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Last week I wrote about how well the kids are doing on the primitive reflexes. That is pretty exciting stuff, but it can be tough to understand exactly how the primitive reflexes relate to behavior.
The second half of the assessment report is more exciting for me because it is easier to see exactly how the kids are progressing. As with the last post, I'm including the text from the three-month assessment so that you can see how they have progressed since then. If you get bored with the details, I encourage you to skip down to the bottom where we talk about how both Kimball and Anahí have practically dropped off of the ADD, Asperger's and Autism scales.
When the kids started, they had very weak eyes. Kimball has always been a fluent reader, but his comprehension has struggled. We found out that at least part of this has to do with the fact that his eyes were all over the page when he was reading. There were times when we wondered if Anahí would ever read, but she was starting to get the hang of it when we started Brain Balance.
So how have they done?
When we started Kimball and Anahí were both unable to separate the movement of their eyes from the movement of their head. This makes it really tough to do things like ride a bike and other things that require good vision and balance. Now Kimball has very strong eyes and can track just fine. Anahí still moves her head, but only a tiny bit. When we started they were also unable to make their eyes converge or diverge (go cross-eyed and come back out). This is important for school work where they have to focus on things that are near and then far. Now Kimball can converge and diverge just fine. Anahí is getting better every day.
One really exciting and easy-to-see area where they have improved is on the eye exercise they call VOR or "head turns." On this exercise, the kids are asked to keep their eyes focused on an object about arms-length away (like an outstretched finger) while they rotate their head from side to side.
Three months ago, neither Kimball nor Anahí were able to successfully complete even one rotation. Kimball can now keep his eyes on the object for 15 out of 15 rotations, and Anahí (amazingly) can do it 6 out of 15 times. This is huge improvement and we can see the benefits in better hand-eye coordination, and better eye contact when they are talking to us and other.
Update: Kimball's eyes now pursue a slow-moving object normally -- without moving his head. Anahí's head only moves slightly, and she lost focus only a couple of times on her test. One of the trickier tests they run is called OPK. The point is to watch a bunch of lines run across a screen. Your eyes are supposed to twitch back and forth rapidly as this happens. When Kimball and Anahí started, their eyes would stare off into space or they would follow one line and then lose focus as that line ran off of the screen. They are both making progress in this area, but it is still hard -- particularly for Anahí. Kimball has almost got it down, but his head moves slightly. They can both now go cross-eyed when watching an object approaching their nose, although Kimball's eyes are still a bit shaky and Anahí loses focus right at the end.
On their VOR, they have both improved a lot. Kimball can keep his eyes on a static object while moving his head without any problems. Anahí has improved from 6 to 11 times out of 15. VOR is a really important skill needed for movement and balance.
Anahí completely failed the simple hearing test three months ago because she was totally unable to understand what she was supposed to do. She got 100% on the test this time which is a huge testament to her progress in the program.
One of the interesting tests is auditory processing. To do this they put headphones on the kids and play a different word into each ear simultaneously, for example: "dog" and "cat." Then they ask the kids to say which word was played into each ear. Neither could do this successfully three months ago. Kimball actually scored lower than Anahí on this. It was a huge revelation to us because even though Kimball's "hearing" was fine, it explained why he sometimes acted like he couldn't hear us. Even though his ears could hear the sounds, his brain couldn't process the sounds from both ears at the same time. So if he was listening with one ear he was effectively deaf in the other. He had the auditory processing of a three-year-old. Anahí was not much better at the level of a four-year-old.
Kimball has made huge strides in this area. He is now processing at the level of an eleven-year-old. Anahí has stayed at level four, but she is visibly more focused now than ever, and we fully expect this number to improve over time. She has begun blending the words that come into the different headphones so instead of only saying "cat" or "dog" she now will say "cog" or "dat."
Update: Both Kimball and Anahí have mad huge strides in their auditory processing. Anahí has now reached age level, moving from the 4 she was stuck on to now 6. Kimball held steady at the level of an 11-year-old.
Another test that they do that is really tricky for the kids is a smell ID. Again, Anahí had no idea what she was supposed to do and scored very low three months ago. This time she got seven out of fifteen right (this is one I struggle with as well).
Update: Anahí held at 7, and Kimball tested at 13 on a scale of 15. Not bad.
On the arm-touch sensation test, where they put a vibrator on the kids and have them tell the tester when the vibration has stopped, Anahí improved from the level of a three-year-old to the level of a ten-year-old. Kimball actually regressed from the level of a ten-year-old to the level of a seven-year-old, but this is a tough one as well. On the leg-touch-sensation test (same as above but on the leg), Kimball improved from the level of an eight- to the level of a nine-year-old. Anahí improved from the level of a three- to that of a six-year-old (age level!).
Update: I'm not sure why, but Anahí dropped back to 3 on both arm and leg sensation (we have been told that it's tricky for them to test this accurately). Kimball's arm touch sensation held at 10, and his leg touch sensation is at 8
Fine Motor Skills
In their fine motor skills, both have really improved. Anahí went from unable to perform to the level of a two-year-old, (anytime they start at zero we consider any improvement a huge jump). Kimball improved from the level of a four-year-old to that of a seven-year-old. Over the past couple of weeks he has even learned to tie his own shoes (another thing I wondered if would ever happen)!
Update: Kimball continues to hold at the level of a 7-year-old. Anahí finally made the jump from 2-3 years, and her fine motor skills are really improving. She is starting to write letters and numbers, her coloring is better, and her cutting is much, much better.
Core Muscle Testing
We have documented hereand here how much the kids have improved in their core strength, but it ought to be noted again here. Anahí improved from threes and "unable to performs" to having the core strength of a five to seven-year-old. She has particularly improved in her sit-ups, going from unable to lift her head off the ground to doing 18 legitimate sit-ups in one minute. Her pushups have also gotten much better. When we started we couldn't get her to do one pushup on the wall. Now she does ten pushups on her knees and holds a good plank position for thirty seconds. She is awesome.
Update: Anahí has pushed her core strength even more. Now she is scoring in the four to eight-year-old range, and she is able to do 5-10 full pushups. This is so important because the core is so vital to all of the other processes.
Kimball, is a core-strength rockstar. He started at the level of a four to seven-year-old. Now his lowest level is that of a nine-year-old (sit-ups) and his highest is that of a fifteen-year-old (pushups)! I was watching him riding his bike yesterday and just pretty amazed at how fast and confident he rides now. I'm sure this has to do with improved core strength that gives him better stability.
Update: Kimball continues to dominate on the core. His age level in the different core areas are now 11 (supine), 11 (prone), 10 (lateral), 11 (brachiation/monkey bars), 11 (sit-ups), and 17 (pushups)!
This category is huge for social engagement. On PRNG, which measures balance, Kimball has improved from a level eleven to fourteen (on a scale of zero to fifteen). Anahí has improved from one to seven on the same scale. She used to stumble and fall all the time -- like a toddler -- now she is much more stable.
On proprioception, which measures general spatial awareness, which is measured on an age-based scale, Kimball has improved from five to six, and Anahí from three to five. This has to do with social interaction because as kids become more aware of where their own body is in space and what it is doing, they are able to pay more attention to what other people are doing.
Update: Both PRNG and Proprioception held pretty much steady for Kimball and Anahí with some minor gains and some minor losses. We're calling this a wash.
As I’ve also mentioned before, synchronization is important because as kids are better able to handle rhythm and timing, their decision making will improve because messages get sent from brain to body in a timely manner — in rhythm.
On the balance beam both kids started at the level of a four-year-old (barely able to go across forward and backward and sideways). Anahí is now at age level (six) and able to comfortably go across the beam while looking up. Kimball is at age eleven and now goes across the beam while tossing a ball and catching it. Awesome.
On their gate (jumping-jacks, cross-crawls, jumping rope, etc.), Kimball has improved from unable to perform to that of a thirteen-year-old! It’s tough to overstate how much this has done for his confidence. Anahí has improved as well, from unable to perform to that of a five-year-old.
On the metronome, where they have to clap to a beat, Kimball has improved from a four-year-old level to that of a ten-year-old. Anahí has improved from level three to level five.
Update: Anahí is now at the level of an 8-year-old on the balance beam, a 3-year-old with her gait (she started 0). Kimball has improved to the level of a 14-year-old on the balance beam, a six-year-old on his gait, and a 12-year-old on the metronome. This is a huge indicator of changes in behavior (which I'll point out in a minute)
Academically, we aren’t too concerned about either of these kids. Kimball is near or above grade level in nearly every category. His math actually got worse over the course of three months, but that is no surprise. We have done zero academic work with him over the course of our time with Brain Balance. With his increased focus we are confident he will catch up just fine. He continues to excel at reading. His reading fluency is now well over a sixth-grade level. His reading comprehension has improved from just under to just over grade level (this with no work done on our part to improve his reading comprehension).
Since we haven’t done any work on academics with Anahí, there is stress over her academic performance. One awesome thing, however, is that her listening comprehension has improved from pre-K to over a first-grade level and her early reading skills from pre-K to kindergarten. She has a bright future ahead of her.
Update: This all has to be taken with sort of a grain of salt since neither Kimball or Anahí had any school for over six months. Anahí has improved in her early reading skills, her math problem solving, her alphabet writing, her oral expression and her spelling. Kimball has really taken off, jumping one to two grade level in nearly every category. He is still a tiny bit below grade level in math, but his reading scores are really high, at fourth, fifth and sixth-grade levels.
The last section of the evaluation has to do with these questionnaires that Betty and I fill out. It takes forever and can be pretty depressing, but the data is good.
On the Brown’s ADD scale, Kimball has improved from a combined score of 65 to a combined score of 49. This means that Kimball definitely could have been diagnosed with ADD three months ago, today he wouldn’t be.
Update: Kimball's composite ADD score dropped even more, down to just 38! He is more focused, better organized, more alert and aware of his surroundings, uses his memory in practical ways, and is more attentive.
On the GADS Asperger’s Scale, Kimball went from an average score of 10.25 to 9.5. This doesn’t quite tell the entire story however as in the areas of social interaction and restricted patterns he actually score worse this time around. This is probably our biggest source of frustration. Kimball seems more obsessive and restricted than ever before. While we don’t know all of the reasons why, we believe that in part it has to do with the fact that his brain is going back through some infant stages in which the staring at fans and the playing with shiny objects is OK. Hopefully he gets out of it soon. It’s important for us, however, to remember that the net is positive, and we are making good headway.
Update: This is probably the best news of the entire assessment. Kimball has nearly fallen off of the Asperger's chart. His average score has dropped from 9.5 to 2.5! In social interaction he dropped from 6 to 1, in restricted patters from 10 to 2, in cognitive patterns from 12 to 4, and in pragmatic skills from 13 to 2. This is absolutely stunning. Betty and I sailed through the questionnaires this time around. So many things that he used to struggle with have gone away.
On the GARS Autism Scale, Kimball went from average of 7.66 to an average of 7.33 — improving in the area of social interaction. Why did he get worse in social interaction on the GADS scale but improve in social interaction on the GARS scale? I don’t know. But I’m going to call it a statistical wash and an anecdotal gain. Kimball is markedly better socially today than he was three months ago.
Update: Kimball's average on the autism scale dropped all the way from 7.33 to 3.66! Many of his autistic tendencies are still there, but they no longer negatively affect his life. For the most part now he is in control. It has been awesome to watch the transformation!
Anahí's scales are a bit more complicated than Kimball’s and I was tempted to throw them out, but they actually make a lot of sense.
On the ADD scale, Anahí went from a combined score of 64 to a combined score of 66. On the Asperger’s scale she went from an average of 8.75 to an average of 10.5. On the autism scale she went from an average of 8.0 to an average of 8.33. How did this happen? Well, Anahí used to be about as happy and docile as you could hope for in a child. She was content to just wander around the house talking nonsense to herself and letting her siblings walk all over her. Now it is like we have started to let out someone who has been locked up for a very long time, and she often doesn’t know how to handle it. She gets angry, she throws big tantrums, she teases her siblings. It’s like all of this repressed emotion is finally finding an outlet, and I am totally happy to let her take some time to figure it all out. In the end, I’m confident that we will be able to help her find the right emotional balance and that her naturally sweet temperament will return. It isn’t easy, but man is it worth every tantrum and every tear to feel like we have broken through that happy prison she was in.
Update: After the three-month evaluation, when Anahí's scores increased in all of these areas, I have to admit that we were pretty frustrated. I look back on what I wrote then, and I'm grateful that we had the optimism and the hope to keep going, even in the face of worsening numbers and a tougher reality with Anahí. But the good news is that as we had hoped and expected, things got much better this time around. Her average on the ADD scale went from 66 to 55. On the Asperger's scale she dropped from 10.5 to 4.75! Her social interaction dropped from 11 to 1! Her autism scale also improved from an average of 8.33 to 5.66.
I know that this is a lot of numbers, and sometimes it is hard to see the forest for the trees. It can be easy to fixate on specific skills and get frustrated when you see your child struggle to make gains. But when you take a step back and take it all in, the results we have seen have been absolutely miraculous. This has been the hardest thing we have ever done, and we continue to work as hard as we can to help these kids get stronger and to reach their potential. There are still hard times, and we will write about them as well. But today it all feels pretty awesome.
As always, please feel free to comment on and share this post with your friends and family. We hope our story helps other people working with children and adults with autism. Feel free, as well, to click on the thermometer and donate to help us pay for the Brain Balance program that has done so much for us. Every little bit helps!