Excellence Resort and Spa - Riviera Maya, Mexico

Bob and I celebrated our 7th wedding anniversary on 3/24. We were going to take a trip to Mexico, but the last time that we went to Mexico for our anniversary, it was too cold. So, we put the trip off until May. Which happens to be my Birthday (5/19). The weather was great and we had the best time. We booked a week vacation at an Adults only Report - Excellence Resort and Spa in Riviera Maya, Mexico.

Bob told the resort ahead of time that we wanted to come for our anniversary, but held off until the weather was a little nicer. When we arrived at our room, the hotel staff had left us a gift (champagne and fruit) and a cute decoration on our bed made out of towels.

The next day was my 43rd Birthday. The hotel staff left another gift in our room (delicious Chocolate cake) and decorated our bed with balloons and a towel wrapped to look like a candle.

The property was fabulous. No shortage of places to lounge and do nothing. They had covered seating, covered beds on the beach and around the pool, rafts to float on the pool, and pool chairs everywhere. We even had our own pool chairs, hot tub, and a hammock outside of our room. There were multiple pools designed like lazy rivers that connected from one to the next. You could swim up to one of many bars to get something cold to drink. The resort was all inclusive, so you could drink and eat all day (including adult beverages). They even stocked the fridge in our room with cold soft drinks, beer, and candy (Peanut M&M's, Snickers, and Oreo cookies). We always removed the candy, so they would restock again the next day. There was no shortage of restaurants or bars. We ate at a different restaurant every night and still missed eating at a few. All of the evening meals where elegant dress with no reservations required. They had Indian food, French food, Mexican food, Asian food, a Lobster house, a Grill, special theme night meals on the property - which they dressed up to look like a wedding dinner. They also had a grill on the beach daily where they cut fresh coconuts and filled them with fruity alcoholic beverages. There are tons of off site things to do. We've been to Mexico several times, so this time we only took one trip off the property. We went to "Explor" which has Zip-Lines, rafting, swimming, and jeep riding. There is plenty to do on the property, so there really isn't a need to leave.

Here are a few pictures of the property and our outing to Explor....

This is a picture outside of our room (you can't see the outside hot tub from this picture). We also had another hot tub in our room, and they provided soft robes and slippers!

Some random pictures of the property...

The food was fabulous....

Mexican Fiesta night

The Indian restaurant (can you tell by the color?)

Dinner at the Grill restaurant

Dinner at the French restaurant (the best meal by far!)

The Grill on the beach


Our outing to Explor...

Explor - Jeep riding through the caves. There were 2 paths that took 20-30 min/each to complete.

Explor - Rafting through the caves - there were 2 paths that took about 30 min/each to complete. You could ride on a single raft or double. The rafts were nice because you could lean back - they had back rests. You paddled with hand paddles.

Explor - Swimming through the caves - There were 2 paths for swimming. We met a really nice couple from Scotland that completed most of the activities with us.

Explor - Zip lining - There were 2 Zip-Line courses. Both had 7 Zip-Lines. Each course took an hour. It was a blast!

School year-end progress report for Carver

Carver did very well during his 6 weeks in a pre-school setting. He seemed to really enjoy it. He had the best 1:1 that we could ever hope for in addition to his fabulous therapists. They are all just unbelievable.

They made this cute picture for him at school. Very cute.

Carver's Progress (6 weeks in a pre-school environment):

PT:

• Carver is tolerating tailor sitting position with minimum assist for 3-5 minutes with fair head control
• Maintains head neutral position for up to 1 minute while in supported sitting or standing positions
• Maintains hip and knee extension to allow weight bearing for up to 3-4 minutes with moderate assist to complete
• Holds a supported quadruped position for up to 1 minute, weight bearing through upper ad lower extremities with fair form
• Just initiated the gait training device with Carver and he tolerated it well with assisted upright forward position using tactile cues on his lower extremities to keep them on the floor and move forward about 5' with moderate assist

OT:

• Primary emphasis within the classroom setting was to support Carver in his need for appropriate positioning and equipment to support that need. He has recently begun working on reaching for objects in various planes, but there are no significant changes in data at this time.
• Carver has been working on removing his hat, but at this time requires hand-over-hand assistance. He does assist by extending his left arm when donning a coat, 2 of 2 opportunities.
• During snack, he has been given opportunities for tasting, but again, the primary emphasis until recently was to fit him with an appropriate seating device.

VI/OT:

• Carver has become more open to exploring braille books this quarter. This week he was interested in "reading" 7 pages (hand-under-hand) out of a 13 page book! Typically, Carver only explores the braille for 3 pages (hand-under-hand) before it becomes too much to handle.
• Carver independently explores the braille 20% of the time by scratching it. His VI teacher would like to see this move to a side to side motion instead of up and down.
• He is also doing better with turning pages, textures and graphics.
• Carver will grip the page to help turn the page 40% of the time.
• He will independently find/explore the tactile graphics 40% of the time.

VI:

• This quarter Carer has had some changes! It took a while to get into the swing of school, but he has gotten better as the weeks progress. Carver is able to visually attend to objects on the light box 40% of the time. This is a little lower than last quarter, but keep in mind all of the changes.
• He has reached out for objects independently only a couple of times. Once he notices an object he will usually track it for a few seconds if it moves slowly. Carver notices objects best in his lower right field.

SLP:

• Primary emphasis within the classroom setting was to support Carver in his need for appropriate positioning and equipment to support that need. That said, he has been tasting a variety of foods. He loves gravy! Has tried spaghetti and pizza sauce.
• He is learning to close his lips around a straw for 2/10 opportunities.
• He is learning how a cup feels on all of the parts of his mouth.
• Sometimes Carver shakes his head "no" when put in a chair for snack. The moments he shakes his head "no" are now honored, so that he begins to understand that he has power in communicating his wants/needs. He is learning to carry this "no" over to other places and spaces. It should be noted, that Carver has also had some colds, and he has been spitting his food at home. When he does not have a cold, he is much more accepting of oral intake. Success observed for 2/10 opportunities overall.

HI/SLP:

• Carver is learning to adjust to the classroom and various teachers/facilitators/peers, as well as the routine in the classroom. He does not yet reach for a listener.
• He requires verbal/tactile prompts to participate in turn-taking activities. He requires more than 2 verbal prompts to "stop, wait, turn on, off, go, give me ___, and put in. He requires 2 or less prompts to eat, drink, out.
• When he wants more of an activity, he consistently kicks his legs. Now he is learning to vocalize or use his hand to gesture that he wants more.
• Carver consistently indicates that he is finished with a task by pushing the "finish box" away or pushing the item away. He needs help dropping items into the "finish box", but upon hearing it drop, he pushes it away and smiles. In 5 opportunities, he pushed the "finish box" away 5 times.
• He gestures "more" by scratching on his tray, the toy, or into his communication partner's hand (if he is already touching it). During games and songs, he indicates "more" by continuing the activity after is has been stopped.
• He needs tactile cues along with verbal prompts to stop, wait, turn on, off, go and put in.
• He will give his hands before playing games with more than 1 prompt and sometimes a tactile cue.
• He chose between preferred and non-preferred objects when they were dropped onto his tray 2 out of 5 times. He did not choose an object that was offered him (cued with a noise of the toy) from someones hand.
• He participated in turn taking with his chewie 2 out of 4 opportunities. He did not gesture "my turn" when it was his turn, but he reached out toward the sound of the chewie vibrating on the tray to indicate it was his turn. He dropped it on the try when it was someone else's turn.
• When he is doing physical activity (swinging, bouncing on the trampoline, etc.), he indicates "go" by kicking his legs. He kicks his legs faster until his communication partner goes as fast as he wants.
• His joint attention to task varies between 2 seconds to 1 minute and 30 seconds, depending on the task.

HI:

• Carver has responded to the Ling sounds by smiling to the ah, ee, oo, and mm sounds consistently when in a quiet environment. His is inconsistent with the sh and s sounds.
• Carver has been introduced to sounds for new toys and knocking at the door. He smiles when he hears the toys in a quiet environment. He recognizes a turtle toy and puts his hand on the top to turn it on. He recognizes the cloth piano and will put his hand on the appropriate part to turn it on. He is not showing a response to a door knock unless it is with wood on the door.
• He smiles when his name is called, but it is not clear that he understands that it is his name or if he enjoys the sound of the voice talking with him.
• We have not worked on distinguishing the names of objects during a routine.
• He will reach for toys that he hears drop on his tray (if he is interested in them) 1 prompt.

There is so much for Carver to work on. Such small tasks are so big when you can't see or hear. It only complicates matters when your mobility is also hindered due to CP. Carver is making strides with the help of an extraordinary group of therapists/teachers and his 1:1.

Again, we can't wait to see where Carver is when the next school year ends!

School year-end progress report for Kinnick

So sad to see the school year come to an end. The kids have both been making great progress.

Kinnick's progress (continues to get therapy/school homebound):

O&M:

• Kinnick continues to show progress in her O&M skills. She has a positive attitude and loves to go outside to work. She loves to explore her surroundings and is improving her ability to utilize the AMD (mobility device).
• She exhibits an understanding of laterality and responds appropriately to left and right commands with about 50% accuracy.
• She is also beginning to identify elements of her environment outside. Several weeks ago, her dad drove past and said hi to Kinnick, while she was walking with her O&M teacher. The following week, when she past the spot where this had occurred, Kinnick stopped and said "dad". Her O&M believes she was able to recognize the area and remembered that this is where she heard her dad the week before. Yay!

OT:

• Kinnick is using a pincer grasp to pick up small items about 65% of the time. She tends to still want to slide the items off the edge of a surface and rake them.
• Kinnick requires moderate assistance to put on her pants (assistance with threading one leg and helping her place her hands on the pants accurately); She requires moderate assistance to put on her shirt (assistance to hold her shirt in the right spot, pull her shirt completely over her head, and orient it correctly to put arms in).
• Kinnick is able to place the shapes in the form board with physical prompting to feel the shape first before pushing in. Tactile cues where added to help with locating destination of shapes. She does not know the differences between the shapes yet.
• Kinnick is improving on taking off lids and getting good forearm rotation but needs assistance to understand to turn and let go and tun and let go to unscrew completely.
• She is working on putting on large beads onto a dowel rod but has difficulty with orienting the bead correctly.

OT/SLP:

• Kinnick is using her hands to touch a variety of foods to her cheeks, lips, and tongue for 5 trials, which is excellent progress! Bites: 0/3 trials. Lips, cheeks, tongue: 5/5 trials .
• Kinnick is not yet drinking from a cup: 0/3 trials. However, she is holding a cup and placing it to her cheek and mouth. With support, she is allowing the therapist to put the cup to her lips, cheeks and tongue for 5/5 trials!
• Kinnick has been bringing the spoon to her mouth on 2 occasions. Usually ask her to kiss it however, she does not seem to enjoy it.

SLP:

• Kinnick continues to impress! She is consistent when using 2 word utterances for 80% of the time. Recently, she used describing words with her two word utterances (yellow duck, blue horse, green frog!). This is carrying over to a variety of educators/family. Kinnick is imitating 3 words consistently, for 70-80% of the time. Way to go!
• Kinnick is able to answer simple "what" questions during 4/5 opportunities. She is able to answer "who" and "where" questions with verbal prompts during 3/5 opportunities. She is not answering "how" questions at this time. Nice progress.
• Due to Kinnick's frequent colds, at times it has been difficult for her to develop consistency at the word level. That said, she has made significant progress with her words Initial position /p/: met /m/: met /n/: met /t/: met. Final position: /p/: 50% accuracy /m/: 50% accuracy /n/: 70% accuracy /t/: 60% accuracy.

VI:

• Kinnick is doing great when reading braille. She is doing better keeping her hands together while tracking the words (3/5 times). Her finger strength is getting better. She can hold onto a Velcro mat with one hand and pull a ball off with the other. She is able to use her right and left index finger to writes dots 1 and 4. Kinnick still needs some help with the other four dots and will occasionally double up her fingers (The dots are the "letters" on her braille writer - there are a total of 6 dots that represent A-Z when used as single dots or combined to make a different letter). She is able to point out the difference between the picture and the braille in a book 5/5 times.
• Kinnick has been introduced to letters a-h. She is still working on tactically identifying them. Kinnick is starting to tell her VI teacher that dot 1 is "a". She is also able to sing her alphabet. With more practice she will make good gains meeting this goal (learning her braille alphabet).
• Kinnick is able to scan visually/physically for objects on the lightbox with 70% accuracy. When asked to identify a shape she typically says circle. We often talk about the difference between a circle and a square and count the sides and she will count them. She will tactically discriminate between 2 shapes correctly about 40% of the time, which is down a little since February. I think that she knows there is a difference but maybe cannot remember the words/choices and so she most often responds with circle. However, if she is only learning about squares one day she has no problem telling you that there is a square in her hand. She is a smart girl, hard worker and very eager to learn. There is no doubt that she will meet this goal (recognize shapes: Circle, square, and triangle).

PT:

• Kinnick can walk up and down a flight of stairs, at home, using same step pattern, and using handrail or wall for support on 2/4 trials.
• She can pedal a tricycle 10 to 15 feet, independently keeping her feet on the pedals, with verbal cueing, but requiring maximal assistance (requiring assistance for 75% of the task) to advance and steer the tricycle on 4/4 trials.
• Kinnick can stand on either leg for 2 seconds, without losing her balance on 3/4 trials. She can bunny hop off the floor, but requires two hand assist, to clear both feet, from the floor, at the same time, on 2/4 trials.

This is all great progress considering these goals have only been in place for about 6 weeks! Again, I can't wait to see where Kinnick is at the end of next school year!

My next post will go over Carver's school year-end progress.