Check out this post-adoption support group on Facebook

I'm very glad to see this new Facebook group. If you're a new or experienced adoptive parent, consider joining to ask questions or share your wisdom!

Just-right space

The awesome news is that Quinn is actively trying to make friends. The not-so-awesome news is that his friend-making skills are not as sharp as they could be. He has some real challenges staying in his own space, and has taken to following kids around with about an inch between him and the other kid. Shockingly, this doesn't go over well.

After his kindergarten teacher asked us for some ideas to help deal with this, his fantastic social-skills teacher taught me about just-right space and suggested I make him a social story book since he's such a visual kid. So I grabbed some photo time with Quinn and his good buddy Andrew (also a sensory seeker who is just fine with Quinn invading his personal space) and created my very first social story book!

Read it here.

 

My worst fear for Quinn at school

A Tucson teacher resigned after Duct-taping a student to her chair because she kept getting out of her seat (hmmm - ADHD? autism? sensory processing disorder?) prompting this retired teacher to write a letter to the editor of my hometown newspaper sympathizing WITH THE TEACHER and proclaiming that such troublemakers should get the hell out of the classroom. No acknowledgment that this could be anything other than a disciplinary issue. I live in absolute terror that Quinn will end up with a teacher like this.

Read the letter here.

The full alphabet soup

ASD. ADHD. SPD. PDD.

He's got them all.

We knew from Day 1 that Quinn had some characteristics of autism. But his therapists felt like the behaviors were brought on by a lack of stimulation in his early months and that they likely would pass with time. Plus, we were doing all the therapies he would receive if he had autism, so an actual diagnosis didn't seem necessary.

Then our insurance company decided it didn't want to keep paying for therapy for a kid who wasn't on the autism spectrum. So, diagnosis here we come.

Getting the testing was no easy feat. It costs about $1,000 and is not covered by insurance. And the only developmental pediatrician in our city of 1 million people who does it has a wait of 19 months.  So we headed up to Phoenix - only a six-month wait - for two days of testing.

The process was actually pretty interesting. We filled out reams of questionnaires and literally discussed or disagreed over every answer. Does Quinn initiate play with other kids? I'd start to mark "rarely, if ever" and Tom would say, "That's not true. He does it at the park all the time." Argue, argue, argue. Then we'd compromise on an answer.

While we were doing that, the developmental psychologist gave Quinn and IQ test and then about six different tests. In some he solved puzzles, in some she watched him play with toys, in some she asked him questions.

Then the next day, I went back for two hours of answering questions, mostly about the paperwork we had filled out the previous day.

A week later we went back for the results. High-normal to high IQ, ADHD (another test will determine the severity) and autism. Not really surprising, nothing really changes except now his therapy will be covered. But I was surprised that hearing the diagnosis set me to thinking, and worry, about Quinn's future. Will he be able to make it in school? Will he be able to go to college? Will he be able to live on his own?

Now we begin the long and difficult road of trying to point all those answers to yes.

At long last, a connection

Until now, guys like this have been Quinn's favorite friends

Even at five years and four months, Quinn has still been stuck in the parallel play phase. He doesn't mind kids, but he shows no real interest in them, either.

This summer we had him in two social skills groups, and they seemed to make a bit of difference. We also tried some play dates, which mostly involved him playing with other kids' toys - or talking to their moms.

But lately he's been showing some interest in other kids. Unfortunately, he's showing it by stealing their toys and screaming at them to chase him as he runs away. But hey, we moms of special-needs kids take progress where we find it. And to me, this is progress. Even so, Quinn and I have talked quite a bit in the last week about other ways to get kids to play. He can say, "Can I play with that when you're done with it?" or "Can I play with you?" or "Would you like to play tag?"

And then... a massive leap forward.

After school one day last week, Quinn walked up to a little girl sitting on a wall and asked her, "What are you doing?" When she didn't answer he asked again. She still didn't answer, so he got on the wall too and started sliding away from her - and she followed him! I told him to tell her his name, which he did, and they started little-kid chatting away. I was just about crying I was so happy.

Then yesterday after Chinese school, he walked up to a little girl he knows (he's gone to her house to play with her toys!) and said, "Let's play tag!" She was too shy to respond, but her little brother wasn't, and pretty soon there was a rowdy game of three-way tag going on around us.

So many times I've watched Quinn play on his own as friendships form all around him and wondered if he'd ever connect. And now, at last, I see signs that he's doing just that.

It's a good day.

Rules, rules, and more rules

I try to keep things positive with Quinn. Before we brought him home, we were lucky enough to have breakfast with awesome psychologist and author Dr. Kevin Leman. He lamented how he hears so many parents walking into Walmart while telling their kids, "You had better not act up! You better not touch anything! You better not ask for any toys." When you do that you're just planting negative ideas, he says.

So we keep it positive. But in our desperate quest to help Quinn stay at the school we really like, we've been blasting him with a barrage of rules. "Don't turn on the microwave." "Don't bang into any friends." Actually, it seemed to be working - he wouldn't do whatever thing we told him not to do, but the list kept getting longer as we added whatever had trouble he'd gotten into at school that day.

Then at lunch last week, I noticed him mumbling and I bent down to hear what he was saying. This is what I heard: "Do not pop anyone's bubble. Keep your hands to yourself. Keep your body to yourself. Do not put pebbles in your friend's mouth. Do not kick any friends on the slide. Do not touch the buzzer. Do not touch the microwave. Do not touch the green button. Do not bump into any friends."

Well, that was just about enough to make me cry. Poor kid. Who could keep straight that litany of rules? No wonder he was getting into new trouble each day. With so much negativity bouncing around in his head, honestly, what other outcome could we expect?

So you might think that this was a wake up call and I immediately changed my ways. You would be wrong. That didn't happen until the next evening, when I was telling Quinn that Miss Leticia said he did a good job of stopping a negative behavior when she told him to (believe me, that was progress!). He looked up at me and said hopefully, "Was she proud of ya?"

By George, she's finally got it! Let's get back to positivity! So on Thursday and Friday we kept telling Quinn how proud we were that he was trying so hard to stay inside his own bubble and how we knew he was going to keep doing better and better.

And guess what? GUESS WHAT? He's doing better. So much better that when Tom picked him up from school Friday Quinn's teacher pulled Tom into the classroom so he could see all the good things Quinn had done that day.

As always, who knows if we've cracked the code? Who knows if this will last? But positive certainly feels better than negative. To all of us.

Two-year post surgical checkup

We're in Boston for our annual visit with Dr. Peter Waters, who did a truly masterful job on the tendon transfer surgery that corrected Quinn's brachial plexus injury two years ago. Last year's visit was a nightmare, with Quinn uncharacteristically crying, hiding behind the curtain, spinning wildly (well, that one wasn't so uncharacteristic...) and refusing to be touched. Only the following day did his clueless parents realize that we had not prepared him for the visit, and the poor boy was terrified we were in town for another surgery. Duh.

So this year, LOTS of preparation. And a much better result, hallelujah. He raised his arms when he was supposed to, reached for the toy monkey when he was supposed to and generally did what they wanted him to do. And this was through three different visits - one with the OT, one with a fellow of Dr. Waters and one with Dr. Waters himself. We were very proud of our brave little patient. Despite all our preparation, through, he was quiet and solemn all day. Some fears are just hard to shake, I guess.

As for the doctor's report, he said Quinn's surgery was about as successful as it could have been. His range of motion and use of his arm (which was almost not useable pre-surgery) is at the top of what's possible. His only real deficit is strength, so the OT gave us some good ideas, like lifting balls overhead, having him hand heavy things up to me when we're emptying the dishwasher, etc.

Unfortunately, Dr. Waters said Quinn is doing so well he was lifting any limitations he had placed on him, meaning the ban on football evaporated before my eyes. But when he was the horror on my face, he said he would reinstate the ban just for me and would happily let me blame him for it. Whew!

The magic cushion

There's no way to know exactly why, but Quinn has gone from daily problems at school to daily successes at school. We are trying a lot of things to help him succeed - daily joint compressions, daily skin brushing, a weighted vest and good 'ole bribery. So I don't know if one thing is key, or it's the combination. But I do know that the magic cushion is a major factor in his success.

A fellow adoptive mom who herself has sensory processing disorder gave his to us when she saw how much Quinn was struggling at Chinese school. He just could not sit in his chair and was really getting in other kid's personal space. It's a bean-filled plastic disc with a thick fleeecy cover. We take it to his special-needs preschool, his typical preschool and his weekly Chinese school.

I didn't realize how much it helped until I noticed that every day when I dropped him off the teachers would ask hopefully, "Do you have his cushion?"

Here's a link to the cushion itself. The cover, which has a velcro closure, was handmade - and all of his therapists covet it, so if you've seen them for sale anywhere, please let me know!

The Concrete Kid

Quinn is so very concrete. The whimsical and imaginary just makes no sense to him.

Two sample conversations from the last couple of days:

Mama (singing): "Here comes Quinny cottontail."
Quinn: "Hey, I'm a boy!"
Mama: "You're not a bunny?"
Quinn (politely but emphatically): "No, thank you."

***

"Quinn, what are you going to be when you grow up? Are you going to be an astronaut?"
"No."
"Are you going to be a scientist?"
"No."
"Are you going to be an engineer?"
"No."
"What are you going to be?"
"Big!"

***

Not surprisingly, drawing and coloring has been a huge challenge for Quinn. Give him a blank slate and ask him to create, and he draws a big blank. All we've gotten so far is page after page of angry back-and-forth lines covering a page.

So when I spotted a color-by-letter at the fabulous Indianapolis Children's Museum on a recent visit, I had a hunch it might appeal to Quinn's concrete nature. If it says O, you color it orange. Concrete.


I brought it home and trotted it out, and the results were nothing less than astonishing. This rooster picture was the very first one he did. And instantly, he went from angry scrawls to this (he even signed and dated it when he was done):

Our secret shame, or how we found success with bribery

I've never believed in bribing children to be good. And yet, here I am, doing it. And darned if it isn't working.

Between Quinn's many delays and his sensory processing disorder, he has a very, very, very tough time sitting still and acting appropriately in school. He also loves to bang, to lean, to push - behaviors that, even though they aren't done with aggression, look very aggressive. The girls cry. The boys push back. The teachers get frustrated. Quinn gets in trouble.

In short, Quinn's behavior was becoming a fairly serious problem at school. As in, the teacher pulled us aside when we picked him up, every day, to tell us about the latest problem. This happened at his preschool, at Chinese school and at his therapeutic play group. Making it especially challenging to help him address these issues, he doesn't do these things at home.

We tried everything we could think of and everything his various therapists suggested.
We talked about keeping our hands to ourselves. We talked about how everyone is surrounded by a bubble, and how we shouldn't pop someone else's bubble. We threatened timeouts. The behaviors continued.

Then one day about three weeks ago, I was telling Quinn how I knew he was going to do great in school that day and he said, "If you keep your hands to yourself, you get a dollar?" Hmmmm. What to do? Sorry, but I bit. And guess what? It worked. Immediately. Since that day, no inappropriate behaviors at school, and Quinn is becoming quite the math whiz adding up his haul.

As a side benefit, he's developing a sense of saving. Now when we go shopping he looks at the toys, asks the price and decides what he's saving up for. He vascillates between Smokey the Fire Truck and a big giant garbage truck, but he keeps saving.

I feel a little embarrassed that such a shameful technique is working for us. But I can't help but rejoice that it's working. My goal right now is to help him succeed in school. And if this is what works right now, then this is what I'll do.

Quinn's on a sensory diet

We have lot of things we do when sensory-seeking Quinn gets a little out of control. He knows his options, and can choose one when he agrees that "your engine is running too fast." He can get a bear hug, joint compressions, pressure on his shoulders. We can do wheel-barrow walks or he can push a big ball up the wall.

But it turns out, which I didn't understand until this week, that we need to be doing that stuff every day - or more - to try to regulate his nervous system.

So for the last couple days we've been getting up a little earlier to add joint compressions and brushing of his arms and legs to our morning routine. Then we do the same two things again before school, and if it's a late school day he wears his compression vest for a bit while we get ready in the morning.

Funny with all this stuff: Just when you think you're doing it right, you learn you've been doing it wrong.

Live and learn.

The coveted spot is Quinn's!

On our quest to find the right preschool fit for Quinn, we keep hearing people sing the praises of a magical teacher named Miss Leticia, who happens to work at a preschool about five minutes from our house. I went to see her in action last fall and agreed the hype was no exaggeration, so I took Quinn for a visit, and she seemed quite able to handle him. Visiting her class was also what convinced me to hold him back a year. We're hopeful that with a year of pre-K, he'll be better able to communicate with his peers and have more self-control so he can sit and follow directions when he needs to.

Today was the school's fall registration kickoff, so I got up before the sun and dashed over there. Ah, first in line! Mercifully, they started registration early so I handed over my forms and check and begged, begged, begged for a slot in Miss Leticia's class. The director opened the book to see if there were any slots left - current students get first dibs - and 16 of the 18 lines were already filled in.

So Quinn is IN! We're so excited and can't wait for August 6, for his next chapter to begin.

The OT speaks (but Quinn, not so much...)

Mary, Quinn's wonderful occupational therapist, visited him at preschool today to get some sense of why he is acting aggressively toward the other kids - we've had some reports of eye-poking and pushing. I figured it was tied to his sensory needs, which seem to be really great when he's around other kids. Mary had a totally different - and totally unexpected - observation: She thinks it ties to his communication challenges. Her theory is that he doesn't know how to tell kids what he wants, so he either shows them with physical force or just plain ignores them. Thinking that through, it makes a lot of sense. He interacts really well with adults, who are patient and help draw out of him what he's trying to say, but very, very little with other kids.

Her idea is to work more intensively on bringing up his verbal communication skills.

I wish we had done this sooner! Quinn does so well at Mary's office that she is seeing him less and less. But today she saw very clearly that he still needs a lot of intervention. That's good for all of us, I think!

Educating the special-needs kid

We've been playing a little revolving door game trying to find the right preschool fit for Quinn. He is in a public special needs program, which is great at teaching him to follow rules and learn the ways of a classroom. However, the needs of his classmates are so great that there isn't much peer interaction, which is a real need of Quinn because he remains mostly uninterested in other children.

At his therapists' recommendation, we set out to find a "typical" preschool where Quinn would see - and hopefully model - more normal interactions. The first attempt was the excellent language preschool that just wasn't equipped to redirect him all day, and decided against enrolling him. The second try is an evangelical school with a special-needs program. Things were great until the assistant director who deals with SN kids retired at the end of the year, and was replaced by a woman who has owned a preschool but never actually dealt with SN kids. She sees his challenges as disciplinary problems that can be solved by punishment. So we yanked him out of there, but - long story - we're trying again, but without her "help." His OT will go with him to school tomorrow and offer some ideas to deal with some behaviors that are disruptive and possibly dangerous: poking kids in the eye and banging or pushing into them. He never does it out of meanness or anger, but out of a need for deep sensory input. Still, it's a problem.

On the one hand, I totally get it. If Quinn was in a class with a kid who seemed to be acting aggressively toward the other kids I'd be freaking out. And yet being around kids is the only way he's going to learn to be around kids. Such a paradox.

Preschool dropout

After a three-week trial, the preschool for kids with speech delays decided not to enroll Quinn. They said that redirecting him ("Quinn, sit down. Quinn, are you listening?") was taking too much of the teacher's time. I can't say I blame them, because I know that is a challenge for him.

Surprisingly, I actually feel some sense of relief because I had been working my tail off trying to hide his challenges since this school doesn't take kids with issues other than speech. We were getting up early to run him around the 'hood and burn some energy, watching his diet very closely, not letting him watch any TV in the morning, etc., etc., etc. All good things, of course, but we were making ourselves a little nutty worrying about them all.

So we're back in the hunt for a school that's a good fit for Quinn. Today we visited a church-affiliated school that employs a PT who specializes in sensory processing disorder. They allow about two kids with SPD in each class. But all the kids get "therapy" -- they bring in an OT every Monday and do lots of sensory play every day. In many ways, this place is the opposite of the last school. While that one was very academically focused, this one doesn't really do academics at all. Its philosophy is that kids (at this private school, in this high-end neighborhood) are getting that sort of stimulation at home; what they need at school is social interaction and play. Since Quinn is doing great academically but is in desperate need of social skills, that sounds good to me. The catch: They might not have a slot for him. The school's SN liason was planning to put him in the 3-year-old class (their ages are developmental, not chronological) but changed her mind after meeting him and seeing his impressive brain at work on a puzzle and a game.

And so we wait. We play. And we enjoy our extra time with this fabulous little guy we're blessed to call our son.

Plan C, D - and working on E

I haven't been  blogging of late because I've been driving. And driving. And driving. Like a long-haul trucker.

As of my last post, I had pretty much decided to skip the speech preschool with the principal who pretty clearly didn't want Quinn. Instead, we decided to give his special-ed preschool another shot, with new goals written into his IEP.

Well.

This year's class has a couple of very challenged kids. And Quinn tends to raise or lower himself to the level of whatever is happening around him. So we were looking at a very bad scene, with increasing behavior issues.

So.

I decided to keep my appointment to visit the speech preschool, and I had the same reaction as the first time I visited. I wanted to hate the place. But I loved it. The teacher is amazing, the assistant is fantastic, the kids are engaged. So I pretty much begged and got Quinn in on a trial basis. We'll find out soon whether he'll be able to stay, and at this point it's anybody's guess.

As the principal feared, he is a challenge to the teachers. He stands up during circle time, walks around during center time, doesn't want to sit and look at a book on his own. But... in three weeks, he has gone from speaking sentences only to himself to having actual conversations with us. He has gone from never, ever participating in his special-ed class group activities to taking part. And he has gone from never, ever singing with us at home to happily singing songs with multiple verses. So I'm working closely with the teacher (who is beyond wonderful), we're practicing school activities at home, we're volunteering at the school and we're praying, praying, praying.

In the meantime, I drive Quinn to "Miss Jocabed's school" for 2 1/2 hours in the morning, then pick him up and drive him across town for 2 hours of "Miss Schreiber's school" in the afternoon. Except on Wednesday afternoons, when we alternate between OT for sensory processing disorder and a therapeutic playgroup for speech and sensory issues. Then it's home to practice "centers."

How much do we practice? In the bath last night, Quinn said, "Mama! This is bath center!"

Plan B

After much negotiating with the principal of the preschool I've been trying so hard to get Quinn into, she agreed to take him on a one-month trial — provided I came along with him. So I got my schedule all worked out, and then ... she called and said they've decided they want us to come again for a "visit" — and that visit won't be until two weeks into the school year. At that point, he may or may not be invited for another visit. And at the end of all this, he may or may not be accepted. 

What it comes down to is, I think, is they just don't want Quinn at their school. It's grant-supported, and in these tough economic times I think they're quite desperate to show that every kid improved with their curriculum. Because the principal fears Quinn has autism, I believe she's scared he'll skew her rankings. I get that, but I also know Quinn a little better than she does, and I honestly do believe he would thrive there.

But ... but. She expects him to fail. So, really, how could he not??

So while I made the appointment for us to visit in a couple of weeks, my gut tells me we won't be keeping that date. Instead, we're going to return to his special-ed preschool and I'm going to ask that the goals in his Individualized Education Plan be updated. Because, honestly, his speech delay isn't that big a deal anymore. He's progressing beautifully. Instead, I want to ask them to work on helping him to listen and follow directions, to make eye contact and to interact with other kids. Those things, I think, are the keys to helping him succeed later in school. As for speech and academics, we'll work on that stuff at home and supplement with some extra-curriculars like the swim and music classes we've been taking this summer.

It's funny, I've been fighting for so long to make this whole speech preschool thing happen. But now that I've pretty much decided against it, I really feel this path is the best one for Quinn right now.

And so ... here comes Plan B.

The big week is now in our rear-view mirror

When last I wrote (which must have been 10 years ago now - sorry!) I mentioned that Quinn had a big week ahead. So here's how it went:

New play group: Eek! He loved the "play" part, which lasts an hour. The circle time part? Um, not so much. He squirmed, he kicked, he didn't listen, he didn't participate. No big nightmare, but not the biggest success, either.

New music class: Yay! Similar behavior issues, but the class is co-taught by a special ed teacher/ music therapist who is both understanding and full of good ideas. Quinn really enjoys it, although he doesn't exactly do what you would call participate...

New therapist: Yay! LOVE her. Very smart, great with kids. On our first visit she seemed a bit flightly; but on our second visit she showed up armed with a plan of action just for Quinn and a truckload of great strategies. She also served up something I hadn't heard of before: a compression vest, basically two pieces of neoprene that wrap very tightly around him. He is not crazy about the vest, but darned if it doesn't calm him right down.

Entrance evaluation for the speech and language preschool: OH MY GOD! In our first phone conversation, the director told me that Quinn sounded like more than they could handle. She agreed to test him, but made it very clear that if he couldn't finish the test - which can last up to 90 minutes - he wouldn't be admitted. Friends and therapists told me not to worry, that it would be games and fun activities. Wrong!

I swear, it was like the test was created just for Quinn to fail. It was 90 minutes of this poor child sitting at a table answering questions. I could not believe this was being expected of a 4-year-old. At two points I had to sit with him on my lap because he got so squirmy. And once we took a break at my dear mother's absolute insistence. (Also, I put the compression vest on wrong and he immediately tore it off.) But, by God, this child FINISHED that test. Even when the tester came out into the hall afterwards and told us SHE HAD MISSED AN ENTIRE SECTION OF THE TEST AND WE HAD TO COME BACK IN - he did it. I was so proud of him I just hugged him afterwards and tried not to cry. The speech pathologist who administered the test took a quick look at his results and said his receptive language skills are absolutely normal, meaning he understands what he hears - he just doesn't necessarily answer or follow directions based on what he hears.

So is he in? We don't know yet. I phoned the director the next day to ask her what's next, and I could tell she was gearing up to say they weren't going to take Quinn - even though she admitted she hadn't seen his test results yet. So I offered to enroll him on a trial basis, and take him out after a set period if they thought he was too disruptive. She seemed open to that, but we'll have to see.

So why am I so determined to get him into this horrible-sounding school? Because when we visited last spring I was absolutely blown away by the quality of the programming, the love the teachers showed the kids and the results I have heard about from friends who sent their kids there.

We're supposed to hear this week. I swear, I'll post an update before another month has passed!

A big (as in important) week for Quinn

Please keep Quinn in your thoughts this week.

Tuesday morning he starts a play group with "normal" kids - something I know he needs, and something I have avoided because it's so hard to sit there and listen to the bragging about how Jimmy is already reading Shakespeare and how Susie has mastered long division. My issue, not Quinn's - and it's high time I get over it.

On Tuesday afternoon he meets a new therapist who has been recommended to us by our doctor and Quinn's speech therapist. She is a PT, but works with kids with sensory processing disorder. I'm happy with the help he's been getting for SPD, but I'm sort of starting to feel like I'm not learning anything at therapy that I'm not already doing at home. So even though I'm sad to leave our current place (owned by a fellow adoptive mom) a change feels right.

On Wednesday we go for Quinn's long-awaited evaluation at a local university-affiliated preschool that specializes in kids with speech issues. I took him for a visit last spring and LOVED the place. Such a high level of teaching and such an impressive place. They were less impressed with Quinn's sky-high energy level, however. The director indicated his lack of ability to sit and listen may render him more than the school can handle. However, she agreed to test him at the end of the summer to give him more time to mature. Amazingly, here we are at the end of the summer - school starts here in mid- August.

This is a big week for Quinn - please think of him, especially at 8:45 a.m. west-coast time Wednesday!!

The boy and the arm

This month has been so busy - and so blisteringly hot - that I totally neglected to post a report from the doctor who operated on Quinn's brachial plexus injury last year.

The good news is that Dr. Waters is very happy with Quinn's progress. He has almost complete "passive" use of his right arm - if someone moves it around for him - which is a good indication he'll have good "active" use as he gets stronger and stronger. We have to have him checked every year (a good excuse for an annual trip to Boston!) and there is always a chance he'll have problems when he has a growth spurt. The biggest challenge is that he continues to favor the right arm quite strongly, so we need to work on that. We worked with Dr. Waters' physical therapist to tweak his twice-daily exercises, and we learned that he'll probably never be able to reach behind his back with his right arm because the tendon that does that is one of the tendons they transferred to give him the ability to lift and rotate his arm. A good trade-off, I think.

So the news was good. But the visit itself? Not so much. We had a longish wait, during which Quinn was quite angelic, playing games happily in the waiting room. But the minute we went into the examination room - the same one he was in that horribly traumatic day last year that his cast was sawed off - he pretty much freaked out. The physical therapist came in right away, and he cried every time she looked at him. He wouldn't let her touch him, he wouldn't do anything she asked and he kept either hiding behind the curtain separating the room into half or hurling himself on the floor. Then he started spinning uncontrollably. Not a good scene. Eventually, the PT gave up and left the room. It wasn't until then that it hit me: Pull out the puzzles. Thankfully, that worked as well as it always does and Quinn sat on the floor happily doing his puzzles, even after Dr. Waters came in. In fact, when he wanted Quinn to lift his arm or reach in a particular direction, he just held up a puzzle piece. Worked like a charm. Surprisingly, Dr. Waters knew a ton about sensory processing disorder and we talked a lot about how to integrate his treatment and his arm exercises. My goodness, how grateful I am for that man.

In short, the visit got better, we learned what we wanted to learn, and we left and had a good rest of the day. But the next morning as were eating breakfast, I noticed that Quinn - who is NEVER cold - was shivering. And he was not eating, which is equally odd for him. I thought maybe he was sick, and then it hit me what was wrong. I bent down, looked right in his eyes and told him he didn't have any doctor's visits that day. Boom. New kid. He started chattering away, ate his breakfast, put on his shoes and announced he was ready to get on with the day. I just felt horrible. I knew that we were finished, but it didn't even dawn on me that he didn't know that. Poor little guy was just plain terrified. Definitely not one of my best moments in parenting...