Friday, January 23, 2009

House Meeting in Appleton 1-21-2009

On Wednesday, we met Becky Prom, the director of the group home in Appleton.

She gave us an update from Stephen's information sheet.

A lot of talk about dentistry. Stephen has had little success with toothbrushing. His dentist, Dr. Steinmetz, was asked about a strategy. He stated to continue doing the same thing but not too being too aggressive brushing in back(where some plack is starting to form). It is feared that the aggressive hand over hand would lead to regressional resistance. Steinmetz says to emphasize the front and sides without a finger pad. The school has said they have had some success with toothbrushing. Prom said she would take as an action item to ask the school more about what they are doing.

There was consensus that Stephen should switch fo a non-floride toothpaste that would be less dangerous to swallow. Becky will discuss the change with staff at the Agape House. Dr. Steinmetz said Stephen needed to be sedated for any involved dental work.

Also, Stephen will be going to have a vision test at Shopko on February 11th.

Stephen's psychiatrist Dr. Phillips says that there are no recommendations for changes in medication. No significant changes in behavior. Becky did mention two severe tantrums which happened in November and December. A cause could not be determined for either one. It's like they came out of the blue. There have been two incidents of gagging. One in November and one in December. One involved a tactile toy. There have been about a dozen attempts to gag that were prevented by a worker at the house. "Finger out of mouth" is the command and it seems to stop him in what he is doing. Becky reports that Stephen sometimes taunts by putting his finger close to the mouth and smiling.

Sometimes, it is reported, that Stephen gets more cuddly when parents leave from visits. Sometimes he gets a little teary eyed.

He three BM's on his own. Becky postulates that consistent opportunities to go into the bathroom leads to more success in this area. He is toileted every hours and is woken up at 11am and 4am to go to bathroom. He wakes every morning at 6am.

Stephen remains on colace 100 mg. He takes this every day for constipation, to counteract the drying up tendencies of Risperdal. He takes one mult-vitamin a day and Risperdal 1 milligram a day.

All meds are given in applesauce and he is doing quite well with this method.

Stephen is given two choices of outfits to where and he picks one. It's not certain how random of a choice this is and how much is real discrimmination.

Staff leader Ann reports that she takes Stephen to church now on a regular basis. He seems to like the music most of all, but hides behind Ann during the sharing of the peace. Nail care is once a month. He is also helping with laundry, taking the basket downstairs. He also likes to push the button on the vacuum cleaner.

An incident of playful teasing was reported by Becky. Stephen would reach over to give her a cheeto and then would pull it away at the last minute from her her outstretched hand. He would giggle thinking is was hilarious. She finally did get a Cheeto and Becky got a kick out of it too.

It was repeated that Stephen needs to be monitored in public because he doesn't understand pedestrian safety skills, does not comprehend them.

Joanne Schneider of Social Services said she was working to get a "Pocket Talker" at home, similar to one they were using at school. It is a something on his belt that he can manipulate by choosing buttons for different things like drink, food, outside, toilet, etc. Schneider said the waiver would pay for this and that it would be a helpful vehicle for Stephen to communicate with others. Becky, Debbie and Jeff agreed.

We also suggested that Stephen be given more chapstick because his lips were dry and could get infected. We also said he drinks a lot when when we take him out for lunch and were concerned how much he drinks at the house. Becky responded by saying that Stephen is sometimes getting up and getting his own water from the sink. BIG PROGRESS!

We were also assured that there would be at least two workers in the house at a time since they were adding another child February 16th. Jeff and Debbie said they were happy about that, and were a little nervous about only one staff member for two kids.

We jointly set our next meeting for April 13th at 2:30pm at the house. We thanked Becky and Joanne for their time and efforts and wished them a good afternoon. Joanne said she would visit the school and then email back info on the pocket talker as soon as she could.


Maddy said...

Great strides indeed. It sounds as if you have a wonderful team all of whom seem to be remarkably good at communicating back! I was particularly tickled with the teasing. It's just the sort of thing that no-one bothers to share but when they do, it is truly treasured.
Best wishes

Rebekah said...

I hope this doesn't sound offensive, but have you tried a non foaming, very mild flavored toothpaste? I'm on the spectrum and hated the mint toothpaste because it felt really hot. Tom's of Maine makes some mild flavors without fluoride. My sons (also on the spectrum) don't like the foaming and are pretty picky...and for soem reason, they do better with an electric toothbrush.