Of course, Cha-cha was wary of the doctor - he hadn't seen her since June and she started right away with his quasi physical. He's approximately 43lbs (only 7 lbs away from his 6 year old sister!) and I think he was 42 inches (Yes, we breed 'em tall here!). Everything looked great and the doctor even commented that his legs were "solid" and he had "great muscle" compared to last time. Cha-cha had a hard time being coaxed into climbing the stairs, but he chased me up and down the hallway enough for the doctor to get a good look at his run and was pleased. She wasn't as concerned about his gross motor skills as the public school is, mostly b/c she said he has good tone (and better tone than last time), but it's his temperament of being difficult to engage and being cautious that is holding him back physically. She was glad to hear that he will be getting some PT at his new school so they can "push" him to take risks. (Glad to see that his bed and couch jumping skills have helped with the muscle tone! lol!)
We moved into her office where she took out blocks and Cha-cha decided that he would not perform. He wanted nothing to do with building her towers or sorting blocks, so we caught up on his progress and my mom and I tried to engage him in conversation to have him "show off" and warm up to the doctor...hysterically, my mom asked him to build a garage out of the blocks and then proceeded to ask him, "Do you have a garage? Who has a garage?" and he responded, "Papa has a garage (in Cha-cha speak)!" The doctor asked him, "What's in Papa's garage?" and he proudly said, "T-burr!" She looked at us and said, "He's joking, there's not really a T-bird in there, is there?" To which my mom and I laughed and told her that there was. He was very intrigued with her collection of water/oil emulsion toys and asked to play with one and then proceeded to talk all about mixing the "soap" and "water" and watching the wheels spin. He also enjoyed looking out her window which overlooks the emergency room.
Over all, she said that she's seen significant progress. Cha-cha's Apraxia is not global and not as severe as she saw back in June, but it's still significant. She mentioned that his facial muscle tone has increased and he doesn't have that "open mouth look" as much as he did back in June. He is still unintelligible to strangers when what he is saying is not in context and I said for me, I understand him about 70% of the time (90 with context, 50 without). She encouraged to continue with our plan of moving him to the Language-based, integrated preschool (she was excited that our city has one) and continue with the outside therapy. She also said to keep him around kids as much as possible b/c they are the best therapists. :) She was very pleased with his attention and his awareness of what is going on around him. He definitely is very deliberate in his thoughts and his actions, and she said that you can almost see the wheels in his brain turning. She made a great point about not forcing him to make eye contact, because he is still engaged when he's not looking at you. She encouraged a 90 degree angle when communicating with him, since if you are looking and talking about the same thing, he is being engaged and communicating, which is the desired goal. She also said that males, even as young as Cha-cha, are intimidated with straight on eye contact and they feel less threatened when it's at a 90 degree angle...I loved her comment of guys staring at a TV screen watching sports and communicating...it's what they do! :)
As for our transition, she told me to write 3-3-3 notes for his teachers/care providers:
3 Things that are important to know about Charlie
3 Things he is working on
3 Things he enjoys
She reminded me to keep them brief and direct and to update them often. ;) Yes, me brief...
Overall, it was a great appointment - at the end, he gave her good eye contact and said, "Gu-Bye!" while waving. He was such a trooper and we go back in 6 months for another update. :)
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