Autism thread

The thing I may never get over my entire life... How hard work yields clear progress for others' kids but seemingly little for mine. Gonna probably need to see a therapist about it at some point.

gewy wrote:

Wow, it's like a completely different world you guys are living in where you can explain things to your child and they have an understanding. I can't imagine what that would be like. Right now I think there are well trained dogs that have greater language ability than my son.

For us, we say it, and sometimes he gets the gist, other times he doesn't understand what we're saying. I think we see both sides of that coin, but it doesn't matter if he understands or not, we have to stick to the routine. He understands going to the car, going to school, taking a bath, brushing teeth, getting dressed, and going to bed. Eating meals is a little different, as he understands when I get his seat ready it'll be time to eat soon, so he anticipates it before I say it (though eating out can be extremely hit or miss). And anything outside of that... well, I'd give it 50/50 odds that he'll get what we're saying to him.

gewy wrote:

Anyway, I was going to type some long thing about the specialists we've seen and what I think they're useful for (or not), but it's probably not universal so I'll just note that the providers who diagnosed my son are not involved in his treatment in any way. They just made some general recommendations and provided some contact info, but it was almost completely up to us to establish his treatment. The school system here seemed like it had earnest, trustworthy teachers but it was clear they would have had no idea how to work with my son. If you're going to move somewhere make sure they have good speech and behavioral therapists, special needs schools, or autism treatment centers. Child psychiatrists or developmental pediatricians probably won't be heavily involved over the long run (except with medications).

We're in the same boat. In fact, we had the ball rolling on a lot of his initial assessments before we saw the pediatrician, and were already prepared for the autism diagnosis before we got referred to the specialist. She was actually kind of shocked because she couldn't recommend anything we didn't already have an appointment for.

With our first son (Sabastian), he had a really traumatic birth, lost a lot of blood, had to be resuscitated, and spent nearly a month in the NICU. We went from a week of "he's likely not going to make it", to "he's physically doing well but still having seizures and will likely show signs of brain damage." He spent 6 months on seizure meds that sedated him a bit, but he hit his milestones. Eventually he started hitting them early, and showed signs that he was quite intelligent. He'll be 4 next month, is ahead of his peers in most things, and the only signs of damage that we can tell is a bit more energy than kids his age, and a bit less impulse control, both of which are manageable by working to maintain his focus, and being bluntly honest about the consequences of his actions.

So when Tristan was supposed to be hitting his milestones, of course we were comparing the two of them. Everyone says not to, but it's really impossible. We understood that two children will never hit the same milestones at the same time, so we watched and waited. But the gap between them went from "possible normal differences" to "significant delays", so I did some research and came to the conclusion that he was most likely autistic, and that I was most likely also on the spectrum. The specialists only spent about an hour with him, and we won't see them again for another few months. All the rest of his therapy has been early intervention through the school system. I don't believe Tristan needs any medication, just as I don't believe Sabastian does. We just need to know how to focus them, and how to de-escalate problems effectively. And his therapy will carry over into school, as we will have a sit-down in a couple months to put together a game plan for the special needs programs he'll likely be in.

Those are some great resources, Concentric, thank you so much. I look forward to listening to those lectures on my commute.

Sending you tons of positive energy, Gewy. It's tough seeing out little ones struggle thus.

I see so much of our own road reflected in the ones here, and we're just getting started. We're doing a lot of digging while we wait for Matt's evaluation, and what we've seen is disheartening to say the least. The waiting lists are atrociously long. One center in Lille has ABA methods but there are 900 families on the waiting list. Nine hundred. Some centers don't take the kids until the age of six. It's insane and we're very frustrated by this. It's true that you gang said, we the parents are the advocates of our child and we'll be doing whatever we can to get him what he needs. It's a long and difficult road.

FSeven wrote:

This is Émile

IMAGE(https://lh4.googleusercontent.com/-wwtIgA-NSjo/TnkwT4HXFWI/AAAAAAAAEZU/lZBd7gfWd2I/s800/DSC01519.JPG)
IMAGE(https://lh6.googleusercontent.com/-kISBIau8Uvo/UJ0FCNJg90I/AAAAAAAAEZU/ymOMjlTPZLA/s576/IMAG0374.jpg)

It's like looking at AbsurdBaby through a time machine. He seems to love that first pic, BTW.

I saw my new primary doc on Thursday. While she seemed a bit surprised that I might be on the spectrum, she did seem to be okay with making the referral to the autism clinic eval. I guess the next step is to see whether BCBS will pay for it (considering the insane cost of the premium, they'd better).

Today, I got the reply from the nursery director regarding diagnoses back in the day:

We felt at the time that you were on the autistic spectrum. You would not have been diagnosed with Asperger's because you had a delay in your [acquisition] of language and that didn't fit the diagnostic criteria.... Even at the age of four, we considered you to be very high on this spectrum. What made us feel that you were on the spectrum was not your language delay - that alone would have been considered a communication disorder. It was the way you used the language that you had socially.

(detail about how I had trouble with eye contact, taking turns speaking, prosody, learning how to speak by repeating things I heard on TV, etc.)

I agree with Concentric, it's pretty impressive that the nursery has records from back then. Hope you're hanging in there, Dee.

Yesterday was a difficult evening for us, with Matt throwing lots of tantrums. He's growing and becoming more difficult to restrain when he's flailing about. Getting him to brush his teeth is complicated. Forget about having him sit still at the dentist. I worry about cavities. He also woke around 3am, crying and moaning and wandered into our bed. It's now 4:30am and baby number is hungry, so I'll admit I'm a bit tired.

Eleima wrote:

I agree with Concentric, it's pretty impressive that the nursery has records from back then. Hope you're hanging in there, Dee.

I don't think the nursery has records from back then; I was just that memorable. It also helped that my mother was a nurse on the neuro unit at an affiliated hospital; she was able to update the neurologist et al. on my progress (it's also how she found out about the nursery in the first place).

I'm hangin'. I've known something was awry off for thirty years; waiting a few more weeks/months/whatever to figure out the technical term and what can (or should) be done about it isn't that big a deal. I won't lie, though; it would be awesome to put a name to my idiosyncrasies.

sometimesdee wrote:

I saw my new primary doc on Thursday. While she seemed a bit surprised that I might be on the spectrum, she did seem to be okay with making the referral to the autism clinic eval. I guess the next step is to see whether BCBS will pay for it (considering the insane cost of the premium, they'd better).

Today, I got the reply from the nursery director regarding diagnoses back in the day:

We felt at the time that you were on the autistic spectrum. You would not have been diagnosed with Asperger's because you had a delay in your [acquisition] of language and that didn't fit the diagnostic criteria.... Even at the age of four, we considered you to be very high on this spectrum. What made us feel that you were on the spectrum was not your language delay - that alone would have been considered a communication disorder. It was the way you used the language that you had socially.

(detail about how I had trouble with eye contact, taking turns speaking, prosody, learning how to speak by repeating things I heard on TV, etc.)

Lots of things in common with my son. Social language and skills are his areas of particular difficulty, and he is still behind in receptive and expressive language. But, like you, obviously very smart and capable. I think it's remarkable that you have so much information at this point from your childhood.

How are you doing with the possibility of a diagnosis?

Eleima wrote:

Yesterday was a difficult evening for us, with Matt throwing lots of tantrums. He's growing and becoming more difficult to restrain when he's flailing about. Getting him to brush his teeth is complicated. Forget about having him sit still at the dentist. I worry about cavities. He also woke around 3am, crying and moaning and wandered into our bed. It's now 4:30am and baby number is hungry, so I'll admit I'm a bit tired.

Dental issues are a big fear of mine. We had to restrain him to get his first cavity filled last week. It went as well as can be expected though. I worry about the future though, when he's bigger. We may have to resort to general anesthesia.

Sleep problems are big for us too. We have recently resorted to giving our son clonidine. It may be helping. Too soon to tell definitively.

Brushing my teeth is still complicated. That part never got any better for me.

I can get cavities filled ok when I like my dentist, but I saw an oral surgeon and got a general when I needed my wisdom teeth done. My dad sees a sedation dentist.

I thought I'd mention a couple of things that my son really loves in addition to finding very calming: in addition to "big hugs" (the kind of tight, strong hugs I've seen some of you mention you find helpful), my son also loves "spaghetti arms" (I hold his hands, he keeps his arms limp, and I move my hands up and down so that his arms flop around), and "milkshake" (I loosen my arms after a big hug, but still keep them around him, and, well, shake him and bounce him around). Better that than have him crawl on my lap and all over me while I'm trying to do something else.

Are there other things that any of you do that help with sensory-seeking?

A big new issue for us now is little guy's boredom. All he does is wander around the house seemingly aimlessly. Sometimes he'll climb things. Usually he'll hit or bite things (including people unfortunately). Same thing at the park or wherever we take him for distraction.

He's even losing interest in most of the physical and sensory activities he used to enjoy. I'd give anything if he could play with toys or even watch TV for a bit. We can tell he's bored because he keeps coming up to us like he expects we'll entertain him somehow, but damned if we know how to.

gewy wrote:
Eleima wrote:

Yesterday was a difficult evening for us, with Matt throwing lots of tantrums. He's growing and becoming more difficult to restrain when he's flailing about. Getting him to brush his teeth is complicated. Forget about having him sit still at the dentist. I worry about cavities. He also woke around 3am, crying and moaning and wandered into our bed. It's now 4:30am and baby number is hungry, so I'll admit I'm a bit tired.

Dental issues are a big fear of mine. We had to restrain him to get his first cavity filled last week. It went as well as can be expected though. I worry about the future though, when he's bigger. We may have to resort to general anesthesia.

Sleep problems are big for us too. We have recently resorted to giving our son clonidine. It may be helping. Too soon to tell definitively.

Clonidine is what we give our son. It's wonderful for getting him to sleep but so-so for keeping him there. We weren't sure it was working until we had to leave him off it for a sleep test and he didn't go to sleep until nearly 2 AM.

Brushing teeth is not easy. I am terrified to take Owen to the dentist, I'm sure he has a mouth full of cavities. We do our best, but he doesn't cooperate and I know we don't get them clean.

We have the first follow up visit with our pediatrician this week since diagnosis, high on the list of questions is a suggestion for a pediatric dentist which uses sedation. I don't see any other way to even have him sit in the chair, let alone cooperate with a dental exam.

Yeah, a sedation dentist is probably going to be on our list of professionals to find...

As for sleep, well... It's getting a bit better. We try to stick to a schedule and have been forgoing going to friends' house in order to do so. He'll sometimes end up in our bed in the middle of the night, but I'll usually chalk it up to a nightmare or something. What's difficult is having him fall asleep. He just won't stay in his bed, he'll get up, wander bleary eyed into our room or the living room, over and over again. Where we're seeing improvement is that he'll turn around and go back to his bed sometimes when asked, so that's a big plus. We're aiming for a 9pm bedtime, butthiscan take an hour, an hour and a half. At least we're not staying beside him anymore (something I've always refused to do), and at least we can do other things in the meantime as it it takes a minute at most to guide him back (thank goodness for the "pause" button in games). So I'm hopeful that we won't need to give him medication but I guess the neuro pediatrician will decide of that.

Sorry to hear you're having a hard time, Gewy. Have you tried maybe a small plastic bathtub full of water? We sometimes do that for others out on the deck and he just goes to town splashing in there. I think it also fills his sensory needs. He even practiced holding his breath, silly monkey. Or he'll just lie there, completely immersed with only eyes and nostrils above the water. Maybe the occupational therapist will have suggestions? Sorry I can't be of much help, we have a hard time having him *not* treat everything like a toy (remotes, keys, ... anything goes).

Those are really nice suggestions, Concentric, I'll have to try those with mine. Deep pressure doesn't seem to be working very well though so bear hugs don't really seem to calm him. What he does enjoy is putting his fingers and toes in my mouth and having me suck on them. That seems to always set off giggling.

Nothing new on my end. We have an appointment on Wednesday with a speech therapist which I won't be able to attend (Wednesdays and Thursdays are my "commute from hell" days with 170km in one day). Other from that, we're just waiting for the appointments and a definite diagnosis.

We have resigned ourselves to the fact that Owen is a poor sleeper. With a routine, we are able to start bedtime at 8pm and usually have him sleeping by 9pm but only with us reading and lying in bed with him until he falls asleep. He will usually sleep until about 7am the following morning with 1 or 2 periods of waking through the night, but about 7 times out of 10 he can put himself back to sleep, the other times one of us has to get into bed with him.

My wife is very reluctant to start medications if we really don't HAVE to, so for now we just won't have much "together" time in the evenings. Hopefully once he gets a bit older he can start to put himself to sleep.

Fixed the link for Unraveling the Mystery of Autism and Pervasive Developmental Disorder (it was pointing to More than Words. I'm definitely finding this list interesting and think it should probably be stickied in the OP or something. I was also recommended Motivation And Reinforcement: Turning The Tables On Autism (Robert Schramm). Thoughts?

Today, our little guy had a haircut. Not an easy task. He hates wearing the cape thingie, so there's hair all over the place, and it's like he starts panicking or something. He used to be so good with haircuts (we've been going since before he turned two). It's so hard to see him like that. I look at all the parents with NT kids at the store or in the street, and I just feel so sad, and can't help but think that they have no idea how good they have it.
We started some sessions with a speech therapist on Wednesday (my husband took him, I couldn't be there), and she has previous experience working with autistic children so she mostly did a bit of behavioral therapy. We're to go twice a week, I'll be taking him on Friday mornings. Gonna have to rearrange my work schedule, and I hate to complain when my child's future is at stake, but it's the most inconvenient time. I've just come back from maternity leave, I'm leaving in November and have to finish my doctoral thesis by then, and I'm taking more time off...

Does anyone have any iPad apps to recommend that could help? We've other toys to try and help him, but we're willing to try pretty much anything.

Eleima wrote:

I was also recommended Motivation And Reinforcement: Turning The Tables On Autism (Robert Schramm). Thoughts?

I don't know that one in particular, but it's a verbal-behavior based book from the looks of it so it would probably be good to get a grounding in it if that's the approach you want to take with your child. There's also the Verbal Behavior approach, which is likely less technical and likely shorter, but also gives a good grounding for those who want to understand what VB is and how it works without having to commit to become home-based therapists themselves (yet). The classic for VB implementation is usually considered to be Teaching Language to Children with Autism or Other Developmental Disabilities.

Sorry to hear about your haircut difficulties, if it helps that's a common struggle. Have you considered consulting with an Occupational Therapist?

I'm sending a big hug your way, gewy.

Here's Alex with his new weighted blanket. The quality is high, though receiving it took way too long. It may have just been an error, but I should have had it in late May, not early July. I hope my experience is not typical.

IMAGE(https://farm4.staticflickr.com/3852/14605468751_44083bc127.jpg)

ETA: Here's a link to the Medicaid report on what each state has regarding services for ASD.

It's great to see these resources listed again or added. I think that stickying them is a great idea.

OT has been really helpful for Alex and us in getting a better handle on sensory issues such as getting haircuts.

Yeah, we definitely want to do OT, I think it's a top priority for Matt. Thing is they're few and far between around here, that's why the speech therapist we managed to see is doing some OT for him (she's the colleague of a friend of the cousin of a friend's ex-husband, you get the idea). We're doing lots and lots of digging, trying to get every scrap of help we can for him, but getting appointments feels excruciatingly slow (evaluation is in September, feels like it's ages away). And as much as I hate to say it, France does seem to be a bit behind the US and Canada, even behind Belgium and Switzerland, in this area. My husband and I are very seriously considering immigrating. Regardless, we're relocating in November, back to the mainland, after I finish my residency, but I'm not really hopeful as to what we'll find there. They have specialized centers in Lille and Paris, but the waiting lists are just insane (over 900 families are waiting for a spot in one of those, to my knowledge, it's just crazy).
Thanks for the other suggestions, Stupidhaiku, I'll look into those, particularly the first one (digital versions are always best for me, getting stuff shipped over here is complicated). I'm not set on one approach particularly, I'm just willing to try anything at this point.

Also, The Out-of-Sync child is the classic "sensory strategies for non-OTs" book, assuming you haven't heard of it. I know it's available in Kindle and on iOS.

We had a nice playdate with a friend whose son is about 6 months younger than Alex (who is 4 years 2 months). The younger child is potty-trained, Alex is not (but is making progress). I was talking to the other little boy about using the potty (as you might with a child that age), and that Alex was still working on it. "Alex is a little kid," says the younger child. Now I know that this was probably just about that particular difference, but this child is clearly well ahead of Alex socially and linguistically as well. So that little statement right now is making me very sad . I am worrying about what is in store for him, because I foresee these social differences widening. At the same time, he is really a sweet, wonderful little boy, and I hope the other children in school will be able to see that.

ETA: I just saw this new New Yorker article by Seth Mnookin, who is just about my favorite science writer. The subheading is "What do you do if your child has a condition that is new to science?" It reminds me of how much time it might take to develop more effective therapies for autism, which is likely the result of a number of genetic differences among other things. I also think of the severely disabled adult son of a good friend. He's got a number of differences, but no convenient "label." But the doctors took all sorts of data to try to fit him into some sort of known disorder. Considering the state of genetics when he was born (he's now 27), I wonder what might be possible nowadays. I also am thinking, Clock, of your son as I read this article.

Much love to you all.

I will post a few updates.

Had our first follow-up appointment with our pediatrician since diagnosis (Dec 2013). She is amazed at how far Owen has come, seeing as when she diagnosed him he was basically non-verbal, used no eye contact, and followed no instructions. On this visit, she called him from the waiting room and he ran right up to her.. said hi and took her hand into her office. While she was talking to us and doing some housekeeping he proceeded to play with his Thomas trains on a track she had babbling away to himself. When she was ready to examine him, she called his name and he turned his head and looked her right in the eye. She just about fell off of her chair.

She credits us and our hard work, which feels really nice to hear. She said not to worry about toilet training at this stage (3 years/4 months), that even if he isn't toilet trained when school starts (she fully expects he will be), that the school cannot refuse to take him. It is their responsibility to provide an education assistant to deal with his toileting needs. We asked how we can expect him to become toilet trained when he has 7-8 soft bowel movements a day on the laxatives that she prescribed. She wants him to take the laxatives daily, because if he has any discomfort when having a bowel movement it will cause him to fear it which will delay training. She apologized profusely for the number of diapers we are changing in a day, but feels it is very important.

With regards to sleep, she would like to see him getting 12-13 hours of sleep which is is not so she would like to see us try a shorter, earlier, more regimented bedtime routine with the hopes of having him asleep by 8pm. We will try this in September once the chaos of summer is over.

We were somewhat worried that because of the progress he is making that when he finally makes it to the top of the waitlist for IBI that he might not be eligible. She said to tell them that he is doing so well because of the work he is doing, and that if they deny him access she will write a letter to the contrary. A huge relief for us, as we understand the IBI program will be instrumental in getting him ready for school.

All in all, it was a good visit and she doesn't want to see him back for another 9 months.

I also have to gloat a bit about Owens socializing as of late. We are at the family cottage on vacation, and my cottage neighbor who is a lifelong friend of mine has his 3 sons there who are twins (age 7) and youngest age 5. Owen has taken to the boys, and is interacting and playing with them like we have never seen. He even got on the back of a sit-on kayak with the 5 year old, and let him paddle around for almost 30 minutes!!! We were absolutely blown away, as traditionally Owen prefers adults to kids. I know he has a LONG way to go, but it absolutely warms my heart to see him at least trying to interact with other kids.

Many hugs, Concentric. I know exactly what that's like. There's another boy at his home daycare, he's six months older than Matt. And every time this potty trained, talkative little guy tells me Matt broke another toy, it just breaks my heart.
Hang in there, Alex is making progress, as you said: he'll get there.

Thanks for the additional suggestion, Stupidhaiku! iOS book is such a convenient format for us with the impending move and shipping hassles.

El Producto, you can go ahead and gloat! It also gives me hope to see that there is some kind of light at the end of the tunnel, and that maybe, with the right tools, Matt to will be socializing with other kids.

There are some things to be happy and grateful for. Matt loves splashing around in the tub and most of the time, I have to physically block his path so that he doesn't climb in with his four month old brother. The other night, hubby told me he let them both sit in the tub and that Matt hugged his baby brother. And this morning, he patted his head! That might not seem like much but he's basically been ignoring him since he was born.
He also attempts to climb on the toilet and pee before a shower or a bath, which is pretty big. He does require being fully naked before he will go though.
My husband has been reading lots of stuff on the internet and he has thought of trying a gluten free diet for Matt. I'm rather skeptical, having seen a literature review on PubMed which didn't show any benefit for autistic children. And it would be a nightmare to implement, Matt loves baguette and other sugary biscuits made with flour...
I think I recall PurEvil trying out this diet to no avail, right? Anyone else?

After three months we ended the gluten and casein free diet today. He hasn't made a bit of progress and, if anything, his behavioral issues have worsened since starting it. I knew it was a long shot going in and am not surprised but I guess I'm glad we tried it. It wasn't as hard to implement as we thought and may have expanded his diet beyond grilled cheese and quesadillas at least.

Really struggling with depression these days as he'll be 4 in about 5 months and it seems like the clock is relentlessly ticking on any hope of major progress.

The combination of inadequate sleep (note I'm posting this at 2 am with a squealing child on the floor here), self injury, boredom and even a bit of violence is really starting to wear me down. It's gotten to the point that I prefer to be at work over home, and I've always hated work. Yesterday my wife came close to shaving her head because little guy keeps relentlessly pulling her hair so hard. We're also both sporting some nasty bite wounds right now.

But the almost complete lack of communication ability is what I find so devastating when thinking about the long term here. Wish I could be more positive or more accepting, but right now it seems like this is something I'll be struggling with for the rest of my life. Sorry to be so negative, but I am thinking the reality of autism for us is way different from what the rest of you recent posters are dealing with. I'd definitely be more optimistic with some signs of progress going on. Of course this is easy for me to say and I might still be just as negative and pessimistic if he were only a few months behind developmentally.

gewy wrote:

After three months we ended the gluten and casein free diet today. He hasn't made a bit of progress and, if anything, his behavioral issues have worsened since starting it. I knew it was a long shot going in and am not surprised but I guess I'm glad we tried it. It wasn't as hard to implement as we thought and may have expanded his diet beyond grilled cheese and quesadillas at least.

Really struggling with depression these days as he'll be 4 in about 5 months and it seems like the clock is relentlessly ticking on any hope of major progress.

The combination of inadequate sleep (note I'm posting this at 2 am with a squealing child on the floor here), self injury, boredom and even a bit of violence is really starting to wear me down. It's gotten to the point that I prefer to be at work over home, and I've always hated work. Yesterday my wife came close to shaving her head because little guy keeps relentlessly pulling her hair so hard. We're also both sporting some nasty bite wounds right now.

But the almost complete lack of communication ability is what I find so devastating when thinking about the long term here. Wish I could be more positive or more accepting, but right now it seems like this is something I'll be struggling with for the rest of my life. Sorry to be so negative, but I am thinking the reality of autism for us is way different from what the rest of you recent posters are dealing with. I'd definitely be more optimistic with some signs of progress going on. Of course this is easy for me to say and I might still be just as negative and pessimistic if he were only a few months behind developmentally.

Gewy, my pediatrician commented on the Gluten Free diet. She said there is absolutely no scientific basis/research to support a gluten free diet. In fact she said that children on the spectrum are often picky eaters as it is, and you may be depriving them of vital nutrients. The only supplementation she suggested was Omega-3.

I always feel so terrible after reading your posts, I can tell you and your wife are having a VERY tough time with your little guy. I too get that feeling of "I'd rather be at work than home", and with it comes some serious guilt. I don't think you should feel badly about at all, to me it's a normal feeling. Are you able to qualify for some respite help at home? Here in Ontario we have a program through the government where we can apply for respite dollars to basically have a professionally trained person come into the home and care for our son so we can have some respite. It may be a longshot, but it sounds like you both need a break.

I went back and reread your posts from the beginning of the thread, Gewy. I'm so sorry things are so hopeless for you guys so often. I'd really encourage you to seek respite care if you're not already getting it. It can be hard to do what seems like putting yourself before your kids, but you will never be able to do anything good for him if you yourself aren't feeling as good as you can.

You mentioned some things about him getting center-based "ABA" and doing PECS. I'm curious what he's been doing, as I noticed you mentioned the VB-MAPP, which is Verbal Behavior, but you also mentioned him signing "more", which would be incompatible with VB. Just curious what exactly they're doing.

tl;dr on GFCF: some swear by it, no (or little) scientific basis, but probably won't hurt.

Thanks for the thoughts guys. We're not to the point of needing respite quite yet and next month he'll be going to therapy 40 hours a week, which should give my wife more free time to recover somewhat. But really, there's no respite from worrying about the future. This backwards state provides no such services anyway I'm almost positive.

As for his current program. It seems like they are now trying to get him to do some basic motor imitation and very basic object differentiation ("point to your juice!" when shown two objects). They do this at table time and he actually does attend to what they're doing and makes an effort even if it takes weeks and months to figure out stuff that kids can often do by 12 months old.

The 'more' sign came from a speech therapist in the past. Probably doesn't matter any more since he seems to have forgotten how to do it. He just hits objects with his hand to signify he wants them. This only works if the object is right in front of him though and he does not seem to know, for example, that the food is in the kitchen, so that's where he needs to go if hungry. If he's ever crying or upset, it's always a big frustrating guessing game to figure out why, basically like it is with infants.

gewy, I hope you and your wife can both get some rest soon, including some full nights of sleep. Your situation sounds so exhausting and stressful. The 40 hour/week therapy ought to be a great help for your wife. It's really hard not to worry about the future. Your son loves you, I know.