to help her control herself.  We are lucky in that Emma seems to have understood and has not struck nor tried to get up from her seat while on the bus since.

As we waited for her bus this morning, I coached Emma, “Emma, it’s nice to say good morning to people.  She’s a nice lady and saying – Good Morning – will make her smile.

When Emma boarded the bus this morning she said, “Good morning, nice lady.”

The bus matron beamed.

There are many people with an autism diagnosis who are on the “mild” end of the spectrum or fall in the “gifted” category of Aspergers or are considered “high functioning”.  These children are often mainstreamed or learning at grade level or above.  And while they have tremendous hurdles, often requiring support into their adult lives, they occupy a different level of hurdles from those who, like Emma are moderately autistic.

I had a friend whose child was unable to walk or even lift his head.  He, too, was diagnosed with autism, though severely so.  That child faced developmental and physical problems far beyond anything Emma has had to deal with.  For me to compare the two would have been ludicrous.  At this point my goal is to get Emma to a higher level on the spectrum.

For more on Emma’s journey through a childhood of autism, go to:   www.EmmasHopeBook.com