Tuesday, March 29, 2011

IEP

Today's IEP for Jordan went very well.  Derrick and I met with Karen, the physical therapist, Carol, the occupational therapist, JoAnne, the speech path, Pam, the ECSE classroom teacher, and Angie, the Director of special education. 

First, we went over Jordan's evaluation...the envelope I didn't want to open.  Each therapist gave their summary of Jordan and then we responded with our thoughts.  Overall, we agree with the report, although feel that the actual numbers are skewed because of Jordan's distractability and lack of focus during the evaluations. 

Next, we discussed that we would like to try Jordan in the ECSE classroom next year, but want to make sure that it is not too much for her in addition to the likelihood of outside therapy (feeding, OT following thumb surgery, etc.)  We are scheduling her for 3 days a week with the option to keep her home for a day whenever we feel that is too much.  We were thinking we would only send her 2 days to start and this was a good compromise because it allows us to easily transition into 3 days whenever we feel ready.  The director offered to provide an additional adult in the classroom on the days Jordan is there to allow assistance in monitoring her and helping her with some of her challenges.  This will be in place for the first 6 weeks and we will evaluate in mid-October if we need to continue that assistance.  We will also train the nurse and 1 or 2 other individuals in the fall to do her g-tube feedings and to be prepared to replace her tube if it comes out.  We requested that Jordan be removed from the classroom during snack time by the additional adult so that there is not a battle with her wanting to eat what the other kids are having.

Jordan will no longer be receiving individual physical therapy as she has no specific challenge areas in gross motor.  Karin offered to consult with us if we ever came across something that concerned us.  We will meet with her one more time before this school year is over.

Jordan will receive OT through the sensory motor group that she has been participating in during the past few weeks.  We will continue to meet with this year's group through the remainder of the school year and next year she will participate with her class.  Knowing that she may have her thumb surgery sometime late summer or fall, she will have individual OT following that as part of her rehab.  If we feel it is necessary for additional support, we will work that out with Carol at that time.

Jordan will be receiving speech at least 2 times a week while in the class.  JoAnne said that at least one of the days Jordan is there, she will be in the class for most of the time and will work with her individually or in a small group.  She will also work with her on the other day she is there ensuring that the educational focus for Jordan be on her speech development.  We are still waiting on the communication device, but are also going to attempt to create a usable picture system for Jordan that she can use when she becomes frustrated with our inability to understand her.  I am hoping to use this significantly this summer and help her to communicate with us as well as with others so she is better understood.

Transportation still has to be decided, but we requested that Jordan be picked up as late as possible due to her feeding schedule and be transported in a car seat on the bus due to her small size.  I am very nervous about putting her on a bus and always have the option to drive her myself...but final decisions don't have to be made until late August.

Overall, I feel good about the IEP.  I know that all of the therapists working with Jordan have her best interest at hand, I just sometimes feel that they are always so focused on what they are doing, that they might not recognize all that I am doing for her in our own home.  We work every day on speech, occupational, and physical therapy.  I may approach it differently than they do and don't have the educational background to support what I am doing...but I am a mom, and I love my girl, and will do anything to help her develop the skills she will need to be successful in life!!!

Final Preparations

Well, this is it...Jordan's IEP is in 2 hours.  It's early in the morning so my brain is still kinda slow. I have spent time over the past few days reading through her past IEP's, reading through info I found online, talking with and listening to other people's thoughts and ideas, and now there is nothing more I can do.

Last night I finally realized that God is in control.  He loves Jordan more than I do...although I'm not even sure that is possible!!  I believe that since the day she was conceived, she has faced numerous obstacles...some of which, other children never overcome...and yet she is here...and she is strong...and she is amazing! 

I know that over the past year or so I came to the realization that I needed to stop praying for Jordan to be able to eat, to be able to talk, to be "normal."  I started to pray that God would work inside her and make her His.  I prayed that He would use her in whatever way He needed to, not the way I wanted her to be.  I prayed that He would give her what she needed, not what I wanted her to have.  These prayers became extremely healing for me.  I no longer worried about her future, I knew that God had that in His control.

I now realized that it is okay to hurt, to grieve, and to cry the losses in our life.  But we also need to be able to get up and move on and know that it is not always up to us to determine the path for those we love.  I love my husband and my kids, but I don't own and/or control them.  I have been given the enormous responsibility of being a symbol of God in their lives, someone to lead them to Him, but I am NOT Him.  I do not hold the responsibility of making sure everything goes as I have planned...it's not up to me. 

Therefore, I lay this morning's meeting and Jordan's IEP before God.  I know that I have done everything I can to prepare myself for this meeting, and I look forward to creating a workable plan for her education, but I know that God will also be present at the meeting.  I believe that if I can just sit back and allow Him to participate, I will find that things will work out better in the end.

Friday, March 25, 2011

The Envelope...Part 2

Well, I did it.  I opened up the envelope and read the report. 

It was titled "Early Childhood Special Education Reevaluation"

I actually made it through the whole thing without a problem...the first time.  Then I went over it again, but it wasn't so easy the second time.  I took my time actually trying to process through what it said and understand it.  I think it was quite accurate in describing the Jordan I know and love and yet I was astounded at the actual test results.  That's when the tears started to flow and I kept re-reading parts of the report and test results.

The Brigance Diagnostic Inventory of Early Development, Second Edition (IED-II) is a standardized test that is used for children from birth to 7.  She was only evaluated in cognition, language and motor skills.  Her results are broken down into several subcategories, but the summary totals are as follows:
Total Motor:
     Quotient (with a mean of 100) = 56
      Percentile (same age kids score at/below) = <.1
      Age-Equivalent = 2 years, 5 months
Total Language:
     Quotient (with a mean of 100) = <57
      Percentile (same age kids score at/below) = <.2
     Age-Equivalent = 2 years, 1 month
Total Cognitive/Academic:
     Quotient (with a mean of 100) = <57
      Percentile (same age kids score at/below) = <.2
     Age-Equivalent = 2 years, 3 months

The Preschool Language Scale - 4 (PLS-4) measures a young child's receptive and expressive communication ability.  Average scores fall between 85-115.  Her results were:
Auditory Comprehension:
     Standard Score = 61
     Age Equivalent = 2 years, 3 months
Expressive Communication:
     Standard Score = 67
     Age Equivalent = 1 year, 11 months
Total Language Score:
     Standard Score = 60
     Age Equivalent = 2 years, 0 months

I was extremely confused by these answers but the more I studied them the more I realized what they actually said.  Basically, Jordan is performing at around 2 years old.  In a comparison with other kids her age, less than 1% score lower than her.  Her overall testing scores her in the area of mild mental retardation.  WHAT?!?!?!?!?

I refuse to believe these scores are an accurate representation of Jordan!!!

The actual written portion describes the Jordan I see everyday.  It describes things I know that she can do and the personality I know.  I believe that there are many more things that she can do beyond what was described but due to her "personality," she didn't complete many of the tests.  Some of the phrases that describe that are, "Jordan's lack of attention to task negatively hindered her ability to complete tasks.  She was cooperative, but easily distracted.  Jordan would enjoy playing with the toys and not respond to the examiner's directions.", "Jordan showed frustration during several of the tasks.  When attempting to turn pages one at a time, in a book, she stood up, walked away from the book and screamed.  Jordan often would flop backwards onto the floor or get up and remove herself from the testing area when tasks became challenging for her.", "When she becomes frustrated or perceives a task to be difficult, Jordan will often call out "momma" or flop down and refuse to participate." and "Jordan prefers to direct her session and shows limited cooperation with tasks that she does not choose." 

These are my everyday challenges with Jordan.

This is the Jordan that not everyone else sees.

These are the things that make me unsure what is the best thing for her. 

Again, they are recommending that we place her in the Early Childhood Special Education classroom.  They feel that "she would benefit from the daily practice to improve her communication, fine and gross motor skills throughout the preschool setting" because she "seems to benefit from imitating others in terms of follow through and trying new activities."  However, they add that she "requires visual and verbal support and multiple repetitions to improve skills that are being taught" and that "it is very important that Jordan be given verbal information with extra time to process the information and to execute the command."

Once again, I don't like that the school feels that putting her in the class would benefit her because she would "imitate others."  I understand that she requires extra time and additional support, but last year when I requested a one-on-one para pro they told me there wasn't funding available for that.  How is Jordan supposed to get that support in a class with 12 kids and 1 teacher and 1 assistant? 

Derrick and I have been leaning toward allowing her to be in the class 2 days a week with a one-on-one, medically trained professional administering her g-tube feedings and a one-on-one para pro assisting her during class "snack-time."  I now feel that they are going to push having her in class 5 days a week and I know that she needs more attention than she will receive without additional support in the classroom.

So now the craziness begins.  We are scheduled for Jordan's IEP on Tuesday morning.  That gives us the weekend to come up with what we consider to be an acceptable plan for Jordan for next year.  We plan to cover everything from how long she can be on the bus to how much one-on-one speech we want her to receive.  I guess it's a good thing we are driving up to Traverse City tomorrow...long car rides are great for conversation...well, at least as long as a movie is playing for the kids!!!

The Envelope

Jordan had speech this morning.  It seemed like a normal session.  Conner and I sat outside reading a book and we heard some talking and occasional screeches coming from her.  When they were done, Jo brought her out and said that she did okay...a few temper tantrums and threw the cars once.  She didn't get her to say the target word "water."  She did say "wa" but would not repeat it for "wawa."  It is another week of trying to target a word with her.

Then JoAnne hands me an envelope and starts to cry.  She tells me this is Jordan's report and that she's sorry.  She says that it was very hard for her to write and as her mom she knows it will be extremely hard to read.  She told me that the tests are standardized and Jordan doesn't perform well on them, but she does not view her as the scores do.

Now I'm terrified to open the envelope and read what's inside.  I know that the psychologist at the Gerber Center labeled her as between "borderline deficiency" and "dullness".  He admitted that he felt that there was more potential based on seeing her, but that is what the test showed.  I mentioned that to Jo a few weeks ago and she said that their scores were lower than that.  I don't know if I even want to read the report.

I know that my beautiful daughter is full of life and is a ton of fun and improving every day!!!  I know that I love her with my whole heart and then some!!!  I know that God has created her just as she is to serve a purpose and reflect His love.  I know that regardless of what some test says, I will never doubt the limits of my precious Jordan!!!

...but I'm still terrified to open the envelope...

Wednesday, March 23, 2011

Compleat!!!

Yesterday, I received a call from Jordan's dietitian at the Gerber Center.  After meeting with the neurodevelopmental specialist last week and mentioning that I would like to consider using a different formula than the magic mixture of 3 different ones that we have been using for 2 1/2 years.  This has been a process I have been working on since last spring/summer.

Jordan's food mixture is made up of Pediasure, Pediasure with Fiber, and Boost 1.5.  We get the Pediasure's through WIC and have to purchase them at the store (usually Meijer) and we get the Boost through Airway Oxygen.  The problem with the Pediasure is that there have been many times I cannot find vanilla Pediasure on the shelves.  I have actually driven to 3 different stores in one day in order to get what I needed to fulfill my WIC benefits before they ran out for the month.  We even tried to order it through the pharmacy and through the grocery manager and both of those efforts failed. 

I am excited mostly because it has bothered me for over a year that the only nutrition Jordan receives is from a bottle of artificially prepared liquid.  The ingredients on the Pediasure are water, sugar (sucrose), corn maltodextrin, milk protein concentrate, high oleic safflower oil, soy oil, whey protein concentrate, medium chain triglycerides, etc.  The ingredients on the Boost are water, maltodextrin, soybean oil, soybean caseinate (from milk), sugar, high oleic sunflower oil, whey protein concentrate, medium chain triglycerides, calcium caseinate, etc.  I hate that during the first 3 years of Jordan's life, when nutrition is vital for brain development, she has been only getting this mixture of ingredients.  I understand that it is considered "complete nutrition", however, in my opinion, it is not healthy.

The new food is called Compleat Pediatric and is manufactured by Nestle'.  It is a blenderized tube feeding formula made from water, cranberry juice cocktail (from concentrate), corn syrup solids, chicken puree with natural flavors (water, dehydrated chicken meat), pea puree (water, pea powder), green bean puree (water, green bean powder), sodium caseinate (milk), peach puree, etc.  I just feel so much better about giving her food that is closer to what we eat.  I know that there are still artificial and manufactured ingredients in this formula, but it is so much closer to what she would be eating if she could. 


The other nice thing is that we order it through the pharmacy at Meijer or Family Fare or other grocery pharmacies that accept WIC.  This means that I call in and order it and a few days later, I go to the pharmacy and pick it up!  LOVE IT!!!


We get her first case tomorrow and start the transition on Friday.  It will take 25 days.  Every 5 days we increase the amount of Compleat and decrease the amount of her current mixture.  We also will be able to reduce the amount of water we give her following her feeding because we will be increasing the total amount of her feedings in order to match the calories/oz that she loses from the Boost 1.5.

A Week = 7 Days

Yes, I realize that an entire week has passed since I have posted anything during this period in which I committed to blogging daily!!!  I will try to make up for it with multiple posts over the next few days :)

Wednesday, March 16, 2011

Nothing...

So, I was thinking that since we stayed home today and I wouldn't have much to report on, it would be a great day for posting some pics and videos.  Unfortunately, there was a ton of stuff to do around the house after a crazy weekend followed by 2 crazy days!!  And then, my wonderful husband took the little kids to church tonight so I could work on the taxes...it is only 4 weeks away!

Therefore, I have nothing major to blog about and I am too exhausted to stay up loading pics/videos...maybe tomorrow...

Tuesday, March 15, 2011

Another Crazy Day!!!!!

Today we started off with Jordan again joining the ECSE (Early Childhood Special Education) 3 year-old class for Speech/OT group.  She did great!  She again had difficulty sitting still and was a talker today and kept pointing to her sleeve and saying "shirt."  While she was in group, I filled out a Sensory Profile and started to fill out the forms for her upcoming IEP. 

Jordan's feeding therapy with Ellen was canceled because she wasn't in today, but they ended up having an opening with Jenny (a therapist that worked with her a while back - check out the pic in the sidebar area).  We headed over there and tried a little feeding bag that I found mixed in with baby feeding stuff.  It has a small mesh bag with a snap cover and a handle to hold.  I wanted to see if they thought it would be okay to use it for Jordan since the holes were larger than the bag we are currently using.  Jenny tried it out and Jordan did very well!!  She loved the banana and enjoyed the hot dog.  She wasn't too excited about the Doritos or the sour gummy worm.  She liked the goldfish crackers but it was too pasty and she definitely had crud in the back of her throat that didn't clear until we gave her some applesauce.  Overall, it seems like a great alternative to allow Jordan more independence in her feeding.  She will still have to be closely monitored and we have to remind her to take the bag out and swallow after a few seconds.  We found that she loved the foods that gave her the most through the bag and disliked the ones that only gave her flavors and a small amount.  I am excited to see how this works for her!!!

After that, I had 2 appointments for Mak.  I came home and threw together some dinner and had a few bites to eat and then headed out with my friend Terri to attend a group discussing healthy eating for our children.  I tried many of these things with our family last summer and they are great...except that they cost a lot of $$$!  I did get some ideas of things to consider and even found a website with information on making homemade formula to with whole, natural foods that I could possibly use for Jordan.  I have realized over the past year how much I hate having her get nothing but chemically processed fake foods.  I'm not sure if this is realistic, but it is something that I want to at least think about.

I am now exhausted from 2 crazy days of appointments...and looking forward to the next 2 days that I am home with no appointments and no van to go anywhere even if I want to!  It looks like I will finally have a few days to focus on doing some school with Conner (and Jordan), cleaning the house (and letting them help), and enjoying my kids and being their mom!!!

Monday, March 14, 2011

Summary of Today's Evaluation

Today Jordan met with the Psychologist and Neurodevelopmental specialist and was evaluated on her development.  She weighed in at 26.5 lbs and was 35.5 inches. 

During her psychological evaluation she did quite well and was found to be somewhere between what is considered normal and what is labeled low for intelligence and performance of verbal and nonverbal skills. He believes that she could make cognitive progress as she continues to improve in her verbal abilities.  He noticed some anxiety that manifested itself with her perseverating* at times through twirling her hair or her hands on the table.

*Perseverating means they do certain actions over and over again, like repeating a phrase, shutting a door, twiddling fingers, lining up toys, rubbing hands together, spinning objects, etc.

Her neurodevelopmental eval went well and she encouraged us to continue what we are doing and focus on Jordan's speech therapy and oral motor/feeding therapy as her gross motor and fine motor skills seem to be developing quite well.  When I questioned about her high sensory needs she recommended we have the school perform a sensory profile and discuss some sensory planning to help her function at a more calm, stable level.

This system was completely different than what has been done in the past.  We used to have a 4 hour appointment where we would rotate meeting with an OT, PT, SLP, nutritionist, social worker, as well as the 2 we saw today.  I don't believe that the evaluation is as thorough and I have always felt that the Neurodevelopmental specialist doesn't always give straight answers to my questions.  I am somewhat disappointed that we were unable to see the SLP in particular because that is the area of greatest concern for Jordan.

Now I am preparing for tomorrow's appointments...Jordan's feeding therapy was canceled so she only has the group OT/speech tomorrow at school.  I hope to have some video of her to post soon!!

Sunday, March 13, 2011

Eval tomorrow...not sure what to expect...

Well, once again I failed to post yesterday...can I blame it on the fact that I spent the morning facing the crazies at Meijer and then came home to clean the house and make a HUGE pot of soup and 21 sandwiches for today's lunch and then had my home invaded by 10 wonderful family members?!?!?  Well, it was quite a crazy day and I didn't even think about missing it until I was at church this morning.  It was great to have so many people here this weekend, but I am now looking forward to what the week has to hold.

Tomorrow Jordan has an evaluation with her neurodevelopmental specialist, Dr. Burdo-Hartman and the psychologist, Dr. Pasternyk.  In the past few years, this has been a HUGE eval by several different therapists and specialists, but they have altered things and now I'm not so sure what to expect.  Tonight Derrick and I put together a list of questions and things that we are curious about and I am looking forward to their views.  Plus, it will give me something fun to blog about tomorrow!!

Well, since we lost an hour last night with the time change, and my fabulous nieces dragged me to Wendy's at midnight to get french fries...after eating a ton of red vines and dark chocolate raisinets, I am now totally and completely exhausted!!!  Oh yeah, and I have to leave the house with the 2 little ones tomorrow by about 7am!!!!!  Therefore, I am going to bed!!!

Friday, March 11, 2011

Failed already!!!

Well, the second day of lent came and went without me posting anything...FAIL!!!  This is going to be much harder than I imagined!  I suppose it was because it was a pretty boring day...nothing to report on.  I know that I have lots to catch up on, but for some reason, I just never did.

This morning Jordan had speech at Century Park with her school speech path, JoAnne Hurley.  JoAnne also worked with Conner a few years ago and is great!  This year started off a little rough, but I think Jordan was just so difficult to work with that it took a while before Jo figured her out.  Jordan now loves to go see Jo and there are no more tantrums or problems.  Although Jordan doesn't always go along with Jo's plan, most of the time she is cooperative and participates.  Today I asked about the communication device that Jordan will be trying out for the next few months - Jo was going to look into that and hopefully we will have that soon!

As I write this, Jordan is bringing every pair of shoes, boots, etc from her room and piling them next to me!  Do I have a fashion queen on my hands?!?!?!  maybe...

Wednesday, March 9, 2011

Lent

I'm not much for giving something up for Lent.  But for some reason, this year I am going to try something new.  I am going to attempt to blog about my journey with Jordan for the next 40 days...every day.  I know it will involve sacrifice...maybe I will have to get up earlier to do it...maybe I will have to do it when all I want to do is sit down and relax and not do anything.  The point is that I will force myself to have the discipline to spend time every day documenting our life and processing through my thoughts and feelings and putting them into words. 

The upcoming month is full of lots of therapy (speech, OT, feeding), some big appointments (multidisciplinary neurodevelopmental eval), as well as just daily life.  I'm sure in the midst of it all I will find many things to share.  I will attempt to spend the next day or so summarizing the past few months and then move forward day to day.

When I look at my last post...November 8, 2010, I realize that I have been AWFUL in keeping up with this blog!  Since Jordan is my third child, I actually have no baby book for her and although I have recorded much of her medical information, I seem to be failing at recording the normal milestones that children reach.  That was part of my intention of starting this blog and now I intend to make it a priority.

I pray that this experience helps me to really dig deeper into discovering the impact that this amazing little girl has on my life and share that with others in hope that they will see just what a miracle she is.