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Friday, April 27, 2018

The power of what we do and don't talk about

Yesterday was our 26th wedding anniversary.  As happens on days like that, Tony and I were reflecting on our past, and especially on my pregnancy with my first child, William. 

Then in the early 90s even more than now, it seemed like pregnancy complications were something not to be talked about.  It was the heyday of "What to Expect When You're Expecting", a book that seemed determined to let you know that everything you were experiencing was just fine, perfectly normal.  There were a few small pages only about what can actually go wrong, and they were presented as something you probably didn't even need to know about, something you certainly shouldn't dwell on.  And so when my pregnancy felt different than what I read about or saw around me, I figured I was just being paranoid. 

I wasn't, and William was born at 7 months by emergency C-section because my pre-eclampsia had progressed to life-threatening levels.  It turned out, in my family anyway, that wasn't that uncommon.  On my father's side in particular, pre-eclampsia turned up often, with the strongest example being my great-grandmother, who died of eclampsia, seizures, a few days after my grandmother was born.  A few months after William's birth, the TV series ER had an episode called "Love's Labor Lost", in which a mother dies from complications of pre-eclampsia.  I wish I'd seen it sooner, although it was the hardest thing to watch I've ever seen.
A scene from ER's "Love's Labor Lost"

Of course, there are reasons we don't talk about everything in our lives publicly.  There is much in all our lives, including mine, that we don't share.  The reasons are many, and sharing or not is a choice we have a right to make, and sometimes an obligation to make.

However, at times, sharing can be life saving, or soul saving.  My life, and William's, were in the balance around the time of his birth.  I wish I had known what I know now about how suddenly and drastically pregnancy can take a turn.  And when it comes to my life with Janey---if I hadn't found the people I have, through this blog, mainly, I don't know if I would be here today.  There were days, and nights, that were only survivable by knowing that others had lived this life and gone on to a place of calm, even happiness.  And what keeps me writing today is those letters I've gotten from others with girls like Janey telling me how knowing they weren't alone kept them going.

Something I try to always keep in mind, though, is that there is much we don't know about the lives of others.  We don't always know what others are struggling with, what health issues or family issues or any other issues are affecting their lives.  There are many things we don't share, or aren't ready to share.  There are many times we are the ones depending on others who ARE ready, who DO share, whose stories we cling to as we struggle with what we ourselves are not yet, or ever, sharing.  Help comes in many forms---both in how we give and how we get help.

I want to thank those who have made me know I'm not alone, over the years---both those who shared their life experiences and those who didn't, but used them to become comforters and helpers of others.  May none of us ever feel truly alone.

Thursday, April 19, 2018

"Talker Machine?"

Janey does things her own way.  We've learned our lesson through the years, and trying to force her to do thing our way doesn't go over well.  This is proving true with our foray into TouchChat.

Last week, Janey's wonderful teacher synched TouchChat at school with our version at home, and also added to both buttons for our family and friends (and cats).  It's fantastic having a way finally to talk to Janey about specific people at school, and to let her talk about people at home while she's at school.  I've been playing around with TC constantly on my own, figuring out all its features.  And we've had it available for Janey to use at all times.

So, how is she taking to it?  It's a mixed bag.  I'll have to say it can be frustrating.  The most common thing Janey does with the program is pick the exact middle button, over and over, though screen after screen.  Doing this creates the sentence "I don't want to listen to CD"  Maybe this is a message Janey wants to get to us, but the thing is, she has basically never seen a CD, never listens to them, and when I showed her some and tried to figure out if she knew what they were or did, she showed no interest.  So like with a lot of things, I think pressing the middle buttons has become a routine, not really a way to communicate.  And that's fine.  If that is a way Janey enjoys using her "talker", and it makes her feel comfortable with it, I am happy.  But I do wish she'd be a little more interested in exploring other possibilities.

I've been doing a lot of reading about getting started with AAC, and modeling the use of the device is a big part of it.  So I am often using it to either say things I want to say to Janey, or to model what she might want to say with it.  For example, if she is irritated we don't immediately take her for a car ride when she wants to, I make it say "I am frustrated" or " I want to go to the store" or "I want to wear shoes" (another way she asks for rides).  This doesn't seem to encourage her to use TC to talk to us, but it does seem to be helping her organize her verbal talking, which is wonderful.  We've heard her use more complete sentences lately than usual.  The other day, she said "I want you to clean my foot" to me, extremely clearly.  The usual way she'd ask something like this is to point to herself and say "you want to clean feet?"  I was startled and thrilled.

The tricky thing with getting Janey into TC is that she is at the height right now of a teenager phase of not wanting me around often.  The most common thing we hear lately is "Want to go away?"  She wants to be alone when she watches her videos, or plays with her regular iPad watching YouTube on her bed, or basically any time we are around harshing her mellow and getting in her face.  So having me cheerily constantly around modeling TC is not really how she wants to spend her time.  I'm finding the time she's most open to it is when she wants something from us.  If you've had teens ever, you know that is about as typical as it gets.  When she wants a ride, or wants us to cook her something, or wants a certain video, she is much more motivated to at least watch us use the TC than other times.

Most nights, as I lie down with Janey to snuggle as she falls asleep, something I do most every thing, I've been having the TC open and playing around with her, saying silly things to each other like "I'm so over that!" and "Whatever!"---one of the great features of the program is it lets teenagers say teenage things like that.  Last night, though, I didn't bring it with me for our snuggle, as Janey has been resistant to it throughout the day and I didn't want to irritate her.  But after we were snuggled down, Janey said "Talker machine? Want to get talker machine?"  That was a wonderful thing to hear.  Whether Janey is using AAC in a conventional way or not, we are having fun with it, and I'll continue to model and play around and do what I can to give Janey a way to augment her verbal talking.

Thursday, April 12, 2018

What the AAC consult said and what I think

At Janey's IEP meeting, I requested she be evaluated by a specialist in AAC (Augmentative and Alternative Communication).  She has had access to an iPad with Touch Chat, an AAC program, at school, and we recently got her a new iPad at home and put Touch Chat on it.  My main goal with all of this is to find a way to decrease Janey's frustration with what I think is word finding problems---when she knows in her head what she wants to say, but can't find a way to say it.  I also just wanted to give her another way to communicate, because although she does talk, her speech is limited.

The consult was done about a week ago, and I got the report this week.  It was a good report---thoroughly done, and I felt the woman who did it got a pretty clear picture of Janey's speech as it stands now.  Her conclusion?  That AAC apps are not something that will help Janey's speech, that in fact, they actually distracted her from communicating functionally.

I was not totally shocked by this conclusion.  There's a couple reasons for that.  One is that for years, I had sort of thought the same thing.  When I had downloaded test versions of several systems like Touch Chat, Janey had no interest, and in fact really seemed to not like the programs.  She even said one time, when I said something like "this can help you talk", a very clear statement "I CAN TALK"  The other reason is that I have been told through the grapevine that the powers that be in the school system (not the teachers or therapists, but the higher-ups) never want to say kids will benefit from AAC, because then they have to pay for iPads or the like.

However, I have to say I don't think I agree that AAC is not a useful tool for Janey.  The main reason the woman evaluating Janey concluded it wasn't is that although she can navigate the system and she show an interest in exploring it, she isn't using it to communicate.  My answer there is---Yeah.  That's why I would like her to get HELP with using it.  It seems like what is being said is something like "She shows she could use it, and she shows an interest, but she doesn't already use it to communicate, so we aren't going to recommend teaching her to communicate with it"  That seems like saying "well, this kid has the capacity to read, and is interested in reading, but she doesn't read yet, so we won't teach her"  It just doesn't seem to make sense.  And isn't exploring a way to learn?  When babies learn to talk, not every single utterance is for communication.  The tester noted that Janey kept pressing the "stop" and "go" buttons, over and over, without a break.  Maybe she was figuring them out?  Maybe she wanted to learn them by repetition?  Maybe she was just having fun with them, and what is wrong with that?

Also, Janey DID, in the presence of the woman doing the evaluation, communicate with Touch Chat.  In the report, she said Janey navigated through a few levels of the application to say "Eat Goldfish Crackers"  However, the reports said that the tester didn't have any edibles with her, and it didn't seem to bother Janey, because she didn't seem to be asking for something to eat.  Now, just exactly how did the woman doing the test know that?  When Janey used the device to say something, why was it assumed she wasn't really saying what she was saying?  I do know the impulse to think "She doesn't really mean that".  For example, at home, Janey has quite a few times gone through several menus to make Touch Chat say "I don't want to wear white.  I want to wear orange"  Because Janey has never, even either shown she knows colors or objected to any certain color being worn, my first impulse was to just think she was playing around.  But I realized that's a pretty big thing to assume.  Maybe Janey never had a WAY to tell me that before.  Maybe she really does hate white clothes.  Maybe she wants more orange in her wardrobe.  No matter what, it seems pretty presumptuous to give someone a way to communicate and then when they do, to assume it means nothing.

To be fair, I really am not sure myself if AAC is going to help Janey with communication, and I don't know if Janey wants to use it or not.  After the initial few days with the Touch Chat (and Proloquo) at home, Janey has been rejecting using them, at one point very pointedly by means of hitting me in the face (I made her stay on her bed and not have TV for a while, but I left the Touch Chat out for her in case she wanted to speak ill of me on it!)  But I think she deserves a chance.

The good part?  Janey's wonderful teacher agrees with me.  Today, I sent her new iPad into school, and the teacher is going to update Touch Chat with things like the names of her classmates and with phrases they working on.  She is going to continue to make it available at school, and we will continue to make it available at home.

I'm trying not to get discouraged.  But at times, I do.  It has seemed over the years this same kind of scenario has played out a lot.  I am told there's some kind of help available.  When I actually decide to try to get that help, it's not actually available in Janey's specific case.  This isn't quite like that.  Nothing stopped us from getting Touch Chat on our own (and I'm glad we did, because if we had wanted to get it paid for by the schools, we would have been out of luck).  We are so, so lucky that Janey has a teacher that believes in her and works closely with us to coordinate our efforts.  But still---it feels often like a theme.  Janey just doesn't quite fit into any program.  She's not "high-functioning", as the music classes we looked into required.  Special Olympics, while friendly and welcoming, was not at all aimed at kids like her.  And now, her particular combination of being able to talk some and not being instantly inclined to communicate through technology---she isn't quite right for AAC either.

More and more, I realize there just isn't a lot out there to help.  And more and more, I appreciate the hands-on school people, the teachers and therapists and aides and all that don't say "she's not quite what we are looking for" but instead just accept her and work with her and love her.  And that is what we will keep doing at home, too.

Tuesday, April 3, 2018

Day One with AAC apps

I thought I'd write white it was fresh in my mind about how it went yesterday afternoon introducing Janey to her new iPad with three AAC apps on it.

I was a little nervous about showing Janey the "talker", as I had told her it was called.  I'd mentioned for a few days that I was going to get her a talker, and that she could use it for an extra way to talk.  She had seemed somewhat interested, and yesterday before going to school when I mentioned it, had actually said "Talking!  Talking!  Talking!"  But I was wary, as sometimes if Janey doesn't like the looks of something, she will never, ever take to it after that first negative impression.  And a few years ago, when I had gotten some demo versions of AAC apps, she'd hated them. So...

Right when Janey got home, I had the iPad out and waiting.  She asked for cheese, and I used the TouchChat app, and said "Let's see if we can get the talker to say that!"  I made it say "I want to eat cheese", and right away I went to get cheese, leaving the iPad with her.  As I had hoped, she jumped in and played with the "dairy" category I had open, pressing "ice cream" and "butter" to hear them said.  We had the cheese, and then Janey asked for soda.  I did "I want to drink..." and got onto the "drinks" page, and she pressed "soda".  So far, so good!

When Janey asked for the store, I had TouchChat say "I want to go to store" while Janey watched with interest.  We went to the store, and when we got back, Janey right away grabbed the iPad and had TouchChat say "I want to talk to Grandpa"  I wasn't surprised, as her teacher had told me that's the sentence she often does at school.  Still, it took going through several screens to get it said, and I was impressed with the ease she had doing that.

A bit later, Janey started screaming, a common interlude in our afternoons.  This time, I used Aacorn, and brought up a choice of five feelings.  This app is a little different---when you pick a general category, it gives you a circle of five choices, surrounded by the general category, so this said "Feelings" surrounded by "happy", "excited", "sad", "love" and "hate".  If none of those are what you want, you can press the "Feelings" button again and get more choices.  The more you use the app, the instructions say, the more it knows what you might pick, and puts those choices in the first 5 to come up.

Janey picked "happy", even though she was screaming.  That's another thing the school had mentioned she does---identifies her feelings as happy no matter what they are.  She pressed the "happy" button over and over.  I pushed the feelings button a few more times, and it came to a place with a choice to pick "hurt"  Janey pressed that, and one of the choices came up "head", which she pressed over and over.  I took it back to a screen with a Yes or No choice, and said "Does your head hurt?" and she pressed Yes, over and over.  Interesting.

Later, I showed her the Proloquo2go opening screen.  She right away started playing with it.  To me, it looks like a more intimidating and less user friendly interface, but as the evening went on, it seemed that was the app of the three she liked best.  Before bed, I put both her old iPad and the new one on her bed.  She grabbed the new one, and went right to the Proloquo app, and played around with it for quite a bit.  What surprised me is she seemed drawn to words like "I", "on", "it"---not so much the nouns.  Maybe those words are harder for her and she likes being able to hear them said so easily.

We were on the feelings screen as Janey was getting tired, and she picked "sorry" and "tired" and then turned to her old iPad and put on YouTubeKids as she went to sleep. 

Overall, quite a wonderful start to trying AAC!  Janey was more interested than I had even hoped.  I'm going to work hard on keeping it all low-key.  That's essential with Janey.  She's a typical teen in a lot of ways.  If I act all hyped up for the "talker", it's quite likely she's react by showing less interest.  So I'm going to keep doing what I've been doing---modeling a bit, leaving screens open for her to play with, and just letting her have fun hearing what she presses be said. 

I like having the three different app choices available for her.  She doesn't seem confused by it, so far, in these early stages, and it's quite interesting to see she seems to like busy, very full screens more than minimalist ones.

I'll try to update our AAC journey regularly!

Monday, April 2, 2018

Celebrating Autism Day by going all AAC

I'll just call it Autism Day, without putting an "awareness" or "acceptance" or anything else on it.  Autism deserves a day, and it doesn't need any modifiers.

I'm starting something new this Autism Day.  Janey has never shown much interest in AAC apps (Augmentative and Alternative Communication).  This year, however, her school has been using a program called TouchChat to has her say certain things, like to help her ask other rooms if they have any recycling or to help her participate in morning meetings.  Reports were she showed some interest in it, and I decided to go for it---to really try to do AAC at home.

The first thing I needed was a more up to date iPad for her, and the very kind gift of a dear friend helped us out there and allowed me to buy Janey a brand new one.  She still is using the old one we got her, and that thing has been through hell and back, protected with a Gumdrop cover.  That is one product I will recommend to the stars and back.  So I've ordered a cover for the new iPad.  Today, since it's Autism Day, a lot of AAC programs were on sale (although not TouchChat).  Since we got the help with paying for the iPad, I decided to toss caution to the wind and buy 3 different AAC programs---TouchChat, ProLoQuo To Go and Aacorn.  The last two were on a good sale.  I figured I'd fool around with them some before showing them to Janey, and see which she likes, or if she likes a combination.  

So far, after just a little bit of testing by me, I really like Aacorn.  It is set up in a very kid-friendly way, and had a great tutorial.  But that's an extremely early observation.  I'll be writing about our AAC attempts in days to come, I'm sure.

How am I celebrating otherwise?  Well, Janey will get her trip to the ice cream store when she gets home, and we'll watch some videos, and Daddy will probably make her some soup for dinner, and we'll snuggle at bedtime.  There might be a car ride, too.  Nothing much different than what we do every day, because in a way, every day is autism day here.  We've figured out the routines that work, mostly, and we don't stray a lot from them.

I'm not going to try, this year, to say anything summing up or meaningful or awareness-raising for this day.  Part of that is just tiredness.  Part of it is a growing realization that thinking about autism as one entity, one type of life, is like calling all different kinds of fruits just "fruit".  There are way too many ways autism shows itself, way too many different variations, to be able to say much about the autism community in general without over-simplifying.  I can talk about Janey, and I can talk about our family, but I can't really speak for others in any general way.

I can, though, sent out a special wave of love to everyone out there with a life that includes autism, whether it be those who are autistic themselves or those who love someone with autism.  Happy Autism Day!