Category Archives: Trisomy 21

Why I’m teaching sign language to ds2

Years ago I read about the benefits of teaching babies sign language, in time to teach dd14 a couple of basic signs when she was about a year old.  I didn’t really know many signs and my motivation to teach my infants wasn’t strong enough to push me to extend myself to learn more.

Enter the birth of my youngest, now 2.5.  I knew that with a diagnosis  of Trisomy 21, he was likely to experience communication difficulties.  I decided to assist him in expressing himself rather than waiting for speech.  At 14 months, when I began introducing early reading I also began introducing signs.

Neurodevelopmental therapists oppose teaching sign language to a child with T21, believing that the frustration to want to express oneself encourages a better degree of clarity in speech later on.  I trust their many years of experience but I’m not willing to withhold a way for my child to communicate now for the sake of later gains.  Every person wants and needs to be able to communicate with others, and deserves to be given the tools to succeed.  Especially children for whom it’s more of a struggle than others.

There are plenty of benefits to using sign language for all young children.  Young children understand so much more than they’re able to express, and giving them ways to let you know what they want is very helpful to you both.  Sign language encourages language comprehension, fine motor skills and is cognitively stimulating.

It’s not hard to learn basic signs.  I’ve learned a number of signs from the Signing Times website; when I needed others, I looked them up at Signing Savvy.  The Signing Savvy site has a much wider vocabulary of words but the video quality can’t compare to that of Signing Times.  They’re both great free resources.

Yirmiyahu is limited to the signs he learns by what signs I learn.  Recently a while went by and I kept telling myself I  needed to look up more words and not getting to it.  So I began considering buying signing dvds for him to watch.  When I looked into this, I learned that Signing Times has a digital subscription option – with a free monthly trial that gives unlimited access to the programs they have available.  So I signed up!

So far we’re enjoying this a lot.  There are several series that include Baby Signing Times and Signing Times.  Each series has a number of programs that are grouped according to topic and taught together with songs.  The program host has an engaging and fun way of presenting the signs and is extremely clear.  Our boys ages 5, 7 and 8 are enjoying watching with Yirmiyahu and me, which is really nice.   They’re learning the signs and that’s helpful so that they aren’t dependent on  me to translate what Yirmiyahu is ‘saying’.  And they can also help me translate when I’m not remembering what sign Yirmiyahu is using!  (Yirmi has a better memory than I do!:))

When the host introduces a sign, on the opposite side of the screen is a picture of what she’s demonstrating along with the word written out.  This reinforces Yirmiyahu’s reading program, which has many of the same words.

Another thing I really appreciate is that the children in the programs are diverse and reflective of children in the real world.  They include a number of children with Down syndrome and other disabilities; children with disabilities are usually shut away from others and having them portrayed as naturally as any other kid is extremely important.

Watching these programs has made it easier and more fun to learn signs.  I don’t know yet if I’ll sign up for a subscription when my trial runs out but I’m certainly enjoying the access that we have now!

Avivah

Tips for supporting a child with Down syndrome

Now that Yirmiyahu is two and in my last post I shared the assessment from the professionals at the Feuerstein Institute that he’s doing unusually well, I thought I’d update on what we’re doing to be supportive of him.  Hopefully this will be of some help to someone else wondering what steps can be taken to help a child with Trisomy 21.

With a long standing passion for nutrition and alternative health, it’s my conviction that what you eat really, really matters.  It affects many more things in the body than we can imagine, and scientists are constantly discovering more and more connections.  I also believe that children with T21 need more specific support than the neurotypical child, and will continue to need more support throughout their lives.

Diet – what we do is very basic.  Yirmiyahu eats a whole food diet that includes proteins, fruits, vegetable and fats (mostly coconut oil and olive oil, some butter) and limited grains.  This is the same as everyone else in the family though we’re more careful with the fats he gets.

We use very minimal amounts of processed foods and don’t give him foods with gluten (wheat protein) or casein (milk protein), both of which are very difficult to digest and can affect the body in negative ways.  We limit these with our other kids but are more careful with Yirmiyahu.

For the first two years he didn’t get any sugar;  now he gets a Shabbos treat along with the other kids if he answers a parsha question (the question we start with for all of our kids when they are little is, “What day is today?” “Shabbos!”  Yes, he knows the sign for Shabbos.  :))  Again, this is similar to our other kids.

Nutritional supplementation – I have a strong preference for supplements that are as close to how they were created in nature but we live in an imperfect world and that’s not always possible.  Our experience has been that the symptoms associated with T21 require more targeted treatment than what food based supplements offer.

Fermented cod liver oil – okay, this stuff is awesome!  It has vitamin D, DHA,  essential fatty acids (and a host of other stuff I’m not mentioning), it strengthens bones, teeth and the immune system.  It’s a superfood that everyone could benefit from.

Probiotics – probiotics are great for everyone, but for someone with a less optimized digestive system, these are critical.  We switched from lactose base probiotics to soil based probiotics several months ago.  I now use Prescript Assist; a little bit goes a long way.  I give him about a 1/4 – 1/2 of a capsule daily.  Homemade lactofermented veggies are another  wonderful source of probiotics but Yirmiyahu isn’t yet a fan of them.

Saccharomyces boulardii – I love this stuff!  Remember Pac Man, the arcade game of the 80s? That’s what this reminds me of.  This probiotic yeast gobbles up the bad yeast and isn’t killed by antibiotics.  This isn’t something I’ve read of anyone else using in the T21 or natural foods world but it’s very valuable for us.

Blood tests when he was in the intensive care unit as an eight month old showed Yirmiyahu had candida.  Since I had researched candida extensively several years before I knew exactly what this was, but asked the doctor for his thoughts on what it was and what the consequences were.  He told  me not to worry about it, it didn’t matter.  Well, it mattered to me since this overgrowth of fungal yeast will manifest itself in many ways as it increasingly breaks down the body.

Yirmiyahu had a good diet but he constantly had loose stools that seemed to burn his skin – his bottom would be bright red and often bleeding after he had a dirty diaper no matter how quickly we changed him.  I tried different things to improve this but the best I could do was slather on a thick layer of zinc oxide cream, which didn’t do anything to improve the underlying problem.

When I added saccharomyces boulardii to his bottles, within a very short time his stools normalized and his rash disappeared.  Since I changed his probiotic to Prescript Assist at the same time, it took me a while to be sure which of the two was responsible for the improvement.  I began leaving out the probiotic and it became clear this was what was making the difference for him.  Since I began giving this to him at the beginning of the summer, he’s had only one bad rash.  What used to be a regular sight has thankfully become unusual and I hope this continues.  I love this stuff.

This is especially helpful for us since Yirmiyahu gets antibiotics twice a day and I can put it into his bottle together with the antibiotics, unlike probiotics which are neutralized by the antibiotics and have to be given at a different time for them to be beneficial.  I ‘m unhappy about these antibiotics but have some peace of mind that I can minimize some of the negative side effects by using this.

PQQ – this is a relatively new kid on the block in the scientific community and is Yirmiyahu’s newest addition.  Every person with T21 has neurons that are constantly dying – you understand this is a big concern, right?  That means you can’t assume that your child as he is now, will have the same mental capacity in twenty years.  It’s well-known that Alzheimers is a huge issue for people with Down syndrome as they age.  That’s bad, bad, bad but thankfully there are steps we can take at this young age to counteract this.

PQQ is one of them.  PQQ not only slows mitochondrial decline, it helps grow new mitochondria.  This is a big part of why I supplement – not to see immediate results, but to help Yirmiyahu maintain his cognition now and avoid the inevitable cellular damage later down the road.  He’s on a starter dose of .5 mg per kilo daily.

A very nice bonus is that within a couple of weeks of beginning PQQ, Yirmiyahu became noticeably more verbal.

Multivitamin – we used to give him a multivitamin formulated specifically for people with T21, but switched when he was about 14 months to a different multi that was recommended based on his specific bloodwork (actually it’s an autism multi – GI Pro for anyone who may be wondering).

I’m doing a thorough blood work up later this week and will likely make some changes to his current protocol based on the results that come back.  I suspect something is going on with his thyroid because the soles of his feet are dry; he had this symptom in the past (it took a long time until I learned it was a symptom of hypothyroidism) and it cleared up with supplementation.  I’m not sure what I’ve changed that his feet are dry again; I suspect it may be because I stopped the additional methylfolate, selenium and B12 I was giving but I don’t know if it’s a combination of all three or one particular supplement that is responsible for this.  (All of these are in his multi and I thought he was getting enough through this. )

His thyroid testing when he was about a year old showed elevated TSH and by the time he was eighteen months, we got into a much better range thanks to supplementation.  We also corrected his hypothyroid symptoms; he had become very weak and lethargic.  The doctor said it was normal for T21 and his blood work was normal; I sent his blood work to two people in the US for feedback and made adjustments to his supplements based on their feedback.  He wasn’t properly absorbing nutrients because of his extra chromosome and it was thanks to the addition of supplements that this was corrected and very soon he was back to his energetic and active self.

Ideally his thyroid should be tested every six months (this is a typical recommendation for someone with T21) but this time it’s been somewhat delayed since I wanted growth hormone testing done along with monitoring his blood cell count (we keep an eye on signs of leukemia because of his history), and needed to get that referral from the endocrinologist; I had to wait three months to get the appointment with the endocrinologist that I wanted.  This week when we do the blood tests, hopefully he’ll only need to get pricked one time.  I wish these tests weren’t  necessary but since they are, I try to minimize the discomfort to him by combining as much as possible at one time.

For us, supplements have been very important in helping Yirmiyahu stay healthy.

Hanging exercises – when Yirmiyahu was an infant, we began encouraging him to bear weight by putting his fists around our thumbs as we lifted him a tiny bit.  Now every time we pick him up (unless we’re in public, since people will tell us we’re doing something dangerous), we let him grasp our thumbs and pull himself up.  This little habit has brought big benefits to Yirmiyahu.

It’s strengthened the muscles in his hands, which is critical for fine motor function.  it’s also strengthened his abdominal muscles.  He climbs up ladders, slides – he’s totally independent in the playground; despite being so small he manages to climb things intended for children taller and older than him.  Recently he shocked and amazed the pediatric endocrinologist when he grasped the edge of the wall mounted sink in her office and began swinging from it.  I didn’t think anything of it, but she told me to turn around and watch what he was doing, exclaiming, “Look at him!!  Look at him!  Look what he’s doing!”  She couldn’t believe a child with T21 could have so much muscle strength at such a young age.  Ideally I would have him using the monkey bars daily to further develop this but I don’t have them available and so for now, our thumbs it remains! 🙂

Early literacy program – we use a computer program called Brillkids for early reading that Yirmiyahu really enjoys.  When he sees me sitting at the computer, he signs ‘words!’ and tries to climb up onto my lap!  This program includes categories of commonly used words – transportation, foods, colors, toys, actions, people, animals, etc – and it gives him regular familiarity with concepts and this translates to better understanding the world around him in addition to hopefully setting a foundation for reading.  I try to do the computer program twice a day with him and more when possible but five times a day is my max (this is at his initiation).  We’re up to lesson 70.

Signing – I’ve taught Yirmi a number of signs and this has been very helpful for him to be able to express himself since his cognition is way beyond his verbal expression, as is true of all young children.  The words I’ve taught him are those that are useful for him day to day – for example, when I noticed how frightened he became when he heard fighter jets roaring overhead, I taught him ‘airplane’, ‘loud’ and ‘scared’.  Now he has a way to tell us what he notices and what he’s feeling – when he hears them from a distance, he will tell us he hears an airplane, or that it’s loud, but only tells us it’s scary when they’re very close.  He also can tells us when something else scares him.  I need to spend some time thinking about what vocabulary would be helpful for him now, so I can look up those signs and teach them to him.  Signing is a wonderful tool.

Communication – I talk to Yirmiyahu a lot and explain what we’re doing as we go along, and have been doing this since he was young.  Most of this is intuitive.  I have one of the books by Dr. James McDonald called Play to Talk, and this helped me tweak what I was doing to be more effective.  He writes a lot about how a parent or sibling is the best play partner for a child and it’s through play that a child learns the most.  He gives clear guidelines for how to make interactions with your child a meaningful opportunity for communication and connection.

Craniosacral work – I take Yirmiyahu about once every 5  – 6 weeks to a wonderful osteopath who does craniosacral work on him.  She works on different specifics each time depending on what area of the body she sees needs the most balancing.  She almost always works on his respiratory system since this is a part of his body that has always been weaker.  This week she did a lot of improve circulation and to help flush out his system (important since people with T21 are less able to get rid of toxins on their own).   When he was an infant, one eye would periodically get goopy, but after she began working with him to release the underlying block in his facial structure, this disappeared.

I’ve asked her to work on his palate since it remains high and narrow even though it’s improved quite a bit since he was born.  This is important since the pituitary gland is above the palate and I want that to function as well as possible.  It was easier for her to work on this when he was younger since now when he bites down, he has teeth!  She does most of the facial work externally and very quickly; most of her time is spent on the rest of his body.

Siblings – my kids are crazy about Yirmiyahu and I can’t overstate how important they are in his life.  He has constant playmates and plenty of opportunities to see and model typical behavior, which is no doubt why his social skills are so good.  He doesn’t have to be taught to take a turn or throw a ball to someone – it’s part of his daily life!

**Disability Is Natural** The mindset that underlines everything I do and how I do it is based on accepting Yirmiyahu exactly as he is right now and believing in his abilities.  I was gifted with the book Disability Is Natural when Yirmiyahu was very young.  Quite some time ago I commented to my husband that over the years, my paradigm of what I assumed to be true and what I now believe had shifted in several key areas that changed my life – pregnancy/birth, education and health/nutrition.  With all of these I grew up accepting what everyone did as the norm until something prompted me to explore an alternative viewpoint, and each paradigm shift dramatically changed my life.   I commented to him rhetorically, “I wonder what the next life-changing paradigm shift will be?”

This book was it.  This prompted my next huge shift in thinking about a topic I had never given much thought to.  It is so powerful and I think it should be required reading for everyone on the planet. 🙂  Seriously.  This will give you so much food for thought and affect your parenting of all of your children and others you interact with in a positive way.  Fortunately, the author has a website with a free newsletter so you don’t have to spend a penny to read more – http://disabilityisnatural.com/.

When I read this book, I kept thinking, this woman thinks like me!  (I did keep wondering how with her personality she dealt with the constraints of the school system and the necessary advocacy – and then in the end she wrote about discovering homeschooling and stated that she wished she had done that from the beginning!)   This paradigm has helped me to find the inner balance of being proactive in addressing Yirmiyahu’s needs and fully accepting who he is.

Avivah

Feeling confused…why is Yirmiyahu doing so well?

Yirmiyahu, age 2
Yirmiyahu, age 2

I’m back from a long day in Jerusalem!

Our visit to the Feuerstein Institute went well.  The eight staff members I met were all professional, warm and caring.  Yirmiyahu was part of a group of five children; I knew he would be the youngest but didn’t realize there would be the big gap there was.  This is the youngest group of children at the Institute right now.  He’s 26 months, and the other four kids were all 3.5, almost 4.  So he’s really, really much younger.

Fortunately this didn’t pose an issue for Yirmiyahu!  Far from it.  He did great.  Even though he woke up at 5:30 am and was tired from traveling and a disrupted sleep schedule, was in an unfamiliar place with unfamiliar people – ie far from his sparkling best – he participated fully in each session.

There’s no question that there’s a lot to gain from being at a place like the Feuerstein Institue, but I decided not to pursue further participation at this point for a number of reasons.  A big part of that decision is that even though Yirmiyahu is so much younger than the other children in his group, he’s more advanced than all of them.  Initially when I had questioned putting him in a group of kids who were older (not realizing how much older they would be!), they said it would advance him to be around older kids.  But I don’t believe that will be true in his case.

There would definitely be benefits but as of now, the other considerations outweigh them.

Since Yirmiyahu was very, very young I have felt he wouldn’t benefit from being in a special education setting, and that conviction was strongly reinforced yesterday.  I don’t look at him as a child with special  needs and don’t treat him like a child who is limited – because he’s not.  Despite my belief that it’s best for him to be with typical kids, I agreed to put him in this group of children with developmental delays because of the incredible reputation of the Feuerstein Institute.  But I felt increasingly uneasy as he sat around the table with the other children.  It felt like a mismatch for who he is and what his needs are.

I paid close attention to everything each therapist did in every group and how they said it because I wanted to soak in as much as I could to hopefully apply their strategies at home – and I was continually struck by how similar it is to how I speak to Yirmi.  That was a big eye opener to me and I began to understand what the evaluator meant when she told me at his six month evaluation that I was intuitively doing the things with him that they usually have to teach parents.  I spoke to a mother during a break and asked her about the experience at the Institute.  One of the things she said is that there are some people who intuitively do these things with their kids, it’s natural to them and they don’t see what the big deal is.  It seems I’m one of those parents.

At the end of the day, I was speaking to a different mother whose daughter was in Yirmiyahu’s group and asked her something specific about her daughter.  She told me, “You’re not going to have an issue because your son understands everything!”  I asked her how she could possibly have noticed that, and she said it was obvious that of all the kids he was the one who understood in every situation right away what he was being asked to do and did it.

Also at the end of the day, the occupational therapist exclaimed, “Your son is amazing!”  She asked if his therapists locally are going crazy by how well he’s doing.  I asked her why she said that – I don’t know any kids with T21 in person who are his age to gauge his progress and anyway, I try to avoid comparing my kids to anyone else so I don’t have the perspective to see what she’s seeing.

She responded that she sees many, many kids with T21 and he’s unusually advanced.   She seemed surprised that this wasn’t blatantly obvious to me.  I mentioned that the way the therapists spoke in the sessions was similar to how I speak with Yirmiyahu, and she said it’s clear that I’ve been mediating (to use a Feuerstein term that means to actively help your child process and make sense of the world) since he was born.  I often hear comments that he doesn’t look or act like he has T21 which I mostly disregard, but the feedback from staff members at this institution is based on many years of experience so that counts for more than the casual comments of someone in the park.

I’m frustrated with my lack of clarity about all of this.  When people told me over the years that my kids were so well-behaved or kind or responsible, I thanked them and knew what efforts I had made that led to that result (along with a huge dose of heavenly assistance – our efforts are never soley responsible for our success).  I could tell you how to do it, too.

But in this situation, I don’t have that same feeling of confidence, of knowing that I did this and it led to that result.  I know what I’ve done and could give you a list if you asked me but I couldn’t tell another parent with the same confidence I can when it comes to parenting issues, do this and you’ll get this result.  I keep wondering, could it really be this simple to successfully raise a child with T21?  It can’t be, right?

I don’t want to downplay what I do with Yirmiyahu.  But I see what I do with him as mostly being a responsive mother just like many mothers out there and have a hard time imagining that this is unusual.  I don’t sit around doing therapy.  I don’t sit around practicing speech.  I don’t sit on the floor playing educational games every day and I don’t read him books every day.

Staying close to his siblings during waking and sleeping time :)
Staying close to his siblings during waking and sleeping time 🙂

Mostly I just love him.  I talk to him like I talk to all of my kids, I know he’s smart and capable and I expect of him what I expect of all my kids.  And he gets lots of love and stimulation from all of his siblings.

I remember predicting to myself in the early days (when he was less than a week old and in the NICU) that when he got older I would hear how lucky I was and that he must have been born high functioning.  I was prepared to hear it was luck and I didn’t anticipate the professionals being so verbal about it being a direct result of my efforts.  It’s nice but I’m uncomfortable with it.

Yirmiyahu, 2 years old
Yirmiyahu, 2 years old

I feel a lot of humility and gratitude for how well Yirmiyahu has done.  Even though there are things I’ve done and I know they matter, it seems like it should take a lot more than the efforts I made to see the results that surprise people so much.  (I don’t see anything surprising, he’s doing well but I don’t think he’s a superstar.)

Is it possible that because I loved him as he was from the time he was born, actively mediated the world for him, believed in his abilities and kept my expectations high, that he could be doing so well?

Food for thought.  I’d love to hear your thoughts and experience!

Avivah

Finally – an opening at the Feuerstein Institute! Now what?

flash-placeholder[1]When Yirmiyahu was six months old, I took him to the Feuerstein Institute in Jerusalem for an evaluation.  At that time I put him on the waiting list for services there, and was told he would probably get in at the beginning of the school year.  Last year.

So here we are a year and eight months later, and I just got an email saying they have a space and do I want it?  It’s in a group setting and begins this week.  He’ll be the youngest of five children with various developmental delays, and the three hours will include speech therapy, occupational therapy and instrumental enrichment (this is a Feuerstein term, it’s nothing to do with musical instruments).  The first two therapies they said differ from typical therapies because of their focus on cognition.

You might expect me to be jumping with joy but the truth is I felt a lot of ambivalence when I got the message.  First of all, it’s expensive.  I was told that I should get some kind of money back from the insurance company but I don’t know how much and I don’t know when I would see that money.  It definitely wouldn’t all be covered and I don’t know what’s going to be involved in getting a refund through the health care system.

In addition to that expense is the cost of traveling to Jerusalem every week.  That’s  not cheap and it’s also not a short and easy trip.  This is my biggest concern.  Yirmiyahu is thankfully a very healthy and active toddler.  His willingness to sit on the bus lasts about ten minutes and the forty minute bus ride to the pediatric endocrinologist last week required a lot of active involvement on my part to keep him from climbing down.  Three hours on a long distance bus that won’t allow for getting up and walking around is really, really exhausting.  That trip would be followed by a local Jerusalem bus for another half hour of travel.  So it will be a minimum of seven hours of traveling, not including wait and transfer time, for a three hour appointment.  It’s a full day – I would leave Karmiel at 6 am and hope to be back by 4:30 pm.

And then I thought, this is the only place in this country that believes in our kids the way that I do, that knows what they can do and supports that.   I expect Yirmiyahu to be an independent and capable adult and it would be so, so helpful to have other professionals actively supporting that, who have the knowledge and experience to guide us. That support would be worth a lot to me.  I still find a lot of encouragement and reassurance from the one evaluation at Feuerstein when he was six months, and there’s a lot to learn from them! 

I decided to put aside my thinking about the limitations and difficulties involved in participating, and trust that if this is what he needs, we’ll be able to make it possible.  He’s  now scheduled to begin tomorrow.  I told them I can’t commit to a year or even more than a month since I have to see if continued participation is feasible for us, but I’m really looking forward to a positive experience there.

Avivah

Breakthrough meeting at Yirmiyahu’s two year assessment

Today Yirmiyahu and I went to his two year appointment with the child development doctor, his speech therapist and his physical therapist.    We have these appointments about every six months.  You may remember that I haven’t enjoyed these meetings in the past and even though our interactions have improved, I still had an apprehensive feeling when thinking about this meeting.

I was thinking about how to approach the meeting and decided it’s important at this point to share with them a bit more of what I do with Yirmiyahu, beyond what they directly ask me about.

The doctor started the meeting with a smile, saying she heard that I’m teaching Yirmiyahu several languages (ie English, Hebrew and sign).  She asked me what words he knows and I began listing them.  She was happy to hear that I use sign together with speech (not to replace it), and asked me what signs he knows and if he uses them independently to communicate.

We were talking while Yirmiyahu was walking around, squatting in place, asking me for a drink and drinking while standing.  They watched him playing with a doll imaginatively rather than copying what he was shown.  In response to her questions, I detailed some examples of how he follows instructions and shows comprehension of what he hears.

When he pointed to their computer and indicated he wanted to climb up to it, I explained he’s used to sitting with me at the computer and asked if they wanted to see the program we do together.  I had brought my laptop along just in case it was relevant, so I pulled it out and turned on the early literacy program (Brillkids) that we do daily.  This is a fantastic program that Yirmiyahu loves – he comes to me several times a day and signs ‘words’ to ask me to do this together with him.  Seeing a demonstration of what Yirmiyahu does at home was more valuable for them than hearing about it, and they could also see how attentive and engaged he was by the words and pictures.

I feel like this appointment was a game changer. The doctor didn’t refer to Down syndrome even once. She didn’t grade him and tell me how he was doing compared to other kids. She didn’t talk about delays, she didn’t pressure me about putting him into a special needs daycare. She didn’t tell me I need to come for more frequent therapy.  She didn’t say anything like, ‘kids like him’, ‘special needs’ – it was just about him as an individual.

After all the assessments were finished, the doctor said to me, “You’ve obviously been very successful with him.”  In the past I would wanted specific feedback on what she meant by that but today I just said, “Well, he’s an amazing boy!”  And then she replied, with something I never expected to hear, “Yes, he is an amazing boy, and you are an amazing mother.”

And then she repeated, “You are an amazing mother.”

There’s a saying, “Don’t quit until the miracle happens.” Well, this is how I feel about my interactions with the child development team.  I stuck with them, they stuck with me, we kept trying to communicate and we’ve gotten to a good place of mutual respect and appreciation.  It’s been a journey.

Avivah

Kids with Down syndrome are smart!

Yirmiyahu, 2 years old
Yirmiyahu, 2 years old

Recently I was speaking to a mother of a child with T21 who is a few months younger than Yirmiyahu who asked me how he’s doing.  I told her he’s doing great – cute, smart, communicative, etc.

“I don’t understand,” she said.  “Mental retardation is the definition of Down syndrome.  How can he not be mentally retarded?”

 

It’s so obvious to me that Yirmiyahu isn’t retarded that I didn’t even know how to respond for a moment.  Then I told her, I don’t accept the limiting definitions by medical professionals as fact; this is what they think they know now and it will continue to change with time.

Earlier in the 20th century, it was believed people with T21 had an IQ of 20 – 40, would never speak or read, probably not walk.  By mid century, parents of a child with Down syndrome were told his IQ would be between 40 – 60, he would walk and talk but never live independently.  Now parents are told their child’s IQ will be between 60 – 80 and he will have a mild to moderate intellectual disability.

Did the children change over the course of a hundred years?  No.  What changed was how people treated them, and this was based on their expectations which were set by the definition of the diagnosis.

Less than a hundred years ago, they were hidden away, institutionalized from birth.  Of course their development was limited.  The support people with T21 are receiving continues to improve and accordingly, outcomes are much better.

In another twenty years, it’s very likely we’ll be hearing kids with T21 have IQs of 80 -100 or more.  (Though it bears mentioning that IQ tests are a very limited and inaccurate way to judge a person’s intelligence and capacity for contribution.)  If you wait for studies to tell you how bright your child can be, you’ll have wasted your child’s growing up years.

Well, I’m not waiting for the studies to catch up with what I already know.

I can see what people with Down syndrome are accomplishing now, people who are now in their twenties and thirties.  They have graduated from regular (ie not special ed) high schools with a full diploma, gone to college and earned college degrees.  They are athletes, activists, business owners.  They are married and living independently; some are parents.  They are living happy, healthy, full lives.  They’ve challenged what we assumed was true of people with T21, shown us what’s possible and set the bar higher for the kids in this coming generation.

I’m going to make the non-scientific assumption that all of these people had parents who believed in them and didn’t let the beliefs of medical professionals of the time determine their view of their children.

Currently I know of many children with Down syndrome who are reading at the age of 3 or 4, speaking two (or more) languages and reading both languages!  Does that sound like a lack of mental ability to you?

I told the woman above, if you treat your daughter as if she’s mentally challenged, that’s how she’s going to be.  I told her about my experience at the Feuerstein Institute, when at his six month evaluation they told me they rarely see a baby with T21 at the level he was at.  This mother asked me what I did.  I don’t think I’ve done that much; the main thing, I think, is that I’ve never believed what the doctors told me when he was born.

Yirmiyahu is a bright boy and I treat him as such.  He doesn’t have to prove that he’s intelligent for me to treat him that way, any more than any of my other kids had to prove themselves.  Will some things take him more effort and time to master?  Probably.  Does that mean he’s not intelligent?  No.  Am I more conscious of providing him with good quality input?  Absolutely.

We can’t limit our kids because of a diagnosis.  We can’t let professionals limit our kids because of a diagnosis.  Kids with Down syndrome have amazing potential and it’s unfair and damaging to view them through the lenses of outdated medical information.

Avivah

Yirmiyahu is two!

Our gorgeous boy is now two years old!  TWO!!!  I can hardly believe it!  Don’t you also feel like the time has flown?

This morning we went to a bris and it took me back to Yirmiyahu’s bris, when we publicly announced the Trisomy 21 diagnosis.

Down syndrome.  It looks like this.

Curious.

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Engaged.

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Flexible.

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Interested.

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Contemplative.

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Active.

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Loved and loving.

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Proud.

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Playful.

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Yirmiyahu – smart, healthy and OURS!!  We are so blessed and so proud of our little boy!

Avivah

Yirmiyahu update – 23 months

Watching Yirmiyahu develop has been amazing.  Children with Trisomy 21 have some challenges, one of which is low muscle tone, which means it takes a lot more work for them to develop the motor skills than it does typical kids. It’s like watching a slow motion film, where I can see every tiny step of development, steps that I hardly noticed occurring with my first nine kids.

Yirmiyahu is a pro at climbing stairs  and has now also learned to safely climb down, so I’ve been able to remove the unsightly safety gate that we had at the bottom of our spiral staircase.  One day I took him to the park and on his first try discovered that without socks on he could climb up the eight foot long slide at the park (about six feet high) by himself!  He loved that and after sliding back down the slide once he reached the top, he immediately repeated the feat at least six times in a row.  🙂

He doesn’t have any recognizable words yet but babbles a lot and it’s clear he has a lot he wants to say.  Even without words, he’s amazingly good at communicating what he wants, combining patting, pointing and making expressive faces.    A few days ago I was holding him and ds11 put his arms out to Yirmiyahu.  Yirmiyahu shook his head, swatted his brother’s hands and then turned his head away while clutching me more firmly.  I told him that ds11 would take him to the park- Yirmiyahu LOVES to go outside-  and he turned and dove into ds11’s arms!  He makes a beeline for the door as soon as it opens and I’ve told the kids they really need to close it behind them to be sure he doesn’t take his opportunity to go out.  He’s fast and he’s the first to notice if the door is open.

Yirmiyahu has been drinking independently from a cup for a while.  I’ve never been a fan of bottles nor sippy cups.  Yirmiyahu has needed formula so bottles couldn’t be avoided, but when he began drinking water I gave him a cup and he learned to control the flow of liquids pretty quickly.

He’s recently become really interested in books and flashcards, and will climb onto the couch and deliberately flip through books and become absorbed looking at the pictures.  In the past it seemed random when he was holding a book and I couldn’t tell how much he was getting from it, which contributed to me not being super consistent about flashcard sessions.  Now he climbs into my lap and settles in for a read and loves it!   This week we were gifted with several board books for him by a mom who no longer needed them and he was so excited by them.  (If you happen to have board books in your home that you’d like to pass along, we’d love to give them a new home!  Believe me, they will get a TON of use!)

And what is his latest achievement that has him clapping for himself and us cheering along with him?

Walking!!!

And now, for your viewing pleasure, a few short Yirmiyahu clips demonstrating his newest skill!

Yirmiyahu started taking his first step a few weeks ago, and it’s been slow and steady progress as he builds the strength in his core muscles to balance and take more steps.  It took him three weeks from the time he took his first step until building up to 5- 6 steps in the last few days.  There have been many, many falls along the way though he doesn’t seem to mind.  I marvel how he keeps trying and trying, enjoying the process of learning and acquiring mastery without getting discouraged.   We could all learn a lot from that attitude!

Avivah

Yirmiyahu update – 20 months

IMG_2282Time is zooming by and Yirmiyahu is already 20.5 months old!  And since today just happens to be World Down Syndrome Day, it’s the perfect time for an update!

Where is our busy little man up to now?

Climbing – For quite some time Yirmiyahu would climb up the first stair of our home, then go back down.  When I take him to the park (usually at least twice a week – all the  kids there know that’s his spot!), he spends most of his time at the bottom of the slide, standing next to it, climbing up and then climbing down.  And then a couple of weeks ago, literally from one day to the next – he climbed up the entire spiral staircase in our home to the second floor.  This was very exciting – he loves it and has a great time waving to us from under each step as he does us – but it’s also a little nerve wracking.  A couple of times I found him upstairs with no one in sight; both times he had climbed up himself when no one was watching him.  He’s really fast and he loves being able to go where he wants to go!

We quickly got a baby gate to close off access to the stairs and closed off the open spaces along the sides of the stairway so when he was climbing there wasn’t the fear of him slipping through the side to the drop below.  The gate works fine as long as we latch it.  For a while we were pulling it shut behind us, until Yirmiyahu began to push it open and then climbed up. A day or two after this,  I watched him push the gate open, climb up a step, then turn and carefully pull the gate shut behind him – funny to watch since he’s copying what we do but the reason we close it behind us is to keep him out!  Since I want to encourage his climbing, I let him climb as often as he wants as long as someone is there to keep an eye on him.

Standing – Yirmiyahu began standing independently a couple of months ago and has gotten much more stable.  He regularly cruises around holding on to the couch and chairs, and in the last week he’s begun taking a step in the direction he wants to go in before falling into the arms of the person he’s going towards.  I have a feeling that he may begin walking as suddenly as he began climbing the stairs, with a long preparatory warm up period as he builds his core muscle strength.

Signing – we’ve taught Yirmiyahu some basic words in sign language.  Recently he signed something to one of the older kids, who showed me the sign and asked me what Yirmiyahu was asking for.  It was the sign for a pear and we had only showed him the sign two times a couple of minutes apart a week before – funny that Yirmi remembered what it was better than his older siblings!  He’s done this a couple of times, signed something a week after having been shown the sign, and at the time we showed him the sign we thought he wasn’t absorbing what we were showing him.  We don’t plan to use sign language extensively, but want to give Yirmiyahu the ability to express himself to some degree while his verbal skills are still minimal.

Reading – Several months ago we began an early reading program with Yirmiyahu.  I began using the BrillKids Little Reader program, which is excellent.  If I’m on top of things, he watches this twice a day but it’s challenging since his siblings all run to the computer when I put this on for him and then he gets distracted looking at all of them rather than the screen.

A few weeks ago I began printing my own own flashcards to supplement his computer program.  Each card is half the size of a letter size piece of paper, with a picture of the word on the back.  I laminated them and use them to quickly flash through each side with him.  I thought this would hold his interest more than the computer program but it hasn’t worked out as much like that as I anticipated.  Interestingly, the set of cards he likes best are action words – and that’s the only set I  made that has no pictures.  I act out each word as I show it to him and he cracks up at some of my charades so no surprise that it’s the most interesting group of words!

Ideally it would be best to use the same five to ten cards each day for a week and then rotate and add in new cards.  But I’m not that systematic.  I made almost 180 cards (clothing, body parts, transportation, colors, toys, common animals, wild animals, nature, action words and things you eat with) and I pick up whatever set I think he’ll be most interested in at that moment.  Part of why I’m relaxed about this is because I think of this as reinforcing his computer program so I’m not strict about the structure.   Sometimes I show him the cards a few times a day, sometimes just once, sometimes in addition to the computer program and sometimes not.  It takes less than a minute each time so it’s not an issue of major time, the bigger issue to is to remember to take them out.

The Little Reader program has options for customization that I haven’t explored much yet.  However, I did do some customizing to create a new category called ‘family’.  This includes all his parents, siblings, and this week I added in my mother and her husband.  (I’ll add other family members as time goes on.)  For each person, I’ve loaded two or three pictures.  In addition to dh and I, dd17, ds15, dd13, ds7, ds6, and ds4 each did an audio recording of their names.  So what happens is Yirmiyahu sees the name of each person flash across the screen while hearing that person say their name at the same time, then sees a picture of the person as the name is repeated.  It’s the same structure as the general program but with words that mean something to him.  I play this category kind of as a reward for him after doing his regular words – he LOVES this.  He sits there absolutely mesmerized and can watch it play again and again.   This week I changed the order of all the pictures and people so it’s not predictable what the next screen will show, and in honor of Purim I added in fun pictures of each person in costume.

I can’t really tell you how much he’s picking up or not at this point (though I think it’s highly likely he can at least recognize the names of the twelve immediate members of our family) since my focus is on providing stimulating input, not on testing.  I’d like for him to be reading English well before we start on Hebrew reading and my general goal is for him to be reading English by the time he’s five or six.  That will take work but I think it’s realistic for my relaxed way of doing things.  I know of people who have taught their kids with T21 to read at 3 or 4 and though I’m sure Yirmiyahu is capable of it, I don’t know if I’m capable of the necessary consistency!  My goal is more of a general direction to move towards, not something rigidly fixed in my mind and if we achieve it a bit earlier or later is fine.

Growth – Yirmiyahu has hardly grown since I posted two months ago that we had finally seen some growth after beginning to supplement for cerebral folate deficiency.  I really don’t know what to do about this.  I posted a picture in my last post of him a year ago at 7.5 months and he weighs only five pounds more now than he was then.  It’s not that having a child who is small for his age is inherently disturbing to me; kids come in all sizes and the outside doesn’t determine the value of what’s inside.  My issue is that he has the same tall genes as everyone else in our family and to be so small is a result of that pesky extra chromosome suppressing his growth and that’s a medical malfunction.  Sometimes I feel like I’m failing Yirmi that I can’t figure this stuff out for him.

Health – Overall Yirmiyahu is doing great – he’s strong and healthy and smart!  There is one medical issue that needs to be taken care of now.  We had an appointment with the nephrologist this week who was appalled that he hasn’t been treated surgically yet for the bladder malformation and felt it was medical negligence that the other doctors recommending leaving it this long with it being at the most severe level, when it could be taken care of so easily surgically.  It’s hard to know which doctor to trust when they’re both saying such different things and both are supposed to be good doctors.  At this point my preference is to do surgery; once it’s taken care of we never have to worry about this again.

The alternative to surgery is ongoing daily antibiotic treatment, which the first urologist and I have a difference of opinion about.  He felt there’s no downside to taking the long term daily antibiotic route (for the next five years at least) and I feel this will seriously compromise his health.  Yirmiyahu restarted antibiotics again a couple of days ago and as of today his stomach is already a mess. I’ve worked hard to rebuild his gut after he went through so much in the NICU and then the PICU and it’s like starting at square one again except if he has to be on antibiotics every single day, that doesn’t leave time to help him grow good gut bacteria.  He’ll need to stay on antibiotics until he has surgery.

The earliest appointment I could get with the recommended urologist is in two months; the appointment is to discuss surgery and we’ll schedule surgery based on his feedback.  I don’t have any idea when we’re moving so I hope we’ll still be here by the time the surgery is scheduled; otherwise I’ll have to start this all over again with different doctors in the area that we move to, and that will delay the surgery by several months more.  Right now I’m making plans with the assumption we’ll be here and if something changes, I’ll adapt my plans at that point.

What isn’t new is the joy and light this little person has brought into the lives of us all!  I love watching my older kids come home each week and interact with him – they are so in love with him!  I joke that his first words are going to be, “Oh my gosh, you’re so CUTE!” because he hears this all the time.  They younger siblings enjoy him but the older kids ages 13 and up simply delight in him!  Last night one of the kids said he hopes Yirmiyahu doesn’t get spoiled because of all this adoration he gets, but I told him a child can’t be spoiled with lots of love.  They can be spoiled when they’re allowed to act badly and it’s considered acceptable, because after all, he has a disability.  But to return some of the love he radiates out to us all back to him isn’t spoiling at all!

Avivah

(This post is part of the Day in the Life Series that is part of World Down Syndrome Day.)

Today’s medical testing for Yirmiyahu

ekgYesterday I mentioned that I had some doctor visits for Yirmiyahu and a couple of readers were concerned about what was going on.

Today we went to check out two things, his heart and his kidneys/bladder.  When he was born his heart was enlarged (not typical for T21) and he had a bladder malformation (also not typical for T21).  I had his heart checked when he was six months and was told to come back to check it again, which I did today.

When he was in the intensive care unit at  8 months old, they found that Yirmiyahu had developed a urinary tract infection as a result of the bladder malformation that led to a situation called hydronephrosis (swelling of the kidney due to back up of urine).  At that time they said the malformation was a level 5 out of 5, five being the worst, and that they anticipated having to correct this surgically.  They told me to wait until he turned a year old to do the surgery since he was so small.  At the 12 month check there was some improvement and the nephrologist said there was no longer an immediate need for surgery and that his kidneys were fine.  The urologist told me the chance of the structural problem improving without surgery is 20% (which I found encouraging since originally we were told there was no option to surgery).  They both told me to keep an eye on it and get further testing done to see how things are going.

So that’s what today’s doctor visits were about.

First his heart.  We started with an an EKG and then did an echocardiogram.  After reviewing the results, the doctor told me everything looked good.  I asked for more details and he told me,  “There’s no sign of any heart problem. Whatever was there isn’t there anymore. ”  I asked if I need to come back in six or 12 months to check this again, and he said, “No, there’s no problem.  His heart is perfectly healthy.  You don’t need to come back ever again!”  I feel like I should highlight and bold that statement and then make it really big letters because to leave it in normal letters isn’t really representative of how I feel.  I think I’ll repeat it.  “His heart is perfectly healthy.  You don’t need to come back ever again!” 

Now about the bladder and kidney ultrasound.  I have been and remain apprehensive about this situation.  When they found the UTI last year, I hadn’t see any signs of it (the only one I would have seen was a fever but it must have been low grade) and I worry that I could miss it again.  This concern is constantly in the back of my mind, that something could be wrong that could affect his kidneys and I wouldn’t be aware of it.

The person who did the scan didn’t discuss the results with me; they give you a disc of the scan and email the doctor the specifics.  I was waiting for the disc when another father waiting for his disc came to complain about the long wait.  (I had to wait an hour and forty minutes for my disc!)  The person responsible for distributing the discs told him that if there’s no problem it will be sent in the mail.  Then he started to tell me to go home and wait for my mail, and the person who did the scan came by as he was speaking and interrupted him, saying, “No, she definitely needs to get her results now.”  So clearly there’s something wrong.  I already know there’s a structural problem and I’m hoping this is all he found but I’ll have to wait until the coming week to find out more about that.  It’s a little frustrating to me that he couldn’t tell me anything about what he found and keep me from worrying for another week.

Whatever the results, I’m glad to have gotten all of this testing done today.  Obviously the wonderful results are wonderful, but I try not to close my eyes to things that need to be dealt with.  Hopefully the results of next week’s doctor’s visit will be good as well.

Avivah