Yo soy La Lay

adventures in family, faith, and Down syndrome

Lesson #21: Unintentional Ableism

Ableism – a set of practices and beliefs that assign inferior value (worth) to people who have developmental, emotional, physical or psychiatric disabilities.

We would love to see Tessa break down barriers, exceed expectations, go beyond anyone’s wildest predictions of what she will accomplish in her lifetime.  John and I have no preconceived notions for what she will do with her life. Full inclusion through high school?  Why not?  Go to college?  OK!  Open a restaurant like Tim’s Place?  Dandy!  Star in a TV show like Glee?  Great!  We set no limits on her potential and watch to see what happens.  Hopefully, that is a powerful force in her life that pushes her to do her best.

She might not do any of those things.

The reality of our future with Tessa (and with any child, really) is that we have no way to predict what will come as she grows.  It is certainly our responsibility, as parents, to teach our children to live to their full potential.  However, we cannot pass judgement on what that potential is.

There is still value in the life of an adult who bags groceries at the local supermarket.

There is still value in the life of an adult who lives with his parents and takes public transportation to a minimum-wage job.

There is still value in the life of an adult who “makes your french fries.”

(On a side note, I just need to vent for one second about the statement “well, someone has to make my fries.” There is nothing wrong with making french fries.  And yes, someone really does have to make them for you unless you plan on climbing into the drive-thru window at McDonald’s and making them yourself.  So why do we need to use this as a sarcastic comment to mock a person’s intellectual ability?  Just wondering.)

Being successful has nothing to do with money.  It has nothing to do with power.  It has nothing to do with influence or intelligence or ability or stuff.  It has everything to do with abounding love, kindness to the most unkind people, friendship, compassion, and contributing in the best way that one can.

I get that now.

Truth.

This is part of the 31 for 21 Blog Challenge!

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Lesson #20: Developmental Therapy is a thing

This is part of the 31 for 21 Blog Challenge!

Pre-Tessa, I had heard of Physical therapy, speech therapy, and even OT wasn’t completely lost on me.  However, Developmental therapy (DT) is a totally new concept.

We get DT once a month, but now that Tessa is sitting, we will increase to once a week in November-ish.  A developmental therapist is kind of like Tessa’s first teacher.  She works with her on intellectual development – concepts like “in and out,” cause and effect, object permanence, all that fun stuff.  During sessions, we play with toys and watch to see how Tessa interacts with her environment.  In the beginning, we worked on getting her eyes to track objects and to show interest in faces, then toys.  Our DT also works with our family to get us connected to the Down syndrome community.  We talk about our own emotional development, our concerns and frustrations… I don’t know if this is in her job description, but Shannon has been a bit of a social worker along with Tessa’s DT.  🙂

Right now, our major hurdle has been Tessa’s startle response.  When anyone (besides Ellie, that is) laughs loudly, Tessa displays the same kind of reaction that you might see in a child who was just given a shot.  Sweet little pouty face, big fat tears…. She has the same reaction to dogs barking.  Other loud noises don’t affect her at all.  We sit right next to our Praise Team (essentially, a band) in church and she has no negative response to the music.  When we play peek-a-boo with her, she often cries when we reveal our faces.  Some strong smells bother her as well.  I know that many people who interact with Tessa feel bad when she gets upset.  However, it’s important for them to know that we would rather teach Tessa to react appropriately than to create an environment in which she doesn’t have to deal with this stuff.

Sometimes, children with Down syndrome can have a sensory processing disorder that causes them to struggle with different types of input.  We don’t necessarily think this is something that Tessa is dealing with, but it’s certainly part of our conversation about her development.  It’s something that we will continue to work on with her DT and also in occupational therapy.

Soon, Tessa will be at four therapies a week.  Sometimes, that can feel like a lot.  Right now, two therapies (Speech/OT) are at daycare and two (PT/DT) are at home.  We just recently changed her Speech time so that I could potentially be there to help out with that.  Recently, she hasn’t been able to get through a session of speech without crying uncontrollably or shutting down and going to sleep, so we hope that my presence will help her manage her feelings better.  So far, it has worked.  I don’t know if it is realistic to think that front-loading all of the therapy will help her in the long run or not, but if nothing else, the consistency in our weekly routine is nice.  Plus, the therapists give some really great tips for working with Ellie, too.  She is more work than her sister most days!!

Still cute when she cries.

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Lesson #19: Occupational Therapy: No occupation required

The most recent addition to Tessa’s therapy regimen is Occupational Therapy (OT). Around six months, we noticed that Tessa wasn’t really engaging her hands. In fact, she spent most of her time with her hands balled up tightly in fists. There was very little reaching for objects and if she actually got hold of something, it was released almost immediately. At her IFSP review, we all agreed that it was time to add weekly OT.

OT focuses more on the fine motor skills required to function. Since starting with Kate, Tessa’s therapist, we have seen great strides in her ability to use her hands. She will reach for toys and play with them. She plays with her toes. When on her belly, she will use her arms to push up. Most of the time when she does that, she has her hands open.

We are still fighting with her left hand. She has a tendency to keep a couple of her fingers curled up when she’s pushing up onto hands and knees. She grabs more frequently with her right, using her left to stabilize her body. In therapy, we work a lot with engaging the left. Her issues are small, but on the radar.

OT is one of the therapies that Tessa gets at daycare, so I don’t have a lot of info about what a session might look like. However, Kate sends me detailed notes so that I can see how she did. Right now, just like in PT, we are working on sitting and playing with objects. We have to get Tessa to build strength in her core so that she can stop counting on her hands for stabilization. Kate puts her in a lot of different positions (belly, knees/hands, sitting, etc) and then uses different toys to motivate Tessa to reach for them. We’re also working on getting Tessa to hold her own bottle.

OT, PT, and Speech are once a week for an hour. The last therapy, saved for tomorrow, is Developmental Therapy. More on that tomorrow!

Sitting at 6 months (see the hands?!)

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Sitting now… Progress! (Also, the only happy Bears fan in the USA today)

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Lesson #18: Little babies can do Speech therapy!

This is part of the 31 for 21 Blog Challenge!

So, first of all, this happened:

photo 1 (6)Ellie was enthralled with her potty costume… Once her cousin Jimmy came over dressed as Curious George, it was over.  Somehow, Ellie convinced him to shed his costume so that she could wear it and then the two of them had a grand ol’ time pretending to use the potty.  Kids are weird.

A rough transition here…. on to Speech.

It was very perplexing to me that we could start Speech therapy on a 6-week-old baby.  However, with Tessa unable to take her bottle in an upright position, we were set up with a type of Speech therapist who specializes in Oral-Motor therapy.  Oral-Motor therapy teaches a child awareness, coordination, and strength of the muscles of the mouth (all related to that low muscle tone that we keep talking about).

(On a side note, because I know some are curious, no, my children have not really been nursed.  Ellie got 5 days and Tessa got 12.  That’s a whole other story.)

During a therapy session, we work a lot on building strength in her core muscles.  When you think about eating, you use muscles throughout your abdomen, neck, and head to eat effectively.  One of the ways that we can improve Tessa’s eating skills is to build strength throughout her body so that she will be stable when she is sitting and can begin to use her hands to move food to her mouth.  This part of the session focuses on sitting and bringing toys to the mouth.

We also work on direct input to the mouth itself.  We started by providing input with a tool like this:

We use it to teach her tongue and gums what different textures and pressures feel like.  We also work on stimulating her tongue to move around the mouth to react to food.  Lately, we have graduated to putting small crumbs of graham cracker or animal cracker on the sides of her mouth so that she learns to move the food and to swallow it.

We always end our session with feeding.  Well, I shouldn’t say always.  Sometimes, Tessa gets really mad when she doesn’t get fed first.  And sometimes, she decides that she has had enough and just closes her eyes and goes to sleep.  However, we like to do some “spoon work” with the therapist when Tessa will let us.  🙂  We have found that a forward-facing presentation of the spoon (how you or I would put a spoon in our mouth) is challenging for her, so we present the spoon sideways.  However, we also continue to work on the forward presentation.  We are teaching her to get the food off the spoon and swallow.  She also has a habit of sticking her tongue out while she eats, so we have to wait until she puts her tongue in the right place before allowing her to take a bite.  Remember that a tongue is made up of a lot of different muscles, so her low muscle tone affects her ability to keep it in the appropriate place and use it effectively.

Our next steps with Tessa are to introduce a straw cup (recommended over a sippy cup) and to slowly increase the variety of textures that she will tolerate. We have begun to work on the actual “speech” part of Speech therapy with practice mimicking noises,  We have introduced signs for more, all done, eat, and drink.

The most important thing to remember is that while we have made modifications for Tessa and we do have to make a conscious effort to teach her some skills that may come naturally to others, our life is not work.  We don’t live in a constant therapy session, always practicing, practicing, practicing.  When we can, we do these things.  That is all.  There are weeks when we do a lot of practice.  Sometimes, we don’t.  Eventually, we’ll get there.

An excellent resource that I have just started to dive into is Early Communication Skills for Children with Down Syndrome.  Click on the blue link to find it on Amazon.

Blurry, but perfect…

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Lesson #17: Life doesn’t revolve around blogging

This is part of the 31 for 21 Blog Challenge!

In under two hours, we are having a Halloween Party.  My house is a disaster, food is half made, my costume needs serious ironing…

I adore blogging.  Writing is wonderfully cathartic for me and my family and friends seem to like hearing about my crazy family.  But I have to live away from the computer screen sometimes.  Like this time.

You’ll get your Speech lesson tomorrow.  For now, I’ve got some serious housekeeping to take care of.  🙂

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Lesson #16: Babies can do Physical Therapy, too!

Our family loves (well-meaning) questions about our kiddo. We share our life with you all because we like people to understand how “normal” our life is – even though we have some fairly unique characteristics.

We get the most questions about the therapy that Tessa gets through Early Intervention, so I’d like to break down what her sessions look like for each area. Today, we’ll tackle Physical Therapy (PT).

We talked about Tessa’s low muscle tone at little bit at the beginning of this month. Because of the low tone, gross motor skills (rolling, crawling, walking, sitting, etc) are more challenging and take more time to master. On top of that, I think there is a natural human instinct to do things the easiest way possible. This can cause long-term issues, so the overarching goal in PT is to teach Tessa her gross motor skills and to teach her to do them correctly. If you remember back, Tessa started rolling at some ridiculously young age (like, 3 weeks or something). While we were so excited about this, it was tempered by the fact that she was doing it wrong. She would arch her back and roll over on her head. Not such a good long-term method.

Tessa has always been a mover. Since the first flutters in my belly, she has not stopped. One of the original evaluators actually wondered if something might be physically bothering her that was making her squirm. In the NICU, they called her “the swimmer” because of how she flailed her arms and legs.  Her motivation to go, go, go is high. So, PT is her strongest area of development. John wanted an athlete – he has one in Tessa!

During PT, her therapist works with her on her various skills. Right now, it’s crawling, sitting, and weight-bearing on her feet. To practice crawling, we physically help her move her hands (and sometimes knees) to teach her to move forward. In sitting, we do a lot of work on an exercise ball, teaching her to balance and not to throw her body backwards. She also likes to use her hands for balance when she sits, so we work to motivate her by giving her toys and objects that help her reach up and grab. She is mostly motivated by Mardi Gras-style beads and her own reflection in the mirror. 😉

Two of Tessa’s main supports in PT are her “hip helper” pants and her kinesio tape. She wears the hip helpers when she’s practicing her crawling. They are little spandex shorts that are sewn together through the legs.  She wore them for awhile when she first started EI to keep her hips from being malformed.  Now, she likes to stick her left leg out in a “splits” position when up on hands and knees and her little hip helpers keep her from doing that.

Kinesio tape is an interesting little invention. I have absolutely no clue how it works. Supposedly, it helps activate the muscles and kind of “reminds” them to work.  It seems strange.. . However, anecdotally, Tessa went all summer without it and it seemed like she slowed down. Once we were taping again in August, she has made huge gains. It may or may not be a coincidence… But I’m not opposed to trying!

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We love PT and we love Rachel, Tessa’s therapist! She has sessions once a week.  We try to practice with her when we can, mostly just through the way we play with her.  We do our best.  🙂  Up next, we’ll share about Speech!

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Lesson #15: We owe a lot to parents of the past

This is part of the 31 for 21 Blog Challenge!

I’m cheating a little tonight…. not because I don’t have time to write.  Actually, one thing I DO have tonight is time.  However, I want to share the words of another mom… words that I’ve been trying to find a way to express for quite some time and frankly, she does a better job than any of the drafts that I have come up with.

Please click below to read…

To the Mother of the Adult Son With Down Syndrome in the Grocery Store Today

Tessa, 20 days old

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Lesson #14: (Not so) Defining Characteristics

This is part of the 31 for 21 Blog Challenge!

It is incredibly difficult to take pictures of an infant who has recently discovered that she can pivot on her belly.  Especially when said infant is highly motivated by the pretty pink iPhone case.

I did my best.

When Tessa was born, both the NICU nurse practitioner (Amanda) and the geneticist that we eventually talked to were sure that Tessa had Down syndrome.  I was very angry with them for a little while… she looked typical to me and I didn’t appreciate their insistence that she had it without any proof.  I couldn’t see Down syndrome in Tessa.  They could.

I can see it now.

I should reiterate that I don’t see Down syndrome when I look at Tessa now.  75% of the time (that’s a total random guess), it’s nowhere in my brain.  But I get what Amanda was saying.  Typically, children with Down syndrome display some or all of the following characteristics:

Sandal toe, a guarantee that no nail polish from your second toe will smudge when it touches the big toe (Am I the only one who has that issue??)

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Straight palmar crease (This is a miracle shot.  Tessa’s OT would be proud that I could hold her hand open long enough to get this):

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Almond-shaped eyes (which crinkle so sweetly with every laugh and smile, and look almost cartoonish when she’s upset):

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Flat nasal bridge… an incredibly difficult picture to get when this little booger just wants to look right at me all the time.

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Brushfield spots… little white sparkles in the blue of her eyes.  These are one of my favorite characteristics (and one of the trickiest to see on camera because of her dark blue color)  🙂

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Ultra cuteness

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There are pros and cons to seeing it.  Pros and cons to people looking into her face and knowing.  That’s a different post for a different day.  This beautiful girl has Down syndrome.  Look and her and you will see it too.  What you do with that information, with the recognition of what makes her unique, is what makes the difference.

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Lesson #13: Advocacy never sleeps

This is part of the 31 for 21 Blog Challenge!

ad·vo·ca·cy

noun \ˈad-və-kə-sē\

the act or process of supporting a cause or proposal : the act or process of advocating something

There are a lot of days that I wake up with a take-charge attitude toward advocacy.  Most, even.  When connected to a community who advocates for special needs, there’s always a cause to fight for.  Some magazine posts an insensitive article about birth defects.  A television program uses the R word inappropriately.  Some crazy scientist tells me that my child is suffering.  Yes, every day, without fail, there is a need for vocal campaigning.  Every.  Day.

Trust me, I’m all about fighting the good fight.  I’ve never been one to shy away from (politely) sharing my feelings.  If someone posts a link to a news story that isn’t supportive or encouraging, I do my research and then I’ll call someone out on it.  I champion the causes of acceptance, love, understanding, empathy, and inclusion through words and actions.  I am all for preaching to the choir, preaching at the devil, even preaching to a brick wall if no one else will listen.

Most days.

Some days (not many, but a few) I’m tired.  I can’t fight every battle.  I do think it’s incredibly frustrating that something happened, but today, I cannot fight.  Because even if advocacy doesn’t sleep, sometimes I must.  Without a break, it’s an effort that isn’t sustainable.

Thankfully, there is a huge network of moms out there ready to advocate for inclusion and acceptance when I can’t.  Not just moms, actually.  A community of supporters stand in the wings, picking up when I’m tired.  I do the same for them.  Together, united behind a worthy cause, our advocacy never sleeps.

True.

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Lesson #12: If I don’t stop blogging, I’m going to be in trouble.

This is part of the 31 for 21 Blog Challenge!

We just returned from a great weekend away.  My parents watched the girls while John and I had the chance to gallivant around our old college town, reminiscing about days on campus, sleeping in until 7 am (!), eating in nice restaurants… it was lovely.

We missed the girls.

Now we’re back and I’m supposed to help John paint our kitchen, which means that you don’t get to hear a lesson tonight.  Because really, if I don’t get my butt off the couch and pick up a paintbrush, there will be mutiny and I’ll have a half-painted kitchen for our Halloween party on Friday night.

That is all.

Three-week-old Tessa.  Too cute for words.

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