"Merry Christmas, everyone!"

Dear Readers:
Miggy wishes you:
"Merry Christmas, everyone!" (He learned that from Hi-5 Christmas video. I still have to teach him the Happy New Year greetings.) We wish you all the best this Yuletide Season. This is Miggy's 7th Christmas and every year, his excitement for Christmas increases, unlike before when he didn't care about gifts, fireworks and Santa Claus riding his sleigh, entering through the chimney and leaving gifts under the Christmas Tree.

"Where's the girl?"

Dec. 24, 2009
It was already 10:30pm. I checked on Miggy, he wasn't asleep yet. He asked, "Mommy, where's the girl?" He was referring to his cousin, Ate Inah, whom he just met that day.

*They watched the Polar Express movie that day; they acted out some scenes from the movie, with Miggy leading the scenes. Miggy knew the movie by heart since he had watched it probably close to a hundred times already. He had memorized every scene, every dialogue, and every music played with all scenes.

*That's how Miggy is. If he likes a video, he will keep watching it over and over again for maybe a month, from morning until night. The only way for me to stop this routine is by hiding the dvd and telling him that the dvd is already broken. And he will always answer back: "Mommy, you fix it." or "Daddy will fix it." or "Mommy, you buy a dvd."

Ridgeview Academy's Christmas Party

Dec. 18, 2009
Christmas Party of Ridgeview Academy
*At the party, Miggy waited by the door, grabbed all gifts of arriving guests and neatly put them under the Christmas tree. He ran back and forth the room, always checking on the little chocolate cupcakes with frosting and sprinkled candies. Thanks to the school staff, parents and schoolmates of Miggy. They all warmly accepted my son's disability. It was nice, for a change, not having to explain to everyone that my son is special. No apologies made, no discrimination seen...just full acceptance of my son's uniqueness. I knew Miggy felt the warmth, he just couldn't express it.

Play and Say Therapy Center's Christmas Party

Miggy and his friends participated in the fun and games. Look at them. Who would even notice and say that they are a little different from the regulars? The way I see it, they are lucky to have two worlds: their world and our world. Who could ever be so lucky and special to have the best of both worlds?

Helpful Materials

FLASHCARDS:
These are some of the flashcards that Miggy used. These helped him increase his vocabulary and develop his language skills.
What's this?, I asked as I showed him every card.
How do you jump? kneel? sing? (action words flashcards).
What's the color of the apple? the corn? (fruits and vegetables flashcards).
What sound does a cat make? Can a dog say meow? Can a bird fly? (animal flashcards)
E-E-Egg begins with the letter ____. P-P-Parrot starts with the letter ____. (with Mommy always stressing on the first beginning letter).
What shape is this? How many sides does a square have? What color is the triangle? What shape is the pizza?

PUZZLES:
Through the completion of these puzzles, his imagination developed and his attention span increased. He started from 6-pc puzzles and later he was able to complete more complex 100+pc. puzzles .
Miggy, where does this go?
Look at the color, can you find the other part?
What's next? Look at the picture on the box.

At Stac-5 Therapy Center, when he was four, he completed the Philippine map puzzle for 20minutes, and when he was even younger, he could even complete the back of any puzzle (back as in back! the brown empty back of a puzzle!) That was his splinter skill.

Disability Card

This disability card is a must-have for all special children. This entitles the child to a 20% discount on medical & dental services, purchase of medicines, transportation, admission fees, in all establishments and educational assistance. Just imagine the 20% discount you will get at Jollibee, Mc Donalds, Pizza Hut, Greenwich, KFC (Miggy's favorites), plus discounts on vitamins and medicines, entrance fees at Enchanted Kingdom and at the movie theaters. Wow, that's a lot of savings! And what's more? There's no tax! So, if your child still doesn't have this card, get one now.

Swollen Eye

Pictures 1 & 2: (Dec. 10, 2009) Crying and in pain
Picture 3: (the following day) Swollen right eye

Reason: This was what happened when I left him all by himself playing with his dusty stuff toy animals. A more-than-an-inch fur was what I extracted from his right eye on the 3rd day of the inflammation. From day 1, he was crying and whining non stop, up to the time I removed the fur from his eye. I applied anti-bacterial ophthalmic drops (as usual I played doctor again).

Miggy has sensory issues and couldn't feel minor pains. The fact that he cried only meant that the pain he experienced was severe.

Mom: You look in the mirror, Miggy is ugly.
Miggy: "Pretty!"
Mom: Are you going to rub your eyes again?
Miggy: "No."
Mom: Do you want your eyes to bleed again?
Miggy: "I don't like."
Mom: Complete sentence.
Miggy: "I don't like blood in my eyes."
Mom: What will happen if you rub your eyes again?
Miggy: "Go to the hospital."
Mom: And if you go to the hospital, what do you think the doctor will do to you?
Miggy: "Put the gamot in the eyes." (gamot is medicine) "I don't like sew my eyes... needle and thread."

Mess and Pack-away

Photo 1: Miggy's playtime (mess-time)

Photo 2: Miggy's pack-away time

Christmas Tags

Last year, it was Miggy who wrote names on our Christmas tags. These are two samples of his works that I will forever cherish.

Spelling

Oct. 11, 2009:
Of the 28 words, only 5 words were misspelled. Miggy wrote this after watching "Special Kids - All About Jesus" video.

October 27, 2009 (Pretend play captured in photo)

Miggy: "Okay, parrot. Take a picture."
"One, two, three.... go.... click!"

Mommy: What is the parrot doing?

Miggy: "The parrot is taking a picture..... taking a picture of squirrel, tiger and kangaroo."

Pizza Hut

This is Miggy's drawing of a "Pizza Hut" delivery truck (although Pizza Hut uses company motorcycles for pizza delivery).
"This is a Pizza Hut truck", he said.

Pizza is one of his favorite foods. Pizza routine every Tuesday and Thursday after his academic tutorials.

Miggy's First and Latest Developmental Evaluations

Birthday: Aug.4, 2002
Date of Evaluation: Nov. 5, 2009
Chronological Age: 7yrs/3months

Diagnosis: Autism Spectrum Disorder

Developmental Pediatrician: Millicent Mae Fronda-De Vera, MD, DPPS,FPSDBP

Test Administered: Griffiths Mental Developmental Scales

Present Developmental Profile:
Locomotor: 6 yrs
Personal/Social: 6.5 yrs
Hearing and Speech: 4.5 to 5 yrs
Eye and Hand Coordination: 6.5 yrs
Performance: 7.5 yrs
Practical Reasoning: 4.5 to 5 yrs

Behavioral Concerns:
Miggy is generally behaved and compliant; impulsive at times; attention span has also improved as he can complete tasks when cued or prompted. He is very talkative but verbal reasons are still limited.

Here is Miggy's first developmental evaluation by
Developmental Pediatrician: Joselyn Alonzo-Eusebio, M.D.
Date of evaluation: May 13, 2005
Chronological Age: 2yrs / 9mos

Locomotor: par w/ age
Personal and Social: 18 mos
Hearing and speech: 15 mos
Eye and Hand Coordination: 18 mos.
Performance: > 2 yrs (non-verbal)
Practical Reasoning > N /A

Diagnosis: Autism Spectrum Disorder
Main Problems:
- hyperactive; fleeting eye contact; selective attention / response
- delayed / deviant speech
- preoccupations / stereotypes
- unusual fears

Creative Play

Here are two pictures of Miggy engrossed in his creative play.

Picture 1: "It's a girl", he said.

Picture 2: Notice that he built 2 floors with stairs, and added some furnitures to make a bedroom.

Routine

A quick drop-by at Video One is Miggy's routine every Tuesday and Thursday at 10:45am before going to his academic tutorials at the adjacent building.

At Video One, Miggy picks his favorite videos; shamelessly sings and dances; neatly returns the cds to the designated racks and waves bye to the friendly staff before he leaves.

Since I cannot break this routine because for sure it will put him in a bad mood, I always turn this into a learning experience. I ask him to name the characters and read the titles of the cds. That way, we both gain. He gets his way, I get mine.

Miggy's Drawing

View some of Miggy's works then and now.

Miggy's Coloring

BEFORE & AFTER:

Miggy's Handwriting

BEFORE & AFTER

Decorating the Christmas Tree

November 1, 2009: All Saints' Day
A day to remember and honor all the Saints of the ancient times and the less distant past. And that was what we just did. We chose to honor Saint Nicholas, popularly known as Santa Claus.

* Back in the days when we were still very young, my 4 sisters, my only brother and I would wake up on a December morning to find our simple Christmas tree in the living room all adorned already by my mother the previous night. Before, there were no fancy Christmas trees, instead a real tree glued with cotton was all you would ever see in any house. It was like a tree in the winter, all white. My mother wanted it to be a surprise but what she didn't know was that we could have had more fun decorating the Christmas tree ourselves. So this time, I'm breaking the rules. Let them have all the fun! Adorn it! Mess with it! Whatever! I don't care! What matters to me now is to see them happy and enjoying the Christmas spirit. Now, the tree looks the way they just wanted it to be... perfect.

Autism cases in RP on the rise

MANILA, Philippines - The number of people with autism in the Philippines and other countries is on the rise, according to experts.

Dr. Alexis Reyes, Philippine Society for Developmental and Behavioral Pediatrics president, said there are no accurate statistics on autism in the Philippines but an upward trend has been observed across the globe. It is “imperative” to have a program to ensure a productive life for them despite their condition. Experts do not know why the number of people with autism is increasing. “There is no single cause so there is no single cure,” she said.

If the prevalence rate in the United States will be the basis, there are some 0.5 million Filipinos with the neuro-behavioral disorder. Of this figure, only two percent of them are given appropriate care. The ratio of autism in the US rose to 1:91 in 2009 from 1:150 a few years ago.

In 1960s-1980s the prevalence rate of autism in the US was 0.4 to 0.5 per 1,000 population but it increased to 0.71 to 1.1 per 1,000 children in 1990 and 4 to 6 per 1,1000. Autism is “likely the result of a variety of factors,” including genetic, infectious, neurologic, metabolism, immunological and environmental.

“Autism is not physical, it’s neuro-behavioral,” Doctor Reyes said. “That's what makes it very challenging for us… They look normal but they have social deficit, language problem, restricted interest and repetitive manners.” While autism is incurable, those who have it could still be productive if they would only be given adequate management and education.

Reyes said the initial cost of diagnosis for autism amounts to some P7,000. For follow ups in medical and educational, some P116,000 is required for the first year alone, she added. In the Philippines, there are only a few schools for children who have “special needs” and they are very expensive. And if there are public schools that offer special education, they mostly “fell short of expectation.”

Source: The Philippine Star (Updated November 04, 2009)

"Who is inside the box?"

Nov. 1, 2009 : Miggy found this big empty box (which recently contained the plastic drawers I just bought).
I always have my camera hanging around my neck so I wouldn't miss moments like this.
Miggy excitedly asked: "Who is inside the box?"
He answered himself: "Miggy is inside the box!!"

* I spent only a few pesos on the drawers but the fun he had was priceless.....
far, far, far beyond what I paid for.

Sad and Happy Faces

Two weeks ago, Miggy drew this. Tell me something about your drawing, I said.
Miggy: "This is Miggy's sad face and this is Miggy's happy face."

*Note that the paper is crumpled. He used it to cover one of his books.

"The man is dead."

February 9, 2009:
Miggy was waiting his turn for a haircut at SM Baguio's Barbero. He saw a man, eyes closed, lying comfortably in a chair, with shaving lotion all over his face.
Pointing to the man, Miggy exclaimed: "Look, the man is dead!"

"Miggy is sick"

Oct. 21, 2009 :
Miggy: "Mommy, drink medicine."
mom: Why? Who is sick?
Miggy: "Miggy is sick."
mom: What hurts?
Miggy. "My neck hurts. It's hot."
I touched his neck and it was flaming hot. And later I found out that his front tooth had just erupted from his pink swollen gums, which caused his temperature to rise.
Notice his red cheeks in the photo.

- Since birth, Miggy had sensory problems. When he was little, he would hit his head on walls, slap his face, hit his chest, scratch little bumps on his skin (vaccine marks, insect bites, old wounds) until he bled without so much as an "ouch" and not even a single tear. He did not register pain the way typical children do. Why did he not experience the appropriate reaction of pain after injury? Because the beta-endorphins released in the brain can produce an anesthetic effect, which would account for his indifference to pain.
- Through sensory integration techniques (deep pressure, massage, pancake and vestibular ball rocking) integrated in his regular occupational therapies, his sensory problems had lessened. Now, he is able to feel pain and even verbalize his pain and discomfort, unlike before when we would always have to guess what was wrong with him.

His First Candy

October 16, 2009: Miggy at 7yrs/2months, ate his very first candy. Oops, wrong word, more so, tasted his first candy.
It was his classmate's birthday and he received a loot bag containing sweets and some goodies. He knew candies are a no-no. It will trigger his hyperactivity. Perhaps curious, he opened his candy and licked it. Because he wasn't used to too much sugar, he handed it to me and said: "Mommy, eat it. Candy is not for Miggy."

Asleep

Sept. 30, 2009: Bedtime
It was 10pm and way past Miggy's bedtime.
I checked. Miggy was breathing deeply and evenly and not moving.
I tested, whispered: Is Miggy asleep?
"Yes", he whispered too.

Calendar Lessons

November 2008 (Calendar lessons with stamping as reinforcement):
mom (Showing Miggy the angel rubber stamp as a come-on): Miggy, do you want a stamp?
Miggy: "Yes."
mom: Okay, get the calendar. (he complied)
What month is this?
Miggy: "January" (I rewarded him with a stamp on his arm)
mom: Can you point to January? (he did) (another stamp)
What month is this?
Miggy: " August" (stamp)
mom: When is your birthday? (he pointed)
Miggy: "August 4. It's a Monday." (another stamp)
mom: Can you look for December? (he turned the calendar pages to December).
When is Christmas day?
Miggy: "December 25" (he pointed)
"Mommy, Miggy open the presents?" "Yes????"
mom: No!

*Every year, before it turns November, we already have the Christmas tree with presents under it (to test if he can be trusted not to open them and wait until Christmas. Every morning, he just leafs through the presents, reading the names on each tag, "Look, mommy, this is for Miggy", "This for Clarisse". "Do not open" (he mimics me).

Comment from Miggy's Speech Therapist

Dear Mrs. Cuevas,

What Miggy is today is a testament to you and your family's struggles, sacrifices and most of all achievements. You've come a long way, and you should be proud. Miggy is continually progressing at a steady rate, thanks to you. He is one of the few so greatly blessed with a family who loves him dearly and gives their utmost effort to help him cope with the demands of daily life. With all our combined effort, we will reach our goals. =)

Teacher Justine

Intervention at 2yrs/9mos to 3yrs/4mos

Profile:

Alphonse Miguel Mabilangan Cuevas

Date of Birth: August 4, 2002

Age: 2years/9months

Diagnosis: Autism Spectrum Disorder

Developmental Pediatrician: Jocelyn Eusebio, M.D., Saint Luke’s Medical Center

Date of Diagnosis: May 13, 2005

Exactly 6 days after the diagnosis, Miggy started the intervention program.

May 2005 to December 2005

Occupational Therapy, one-on-one, 1hour, 2x a wk at Child’s Dream Foundation

- started May 19, 2005

Activities:

Sensory integration ( deep pressure, brushing, massage, pancake); Spooling – for concentration, attention span, color identification; Coin translation; Waiting skills; Pack away; Colored thumbnail; Ball rocking; Colored pop-locks; Coloring Activity using templates; Obstacle Course - jumping on trampoline & crawling w/ color identification; Puzzles – animals, numbers, alphabets; Alphabet flashcards; Number clock; Alphabet board; Drawing, tracing & shading of different geometric shapes using templates; Writing activities; Brushing of teeth simulation; Body parts identification; Letter sounds; Color sorting; Shape sorting; Speech & language stimulation; Number identification & Counting; Beads activity & spooling – for color ID, counting & concentration; ADL activities - Lacing; Alphabet identification; Feeding simulation; Shape identification; Animal sounds; Sounds of things; Pre-speech and Pre-writing activities.

(In some activities, HOHA – hand-over-hand-assistance was given.)

Mom Sessions:
Activities: 24/7 redirecting, modeling, prompting & copying what the occupational therapist did.
Watching videos with Miggy (pausing the video every few minutes for step-by-step teaching) – ABCs, 123s, body parts, animals, colors, shapes.
Flashcards of alphabets, numbers, body parts, animals, shapes & colors, food. Swinging in a hammock for 30mins -1hr per day for SI sensory integration (while Miggy listened to Mommy counting aloud or teaching alphabets: A is for apple, B is for ball, …. Z is for zebra (always stressing on the first beginning letter of the word).
Deep pressure, massage for sensory integration, at least 30mins., 2x a day.
Establishing eye-contact : peek-a-boo games; always talking to Miggy at eye level. Prompting Miggy to talk: not giving him what he wanted unless he said the word.
Spelling of words (animals, colors, familiar words);
Reading common words.
Puzzle completion (alphabets, numbers, 10 to 20-pc puzzles).
Pointing – Point to ___.
Pack away toys.
Animal sounds; Vehicle sounds.
Creative play – Lego building; building roads, railways, bridges.
Pretend play – tea party, feeding stuff toy animals, actions like swimming, flying, driving, sleeping, eating, etc.
Taking turns (but always unsuccessful).
Potty training (Unsuccessful: still diaper-clad at night and at poop-time; He probably did not like the feel of the cold seat on his bottom) (not diaper-clad during the day: he expresses his need to urinate by pulling down his shorts).

Family sessions: Regularly going to church (He remained seated inside the church for 5mins only, the rest of the time spent on just walking around the church or staying in the car); Bedtime prayers.

No diet - except for a little limitation on sugar intake, especially from 4pm onwards, as this will cause hyperactivity.

Intervention at 3yrs/5mos to 4yrs/4mos

January 2006 to December 2006

Occupational Therapy, one-on-one, 1hour, 2x a wk at Child’s Dream Foundation

Activities:

Sensory integration ( deep pressure, brushing, massage, ball rocking); Writing activities - straight, diagonal & horizontal dotted lines; Tracing / Drawing of geometric shapes with templates; Spelling activities; Picture dictionary; Learning opposites; Color combination; Spelling blocks & Spelling puzzle; Identification of common objects; Group activities; Alphabet sequencing; Problem solving skills training; Interpreting pictures; Fine motor activity - using clothespins & small pegs; Coloring within borders; Tracing / Writing letters; Puzzle completion; Obstacle Course - get a little___, go under table, put in correct slot; Pegboard & color sorting; Waiting skills; Following instructions; Answering questions; Color identification; Alphabet identification; Coloring / Tracing; Tracing letters of name; Number identification; Alphabet sounds; Speech & language stimulation - speaking in simple sentences & short phrases; Listening / Following instructions; Following more complex verbal instructions and responding to questions appropriately; Using complete simple sentences; Using longer phrases; Action songs; Coloring within small regular & irregular boundaries; Tracing numbers; Matching; Fill in the blanks; Connect-the-dots; Writing numbers; Functional counting; Writing name; Action words; Reading / Word recognition; Answering "how many?"; Missing letters of common words.

Regular preschool (July 17–Aug 17, 2006), 45mins, 3x a week, at Step Tutorial Center:

For social interaction with regular kids; Academics : alphabets, numbers, colors and shapes; coloring.

* (It lasted only for a month because Miggy and four other special children were

rejected by the center and some parents.)

Mom Sessions: 24/7 redirecting, modeling, prompting & copying what the occupational therapist did.

Watching videos with Miggy (pausing the video every few minutes for step-by-step teaching) –

Special Kids Video Collection: Alphabets, Numbers & Quantities, Colors & Shapes, Spelling, All about Jesus, Animals, Birds & fish, Body Parts & Grooming;

Bumble Bee Vocabulary Builders (Volumes 1-5) and Action Words (Vols. 1-3)

Swinging in a hammock for 30mins -1hr per day for SI sensory integration (Miggy listened while Mommy counted 1 – 50, pausing to see if he would say the next number, which he did.) (Teaching alphabets; Mommy prompted: A is for____. Miggy answered “airplane” , B is for ____. “balloon”,…... Z is for _____. “zipper”.) Flashcards - alphabets, numbers, body parts, shapes, colors, fruits & vegetables,

vehicles, action words.

Sensory integration – deep pressure, massage, 15 - 30mins, at least once a day. Maintaining eye contact - always talking to Miggy at eye level; always prompting him to look at me.

Following simple instructions – Miggy, get the___. Open the door. Wipe your mouth. Throw in the garbage can. Pack away your toys.

Vehicle sounds; Animal sounds.

Self-help skills – washing hands, eating cereals by himself using spoon, eating cake using fork, combing hair, taking a bath, getting dressed.

Requesting/ Naming the title of the cd he wants to watch.

Reading / Spelling of common words (colors, shapes, animals, body parts)

Creative play –Basic toy manipulation: Lego building; building roads, railways, bridges and houses.

Pretend/imaginative play – acting out action words (Mommy acts, Miggy imitates) and puppet play.

More complex puzzle completion (up to 120 puzzle pieces).

Taking turns (still unsuccessful; very impatient at waiting turns).

Potty training -(still unsuccessful): diaper-clad at bedtime. He wouldn’t go back to sleep if I wake him up to urinate; diaper-clad at poop-time. He probably did not like the feel of the cold seat on his bottom.

Family Sessions: Regularly going to church (now able to remain seated for 20-30mins,

still fidgety);

Praying at bedtime (Miggy listened only while Mommy prayed: Dear Jesus, bless Mommy, bless Daddy, bless Ate, bless Miggy.)

Still no diet, except for a little limitation on sugar intake, especially from 4pm onwards, as this will cause hyperactivity.