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Sunday, December 9, 2012

From EI to CPSE

By mid-January we had finally settled into a comfortable routine. Get Chaim on his bus, get Dovi's food together, walk him to the basement (on Bessie's days; take him down the stairs to Ellen on her days), do my errands/housework, get Dovi dropped back off at noon, wait for the speech therapist, take him to OT or wait for the volunteer to take him to OT, come back and do the rest of my housework, wait for Chaim's bus, ad infinitum. It was all shattered when Becca called to inform me that she was starting the CPSE process.

What? So soon? He was barely 2 and a half!

Becca reminded me that we were trying to get Dovi into the TABAC center before his 3rd birthday - at 2 and 9 months - and therefore we had to start the evaluation process already, so that we could have our meeting with the Board of Ed in March and get Dovi into TABAC for April.

And so, we began the evaluation process again. Once again, evaluators traipsed in and out of my house, five of them in all, reminding me once again of all the things Dovi didn't do and couldn't do, and all the things he shouldn't be doing anymore but was still doing. It painted a dismal picture of the progress he was not making. It was gut-wrenching all over again.


From the speech therapist:

Dovi presented with markedly impaired nonverbal behaviors. He presented with a lack of social and emotional reciprocity and a lack of varied and appropriate imitative or pretend play. He further presented with an absence of spoken language that was not accompanied with any attempt to compensate with other forms of communication. He did not imitate any actions despite significant prompts by the clinician. He could not or would not imitate any sounds presented.

From the occupational therapist:

Dovi presented as a sweet child who had a lot of difficulty transitioning to evaluation process. He did not display appropriate attention to structured tasks presented, and did not consistently follow simple instructions to complete activities as requested. Dovi did not establish or maintain appropriate eye contact throughout. No verbalization during evaluation. 

From the psychological evaluator:

Dovi presented as an extremely active little boy. He seemed unaware of the examiner or of his environment, as he constantly ran about the room and screeched. Dovi continued to engage in this form of behavior for some time, and then often appeared to grunt as well. Dovi's mother attempted to gain his attention, and carried him to the testing area, in attempt to engage him to play with the examiner. Dovi seemed highly unfocused, continuously gazed about the room, turned about in his chair, or ran away from the testing spot. Dovi then ran into the kitchen, threw the stove burners down, and almost spilled the soup that his mother had cooked hours ago. Dovi seemed to be in a constant state of motion as he continuously ran backwards and forward and about the room, failed to make eye contact with the examiner, and seemed completely unaware of the examiner's presence.  Although Dovi showed little interest in the examiner's test materials, he appeared to show slight interest in a puzzle of his own that was familiar. However this was soon followed by Dovi's constant tendency to mouth and bite on these items, and failure to engage with this item in a constructive fashion. Throughout the assessment, Dovi failed to engage verbally with the examiner, or to utter any words that were discernible. occasionally babbled, yet most often continued to scream incessantly. The aforementioned forms of behavioral responses were manifested throughout most of the current testing session. 

From the educational evaluation:

Dovi was evaluated at home, where he sat in a booster at at the dining room table aimlessly shaking to and fro, knocking items from the booster tray onto the floor. It was impossible to engage him in eye contact or get him to acknowledge the presence of the evaluator. Throughout the evaluation, he manifested various odd behaviors, i.e. laughing to himself while making funny faces, grabbing at the evaluator's necklace, etc. When his mother brought in electronic toys with flashing lights and music, he often mouthed and chewed on them or fixated on protrusions, apparently trying to pull them off the toy. He ignored his mothers commands to clap his hands, touch his eyes, etc., insisting on pursuing his on agenda. Dovi's dysfunctional behaviors rendered impossible to assess his skill levels across developmental domains.

While I know that evaluators exaggerate a bit in order to get the child as much services as possible, it stung anew to read Dovi's dismal evaluation. He had been getting ABA, speech and OT for seven months and nary a dent was yet being made in his situation. If there was still a shred of denial left that I was faced with a long uphill battle, and that I had a severely autistic child who had little chance of ever being mainstreamed, the facts now stared me in the face.

With the reports all ready, it was handed in to the Board of Ed and I waited for a scheduled date for our meeting.

I was unaware of the drama still to unfold, which would shake me awake from my anguished slumber and prove to me once again that there is a Higher Power running this world.

To be continued...

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