Menu
Jump to content

What's with the ads?

Cake and Pi

UPDATE page 2 - Feedback on my plan for DS 6 for the rest of the year

Recommended Posts

Oh my goodness, it does REALLY sound like anxiety is a significant issue.   And....I know it sounds crazy, but I want to encourage you to really think about medication for anxiety.  My youngest was anxious from birth.  She was incredibly precocious, spoke in sentences at 11 months, knew all her letters and sounds by 18 months, but when she was two, we moved across the country and she just stopped.  She stopped learning, stopped interacting, stopped developing.  Her physical growth slowed way down.  She pretty much did not gain a single new developmental skill between ages 2 and 5.  We put her on an SSRI right after her fifth birthday.  The difference was night and day.  And it wasn't a six week ramp up.  Within two days, she was talking at preschool.  She started learning.  She started growing physically.  She looked REALLY autistic before the meds but much, much, MUCH less so after.  (She still wound up with an ASD diagnosis by 11, but it's really subtle.)  The difference in the quality of life for the entire family was dramatic.  I really wish we had medicated at three.  She really had an acquired developmental delay from those three lost years, and it took a long time to really recover.  She never tested that way because she had been so incredibly precocious at 2, but over the years, those percentiles dropped until she started learning again at five.  

I was really hesitant to medicate such a young child, but it really was necessary and the difference it made was profound.  I would never have guessed that so many of her issues were tied to the anxiety, but they were - including growing physically.  We knew she was anxious, but we didn't realize how global the effect was until it was somewhat ameliorated, you know?  

  • Like 2

Share this post


Link to post
Share on other sites
2 minutes ago, Terabith said:

Oh my goodness, it does REALLY sound like anxiety is a significant issue.   And....I know it sounds crazy, but I want to encourage you to really think about medication for anxiety.  My youngest was anxious from birth.  She was incredibly precocious, spoke in sentences at 11 months, knew all her letters and sounds by 18 months, but when she was two, we moved across the country and she just stopped.  She stopped learning, stopped interacting, stopped developing.  Her physical growth slowed way down.  She pretty much did not gain a single new developmental skill between ages 2 and 5.  We put her on an SSRI right after her fifth birthday.  The difference was night and day.  And it wasn't a six week ramp up.  Within two days, she was talking at preschool.  She started learning.  She started growing physically.  She looked REALLY autistic before the meds but much, much, MUCH less so after.  (She still wound up with an ASD diagnosis by 11, but it's really subtle.)  The difference in the quality of life for the entire family was dramatic.  I really wish we had medicated at three.  She really had an acquired developmental delay from those three lost years, and it took a long time to really recover.  She never tested that way because she had been so incredibly precocious at 2, but over the years, those percentiles dropped until she started learning again at five.  

I was really hesitant to medicate such a young child, but it really was necessary and the difference it made was profound.  I would never have guessed that so many of her issues were tied to the anxiety, but they were - including growing physically.  We knew she was anxious, but we didn't realize how global the effect was until it was somewhat ameliorated, you know?  

Wow. That's an amazing story and real food for thought. 

Share this post


Link to post
Share on other sites
2 hours ago, Cake and Pi said:

However, he is very socially related. He's got that joint attention.

He has a mom who is very clued in on ASD issues who doubtless has been hitting those things just by habit. Once you've parented one, you don't turn that off. My ds had that with some of his evals, that people weren't realizing just how much time he had spent working with adults. He really had the adult gig down. And he has siblings, so that is doing good stuff for him too! The ADOS modules mature as the kids mature, and there comes a point where the psychs diagnose anyway and use their judgment over the ADOS. 

That two year wait sounds horrible, wow. Around here it's 6-12 months for the children's hospital and shorter for private.

2 hours ago, Cake and Pi said:

He is extremely good at blending in a group. He's quiet.

Could I just say that when you pair that with a serious language delay and so much scripting and echolalia that that *isn't* a good thing? That could be more the language difficulties than personality. Might be something to talk with his IEP team about, how they can structure him next fall so that's not happening.

2 hours ago, Cake and Pi said:

He does pretend play and roll-playing type play in ways that DS 12 and DS 8 have never done.

Technically it's not just whether he does the pretend play, etc. but what the characteristics are. But you know, seeing good stuff is what you want! But it can vary, yes. I mean, dude, how many people on the spectrum are doing DnD and cosplay, kwim?

2 hours ago, Cake and Pi said:

Their argument against OT and PT is that his lagging physical skills do not impact his ability to access

Yup, that's how it always is. 

2 hours ago, Cake and Pi said:

I mean, he's constantly changing

And that's good! I remember someone who used to post here years ago, and she'd go so frustrated because NO ONE had a dc as unusual as hers. That can happen when a dc is unique even among unique kids. With my ds, I identify with *some* posters here. Like I'll have moms write me and be like hey your ds is like my dc, we should gab, we should get together. It's not super common, because he's a little less common. But he's not like needle in a haystack unique. Yours sounds needle in a haystack unique. Just saying.

2 hours ago, Cake and Pi said:

Last year, his first time through kindergarten, he came home every week with empty worksheet after empty worksheet that someone else had written his name on. They sent home his math workbook at the end of the year, and it was so empty that we were able to send it back to school with him this year and not have to pay the fee for a new one. Honestly, it was heartbreaking to observe.

Wow. That is sad and hard to watch. With my ds, he seems to run a year behind on academics. Like it would be really laudable to say keep him on grade level, but I balance other things (life skills, mental health, him learning to self-advocate, time for social, etc.) so that's not what happens. And it has been pretty consistent. I also think we'll probably grade adjust a bit so he gets some extra time on the other end too. His IEP technically still says grade level, but I don't want him graduating and losing access to services before he's ready. So we'll see. 

Fwiw, my ds' IEP has almost all academics with pullouts and intervention specialist hours. Maybe their move to add SLDs is a move toward that, dunno. It's kind of a funny thing because maybe as parents we have one set of goals and the school has different goals. But sometimes they're are reasons why they think it's the best way.

2 hours ago, Cake and Pi said:

 He likes to glue things together, draw, and color. Recently he's been into tracing simple stencils. He also likes play dough. He likes dot-to-dots, but he needs support to do them correctly

That gives you a lot to work with! Kumon has cute workbooks                                             Let's Cut Paper! (Kumon First Steps Workbooks)                                       

2 hours ago, Cake and Pi said:

He has this Automoblox wooden car thing that he takes apart and puts together over and over and over and over.

 

2 hours ago, Cake and Pi said:

He likes to cut paper in to tiny shreds. He could do that for hours as long as I'm nearby. 

Are these activities calming to him? Maybe you can follow them to find other things that are like that, things with parts so he can take them apart and put them back together, things he can do repetitively. Or is he doing them so much that he's sort of falling into it and not coming out to talk, to pause, to take a break, to be with people? With my ds, he would fall into the aut even with audiobooks. I made it a practice (and still do!) to stop every 20 minutes and talk with him and reconnect. 

2 hours ago, Cake and Pi said:

No, he hates them. We listen to audiobooks

You could see if your library has audiobooks more at his comprehension level. I know BARD does. You'd never want to pay for them on audible or whatever, but they do exist. Picture books, 6 minute books, etc. Or try apps for books, so he gets the visual with the audio. You could put headphones on him with his things that he can understand on a tablet so the other kids get their audiobooks. That's not cool if he's learning that screaming gets him what he wants. Now asking nicely, using language he has been taught (hurts my ears, it bugs me, too loud, whatever), language is fine. But screaming is not fine. When my ds was younger, we had a lot of stop the car, can't go forward with that. But yeah, whatever, you already know that, lol.

Our library has overdrive and can do audiobooks and ebooks. So if you check out an ebook through them, it goes through amazon (weird, I know) and for the duration of the loan it's as good as owning, meaning amazon offers you the other component. So then you have something with a picture book and professional recording where he can just tap to go to the next page.                                             Bats at the Beach (A Bat Book)                                       We did this book around that age and it was a lot of fun. Ok, I'm listening to the file and the language might be too complex. But it's just the idea.

Oh I REMEMBER!!! I had started that whole long "what if we approached it from all the other angles" thing because I had been thinking about how you could use MUSIC to connect with him! There's a lot about using music to connect with language through other parts of the brain. There's music for apraxia, and it has a slower pace and simplified vocabulary and syntax that could really work for this. Kids Express Train and Time to Sing were the ones popular when my ds started. 

 

  • Like 1

Share this post


Link to post
Share on other sites
3 hours ago, Cake and Pi said:

He probably has anxiety. Developmental peds thinks an underlying anxiety problem is probably the cause of most of his restrictive, repetitive behaviors and trouble with transitions. I don't know what would lessen that. All three of the older boys and I have diagnosed anxiety. It runs in the family. Possibly some medication eventually. I think bringing him home officially and ditching PS would improve his quality of life, but only if I can pull it off while still meeting everyone's needs, which feels overwhelmingly impossible from where I'm sitting right now.

So we ran genetics and found some easy explanations (TPH2 defect, blah blah). Sure treat it, either with supplements or meds. That's kind of interesting to say the stims and repetitive behaviors and difficulties with transitions are anxiety. They are, sure. And anxiety makes them worse, sure. But is it possible he also has those when he's NOT blazing high on his anxiety? My ds has those all the time to some degree, which is why he gets an ASD label. Sometimes they're really mild and you're like what were we worried about, lol. But rev up that anxiety, and they're gonna go off the charts. So teasing those apart is kind of, well I guess it's more helpful to just say the behaviors occur and that if he's anxious while they're occurring he should have supports. Someone can stim to calm. So do you want him to stop cutting paper into shreds and stop assembling and disassembling those car blocks?? They're clearly intertwined with who he is and they sound like something that would continue to occur.

In our state anxiety is a tier 3 diagnosis, so they want to go through that FIRST before they get to ASD. It's just how they roll. ASD is a tier 5, so they want to use anxiety supports and see what remains after they do anxiety supports. And the funny thing for us, what I hadn't anticipated, was that ds actually looked MORE autistic after he got supports for his anxiety. The autism was actually MORE apparent. Go figure.

3 hours ago, Cake and Pi said:

I think bringing him home officially and ditching PS would improve his quality of life,

That sounds like a lot of guilt on your part. He's got an IEP and is in with people who care about him. You're saying he's well behaved there. What indication do you have that anxiety is a factor at school? Are things happening there? Or does he hold it together and then come home and melt down?

You know what is amazing. I think you've done SUCH A GOOD JOB and hit so many bases that you're literally like what's left, kwim? You've done every therapy, he has access to social, he's surrounded by love. He gets worked with on life skills, gets attention. You may literally just flat be right that you've DONE it. I wouldn't feel guilty about that, kwim? You also can't feel guilty about not being able to fix the unfixable. 

3 hours ago, Cake and Pi said:

Really, my math-learning pattern mirrored what happened in reading.

Oh boy. Well I guess you'll just see how it goes. At least you know you have options. :biggrin:

3 hours ago, Cake and Pi said:

He can read his name if it's written with a capitol first letter and the rest lower case. If you show him his name in all caps, he has no idea what it says.

So you may need to play some games with upper and lower case so he begins to memorize them both and make the connection. Do you have sandpaper letters for both? 

3 hours ago, Cake and Pi said:

Yes, I already see this issue with not transfering skills now.

So the magic number for generalizing is 6. Somebody here said it and our behaviorist said it too. Six different settings, six different people/scenarios/situations. Whatever the thing is, keep hitting it more ways. So matching upper and lower case with sandpaper then with environmental print then with two different alphabet puzzles then with... kwim? 

3 hours ago, Cake and Pi said:

My kids seem to get all the rare side effects.

This is a rant, but it totally irks me that the psychiatric field is SO FAR behind on using genetics to predict these reactions, just saying. 

 

Edited by PeterPan
  • Like 2

Share this post


Link to post
Share on other sites
38 minutes ago, Terabith said:

it does REALLY sound like anxiety is a significant issue. 

I missed it, what behaviors are impacting his ability to access his education or have a joyful life that are due to anxiety? I'm not sure that's cool to give someone meds simply because they stim or have repetitive behaviors. Not disagreeing on treating anxiety. Just saying I missed what is going on here that screams put on anxiety meds.

Might be safer to start by working on interoception and his ability to self-advocate. Daily body scans using the nonverbal/simplified boards in Kelly Mahler's materials.

https://www.kelly-mahler.com/product/the-interoception-curriculum-bundle/

Edited by PeterPan
  • Like 1

Share this post


Link to post
Share on other sites

Food for thought. When he disassembles the autoblox cars and reassembles them, does he ever use them AS A CAR? Like does he do whatever boys typically do with cars? Or is he really about the parts? 

My ds was like that with playmobil. He'd set up this really complicated play, but it usually involved taking apart anything that was supposed to be something else and using the parts to make something totally different. He never actually played with the thing as it was intended. And his creativity is REALLY AMAZING! Like it's astonishing to watch, it's great. But it was also very obvious that he was not engaging in typical play. And when it looked like he was engaging in more typical play, he was *scripting* following things he had learned in speech.

See that's the thing. We expect narrative language to show up in play too. And the narrative language development and the cognitive, the cognition of the concepts, go hand in hand. Unfortunately narrative language development DRIVES higher level thinking. Meaning when our kids are delayed for language, they're also behind going forward in these higher thinking processes. So the language and the thought process that would show up in age typically play cannot be there, because the language and development is not there.

Or to put it another way, when we teach language we are driving cognitive development. So right now, I'm teaching my ds ethics. You can laugh, but it's for real. I read to him from the Old Testament law and we discuss all these conditions. What if you have an enemy and that enemy's ox wanders onto your land? What about finder's keepers? Does that mean you can just keep it? Well to discuss these requires more complex syntax, and the development of the THOUGHT and the SYNTAX go hand in hand.

So if you want to play in a targeted way with him, you can use his language targets in his play. The sentence length targets we were talking about plus the language goals (attributes, functions, whatever) come over to his play as narrative language. 

  • Like 1

Share this post


Link to post
Share on other sites

I have known several kids make major progress after starting anxiety medication.  For a couple they did everything at the same time as far as — making changes.  But also a couple where they were doing other things already and then added medication, and still saw major improvement.  
 

Age 5/6 is an age I have seen several kids start and it has worked well.  
 

Not sure if this has been mentioned, but one issue is if kids start to develop a social delay due to limiting their social interaction due to anxiety.  That can be something that is accumulating through pre-school years and early school and then that can be an extra issue, and then that can get into negative cycles with social anxiety and more limited social development, etc etc.  

It’s a reason people due go ahead with medication even if they think their kids are young and don’t really “want” to do it.  

  • Like 3

Share this post


Link to post
Share on other sites
3 hours ago, PeterPan said:

I missed it, what behaviors are impacting his ability to access his education or have a joyful life that are due to anxiety? I'm not sure that's cool to give someone meds simply because they stim or have repetitive behaviors. Not disagreeing on treating anxiety. Just saying I missed what is going on here that screams put on anxiety meds.

Might be safer to start by working on interoception and his ability to self-advocate. Daily body scans using the nonverbal/simplified boards in Kelly Mahler's materials.

https://www.kelly-mahler.com/product/the-interoception-curriculum-bundle/

I'm just thinking, you have a kid with restricted, repetitive behaviors, a strong family history of anxiety, developmental delays, and physically struggles with growth (and a pediatrician that wonders if anxiety is underlying a lot of the issues)....  These don't make it so he can't have a joyful life.  But, they're really unusual presentations of anxiety that most of the time people don't associate with anxiety.  And especially with a family history.  I get being cautious with meds, but these are the EXACT issues Cat had that responded overnight to meds.  We would not have thought to try meds except for the fact that she was having panic attacks if she wasn't in physical contact with me.  But when we did, not only did the panic attacks stop, but so did the repetitive, restricted interests, the sensory stuff calmed down, she started growing physically and gaining weight, and the learning, particularly her memory, improved overnight by like 30 points.  She still has significantly impacted working memory, but it's in the realm of functional.  We didn't realize how much it was impacting her, because we didn't associate these issues with anxiety.  It's to the extent that I wonder, even now, if we overtreated the anxiety (upped her meds or whatever), if the autism symptoms that remain would disappear.  They're THAT tied to anxiety.  She's functional 95% of the time and happy and stuff, so we don't, but there are all these weird things that are anxiety but don't look at all like it.  And we were unable to do any CBT or interoception or even OT work until she was medicated.  I just think it's easy to not realize how impacting anxiety is until it's gone.  

Now, it's totally possible to have those symptoms and they're just ASD or something else entirely.  It was the constellation of weird, unusual things that were the same weird, unusual characteristics we saw, along with the strong family history (which again, we have) that made me think it was worth a two month med trial.  

  • Like 1

Share this post


Link to post
Share on other sites

It’s really common for ASD to also have anxiety and have a good response to anxiety medication.  

  • Like 2

Share this post


Link to post
Share on other sites
4 hours ago, PeterPan said:

That's not cool if he's learning that screaming gets him what he wants. Now asking nicely, using language he has been taught (hurts my ears, it bugs me, too loud, whatever), language is fine. But screaming is not fine. When my ds was younger, we had a lot of stop the car, can't go forward with that. But yeah, whatever, you already know that, lol.

I didn't really explain that well because I was trying to be concise. DS 6 can scream nonstop for an hour or two, and he gets where even giving him what he wants doesn't get him to stop. Sometimes these can come out of the blue, as when he screams for an hour that he wants a banana and there are. no. flippin'. bananas. in the house. Nothing I say or do will get him to calm down. Other times I can spider-sense a meltdown coming on and I will respond to his initial bit of screaming (that isn't yet hysterical) with structured "outs" so that he can communicate in *some* way to get what he's needing and the rest of us don't have to be stuck in the car while he screams bloody murder for the entire trip (and possibly for some time after we get to our destination). This is something I learned in DS 8's ABA, where they give him other ways to ask for a break besides just "I need a break" when he starts to get worked up and is past the point of being able to use complete sentences. DS 8 can reduce to single words, "break" or "done" or touch a break card, and so I have just modeled what I do with DS 6 after that but with expectations more appropriate for where he's at. So, no, I don't always require asking nicely, but when I don't it's intentional and part of my master deescalation plan, lol.

Also, we normally (sans COVID-19) run such a tight schedule that there just isn't time to pull over basically ever. We have one thing after another after another scheduled.

3 hours ago, PeterPan said:

What indication do you have that anxiety is a factor at school? Are things happening there? Or does he hold it together and then come home and melt down?

Well, after 3.8 years of public school, he is still crying most days at drop-offs. We're at the point now where he has a designated morning transition person who meets us at the front doors (parents are not allowed past the main office) to distract him and entice him into letting go of me. When this works, he gets to blow some bubbles or something and gets a star on his chart to work toward a bigger prize. When it doesn't work, which is usually about 3 days a week, I have to carry him kicking and screaming into the school, pry his little arms off of my neck, and pass him to the clinic aid, his transition person, so she can gently restrain him while dash out of the building. It sucks, and we've been doing it near daily for almost 4 years!

When he first wakes up in the mornings he sometimes asks if he has to go to school and will cry and ask not to go if I say yes. He says hes scared, but I've never gotten him to say anymore than that. It's just, "I'm tared." He can't tell me what he's scared of. He's never told me about anything bad happening. Granted, he doesn't really have the skills to tell a story about something real that happened earlier in his day yet (though there was one time when he talked at length about the time our cat died... a year before), so he wouldn't necessarily be able to verbalize a bad experience. He does say that he likes his teacher and his friends -- and this kid is beloved by half the school. Everyone knows him by name. Every day when I go to pick him up there are at least 3-5 kids calling out to him, waving, telling their parents, "That's my friend M!" It's astonishing how well loved he is at school.

They assure me that he's completely happy within a few minutes of my leaving, that he has a great time at school all day long, and that he has lots of friends. I'm promised that they've seen no indication of other children mistreating him, and they say that he seems to really like being at school. 

Like I said, anxiety medication is probably in the cards for him at some point, most likely sooner rather than later, once we get through the 6-9 month wait list for an intake eval and then another 3-6 for a medication eval. I'm not interested in taking him anywhere but our big, regional children's hospital for financial and quality-of-care reasons.

  • Like 1

Share this post


Link to post
Share on other sites
6 hours ago, Terabith said:

I'm just thinking, you have a kid with restricted, repetitive behaviors, a strong family history of anxiety, developmental delays, and physically struggles with growth (and a pediatrician that wonders if anxiety is underlying a lot of the issues)....  These don't make it so he can't have a joyful life.  But, they're really unusual presentations of anxiety that most of the time people don't associate with anxiety.  And especially with a family history.  I get being cautious with meds, but these are the EXACT issues Cat had that responded overnight to meds.  We would not have thought to try meds except for the fact that she was having panic attacks if she wasn't in physical contact with me.  But when we did, not only did the panic attacks stop, but so did the repetitive, restricted interests, the sensory stuff calmed down, she started growing physically and gaining weight, and the learning, particularly her memory, improved overnight by like 30 points.  She still has significantly impacted working memory, but it's in the realm of functional.  We didn't realize how much it was impacting her, because we didn't associate these issues with anxiety.  It's to the extent that I wonder, even now, if we overtreated the anxiety (upped her meds or whatever), if the autism symptoms that remain would disappear.  They're THAT tied to anxiety.  She's functional 95% of the time and happy and stuff, so we don't, but there are all these weird things that are anxiety but don't look at all like it.  And we were unable to do any CBT or interoception or even OT work until she was medicated.  I just think it's easy to not realize how impacting anxiety is until it's gone.  

Now, it's totally possible to have those symptoms and they're just ASD or something else entirely.  It was the constellation of weird, unusual things that were the same weird, unusual characteristics we saw, along with the strong family history (which again, we have) that made me think it was worth a two month med trial.  

Thank you very much for sharing your DD's experience.

  • Like 1

Share this post


Link to post
Share on other sites

Have to go back a page and finish catching up!

18 hours ago, PeterPan said:

So with the hearing loss and the question of APD, is there an issue with background noise? Does his comprehension change if the room is quieter? I'd probably just be watching for that, like what happens if the air conditioner is on, etc. And you might try to use *headphones* any time you're wanting to make sure he gets the input. Or does that make a difference? 

I've never noticed... I'll have to pay more attention and find out.

18 hours ago, PeterPan said:

Working on interoception can help. But yeah, the -3 thing. It sounds like your other kids weren't that way. What is their support level for their ASD? Are they all ASD1? Just wondering. Just saying everything you're saying is normal for a much higher support child and a shock when your other kids don't need that kind of support.

They're both ASD-1 and exceptionally/profoundly gifted. It makes for an interesting spread in abilities.

DS 12 can pass for NT and wasn't diagnosed until just a year ago. The road to diagnosis for him was an epic saga, seriously. I could write a book about it. We'd been doing ASD-specific interventions off and on since toddlerhood because they worked, but under different diagnoses. I'm pretty sure you and I had an exchange about that several years ago (At least I think it was you, maybe, possibly, probably, under a different SN?) where I mentioned that we did ABA for my non-ASD kid and you were were questioning why/how that would work... well, it worked because he actually did have ASD, lol.

DS 8 has adaptive scores low enough to qualify as developmentally disabled, but he's also undeniably brilliant. His self-care skills totally hit the -3 rule, social communication is more like -5, but he makes up for it by being able to follow directions. So even though he can't brush his teeth independently, if I talk him through the process (every single time) he can do all the brushing himself with me standing there telling him how to do it. DS 6, on the other hand, needs me to actually brush for him, and then there's a high probability that he won't cooperate and it'll turn into a 2-person job or not get done at all. Same thing for getting dressed. DS 8 might try to leave for therapy in shoes and a pair of underwear, but if I tell him to put on pants and a shirt and hover nearby, he'll do it. Meanwhile, DS 6 will strip down naked and then when I try to get him redressed he'll turn into a freaking octopus and 20 minutes later I'll maybe have managed to get pants on him. So, yes, totally different levels of support needed, lol!

18 hours ago, PeterPan said:

https://www.dropbox.com/sh/4rcl6f0uo70esmv/AAAaGAHw3_YTMEQZSw_WI-t_a?dl=0  This is a link to my dropbox of RAN/RAS files. You can print and put in page protectors. If he can say the color names of the dots, you're golden. You can make your own with anything you want. Start very slowly. On the CTOPP (test of phonological processing psychs use) they run the RAN/RAS multiple ways. With my ds, we worked on it one way (with color names) so that he scored poorly on some of the others. So he was still flagging, but he got the benefit. What is your ds' processing speed from his IQ testing? Processing speed helps there too obviously. But anyways, high RAN/RAS is strongly correlated with strong readers. And you'll see reading tutors online saying don't bother, blah blah, but to me that's silly. It's free to work on, motivating, and probably makes a difference. If you're looking at things you can focus on for 1-3 months that will make a major difference when he goes back to school, that could be one. And you'd be surprised how often therapists are NOT working on it.

Very cool, thanks! They did a rapid naming test with DS 6 at his 6yo eval. He had a scaled score of 3 on the color one, which I think is 1st%. Processing speed was in the borderline range.

  • Like 1

Share this post


Link to post
Share on other sites
4 hours ago, Cake and Pi said:

This is something I learned in DS 8's ABA

Do any of your other kids have the types of challenging behaviors this ds6 does, or does he require a much higher level of support? Asking for a break IS asking for something nicely btw. That's a great thing to be doing and yes, dropping language demands and going to pointing, etc. is great stuff. I'm just kinda feeling for you here. It's pretty obvious that he has much more significant support needs and we don't have to hear all the stories to know that, lol. That's why I keep thinking wow, if you had someone helping you with that, you'd get that next step up of answers and options. There may be tools you *didn't need* for your olders that you need for this dc. 

                                            Stuck Strategies: What to Do When Students Get STUCK                                      This book is very practical, highly recommend.

https://www.zonesofregulation.com/index.html to catch things before it turns into two hours. He may have subtle yellow zone signs you could catch.

https://www.kelly-mahler.com/what-is-interoception/  A lot of what you've described could respond well to interoception work. She has nonverbal pointing response cards in her printables. 

4 hours ago, Cake and Pi said:

They assure me that he's completely happy within a few minutes of my leaving, that he has a great time at school all day long, and that he has lots of friends.

It's very probable!

4 hours ago, Cake and Pi said:

It's just, "I'm tared."

It's also possible that's not the right emotion word. His language issues are so funky, just given what you've described I wouldn't, as a mom, assume that's even the right emotion word. Now if you do interoception work and he's saying that 6 months from now when you're converting body signals to emotions, that's different. 

I'm *not* saying use this with him right now, because it sounds like he needs interoception work first. But you can file this away for later. It might be a simple form that would work well for him https://ianbean.co.uk/Downloads/SelfRegulation.pdf

4 hours ago, Cake and Pi said:

Like I said, anxiety medication is probably in the cards for him at some point, most likely sooner rather than later, once we get through the 6-9 month wait list for an intake eval and then another 3-6 for a medication eval. I'm not interested in taking him anywhere but our big, regional children's hospital for financial and quality-of-care reasons.

I hope you're able to get in then! Our children's hospital is like that, with long waits. 

When you think through it that way, maybe what he's calling "scared" is in fact anxiety? Like he's really, really close on the words. That could be. So, fwiw, on my ds (who was frankly unlivable and unworkable before), we ran genetics, found some treatable defects, and his moods stabilized out with a mixture of vitamin D, 5HTP (time release), and niacin. I'm not saying take those, but it was surprising how innocuous the things were that he needed. I think maybe undermethylation is more common. It definitely gets really complicated really fast. Like I said, just an aside. 

The bummer for us was when ds transitioned from small enough to compel to big enough that he really had to be able to anticipate being able to handle it and anticipating feel calm.

2 hours ago, Cake and Pi said:

They're both ASD-1

Well I was going to say you needed more tools, but then I keep reading and it sounds like your ds8 will rebadge to ASD2. I mean, that's significant support. And I'm not knocking you here. It sounds astonishingly hard. Someone from the boards here met me, and she didn't use profanity or anything, but she was really shocked, like WOW WHAT YOU'RE PUTTING UP WITH. And it's not that I wanted to put up with it in my head, by I was really lobster in the pot. And when the mix is really challenging/dangerous (like a kid screaming for hours, like a kid going aggressive like mine was), it's very hard to bring in all the rational stuff and get everything done. We're also mortal, and we don't get everything done we'd aspire to.

So I'll just ask this as a question. What if you mentally rebadged your kids as ASD1-3? Like screw the system, and just go you know, my ds12 needs SUPPORT. My ds8 needs SIGNIFICANT SUPPORT. And my ds 6 needs... But you know I'm not sure your ds6 would go 3. But he's at least at the high end. There's sort of a range. There's like skin of your teeth, really high 1 going into 2. For your trivia, *language* issues are the discriminator there. So it could be that ds8 is high 1 by the numbers. They'll take a GARS or the ADOS and use that as a consideration, but also there's just the common sense. 

And I'm saying play with it mentally and ask what you would change if you thought of it that way? A kid who is needing supports to know the steps to brush his teeth one needs significant supports but two has it showing up more ways. So what tools would you ask for if it was like wow this isn't just gonna poof and I need better access to more tools, kwim? Where is the BCBA in this??????? 

I don't know, you deserve an award. Just saying. 

Share this post


Link to post
Share on other sites
3 hours ago, Cake and Pi said:

I'm pretty sure you and I had an exchange about that several years ago (At least I think it was you, maybe, possibly, probably, under a different SN?) where I mentioned that we did ABA for my non-ASD kid and you were were questioning why/how that would work... well, it worked because he actually did have ASD, lol.

That sounds like something I would say, lol.

3 hours ago, Cake and Pi said:

The road to diagnosis for him was an epic saga, seriously. I could write a book about it. We'd been doing ASD-specific interventions off and on since toddlerhood because they worked, but under different diagnoses.

Ok, but then you're really dogmatic about how ds6 is definitely not the duck quacking like a duck, walking like a duck, swimming like a duck because psychs are omniscient and everything is obvious because they rub their hands and divine and just KNOW? LOL :biggrin:  Sorry, I'm just being lighthearted there.

Fwiw, I think it's possible the children's hospital system that is screwing you on this. Our children's hospital system is a teaching hospital. Every screwy story I hear with drawn out mess came out of a children's hospital. I'm not saying *why* it happens, just that I've heard a LOT of these stories. Their departments are very split up, compartmentalized, and it changes how they think of kids. I don't know what the explanation is. I'm just telling you I've seen the reports, talked with the people, and what you're describing is happening a lot. I think sometimes there's political pressure. Remember, these diagnoses have economic implications. And I think there's a level of inexperience. 

Every time someone hears my ds' speech diagnosis they're like oh, you go to *insert name of really well known, nationally well known children's hospital near us", and I'm like no I drive 2 1/2 hours because that children's hosptial doesn't even have people trained in the best techniques. My ds has BEAUTIFUL speech btw. I was right. So that was my first reality check years ago, that paying big $$$ to the big names wasn't always going to get the best care. It gives the impression, the reputation, but sometimes not the reality. Sometimes, yes. I'm not saying why, just I've heard so many stories that I no longer assume.

The problem is, no one is omniscient. You can go to a private neuropsych and have the same thing happen with shallow, incomplete answers. No one is omniscient and some things are more obvious with time. My ds, for instance, when he got diagnosed with ASD1 was right on the line. His GARS scores, everything were at that really high 1. Brought a behaviorist in who worked under a psych, and they're like high 1, bordering on 2, not sure which way it will pan out over the long run. They were looking at language as the discriminator between the levels, and his language issues at 6/7 weren't as radically different from his peers as they were about to be. He had also had like $80k in speech therapy, remember. But give it another year, and even that became more obvious as his peers pulled away. 

So needing to point for breaks, needing the steps of life level stuff, etc., that's really ASD2, significant support. Or don't worry about the term but just say kids are not the same, some kids need more support than others. And kids need the supports SPECIFIC to what they need.

There's no like well this is autism, so I've got this nailed. There's this is what is happening so this kid needs support. Rinse, repeat, over and over. There's no knowing autism. Every person will have their unique mix and presentation. And whatever you call it, you have multiple kids with unique presentations and support needs. So I'm just thinking about you, and I'm like WHO IS HELPING YOU DO THAT? 

So if you got access to ABA before without a label, then do it again. Quacks like a duck, gets duck food and duck care. Any ABA tools, any tools that would help him you want access to. And as a mom, you need someone talking through with you what you don't know yet. Your oldest is going into puberty, so you're dealing with puberty, puberty with ASD1, and all these other wide ranging needs. So someone to help you keep your head on straight and talk through each kid individually and bring in inhome hours to get it done. Ie. clone yourself.

 

Edited by PeterPan

Share this post


Link to post
Share on other sites
3 hours ago, Cake and Pi said:

DS 6, on the other hand, needs me to actually brush for him, and then there's a high probability that he won't cooperate and it'll turn into a 2-person job or not get done at all.

There's a reflex that affects this. Does he mouth or chew on things or come up and sorta gnaw/nibble on people?  I think the reflex was in the hands, babinski. It has to do with nursing, which is so bizarre to me that my ds needed the work because he nursed! Anyways, Nope, not babinkski because that's feet. Ds had that too. It was very subtle when the PT tested him. I think it may have been Babkin. Basically I just stroked his hands. 

So whatever the reflexes, I'm just thinking maybe work on them for 6-8 weeks and see what calms down. If it's uncomfortable because of reflexes, that's hard to overcome. Meanwhile, you could get your BCBA to give you a visual schedule with the steps for brushing teeth. Or go to TPT or google image and get one. There are visuals of steps for anything, definitely for brushing teeth. Or you can take a picture with your iphone of each thing (toothpaste on brush, wetting under faucet, toothbrush across teeth while he SMILES, timer shows 2 minutes if you're going wild haha, foaming, rinsing, toothbrush put away). 

https://www.pinterest.com/pin/477029785510911907/  The one at this link looks good. You can save the image and throw into your word program and expand to fill the page so you can print. Then pop in a page protector or just tape on the mirror. If you click the actual link, it takes you to some weird site, not sure why. But it's saved here on pinterest, haha. 

I brushed both my kids' teeth a long time. Ds is independent now, and if they're not clean enough I send him back. He's not so bad anymore, but he's 11, kwim? But that's really high support when it's taking 2 people. Is the flavor on the toothpaste really strong? Both my kids are HIGHLY PICKY about the toothpaste. My ds used a particular Toms of Maine for kids that had a mild flavor. Now at 11 he tolerates one of the mints. Not the other, just the one. I think it's the spearmint. But cutting down on the extremeness of the flavor can help immensely. They just keep changing the toothpastes so sometimes it's hard to find the milder ones without flouride. (if that matters to you)

                                            Tom's of Maine Fluoride-Free Children's Toothpaste, Kids Toothpaste, Natural Toothpaste, Silly Strawberry, 4.2 Ounce, 3-Pack                                      I think this is what he used when he was younger.

I used Calm Child when my kids were younger. Now my ds can take capsules, so I give him straight chamomile. You might see if something like that, administered say 30-60 minutes before you want to start your bedtime routine, could work. So I give my ds his 5HTP (400mg time release, 8pm) and a capsule of chamomile, and we then can have a smooth bedtime routine at like 9-9:30. Before, it was running around trying to calm his body, dangerous, utterly insane. I'm just thinking as a stop gap till you get your pdoc meds. 

https://www.iherb.com/pr/Planetary-Herbals-Calm-Child-Herbal-Syrup-4-fl-oz-118-28-mL/13690

Edited by PeterPan
  • Like 1

Share this post


Link to post
Share on other sites
On 3/23/2020 at 11:06 AM, PeterPan said:

Hey, let's page @Mainer She's fluent on Wilson, right? So where can op jump in and what can she do easily? And what are the odds that they were doing Fundations instead of the full Wilson? How can she assess where to start? 

Hi guys! Sorry I'm late to the party but thanks for the invite! I agree with everyone here that suggested just focusing on that phonological awareness. And if mom isn't so good at it, no problem, that can be something to work on! You can always get better at it, even as an adult. I find your description of knowing the entire word vs. parts really fascinating 🙂 On that previous thread that PeterPan shared, I talked about how to work towards the goal of doing everything out loud - but like Cake and Pi said, she is able to do it if the word is written down, but not out loud (yet!). So you start to do things written down - like writing the word 'flap', then taking out the /f/ sound (cross it out), leaving "lap." Etc. Then when that's easy, represent each sound (4 sounds, f/l/a/p/) with coins or buttons or whatnot, and take off the button that represents the /f/ sound. Then tap out the remaining sounds, l/a/p/. After that, try it out loud. Boom! Mastered that level. Moving on.

I would buy David Kilpatrick's book "Equipped for Reading Success." It's my reading Bible. I LOVE it so much. The first many pages are informational, and then the last 50 pages or so are his phonemic awareness program. It starts with syllables and moves ever so slowly down to the nitty gritty of phonemic awareness. My kids, even those who struggle with sounds, love it. I think they love it because it starts them where the work is really easy, and then slooooowly moves them along. If they need it, we use letters, then objects, then just sounds. It's so gradual that it's not stressful.

I'm so interested to hear how it goes with a probably dyslexic adult. 🙂 I'm not so great on the other language stuff, so I won't chime in on that.

A really big bonus of the phonological awareness work is that it helps so many other things, just by the nature of it... focus, patience, perseverance, etc. 

  • Like 3

Share this post


Link to post
Share on other sites

Update with more questions!

 

UPDATE:

We had DS 6's annual PS review recently and came out with an excellent IEP. He's got goals for articulation (make the "s" sound), auditory memory (follow 2-3 step directions), language (use correct syntax), reading (read at least 8 cvc words), writing (write "at grade level" by writing words that contain correct beginning, middle, and ending sounds), and math (understand numbers 11-19 as 10 and 1s). They increased his speech minutes and kept PT on consult. We also decided to move him to a different school with a higher sped population.

If this were a normal year, I'd be feeling pretty dang good. But it's not. Not only do we have COVID going on, but unemployment dropped state revenue so significantly that our already underfunded district is facing budget cuts of 12% or more. In response, school will only be held 4 days per week going forward. Our district is encouraging families to do fully remote learning in the fall, though we do have the option of choosing a hybrid model where students come to school once a week and do remote learning the other three days. This is not going to work for DS 6, so we're making the leap. We're going to homeschool him officially next year!

I found an in-state but out-of-district homeschool charter that we can use for funding (I'll have $1,500 to use on educational materials!) with very few strings attached. So now I can order pretty much whatever is going to work for him. It's all in the budget, lol.

Learning-wise, we're now heading into week 12 of me teaching DS 6 at home. He's still in lesson 7 of RS A, so it's probably safe to say that RS is not going to work for him. He's not a fan of the abacus, but he loves our Nooms (home-made c-rods) and playing with pattern blocks. He still knows 21 letter sounds, so he hasn't learned any new sounds, but he also hasn't lost any. We're making a sound book, focusing on 1-2 letter sounds each week. He gets a page with the upper and lower case forms of a letter at the top, and then we go on a sound hunt finding things that begin with that sound, which he draws on his page. We review the entire book every day, saying the sounds and words. He's really enjoying it.

I bought Ronit Bird's Dyscalculia Toolkit book and Kilpatrick's Equipped for Reading Success. I'm going to spend the summer reading those and then working through what I can with him. I also plan on experimenting with a bunch of other resources I've got temporarily.

 

QUESTIONS:

I'd love feedback on the following programs (I've got free trials/borrowed copies now):
ST Math
MUS Primer
Hearbuilder

READING: In addition to continuing with Kilpatrick, I'm leaning toward at least trying Sing, Spell, Read & Write with him this coming fall. I already own it and he seems to learn more quickly and retain better with songs than with straight spoken language, plus he saw me going through the box and is now super excited about it and wants to use it. I've never used SSRR though. I just scored a free kit years ago and held onto it just in case. I have no experience with the program itself. Thoughts???

MATH: I understand Ronit Bird is just supplemental, so we'll need a main math curriculum. All I know is that it's not going to be RightStart. 😭 I think I'll still incorporate what I can from RS, card games and such, since it's the program I used with my other three and I'm so familiar with it. However, I need something as a spine for DS 6. I borrowed a copy of MUS Primer and it looks like a good fit for where he is now. I worry about the levels beyond Primer though. I'm a bit nervous about using a mastery based program with him. He needs to keep reviewing or he'll forget what he learned. Do the review pages incorporate skills from earlier levels as you move through MUS?

TIA!

  • Like 2

Share this post


Link to post
Share on other sites
22 hours ago, Cake and Pi said:

he loves our Nooms (home-made c-rods)

Congratulations on moving to homeschooling! Yes, you'll do great.

So I would look at ronit Bird. Ok, you're saying you want a full alongside. Thing is, his disability is so significant you don't need a *lot* alongside *right now*. I have used some workbooks alongside. Instead of thinking full curriculum, think complement. Do what RB doesn't do, not what it does. A kid with dyscalculia doesn't need more computation. He needs more APPLICATION. So look for things that involve measuring, graphing, word problems, understandign the language of math. I have used tons of stuff, but I can tell you I just go to my favorite haunts and find what strikes me. 

Carson Dellosa

Teacher Created Materials

Evan Moor

These are my three uber favs. I'm also seriously in love with ANYTHING from Lakeshore Learning. Dump money there. I buy math kits from them. Look for clearance, especially if you can get in a physical store. I find things from them regularly half off. As far as workbooks, Lakeshore sells stuff too. See the samples, start with a little something, go with your gut. Don't try to do too much at first, kwim? One curriculum is not the cure for everything when there's an SLD.  I really like "daily warmup" type workbooks. There was a "Using the Standards" series for math I really liked. Graphing Art from Teacher Created. Just look through stuff, see what you find. there's a workbook that focuses on the basics I like, but I'm not sure I would have wanted it at that age. I can grab the title if you want. I like it now, but really at this stage you want Ronit Bird, games, application. 

22 hours ago, Cake and Pi said:

ST Math
MUS Primer
Hearbuilder

What is ST math? 

No, I would not use MUS. Focus on the Ronit Bird, because it's the most foundational, most meant for dyscalculia. Unless you find it fitting. But I'm just saying MUS is about the same level of instruction as RS. RB is intervention.

Hearbuilder is fine but that's therapy. I'm not up on Kilpatrick's stuff. Does your ds pass the Barton screening tool? Have you administered it? I think you could make more progress in phonological processing with a high quality program. There are some free OG options. If your ds passes the Barton screening tool, you can begin any OG program. If he does not pass it, you need to back up farther and are going to need more support than your letters of the week approach. That's charming for now, but I think you might want to step up the pace on that and within the next month make a move to the next step with either a program to intervene on his phonological processing or a full OG program. 

Ok, you have RB's Toolkit. Have you seen her ebooks? Her Dots ebook is superb. We spent 1-3 weeks on a two page spread. The ebooks are inexpensive and rearrange the instruction into a logical order and include videos. HIGHLY recommend even when you have the print books. Do what you want, but just saying.

Oh my, you want to use SSRW? I missed it, does he have dyslexia? Why the IEP? What are his diagnoses?

https://bartonreading.com/students/#ss  Here's the Barton screening tool. If he's not passing this, he doesn't have the foundation to succeed with *any* OG based program. So this is free and would give you some info about where to start with intervening. I love that he's excited about learning!! However you also want him to be SUCCESSFUL. If you're looking at using a charter, can they be compelled to offer services? Intervention? Do they have anyone who is OG trained or solid materials you can borrow? 

If you're asking what would be *charming* and the most charming for a fun loving dc who needs some OG, sigh, well Barton isn't charming. But still do the pretest and see what happens, kwim? *Some* kids with a reading disability can do AAR successfully. It's charming. There is free OG and some tutors will be able to make it charming. There are ways, sure.

http://www.helpinschool.net/home/reading/reading-and-dyslexia-overview/reading-and-dyslexia  Here's an article on SSRW for dyslexia. I'm not sure what you have going on, but it's more important that he be successful than that it be charming. You can make things charming by applying the skills in fun ways. You can bring in Lakeshore Learning kits, go multisensory, etc. I used the letter magnets from Lakeshore along with Barton for my ds. I used phonics dominoes, etc. etc. You can be fun without a fun program. Main thing is to get a tier of intervention that will connect with him.

http://www.marooneyfoundation.org/professional-learning.aspx  free OG materials 

  • Like 3

Share this post


Link to post
Share on other sites
5 hours ago, PeterPan said:

A kid with dyscalculia doesn't need more computation.

We don't know yet if he has dyscalculia, but I suspect not. His neuropsych eval said he was at risk for SLD in reading, writing, and math (and ADHD) based on his achievement testing being that much farther below his (low-average) IQ. HOWEVER, *I* believe that his math ability may actually be pretty close to average and that his math learning so far has just been severely impeded by his language difficulties. He has excellent spatial skills, and when he plays with our c-rods I get the impression that he's got an innate grasp of quantity as long as no language is involved. You add words like "eight" and "middle" and "more" and it all goes out the window. Point being that I think it's too early to really tell if he actually has dyscalculia or if he has language-limited math achievement.

5 hours ago, PeterPan said:

I'm also seriously in love with ANYTHING from Lakeshore Learning

Yes! I love Lakeshore! And Didax. ITA. Just about anything from either of them is awesome.

5 hours ago, PeterPan said:

What is ST math?

It looks really promising and claims to be a math program that doesn't use language. "Spatial-Temporal Math." I've read some maybe not-so-positive reviews online, but none are from parents with language disabilities like my DS has, so it still seems worth looking into.

5 hours ago, PeterPan said:

MUS is about the same level of instruction as RS

Really? It looks so much more streamlined and simplified to me, like all the bells and whistles were removed. At least that's my impression of Primer. I haven't looked through Alpha and beyond. Did you try MUS with your DS? I met the program author, Steve Demme, at a homeschool conference a couple of years ago. I wish I would have paid more attention. I think I remember him saying he wrote the program largely to meet the needs of his son with Down Syndrome, and, incidentally, my DS 6 has a learning profile very similar to a child with milder Down Syndrome.

5 hours ago, PeterPan said:

Ok, you have RB's Toolkit. Have you seen her ebooks? Her Dots ebook is superb. We spent 1-3 weeks on a two page spread. The ebooks are inexpensive and rearrange the instruction into a logical order and include videos. HIGHLY recommend even when you have the print books. Do what you want, but just saying.

I don't have any Apple devices, so I can't get any of her ebooks. 😞

5 hours ago, PeterPan said:

Oh my, you want to use SSRW?

Well, I already own SSRW, so...maybe? I only used the SSRW readers with some my older kids. Two needed very minimal instruction and one taught himself before I got around to it, so I just never needed the complete program.

5 hours ago, PeterPan said:

I missed it, does he have dyslexia?

He is at high risk for dyslexia. I probably have dyslexia. My brother is diagnosed with dyslexia. DS 10 has a dyslexia diagnosis. It would not be surprising at all if DS 6 were dyslexic, and it's probably safest to proceed as though he were dyslexic. 

5 hours ago, PeterPan said:

Why the IEP? What are his diagnoses?

His main diagnoses are neurodevelopmental disorder associated with his birth history (IUGR preemie) and moderate-severe language disorder. He also has moderate-severe articulation disorder, sensory processing disorder, mild (sub-speech) hearing loss, and a *very* long list of minor physical diagnoses/differences that probably don't make much difference individually but altogether might impact his ability to learn and achieve. He also almost certainly has ADHD-inattentive (no hyperactivity). He would have been diagnosed at his last eval except that the questionnaire I filled out did not endorse inattentiveness. Now that I've been trying to work with him at home for a few months, I can see that he absolutely does have issues with inattention. He is very much off in la-la land a lot of the time.

5 hours ago, PeterPan said:

Here's the Barton screening tool

Did it a couple months ago and he did not pass any part of it. This is how we came to the conclusion that he needed a lot of focused attention on phonological awareness, hence the Kilpatrick book. That said, *I* didn't pass the Barton tutor screening and I still learned to read, so I'm inclined to run phonological awareness and reading instruction in parallel. He may spend a veeeeeeery long time on phonological awareness before he can pass that Barton screening. I figure it's okay to keep moving forward at least learning the letter sounds and beginning some digraphs and blends as he's able to, regardless of his passing the Barton screening. Eventually all the pieces will be present and then we can work on clicking them into place together. Or this was my theory, anyway.

5 hours ago, PeterPan said:

So SSRW will absolutely go too fast. Since we just spent 11+ weeks on 7 lessons of RS, I'm thinking just about everything will go too fast. 

This site is *very* interesting. It recommends DISTAR/ Reading Mastery. TYCTR in 100EZ Lessons is also DISTAR. Does that mean that 100EZ might work? Okay, there wouldn't be enough practice in 100EZ. Maybe I should look at getting some Reading Mastery materials. I actually used 100EZ with two of my boys (plus SSRW readers and Primary Phonics readers) and am very comfortable with the system. 

  • Like 1

Share this post


Link to post
Share on other sites

If MUS Primer looks good for now, don’t worry about the upper levels.  You can change or adjust later. 

If retention has been an issue in math, expect to reteach sometimes.  It’s okay.  The lower levels of math can take a lot of work, that is okay. 
 

I don’t know where you can find a list (maybe school?) but there are lists of math language/vocabulary words, for younger kids.

It is things like more/less, half/whole, part/whole, longer/shorter, heavier/lighter.  
 

These are more abstract in their way, but also something possible to make concrete (compared to some other abstract things lol).  If you have an idea of words to work on, you can look for chances in games or during the day.  
 

These are hard concepts, but they go a long way.  

 

  • Like 1

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

×
×
  • Create New...