Getting a Cavity Filled

If you recall about a month ago, I posted about Gus's trip to a new dentist. I was less than thrilled, but I decided to keep his appointment to get his 3 cavities taken care of. Instead of worrying about the dentist's behavior, I decided to focus on him and preparing him for today's visit. I'll also focus this post of that aspect to spare you a venomous tirade about the dental industry.

I knew a couple of things going in: that they'd probably use nitrous, and that he'd likely be very grabby with the instruments once she started working on him. I wasn't so sure the nitrous would even work - he had a difficult time having anything over his nose when he had his ear tubes put in years ago. At least I had a starting point.

MM had been given one of the 'piggy noses' or nose masks that the nitrous is delivered through. So I made sure we practiced having the nose on and breathing with it. That way Gus wouldn't be too freaked out by it. He was only a little freaked out by it and eventually relaxed - there were other more pressing things to freak out about anyway.

Last night, we also had a talk about grabbing the dentists instruments and how it is dangerous to do that. So we discussed options if he needed her to stop for any reason. I gave him a hand signal, which he modified to his own taste, and we also discussed how he could use his words or sounds if he couldn't speak. This worked well for him despite the dentist telling him not to yell. It was either that or let him grab her hands, so I let him yell. There was a wedge in his mouth to keep it open, so it wasn't like he could move his jaw much.

He was in a rare belligerent mood and wasn't being all that polite to Dr. P. at a few points, but all things considered, he did rather well. I knew the vibration from the drill would be a problem for him and I explained that to her. She respected his wishes for breaks, to her credit, and once the drilling was finished he calmed down considerably. He didn't appreciate the taste of the amalgam, but once he learned that it was "Pokemon paint" he was mollified. Of course he had to demand that it was Sceptile Pokemon paint, but no one really felt the need to contradict him.

All in all, it could have been a million times worse than it was. I will probably still look for another dentist, but at least I know that Gus will be able to handle it.



*image of MM's practice bubble-gum-flavored "piggy nose."

It's Duck Season...No, It's Wabbit Season...No, It's Tick Season

What's more fun than a barrel of rage-infected monkeys? Trying to remove a very large, very gross, very embedded, and very engorged tick from your very panicky autistic child. And for extra laughs, try doing it in a supermarket parking lot.

Yesterday, my poor Gus found a huge tick behind his right ear. He seemed to feel it suddenly and started scratching at it as we were getting in the car to leave the supermarket. One look told me that it had been there at least since the day before, and that's really the only time he could have gotten it. Of course, I panicked because, well: supermarket parking lot, kid picking at nasty bug, twenty minute ride home...take your pick of bad situational elements.

After dragging the kids through the parking lot trying to find someone with tweezers, I finally went back into the supermarket and a lovely clerk gave me a pair. I took Gus outside (with MM in tow, bless her little heart, she was so good about it) and with him screaming bloody murder, I managed to rip the thing apart and leave the head embedded. In other words, exactly what I was not supposed to do. It's kind of hard to remember all the rules in the midst of a panic, especially when you don't know the rules to begin with. I sort of half knew them, but with him twisting and writhing (and the nice people in the parking lot staring like I was ripping his head off instead of the bug's) just as I grabbed the head, Gus jerked and...pop, squish, off came the body without the head.

The good news is that the tiny deer ticks are usually the lyme carriers, but this isn't set in stone, so we will still watch for the signs of lyme: fever, fatigue, rash (can appear as long as 6-8 weeks from the time of the bite), etc.

From what I've learned, the most important thing is to not squeeze the tick because that makes it inject more (potentially infected) muck into the site. To remove a tick, if tweezers are the only thing available (preferably splinter tweezers), you've got to get the head and pull back gently to avoid breaking the tick and getting the head stuck in the skin, which can lead to infection. The head itself won't transmit lyme, but infection is still not really desirable. There are apparently devices, available in pet stores, for removing ticks that are supposed to be more effective than tweezers:

Commercially available tick-removal devices include the Sawyer Tick Pliers (B&A Products, Bunch, Okla.), Pro-Tick Remedy (SCS Limited, Stony Point, N.Y.) and Ticked Off (Ticked Off Inc., Dover, N.H.)*

From American Family Physician

Methods to avoid include hot matches, vaseline, clear nail polish or nail polish remover to get the tick to dislodge. Those tend to make the little bloodsuckers dig in deeper and, you guessed it, squirt more nasty fluids.

Two preventative measures to take against these critters are to use insect repellent regularly, which can be difficult with a child who has sensory defensiveness to smells, and to perform tick checks. I've tried several formulas for Gus that he has absolutely hated. Aside from the odors, he doesn't like being sprayed with things. I'm next going to try a natural lemon and eucalyptus repellent (doesn't have a very strong smell). Bed, Bath and Beyond used to sell insect repellent bracelets (they looked like small coils) but I found those to be ineffective, and the kids would just play with them and take them off anyway. There are wipes to use for kids who dislike sprays.

During this time of year, especially if you live in a grassy, woody area where ticks are prevalent,you should check for ticks carefully every day. Spending a lot of time outdoors isn't a requirement for getting a tick - MM has had them jump her when she was just passing by a bush as soon as we left our house. (I caught that little bugger before he could attach himself.) She hadn't even made it to the grass and was still on the concrete path. We usually check every night, but it's not hard to miss something that small - do your best and be sure to check between toes, hairline, behind the ears, armpits and groin area.

Gus is fine now and I'm fairly certain we were able to get the rest of the tick dislodged from his skin. Be careful out there - the bugs seems to be particularly numerous this year. For us, we're going to try one of those tick removing devices very soon. This happened just in time for us to go camping! Keep your fingers crossed for us!

IEP Assessments

I recently wrote an article on Understanding IEP Assessments for Bright Hub and thought I'd put some comments here as well. I've always found the assessment score portion of Gus's IEP to be more complicated than deciphering the Dead Sea Scrolls, but I've come to gain a little better understanding of them. They're not quite as complicated as I thought (very close, but not quite). The odd thing is that the keys to understanding these things seem to be some nationally guarded secret – none of our service providers could ever give me a solid explanation for what it all meant. So here's my attempt at demystifying the matter.

The first things you need to understand are the terms and acronyms. Most of the assessment scores will be expressed as one or more of the following:

• SS – standard or scaled score. This is the score of the assessment itself. For instance, the SAT has a different scale (200-800) than the AP exams which are score on a scale of 1-5.
  
• Percentile – the percentile shows where your child falls within the range of other students being tested. A score in the 98^th percentile means your child scored in the top 2 percent of students tested, or better than 98 percent.
  
• AE/GE – age or grade equivalents tell where your child's skills are in comparison to kids of different age groups or in different academic grades.
  
• Raw Score – I've never seen this on our IEP, but it's useful to know just in case it comes up. The raw score is the actually number of successes your child has on each of the different test components. For example, your child might get 8 correct responses on one test out of a possible 10.
  

Many assessments use similar scales, but some have their own (just to keep parents hopping and guessing, I'd imagine). If you find out what assessment tool was used for your child in each area, you can try to find out what the scale is and take it from there. Some common tests are:

• General or Comprehensive
  
  • The Brigance Comprehensive Inventory of Basic Skills (CIBS)
    
• Speech/Language
  
  • Oral and Written Language Scales (OWLS – they're not just for wizards anymore)
    
  • Peabody Picture Vocabulary Test (PPVT)
    
  • Expressive Vocabulary Test (EVT)
    
  • Educational – Woodcock Johnson III
    
• Motor/Physical Skills
  
  • Bruininsky-Oseretsky Test of Motor Proficiency
    
  • Peabody Developmental Motor Scales
    
• Behavior
  
  • Vineland Adaptive Behavior Scales
    

The article goes into a little more detail about scoring and interpretation, so if this is a topic that tends to confuse you (like it did me) by all means, check it out! And if you know of any assessments that I can add to the list, by all means, please share! Have a great day!

How to Get Your Asperger’s Child to Give up That Loose Tooth

Gus has a few loose teeth, but there was one that was sticking out and was clearly ready to come out. When it finally got to the point of hanging by a threadlike piece of skin, even he wanted it out lest he accidentally swallow it. There was a sort of approach-avoidance thing happening. "Ok, pull it out…No! Leave it alone!" On and on it went, delaying the much longed for (by me, not him) bedtime. DH wanted me to just leave it be, but there was also the problem of Gus having field day the following day – wouldn't want it knocked out on the field, now would we? So we had to do something drastic. Here's the process that worked for me:

1. Repeatedly assure your child that he can certainly leave the tooth in, especially when he insists he wants it out. Never underestimate the power of reverse psychology.
   
2. Try an easy method of tooth removal first, like plucking out with your fingers. This can accomplish two things – first you can see just how ready the tooth is to come out an second, you can subtly loosen it a little more until your child screams again to leave the tooth in.
   
3. Make lots of jokes and then pull out something really scary, like pliers. Tell your child to keep his eyes closed (he won't) and then grasp the tooth with the pliers. Do not pull! The tooth may come out, but not likely. Your child may think you're nuts and then (hopefully) will find it silly once you start laughing it off.
   
4. Offer to use a string to pluck it out. For the child with sensory defensiveness, of course, this will not fly, but best to get all the options on the table, especially the ones you know are absolutely not going to work.
   
5. Go brush teeth. The tooth will pop out like a hot kernel of corn. Your child won't even notice. He'll be too busy making sure you're not hiding pliers behind your back!
   
6. Oh, and remember to take care of all tooth-fairy business as soon as possible! The worst is to forget and have your child confront you before dawn in the morning!
   

In all seriousness, I've now found that tooth brushing seems to be a fairly painless and easy way to get stubborn loose teeth out. How do you get your child's teeth out when they are ready? Or do you just leave them alone?

P.S. Just to be clear, I wasn't actually terrorizing my son - there was a great deal of laughing and silliness going on at the time.

Image from cksinfo.com