Thank God The Stress Test Was Pass/Fail

See, if you fail the test in the morning, the doctor calls you in a tizzy in the afternoon. If you pass, they let you wait the full eight weeks for your appointment. Looks like I’ve got a date with the cardiologist the end of September.

The echocardiogram went great – the nurse said she got great pictures and the stress echo guys were going to love me.

What do you say to that? Gee thanks doesn’t quite fit.

The stress echo consisted of walking on the treadmill for 9 minutes as they slowly raised the incline and the speed. I found the looks the techs were shooting each other to be a bit alarming. They must have had something to do with the fact that my heart rate shot to 170 around minute 4. They let me stop at minute 6 – and then it took an eternity for me to stop huffing and puffing – I think I was hyperventilating. They never could get my heart rate back below 100.

Have I mentioned how much I dislike exercise?

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Heart Monitors and Stress Tests

For the first time since Bella was born (5 years ago), it’s MY turn to see the specialist. My pulse seems to stay above 100 even at rest. Last week at the cardiologist I was congratulated for being a good patient – when they took my pulse, they captured it at 112. Most people’s symptoms seem to disappear upon entering the office only to reappear the moment they get back in the car. I’ve never hit 112 before at rest that I know of – what can I say, I’m an over-achiever.

So Saturday they did a complete blood workup on me, and today I’m off for an echocardiogram and stress test. I really dislike exercise of any sort, and I’ve never even been on a treadmill, so this should be fun. NOT! And did I mention I have to fast? Personally, I think they’d get a much better picture of how my body handles stress if they set up their equipment at my house about 9:00 when I’m getting the kids ready for bed all by myself, again, while hubby is working on the new house we were supposed to be in two months ago. Now THAT’s stress!

I guess that’s what the 7-day arrhythmia monitor is for.

My friend who knows the details of our home purchase and remodel laughed when I told her about all this – she said she is not surprised my heart is beating over a hundred times per minute.

I feel like Frankenstein – at the end of this, they’ll pronounce me alive and I can take my toys and go home.

Noah See, Noah Do: Imitation Skills in Children with Down Syndrome – The Good, the Bad and the Ugly

Betcha thought this post was going to brag on my courageous hero’s latest conquest.

Nope.

Noah (6- with Down syndrome) has entered yet another milestone in his Mommy and Me gymnastics class.  He has become the master of imitation.  I first saw it a few weeks ago when we were introduced to the chicken dance.  I tried the usual hand-over-hand-assistance to teach him how to do it, and he gave me the new “No-thanks-mom-ill-do-it-myself” response which included an angry growl and a yank of his hands.  He watched the other kids intently and ever so slowly he began imitating them.

Okay.  I’m good with that.  So he’s going to learn how to do new things by watching the people around him.  It’s all good.

NOT!

Because last week in his special needs gymnastics class, he continued the imitation game to the tune of  throwing himself down on the mat and refusing to get up after he saw another child do that.  Then he started racing off to the other side of the gym after he saw another child who I believe is severely autistic and a “runner” do that.  Then there was the refusal to do the bear walk on the uneven bars and instead just walking between them.  Yup, you guessed it, he saw somebody do that too.

Sorry guys, all I could think about was after class was thank God he is not in a school with other kids all day.  Can you imagine what he’d be coming home with?

It did prompt me to do some research on imitation skills of children with Down syndrome.  I knew I had seen in the volumes of literature I’ve encountered that imitation skills are a strength in children with Down syndrome.  Oh yes, my further research tells me, oh yes.  It would be SOOO nice if those imitation skills included imitating language, but at least one study reveals it does not and is limited to visual imitation; visual imitation as in I saw one child out of a hundred children do something aggravating, and so now I’m going to do the exact same thing.

As I pointed out to Noah’s physical therapist, Why is it that it takes us forever to teach him a new desired behavior, yet he can see one child do one thing one time, and if Noah finds it amusing, he instantly adds it to his repertoire?  Perhaps it is because showing him how to do something is slightly different than him watching a peer do it.  And maybe it’s because these little ones with Down syndrome seem to have a predisposition to being mischievous.

Researching this topic wound up being an exercise in hilarity.  I’ve been laughing a lot lately – laugh or cry, right?

This came from an article out of Ribeirão Preto Medical School, University of São Paulo, Brazil.  You can find the complete manuscript at

http://cdn.intechopen.com/pdfs/17987/InTech-Imitation_as_an_element_of_social_interaction_of_children_with_down_syndrome_at_school.pdf.

“Imitation, as any other cognitive processes, is not innate, it changes due to the subjects’

actions on the objects in the environment, firstly it is an extension of the action, that is,

movements where the child can see her/himself doing the action and it evolves to a moment

when the action becomes internalized and the child acquires the possibility of imitating

events even in the absence of role models (Piaget, 1964/1978).

In child development, imitation presents two different but complementary functions, one of

them is the cognitive function that makes learning about world events possible, and the

other is an interpersonal one, which allows sharing experiences with the others (Uzgiris,

1981). Imitation occurs primarily because the child needs to understand the others’ intention

in communicating, that is, he/she is going to imitate whatever she/he thinks that his/her

peer wants to be imitated, thus “feeding” social interaction (Nielsen & Hudry, 2010). As can

be seen, imitation is a very important characteristic of the construction of social skills.

There has been increasing evidence that children with DS are strongly likely to copy the

others (Wright, Lewis & Collis, 2006; Anhão et al., 2010). Children with DS are very

observant and they use imitation as an instrument for creating social skills.”

Here is the heart of the paper and the heart of my desire to train Noah to behave to the very best of his ability:

Thus, specific behaviors and impairments, emerging at a very early age, compounded by the presence of biological factors (like illness and sleep disorders), are likely to result not only in the development of challenging behaviors during the toddler years, but the maintenance of these behaviors throughout childhood.  Such behaviors also not only interfere with the acquisition of skills, but, in many communities, preclude individuals with Down syndrome from opportunities with typical peers within educational, community, and employment settings.  In light of the negative impact challenging behaviors can have, attention to the identification of effective interventions that correspond to the characteristic behavioral deficits associated with the Down syndrome behavioral phenotype, beginning at the earliest stages of development, is essential.”

The document that pushed me over the edge into laughter I found over at http://www.down-syndrome.org/reviews/2076/.  It was the paragraph entitled “Increased likelihood of challenging behavior.”  Yup.  This is an excerpt from an article written by Kathleen Feeley and Emily Jones for Down Syndrome Education Online:

“Several characteristics associated with the Down syndrome behavioural phenotype as well as biological factors are likely to increase the presence of challenging behaviour in individuals with Down syndrome. The application of evidenced based strategies assessing and addressing challenging behaviours in individuals with developmental disabilities can be systematically applied to address such behaviours in individuals with Down syndrome. Additionally, evidence based strategies can be systematically implemented by caregivers of very young children with Down syndrome to address early communication skills (requesting, vocal imitation), escape behaviours, and self stimulatory behaviour thus diminishing early developing behaviours likely to lead to more significant challenges as the child with Down syndrome matures.”

This has got to be one of the most brilliant, important paragraphs ever written for parents of children with Down syndrome.  It shouts to me, “Hey Mom – you and your child don’t have to be powerless when it comes to some of the challenges that Down syndrome brings.  Adapt, adapt, adapt!  Address, address, address!!”

That paragraph is followed later in the paper by a paragraph entitled, “Preventing challenging behaviors from entering the repertoire of young children with Down syndrome.”  And then there’s the three paragraphs that address just that.

And guys, let me tell, you, this is already happening with Noah.  That “typical Downs” behavior is starting to be a visitor who we are trying hard to make feel very unwelcome.  As I contemplate getting Noah involved in some group activities with his “typical” peers in the fall, it is not his cognitive level that worries me, it’s mostly behavioral.  Nothing worse than anybody would expect from a child with significant cognitive delays, but I am convinced that most of the behavioral issues can be addressed and conquered.

So, dear gymnastics mommies, please don’t be offended if Noah gets timed out or flicked for copying what he is seeing.  I know, I get it, there are some things that you have to deal with on a day-to-day basis that you know you can’t train out of your child at this point.  But with all the challenges wrapped up with parenting Noah, I think I’ll try to capitalize on his increased ability to imitate some other way. 🙂  I’ll let you know how it goes.