Preschool isn't going well

I had a conference with Kevan's teacher today, and it sounds like he's not gaining anything from being in a preschool setting -- and he's disrupting the class, besides. She was in tears telling me that she was at her wit's end in dealing with him. I felt terrible.

Short background -- Kevan has a severe speech delay, most likely apraxia. He also has gross and fine motor delays (probably related to the apraxia). He's in several hours of speech, oral motor and physical therapy a week, and we're about to start OT as well.

We're not sure where he is cognitively, although he definitely "gets" a lot things, but others he doesn't. His physical therapist says he's a bright kid and understands what's expected of him, but he's clearly far behind Karina in this area. We've had no real reason to suspect anything on the autism spectrum, but he's definitely a *different* kind of kid. I think he has some sensory issues that haven't really been diagnosed, and he craves sensory input, so he moves constantly and is always into everything.

Anyhow. He's been going three mornings a week to a mainstream preschool. He separates well from us and runs right in -- that's never been a problem. But he hasn't yet figured out how to identify his cubby with his picture in it, and won't hang up his bag.

He will sit down and eat his lunch, but he then steals everyone else's drinks, no matter how many times he's told to stop. At home, he likes to put Karina in a headlock and wrestle with her, which is kind of funny -- but, he's doing it to kids in the class and making them cry. He thinks he's playing, and doesn't understand that it hurts other kids, or that they just don't like it. He's got no sense of personal space.

They don't take him to music or chapel anymore, because he absolutely cannot sit in a circle for more than a minute. Instead, one of the two teachers will walk around with him outside while the other kids are in music or chapel.

He puts everything in his mouth, still -- glue, mulch on the playground, hand sanitizer, etc. He just doesn't understand/remember that he shouldn't do it.

I know a lot of these things aren't unusual for a 2-year-old, but it's extreme enough that he really needs one-on-one attention from one of the teachers at all times, to prevent him from being a menace to the other kids.

So, that's not fair to the class. I'm going to have a meeting with the learning specialist at the school today, and she's going to go observe him in the class on Monday, and speak to the teachers further. And then, I suspect we will make the decision to pull him out next week.

But, then what? We know he's behind in a lot of areas, so does that mean he's just not ready for a school setting? I'm fine with that, as he's only 2 -- maybe he will gain a lot being home with me, while Karina is at school? But, both of his speech therapists say that putting him with his peers is the best thing to improve speech, so I'm not sure what to do about that.

He's already in tons of therapy, so how do we find out what else he might need? A lot of kids with apraxia are diagnosed with ADHD, so it wouldn't surprise us if Kevan went down that path. I'm addressing that with nutrition and supplements right now -- he gets a lot of omega 3's, vitamin E, phosphatidylcholine, and piracetam.

But, what else can we do? Should we suspect something beyond the apraxia/speech/physical issues? Should we take him to a developmental pediatrician? I was holding off on doing that, because they're very expensive, and because I didn't think he was old enough to really discover anything worthwhile before now. But, maybe now we should.

I know there are special needs preschools, both private and through the school system, that start at age 3 -- and we'll definitely look into those. But, until then, I'm not sure what else to do for him.

Any thoughts are much appreciated!

 

:hug: I don't have a lot of experience here, but can you schedule a conference with the therapists and the teachers? Also, in my town we have a developmental playgroup once a week at our library geared toward kids in EI. That might be something to look into as well if you decide to pull him out of preschool (so he has a "school" to go to while your girls are in school). :hug:

 

:hug: Let me think on this a bit - I will come back in a little while to give some thoughts. Just wanted you to know I am thinking of you and what a hard situation this must be for you! :hug:

 

It does sound like pulling him out might be the best for now. If that's what ends up happening, I would focus on planning playdates for him so he has the opportunity to be with peers but just for an hour or two. Or you could enroll him in a music class or gym class.

It might not hurt to get an appointment with a developmental pediatrician, especially since they are usually booked so far in advance. You can always cancel the appointment if he makes a lot of progress between now and then. However, it sounds like you've got him in all the therapy he would need, even if he was found to have an ASD or SPD.

My DS Aidan is involved in this group therapy/preschool program through EI and he seems to be thriving in it. Basically, it's 10 kids with delays, 2 developmental therapists and 1 DT aid who run the program. Then there are ST, OT and PT that come in to give the kids individual weekly therapy. So, my DS gets his ST and OT while at "school", but the rest of the time he is there, he does typical preschool activities like painting, gross motor play, snack time, etc. DS is doing well here, but I don't think he would be able to do well in a typical preschool setting that didn't accomodate for his delays.

 

Do they have a preschool through the school district that can meet his needs better? When I worked as a Speech Therapist in the schools, we had a ECDD (Early Childhood Developmentally Delayed) preschool. About half the class was made up of special needs kids (many various diagnoses and some that just had behaviors or issues not diagnosed) and about 1/2 was made up of average peers. The class was taught by a Early Childhood Education special ed teacher with 1 or 2 spec. ed parapros. Often times, the therapists would come in and work with the kids in the classroom, but sometimes pull them out as well. I'm not sure if you have anything like this available. I'm sorry that you're going through this. I think that it's important for him to see peers doing some of these things that are expected for his age, but I can see why you and the staff may be frustrated. I wonder if there's a way for some of his therapists to come to the preschool and guide the staff in how to handle some of the situations that are arising. I don't know if he uses a picture schedule, what their reinforcement is for positive behavior, etc. Maybe a meeting with everyone involved would help eleviate some of everyone's frustration. I can't tell you whether you should pull him out or not. But, I can say that the longer you don't have in some small amounts of structured situation such as preschool, the harder it may be for him to adjust to it in the future. Good luck. PM me if you ever want/need to.

 

I would at this point, call the school district and get the ball rolling on an eval for the preschool. At this point, the best thing would probably be to pull him, and get his EI services (I think you do private, but you know what I mean) done while Karina is at school. I think you will find that when he turns 3, and spends every day--regular schedule--doing the same thing with a small group and teachers who specialize in special needs kids, he will start to turn the corner. My guess is he is acting out as a result of his lack of speech, and it is the only way he can figure out how to communicate his needs. Jon was a lot like you describe in terms of behavior and speech, after being in the special needs program only a month, he was a totally different kid!

For socialization, I would look at more of a Mommy and me program--especially if you can find one while Karina in in school so you can focus all your energy on him.

Hope this helps!

 

:hug: Sorry to hear you all are going through this. :hug: I agree with pp's....pulling him out might be the best thing for him right now. I also agree with Sharon that his acting out might be from his lack of speech and communication problems. My nephew was delayed in speech due to hearing problems. He had a horrible time with acting out/aggressiveness/tantrums, etc....He just didn't have a way to communicate yet and it was VERY frustrating for him. Once his speech improved his acting out/aggressiveness improved. It sounds to me like he would benefit from a more one on one setting. I think the suggestion of having EI come in while the girls are in school is a good one.

 

:hug:

I don't really have any real advise to give except that you should wait and see what the learning specialist thinks. Maybe he's just not ready for preschool yet.

I hope everything works out!

 

Kevan sounds a lot like my little nephew, Evan. My SIL put him in a special needs preschool and it has done wonders for him. Evan also goes to speech and OT, but this preschool has really, really brought Evan out! Evan did not say anything at Kevan's age, no mama, dada nothing. He, like Kevan would not have recognized his cubby, or hung his back pack up. I am not even sure he would have even really recognized people that he did not live with (my twins or me for instance, he acted like we did not exist and he saw us most days. Strange thing was that he was not shy at all - but it was like he was in his own little world . He could not get out and we could not get in. He is 4 now and a great conversation holder! My SIL has never really gotten an official diagnosis. Some mentioned the autistic spectrum, others said developmentally delayed. Either way, the child has come a very, very long way. The other day he was at a friend of SIL's who is also named Heather. SIL had told him that they were going to Heather's house. When they got there and he saw the other Heather he said "This is not the real Heather's house" :wub: He is still behind but not too bad, they are hoping that he will be able to be mainstreamed in kindergarten.


also, I will say now that I have children of both sexes, boys can be different than girls. 2 of my 3 boys were not ready for preschool until they were 4 and even then I wish I had kept them in preschool an extra year my 2 were no more interested in circle time or hanging their back packs up than the man in the moon. My ds#3 would have been like a greyhound and chased a rabbit to the end of the planet, but to sit and do anything that was "expected" of him in a classroom setting, no way. It was almost like it was just too much stimulation??

:hug:
Heather

 

I agree w/ this. Our area has a early childhood program - from 0-3 they have playgroups for special needs and offer a lot of 'mom' support as well. Are your therapies through EI? After age 3 (start evaluation at 2.5) they have ECDD. It is really a good program and involves a lot of therapy and the teachers/staff are able to deal with active behaviors/short attention spans/ low or no speech. It would be really good for him to work with teachers that are experienced in apraxia/sensory/ developmental delays, plus they have 'age typical' peers to provide social role models. Also are there other 2yr old activities that are shorter and geared toward more movement/action that he may benefit from?

Our OT also had a 'play group' over the summer for kids and that was great! It was sensory based and they had several different 'groups' of different ages that met every week for 6 weeks. They did a lot of wonderful activities and the therapists had all sorts of kids in the groups (adhd, CP, ASD,etc) and were used to working with different needs and abilities. Both my DD did it 2 summers ago (at 2) and one DD did it again this summer (at 3). Another local OT clinic runs playgroups for speech for ages 18m and up. DO you have anything like these? They are in additon (private insurance- but one of them had a sliding scale) to the wonderful things our EI offers for ages 0-3.

Time will also make a difference. One of my DDs did a small church Preschool last year at 2y10m- 3y8m. She did well over all, but struggled with group settings (circle time, field trips, etc) and had sensory issues (noise, texture, gross motor/motion). Luckily there were 2 adults and only 6 kids so it worked out and it was only 2 hours 2x a week. But she would not have done well in a larger setting at. all. period. The 4 hours a week were a strain and totally wore her out- the social skills she gained were nice, but I know the teacher struggled at times with how to deal with it (she had non aggressive behaviors- like eating nonfood, hiding under tables, ear covering,etc). She has had PT &OT through EI and privately. Now she is on an IEP through the schools (PT/OT) and in a special PreK class of 15 (2 adults). The past year has made a HUGE difference, in addition to her current teacher is used to working with 'risk of academic difficulty' kids (risk for behavior, academic, social, or other reasons). This teacher is awesome and she is really blossoming. We see a lot fewer 'quirky' behaviors, although they are still there. Just wanted to tell you a lot can change in a few months, in addtion to the fact that an experienced teacher makes a huge difference!


KC

 

Just happened to click on this topic because my niece had a tough time with preschool. Anyways, I'm sorry you guys going through this Becca. :hug:

 

My twins have been diagmosed with autism and they have many, many of the same issues os your Kevan. I am NOT saying he is on the spectrum, I certainly have no authority or ability to diagnose your son in any way. Anyway, my boys were evaluated and diagnosed through Early Intervention and it was free. Someone mentioned they thought you have private services for Kevan and that is great. However, what is the harm in involving EI as well? He could get an increase in services and then he will be in the system when he turns 3 and moves up to the school system's educational opportunities? My boys were receiving services through EI from the time they were around 13 months old. They came a long way with speech, understanding, sensory issues, etc while with EI. However, now that they have "graduated" to the school system they are in preschool at a local elementary school. I cannot explain or express how far they have come since the school yeat started! They started talking- like real, meaningful talking! They are not just repeating what they hear in a garbled, only we can understand way- they are talking! Now Jacob still talks less and has more issues trying to figure out how to use his tongue, which make him harder to understand and there are feeding issues, etc. Anyway, they are learning SOOOO MUCH and doing some really incredible things. I have been shocked and amazed every single day since they started school. They are in an Autism Specific classroom, but children with any developmental delay that need as much as they need (constant supervision, more therapies, special acoomodations, etc.) in a full time basis can be in the classroom.

I do not know how you feel about a diagnosis of any kind.A diagnosis does not necessarily change his needs or hwo he is to you or anyone else. Of course I "knew" in my heart my boys had autism, when I heard the diagnosis,( I had them evaluated twice a year apart) both times I cried.It is not because I was devastated or that anything had changed about them. I think it was the relief of a real diagnosis and a true sense of how much work was ahead of us and them in their lifetime. I think it is wonderful Kevan has been getting all of the help he has been getting. That will go a long way in his future prognosis. He is lucky to have you working so hard on his bahalf. A diagnosis or several different diagnoses will not change Kevan. He just may be able to receive more services and more assistance in life with a diagnosis than without. Just my 2 cents. Again, I am not saying Kevan is on the spectrum. Anything you have mentioned- apraxia, sensorty processing disorder, developmental delays unrealated to autism- can look like autism.

I do know how frustrated you are and how difficult all this can be. You are doing a great job.

 

Thanks guys, for all your kind words! I spoke to the learning specialist at length today, and she was really helpful. She's going to observe him in the classroom for several hours on Monday, and then discuss some options with us.

One thing she said she's done often is shorten the child's day, and then restructure the classroom activities to make it work for everyone. For example, maybe I could just send Kevan from 9 to 11, and pick him up before lunch, or before they go to music/chapel, etc. And, then the teacher could ensure they do some fine motor activities, free play, etc. during the hours he's there.

But, we're leaning toward pulling him out altogether. We'll see what happens on Monday.

Kelly -- Kevan doesn't yet have a diagnosis, but I'm not opposed to one. I've discussed it with both his pediatricians, his two speech therapists, his physical therapist, and also with the geneticist (oh yeah, he's been through extensive genetic testing, and he does have a chromosome abnormality, although it's not a known disorder so we don't know what it means) -- and no one thinks he's on the autism spectrum. I agree that some of the behaviors are the same, though. Personally, I think ADHD is on the mild end of the same spectrum -- both neuro issues, really -- and like I mentioned, I wouldn't be surprised if Kevan is diagnosed with it at some point.

We did start with an EI evaluation when he was 12 months, and he qualified for speech therapy. But, our county's EI program is done on a sliding scale, and we didn't qualify for any sort of discount. Thus, it was actually cheaper to go with a private therapist recommended by a friend.

And then, the geneticist flipped out when she saw Kevan at 18 months, and said we needed to get him in physical therapy *right away.* So, we opted not to go through another EI evaluation, etc. -- which would have taken months -- and instead chose to go private. That therapist was such a good match for Kevan, and her personality works so well with his (he is very, VERY challenging), that we decided to stick with her. Kevan started walking a month after he started seeing her.

Finally, his speech therapist recommended that we take him to an oral motor specialist, because he needed some specific help on several areas. There is a woman in our area who is renowned in this field, and she doesn't work with EI or any insurance, for that matter. But, she is good enough that people come from far and wide to get an appointment. (Sharon Wexler, FYI)

So, he's technically still in the EI system, but we've never used services through them, and the coordinator stopped calling me long ago. I need to contact them again and get the ball rolling.

 

I hope the meeting goes well. I didn't realize that he was gone 'all' morning and lunch. A shorter day may make a difference! Give a shot, you have nothing to lose and he would still get the social/speech benefits but not face the challenges of chapel/circle time at this point. You can slowly extend the day if you want later. Also, have you asked the therapists about a sensory diet?? It may help--I know one of my DDs was much 'calmer' at Preschool when we did a modified diet before and after school (2 hours). She would have melted down going longer than 2 hours last year.

Good Luck!

 

Thank you! Will you give me an idea of what a sensory diet looks like? I know gluten-free and casein-free helps a lot of kids, but honestly I've been dragging my feet on doing that, because it seems unfathomably hard -- and I don't know if it's necessary for Kevan. But, we will do it if we have to, of course.

 

Here is a good explanation of what a sensory diet is. It is a set 'time' based set of activitites to do that is tailored to each child to meet their needs in order to help regulate their sensory systems.

With my DD it was a 2 hour pattern of brushing, weighted vest, vestibular activities (spinning/rocking), and auditory training. We did a 15 minute 'round' of the diet every 2 hours or so--with the auditory portion only 2x day. It really helped and we saw a big improvement on sensory seeking behaviors (touching people so much, avoidance of movement, ear covering,tactile defensiveness, rocking/spinning,chewing non food items, etc). We even fall back on it now if I see her 'ramping' up for a day or 2. The brushing was very helpful as well-- but that was only for 2 weeks (on 2 separate occasions). For the past year we have done a 'modified' diet of a weighted blanket to sleep, a hanging swing available for her in our house, a pattern of 'heavy work' (deep pressure hug, joint compressions,and/or hard physical activity) before she needs to tolerate a lot of tactile exposure and/or she needs focus.

I have to say the weighted blanket and swing have been the 2 big changes we made permenantly that have helped 'calm' her and lessen the 'stuff in the mouth', touch everything, climb people, toe walking. She is very verbal (with some echolalia in the past), and only recently started telling us what was bothering her (the clothes are itchy, the fan noises hurt my ears, the floor hurts my feet, etc)....it has been insightful. I wish she could have told us a long time ago, it would have explained some of the 'quirks'.

Not to say it is a cure-all, but this year we have only had a few times that we have been told she 'ate' something inappropriate (markers, crayon, chewed on plastic toy) instead of daily, she is also sleeping better, and has learned more 'personal' space for not touching/laying on/leaning on her peers. Some of it is age, but really we saw signifigant changes with OT (versus PT) and some home systems in place.

IF you have any ?s ask. We did a GFCF diet too--no changes so we dropped it. She is dairy free but that is for lactose intolerance rather a behavioral point of view.

 

First of I think you are great to reach out for advice for your son! (some parents would just continue on sending their little one to preschool, thinking he/she will just outgrow it)
I think you have recvd great advice so far, but I wanted to echo to idea of making the appt with the develp. ped NOW since it takes forever to get an appointment with most of them. Even if down the road things are working out (shorter day, sensory diet, etc) you can always cancel if you want. I have seen some of the famiies I work with wait almost a year for an appointment.
Kavan is blessed to have such a caring mom, looking out for what is best for him!

 

Becca, you've gotten some great advice and I can't add anything much. :hug: I would recommend getting in touch with the public school for the evaluation so they are ready to start services for him when he's 3 and the developmental peds can have a really long wait here, too, so I would call them soon.

 

Just wanted to give you guys an update -- the learning specialist observed him today. She recommended that we just do 9-11am on Tuesdays and Thursdays, which is what we're going to do.

That actually frees up some time for OT, and it gives Karina a chance to be in the class without her brother there -- I think it will be good for both of them.

Also, the learning specialist had specific people that I could call for a special needs preschool for next fall, which she thinks he'll definitely need unless he makes *huge* strides this year. So, I'll get moving on that, as well as getting him in to a developmental pediatrician.

KC, I'll talk to the OT about the weighted vest and other things that are part of a sensory diet. It sounds like that might be really good for him, as he is often hugging others because he craves physical contact, but he doesn't realize he's being aggressive.

Thanks again for letting me bounce this off you!

 

Sounds like you have a good plan. You may find some information that could be helpful (in regards to sensory diet, etc) in "The out of sync child"

 

:hug:

 

One more quick update. We have to start over with EI, so I have the intake appt scheduled for Nov. 23. Then, Kev's eval with the team of therapists will be on Dec. 1. If he qualifies for therapy -- and he surely will -- then we can probably get started the first of the year.

And then, I spoke to the coordinator for the special needs preschool program in our county. She is sending me the intake paperwork, but I don't need to send it back until March or so, because they start the process about 60 to 90 days before the child's 3rd birthday. Apparently they have two different models -- one that sends a therapist into the child's current school, and another that makes up special needs classrooms at local public schools. So, we can tailor something for him that makes sense. If he is in the EI program by then, they will help facilitate this transition.

This week, we tried just sending him 9 to 11am on Tuesday and Thursday. That went pretty well -- the only issue is that Karina gets a little confused when he gets picked up early, and walks around saying, "Oh no! Where Kennan? Where he go?" I'm not sure she'll understand even if I try to explain why he gets to leave early. But, she's doing okay.

Anyhow. I also have a private OT eval scheduled -- if I can get EI services moving fast enough, I will cancel it, but I'll keep it for the time being. I ordered those sensory books. And, aside from the major inconvenience of picking up Kevan at 11am, Karina at 1pm, and Nadia at 3pm, everything is going well for now, and I feel like we have a plan in place.

As an aside, I'm re-reading a book called The Late Talker that is about kids with apraxia (title is a total misnomer, because apraxic kids are not just late talkers). One of the authors is a mom whose son had this disorder. They profile this kid -- Tanner -- in the book, and his symptoms sound *exactly* like what's going on with Kevan. In addition to the oral and verbal apraxia, he also had hypotonia and sensory integration disorder, just like Kev does.

Ironically, Tanner's SLP was a woman named Lauren Zimet, who I actually know through another connection -- she's based here in Atlanta, and I met her a couple months ago. I just exchanged emails again with her this morning, and will probably meet her for a consult.

There are speech clips posted on the web of the child in the book at 3 years, 4 years, etc. He's now 12, doing great in a mainstream classroom, and he sounds fantastic. I'm overwhelmed at the thought of what's possible for Kevan, because right now, it seems like an impossible road.

Okay, now I'm rambling. But thanks for listening!

 

Becca, :hug:

Karina will get used to the routine after a while. To being there on her own. And she'll do great.

I'm glad that you are getting such quick responses from everyone and are able to go ahead with the EI, etc. I hope that this new schedule works well for him. Let us know how it is all going.

 

:hug:, Becca.

I think Karina will get used to it once it becomes part of the routine. Sounds like things are moving along as far as the evals, meetings, etc. go. Can't wait to hear more about the SLP from the book - maybe she'll have some recommendations for Kevan.

 

Becca - wow - you are one busy lady with all of those pickups, but it sounds like you have a great plan. And what an awesome advocate you are for Kevan. Every time I read your posts I think about a blog someone sent to me a while back called amalah.com. The older son in the family is going to a special needs preschool and much of the blog now is Amy (the mom) talking about what an amazing difference it's made for her son -- who sounds a bit like Kevan. Anyway, I mention it just in case you want to see another success story. Good luck with the new routine!

 

Becca, thanks for the updates! I just want to say that you inspire me! You are such a caring and wonderful mother!!! :hug:

 

I have nothing to add - in fact, I've learned a ton reading all this! - just wanted to say you're doing such an amazing job of getting Kevan all the help he needs. :hug: