Speech and Language Evaluation; Speech and Developmental Delays

About a month ago, Tantrum Tot, my 23 month old, had his initial autism screening during a well-baby appointment at the pediatricians office.  The result conveyed was extremely high risk.

The pediatrician made an appointment for us to have a speech and language evaluation while we wait for an appointment with the developmental pediatrician, who by the way, we will have to wait several months to get in to see, AND drive three hours in each direction for a visit!

We are still waiting for our initial information packet, which needs to be filled out and returned to them to arrive in the mail.  No appointments will be made until they receive the packet (it would be nice if they actually send the damn thing to me though). To date, I am still waiting.

Today we went for T's Speech and Language Evaluation.  He played quietly lining up toy school buses in the waiting room while me and hubby filled out the intake paperwork.  Unfortunately that quiet was followed by a head-banging temper tantrum two seconds into his evaluation.

The speech pathologist took him into the therapy room leaving hubby and I in an observation room behind two-way glass.  I felt like my poor baby was being interrogated while we lurked on the outside.  She attempted to sit him in a hair with a "tray" of sorts.  It was like a highchair tray--big mistake! He freaks out if you attempt to restrain him to a high chair or anything where he cannot move around freely.

He screamed, cried, threw things, and tried to hit the poor woman with his head. I had to go into the room to hold and rock him because the poor kid was hyperventilating he was so upset.  The pathologist said that most of the autistic children she works with love to be in that chair, and have their own play space.  Well, not mine!

When finally calmed, he wanted the animals from the Noah's Ark toy on a shelf. Mom and the little guy sat on the floor lining up animals together. He was fairly cooperative from that point on.

The results: Receptive Expressive Language Delay; Developmental age was determined to be right around one year.  He is only using three words at the moment: Mom, No, and Go. Little guy does not respond to his name, or make eye contact--but we knew all this already.

We are still awaiting a visit with the Developmental Pediatrician to confirm his doctors ASD suspicions, and will (hopefully) be starting therapy two days per week--if our insurance will pay for it.  If they do not, I am not sure exactly how much therapy we will be able to afford.

I was not able to get anyone from Blue Cross / Blue Shield on the phone today, so I will be hounding them first thing in the morning armed with my diagnosis and treatment ICD-9 codes.  If anyone has experience with BC/BS and speech therapy, please let me know what your experience was.

This is the first of my three boys who has had any kind of speech therapy/intervention this early so I am not sure what to expect fully at this point.  The older boys were both at least four when they began speech therapy through the school system.

If your little ones had early intervention speech therapy, what was the outcome?  Do you think it is really effective at such a young age? I'd love to hear your experiences.

I bought a juicer! Happy New Year's Day to Me!



A long time ago (years), I used to exercise, and juice—a lot.  I can recall feeling very good in general, and good about myself and my health.  I’ve gotten so far away from those days in recent years, and after reading a few health blogs I’ve decided to give juicing another go. 

Today, I bought myself a juicer (Happy New Year’s Day to Me) and I am sitting here typing and drinking my first juice from my “gift” to myself—apple, orange, grapefruit, lemon, carrot juice. It is tart, kind of sweet and sour, but not bad for my first time dropping fruits and veggies  indiscriminately into a juicer in—oh, about ten years.

I have had an issue recently, which I wrote about here: The Adderal Experiment, about how I am increasingly cranky on Adderall.  I was unable to ascertain if it was the Adderall itself making me irritable and giving me headaches, or if it is that that I simply do not eat while taking the medication.  A combination of laziness and stubbornness lead me to forego my Adderall intake for the past few weeks because I was running out and dreaded picking up the phone to make a doctor’s appointment for a refill.

I have not really been less irritable, but I have definitely been less productive and focused.  Another downside—I’ve put on fifteen pounds in the past month and a half, not good. Fifteen pounds represents about 12 % of my total body weight so it is a huge amount of weight for me to gain so quickly.  I can feel it in my legs, knees, and my incredibly painful back.

Unfortunately, I have a pretty bad case of degenerative disk disease and osteoarthritis throughout my spine—not fun, and it begins to hurt if I carry around any extra weight (which is most of the time). Out of sheer vainness, I decided I would start taking my Adderall again, lose the pounds, and be able to focus better.  The problem is I will likely not eat well, or at all most days except for maybe my morning coffee (ya, I know real healthy!).

My solutions: juice!! I will definitely drink when I take my meds because they make me insanely thirsty. My new experiment is to drink vegetable (green) juices, and fruit juices to ensure that I get the nourishment my body needs.  Let’s see then if I am super cranky and flying around the house on my broom stick…I hope not, but only time will tell.

Today is Day 1 of my juicing madness.  I didn’t take my Adderall, but I will begin to take it again tomorrow (I have a small supply leftover in the back of the cabinet) and make an appointment for a check-up and refill.  Alright, I’ll have hubby make the appointment.  I hate picking up that telephone and talking to anyone including the receptionist who makes appointments. So stay tuned, and we will see what happens...if I don't give you all an update someone, please, remind me!

Have a Happy and HEALTHY New Year!

~Aspie Writer

Oh by the way, my kids bought me Wii Fit for Christmas (think they were trying to tell Mom something), so I’ve been playing with my new “toy” too—and everything hurts! 

Executive Dysfunction and Goal Planning 101: Why Aspies Must Goal and Plan Differently.

Have goals, write them down, and then make a plan/roadmap to follow in order to accomplish them.

If I had a nickel for each time I have been given this advice I would be retired in my dream place on the Amalfi coast in Italia. 

Now I am going to tell you why making goals, resolutions, and promises to yourself only serve to make you feel bad in the end.  Having goals, dreams, ambitions, aspirations are important to all people, but goal setting for those on the autism spectrum is a two-edged sword. 

For those Aspie’s who apparently struggle with executive functioning issues, making it to our goals can be grueling, discouraging, and at times down right impossible.

Executive Functioning

Executive Functioning is the higher-order brain process that is responsible for being able to work towards our goals. It is the process that is responsible for planning, sequencings, prioritizing, shifting attention, and completing.

Many people on the autism spectrum, (like me) experience executive dysfunction. This important self-regulatory system when in deficit, makes it difficult to take steps towards a goal while incorporating information and making adjustments along the way.

I liken the goal reaching issues to my sensory processing issues (and wonder if on some level in the frontal cortex of the brain they are related). My auditory system seems to be unable to filter out background noise, or hone in on a particular sound when required. 

There is no filter; everything is coming at me at the same time, fawning for my attention—now. There is no hierarchy of importance in these sounds, meaning the sound of a voice speaking to me is of the same importance to my auditory system as the sounds of the traffic in the background, and, therefore, seemingly as loud and distracting. 

The person’s voice blends into the backgrounds sounds, often disorienting me, and making all the sounds and words blend together.  This is particularly problematic if I am stressed, distracted, or overloaded in any way. 

Making progress towards goals is very similar to this experience when you live with executive dysfunction. All the steps required to make progress towards a specific goal gets jumbled together. 

I often have trouble deciding what to do next (sequencing) in order to move myself closer to the goal because all the tasks needed to be completed, are of equal importance (prioritizing), and need my attention—now (no filter). This inability to sequence, and prioritize effectively often results in not being able to complete a project/goal.

“I am a sprinter, not a marathon runner.” ~ Jeannie Davide-Rivera, Twirling Naked in the Streets—and No-One Noticed

Long term goals (marathons), that have steps which need to be completed on a consistent basis (daily, weekly, monthly, etc.) such as maintaining a balanced budget, saving for the future, or paying things in a timely fashion are infinitely more difficult than short-term goals (sprints). I need to sprint to that finish line, getting there as fast as I possibly can before I lose sight of the line.  The longer it takes me to get to the finish line, the blurrier that line becomes until it has vanished from my sight altogether.

Simply telling me I have to work on these things and try harder is not the answer.  It can’t be because it really has little to do with how hard we try.  In fact, I try ridiculously hard, and have for years only to the same result—colossal failure.

One thing that happens to me often is that when I am working on a project/task/goal I have a difficult to time being able to start and/or stop.  This self-regulation process is also a product of executive functioning. The ability to begin a task and know when you have done enough work on that particular part, and move on to the next step necessary for completing.  However, autistic individuals, whether because we get lost in the details, or because we lose track of the time that has slipped away from us have a difficult time with starting and stopping.

I can often work on a piece of writing, focusing intently for hours on end, and still not feel like it is done.  I do not realize when it is time to take a break, eat something, use the bathroom, or go to bed.  While hyper-focusing on things that I enjoy or things in my special areas of interest, the ability to self-regulate, starting and stopping, becomes non-existent. 

I can often forget about everything and everyone around me and get lost in my own private world.  In these times, I have the capability to far out perform most any NT I know.  My special talent is the ability to focus intently, but that does not serve me well in the everyday things of life where I am expected to perform as everyone else.

I believe that our ability to intently focus is another manifestation of executive dysfunction, but one that can be harnessed and used as strength if only we would make plans and life goals that we are intensely passionate about. If only we would make goals that are suited to our special abilities. The problem I fear is that we very likely may only be able to work towards one goal at a time.

I, for one, cannot work on balancing a budget, keeping a house, working for a company, and working towards completing my writing projects.  I have to choose ONE, and only one at a time because it will be to the exclusion of everything else. 

Tasks like budgeting and housekeeping are particularly problematic because there is no clear beginning or end.  They continue on endlessly with no finish line in sight (the ultimate marathon). There is no conclusion, I cannot sequence, prioritize, organize with enough competency to make these tasks a normal second-nature part of my life.  I would then have to focus intently on them to the exclusion of everything else—indefinitely, which in reality is not possible.

The world around me seems to do these tasks with seeming ease, naturally, without having to think about every single little task, and then figure out in what order they should be accomplished. 

There are times I wish that I had that ability, to move through certain areas of life with ease, especially when they are domestically related because I am “expected” to be able to perform at a certain domestic level. But the simple true is that I do not possess the ability, I never have, and working toward unattainable goals just makes me miserable.

On a brighter note, I can focus longer and harder accomplishing more in areas that others struggle.  I learn quickly, and with ease subjects of my interest, which is something that does NOT come easily to most of the world.  So my solution to goal setting/ New Year’s Resolutions etc., is not to  make ANY that anyone else things I “should”.  No goals, lists, or promises to myself that I cannot keep! 

This is not to say in any way, shape, or form that I do not have goals, or that I am not ambitious—I am. Only that I will resolve to do more things that I enjoy, and less of what I do not.

I am resolving to make goals that I am intensely passionate about, and leave the things I can’t accomplish to others who can. Maybe the simple truth is that I am not “meant” for those tasks, maybe I am meant to do and accomplish so much more—so much more than I could have ever imagined if only I could shed the idea that I must work towards goals that are acceptable to everyone around me.

My advice to all this year’s goal makers and New Year’s resolutionists:

1.       Don’t make any resolutions!  If you need one, resolve to do more of what you like and less of what you do not.

2.       Only make goals to accomplish things you are INTENSELY passionate about, and try to complete them in short spurts in a series of short goals. For instance, make a goal to do something you enjoy today, whatever that activity may be—do it and feel good about yourself.

3.       Stop beating yourself up (as I have done every single New Year’s Day in the past) about the goals, resolutions, and promises you made to yourself last year that did not become realized.

4.       Make two lists—one of things you enjoy doing, and one of things you absolute hate.  Then work on doing more from list number one.

5.       Get to know yourself—really know yourself.  Think about your strengths (I suspect they may be tied very closely to your list of things you really enjoy doing) and then celebrate them. Make this year a celebration to you, your uniqueness, and your autistic-ly awesome self.

Now—Bring on 2013!!