Sensory Saturday: What is a Sensory Processing Profile?

Sensory processing or sensory input refers to the constant flow of the information from sensory receptors in the body to the brain and spinal cord–there are seven total sensory receptors, but today we will focus on information from these five sensory systems:

  • Touch (tactile)
  • Visual
  • Auditory (hearing)
  • Proprioceptive (body position)
  • and Vestibular (balance)

Sensory processing is a complicated set of actions that enable the brain to process sensory input. Without this process, you would not understand what is going on both inside your own body and in the world around you.

Sensory Modulation is the body’s awareness and ability to filter, adjust, and respond to a variety of sensory input based on the frequency, intensity, and duration of that input. Behavior, attention, learning, play as well as peer interactions are significantly influenced by a child’s ability to process sensory stimuli. Self-regulation refers to the way we behave to manage our own needs.

When a child is evaluated by an Occupational Therapist (OT) one of the tests they will utilize is called The Sensory Profile-2. It is a set of judgment-based caregiver–usually mom or dad– questionnaire providing a standardized means to capture a child’s responses during the regular course of daily life. This information provides a unique way to determine how sensory processing may be contributing to or interfering with participation.

The Sensory Profile-2 evaluates four areas or quadrants and determine where a child falls–much less than others to much more than others.

  • Seeking/Seeker: Seekers have an active self-regulation strategy and generate new ideas.
  • Avoiding/Avoider: Avoiders are great at creating routines and order because they need “sameness” to reduce unanticipated sensory input.
  • Sensitivity/Sensor: Sensors detect sensory cues.
  • Registration/Bystander: Bystanders are easygoing.

Example:

The following is a sample of what you might see when you receive a report back from the OT who performs your Sensory Profile-2 evaluation.

Sensory Profile | Sensory Ninja

The sample Sensory Profile assessment reviled that this Ninja is a tactile seeker. This means that they need constant additional input from their surroundings. They might constantly be touching objects around them. In school, they might tap their pencil or want to chew on things. The more sensory input they could get the more alert they will be.

Under the avoiding quadrant, it reviled that this Ninja would move away from activities or work alone. By avoiding interaction they would be able to control their surroundings and the time they would spend on an activity. Whereas working in a group they would have little to no control.

This Ninja fell within “the majority of others” for sensitivity to the feel of tactile objects. What that means they probably are not picky about things like the fabric they wear or the texture of their food.

At the “more than others end” of the Registration/Bystander quadrant, this Ninja will miss sensory cues others would not. For example, they will not notice the teacher calling their name, or they might not notice they have their shirt on backward or twisted.

In summer, this Ninja can successfully use and understand some sensory information, they have difficulty processing touch (Tactile), movement and body position (Proprioceptive) stimulus. These deficiencies correlate with a need for an increased frequency of poor conduct and social/emotional responses. Some of these behaviors can be things such as extreme inattention, seeking out tactile and movement opportunities. This will contribute to making disruptive, impulsive, and/or unsafe choices at home, in school, social outings and during play.


The OT evaluation will take about an hour. For us, it included observing our Ninja’s tone/strength/range of motion, fine motor–Developmental Test of Visual Perception (DTVP-3)–, his ability to self-help, emotional/behavioral responses, and the sensory profile.

I was most fascinated by the results of our Sensory Profile test. Which is why I chose to cover this topic today. For me, it felt like FINALLY, someone understood my child and there he was in black and white. It was a huge relief that after years of struggling to figure things out, we could now put a plan in place and move forward with goals that would help support our Ninja at home and in school.

photo credit: Markus Spiske

Know the Law: 504 vs IEP

When I first began to hear the terms “504” or “Individual Education Plan” (IEP), I found it difficult to distinguish the differences between these two types of school services. These services are designed to help your child with learning disabilities. I quickly became lost during critical conversations regarding my child’s education, and rightly so, as they both service children with physical, mental, emotional, behavioral, learning, or attention issues.

If you hear these terms and are trying to understand the benefits they will provide your child, you are also, possibly, experiencing an onslaught of all types of new terminology and diagnoses from your doctor or specialists. This moment in time is going to feel overwhelming with all the new information the doctors are giving you, which is imperative, to your child’s development and growth.

What I have for you here is a bare bone, boilerplate, easy to follow, explanation regarding the similarities and differences a 504 or an IEP will provide and service.

How the 504 and IEPs are Similar:

  • Both act as a “map” for a child’s education career.
  • Both are free of charge to families seeking the services the school will provide (i.e., counselor, occupational therapist, physical therapist, or speech therapist.)
  • Both will consist of a team of people – I like to call it “Team Ninja” – the parents, teachers, administrators and other child development experts (i.e., counselor, occupational, physical, and speech therapist).
  • “Team Ninja” will collaboratively create a plan and monitor progress. The rules about who must be involved are stricter for the IEPs.
  • Services cannot be provided without Parents consent first.

How they Differ:

504 Plans

  • Accommodations to make appropriate changes to classroom environment:
    1. “Sensory fidget” items – such as stress ball, Velcro to the desk, selection of sensory seating options, weighted items, etc.
    2. Be allowed to take a test orally vs. written.
    3. Supplementary aids to help support in the general classroom (i.e., audiobooks, or copy of a teacher’s notes the class would be required to copy)
  • Cover children with any learning disability, such as Attention Deficit Disorder (ADD, ADHD), Dyslexia, Dysgraphia, Asthma, etc.
  • The 504 does not require a formal evaluation by an outside expert. Your school district will not cover the cost should you choose to have an evaluation to determine under what disability your child will qualify for a 504.
  • States will not receive any additional funds for implementing a 504 plan. However, the government can withhold funds if the state is not in compliance with Section 504 of the Rehabilitation Act of 1973. Funding given from Individuals with Disabilities Education Act (IDEA) may not be used to serve students with a 504 plan.
  • A 504 is not a formal document. “Team Ninja” will meet to discuss strategies and assess results and make adjustments accordingly. Meeting minutes may or may not be taken and signed at the end of a 504 meeting.
  • Schools do not have to give written notification to the parents should any “significant” change happen to the 504 placement. However, most schools do so anyway.
  • The rule will vary by state, but in general, a 504 plan will be reviewed at the beginning of each school year, and reevaluations are done every three years or as needed.
  • 504 process for dispute-resolution are as follows (for more detailed information visit https://www.understood.org)
    1. Mediation
    2. Alternative dispute resolution
    3. Impartial hearing
    4. Complaint to the Office of Civil Rights (ORC)
    5. Lawsuit

Individual Education Plan (IEP):

  • An IEP is an INDIVIDUAL map for each child. (curriculum accommodations)
  • Requires a formal evaluation to determine if and what services your child will receive.
    1. Parents can request the school to provide the series of evaluations known as an independent educational evaluation (IEE) given by an outside expert. The school district does not have to agree.
    2. Parents may elect to pay for a private evaluation from an expert.
  • To qualify for an IEP, you must have 1 or more of 13 specific disabilities such as Autism Spectrum Disorder; Blindness; Deafness; Hearing Impairment, etc. (to view all 13 qualifying disabilities visit www.specialeducationguide.com)
  • There are strict legal requirements about who must participate on the IEP team – “Team Ninja.”
    1. Parents
    2. Teacher
    3. At least one special education teacher
    4. Schools psychologist or another individual who can interpret the evaluation results
    5. A district representative over the special education services
  • The State will receive additional funding for a child that is eligible for an IEP.
  • IEP’s are enforced by your state’s education department – for example, in Arizona, that is the Department of Education
  • The IEP is a very structured enforceable document that will contain a current academic assessment, track annual education goals and the length of time to achieve said goals
  • Should the school wish to make any changes to a child’s IEP or services that are provided they must inform parents in writing, known as a “ Prior Written Notice.”
  • List any accommodations—including class environment—along with who will provide the support and services your child will need.
  • The IEP Team – “Team Ninja” – will review the IEP at least once a year. Depending on the goals made for the IEP your Team may meet more often. All students with an IEP must be re-evaluated every three years. It will then be determined if and what services will continue to be provided.
  • Explains all modifications (taught curriculum) and accommodations (classroom environment) and how your child will participate in standardized tests.
  • Your IEP will state a plan that will show how your child will be included in school activities as well as in the classroom.
  • The IEP’s dispute-resolution consists of the following (for more detailed information visit https://www.understood.org)
    1. Mediation
    2. Due process complaint
    3. Resolution session
    4. Civil Lawsuit
    5. State complaint
    6. Lawsuit

Knowing which laws do what was a huge part of helping me understand the difference between a 504 and an IEP. I found this chart super handy when I started on our journey. If you are still confused about your eligibility and rights, I strongly encourage you to contact your state’s Parent Information & Resource Center. Also, try meeting with your child’s teacher. They are a great resource as well as an additional set of eyes to help spot the struggles your child may be facing. Another excellent advocate to have on your side is your child’s primary care physician. They can give you referrals to a specialist to obtain any evaluations you feel your child may need.

Resources used to write this article can be found at the following sites:

http://www.idea.ed.gov

http://www.raisingspecialkids.org

http://www.azdisabilitylaw.org

http://www.understood.org

https://www.greatschools.org/gk/articles/section-504-2/

https://ldaamerica.org/types-of-learning-disabilities/

 

   

 

Do’s and Don’t’s: IEP and 504 Meeting Preprations

With my first 504  and Individual Education Plan (IEP) qualification meeting approaching, I did what any overly prepared, easily intimidated person would do, scour the internet for tips – after all, knowledge is power. I also braved a seminar our school district held to help parents understand the 504/IEP laws, it, unfortunately,  turned from an informational meeting to a platform for other parents to air grievances. Super frustrating for those of us who attended with the hope of learning something.

I wanted to share a few amazing DO’s and DO NOT’s I have found from research and having attended my own 504/IEP qualification meeting.

DO

  • Put together binders with all current information you have to date on your child. (Should your meeting be regarding possibly seeking evaluations I recommend having medical information such as birth weight, length, and term of pregnancy as well as the notes your Pediatrician has on their monthly, bi-monthly, and yearly growth milestones. You can request a copy of this information from your doctor’s office)

Make a MASTER copy for you, one for the teacher, principal, nurse, special education director, and school counselor.  Include a picture of your child doing an everyday task – it helps to put a face to the name plus it “humanizes” your child.

Every binder should have the same sections and information, i.e.,  Psych Evaluation; Occupational Therapy Evaluation; Physical Therapy Evaluation; Doctor Reports; Teacher Progress Report; Teacher Correspondence; Multidisciplinary Evaluation Team (MET) – for the official signed meeting notes); and Notes.

  • Have a firm understanding of the rights and resources that are available for your child.
  • Know the difference between a 504 vs. IEP and which you feel would best support your child.
  • Arrive at your meetings with well thought out ideas or strategies to help support your child and teachers.
  • Prepare to compromise and have realistic expectations of what can be accomplished during school hours vs. at home.
  • Dress appropriately for the meeting. (i.e., slacks and semi-casual top vs. workout clothes) You would think this is obvious, but many parents show up like they are going to the gym or have just rolled out of bed. Your 504 or IEP is an important meeting dress accordingly.

All of these things will help you to be prepared and ready to advocate with confidence!

DO NOT

  • Expect the others at your meeting to have all the answers.
  • Argue about unimportant details. As much as we want the 504/IEP to be the magic wand remember that nothing will be 100% perfect.
  • Expect the school to put in all the effort. It is a two-way street, and a lot of work and time will need to be given by you the parent.
  • Be argumentative. It is easy enough to do, trust me, I wanted to bang a few heads together a couple of times. Keep calm and remember everyone in the room is vying for a spot on “TEAM NINJA,” and working to find the best way to help your little Ninja to be successful.

I know that this time can be super stressful when all you want to do is help your child be as happy and successful as they can be. I promise that is everyone’s goal.

Keep in mind that the qualification meeting for a 504 or IEP is the first step in the process of continued meetings and goal setting. You will want to have lines of communication open between everyone.

I remember the first 504/IEP meeting I felt like I was sitting in front of a firing squad pleading our case. The hoops you have to jump through to obtain a 504 or IEP are intense. Once the meeting concluded, I felt utterly drained. It is tedious, emotional, and demanding. The best news is, you will be one step closer to creating a successful school career for your Ninja. Now that is worth celebrating. Eat some chocolate; you’ve earned it!  

Life Under the Microscope

When you start out on this path of discovery, be prepared to have your life put under the preverbal microscope. Everyone and I mean everyone will be looking down the eyepiece lens adjusting that “fine tuner knob” to judge every single aspect of your life. How do you live, where do you live, what is your diet like, what do you watch and when? How much physical activity is in place? You’ll be asked about socialization patterns for the adults and children. It will be all of your life, every moment of every day, being accounted for the: “ON AVERAGE…?”.

For me, it has been a dishearting, frustrating, and exhausting three years of paperwork. A few times in total annoyance I would just huff and mutter loudly “I DON’T KNOW!” To which some well-meaning front office staff member would respond “It’s O.K., any questions you have just ask the doctor.”

I had to know my health history all the way back to the great-grandparents, my husband’s medical history, my Ninja’s medical history…even the bits before he was born. I had to remember how many weeks along I was when he was born, his birth weight, length, and what time he was born.

How did they expect me to even remember that?

I have three! THREE! boys. I’m lucky if I get their name and birthday correct. I felt like I was in front of a firing squad and one wrong answer would send me to my grave!!  To top it all off, I had to contend with what one specialist thought was important vs. what another did not. The paperwork Q&A was never-ending. Don’t even get me started on the nurse/doctor conversations. It was like being a broken record. I still don’t know why the doctor will walk in and ask the same questions I just had spent a half hour answering on my medical forms. Did they think I lied?

At one point in our process, I seriously started to have second thoughts and doubt! It was the dreaded reality that maybe I was overreacting? Maybe he was just being a boy. Maybe my Ninja doesn’t fit into that perfect little box the school likes to call “normal.” Let’s be honest, our public school system is set up for well-behaved, rule following, overachieving girls. I am not saying that boys can’t be all those things. I’m well acquainted with several bright, well-behaved, little guys. But overall, if you look at it objectively, for whom is the classroom structure modeling more? In my humble opinion, girls.

I remember I was sitting in the Neurologists waiting room filling out what felt like my hundredth medical form and I absolutely dreaded the possibility that I could be chasing my own shadow. At that point in our journey, no one had been able to pinpoint the underlining cause of the symptoms the Physiologist had noted. Each specialist said that “things were a bit off,” but they couldn’t say what or why.

It was the longest year for me. Every new specialist appointment was months out for new patients, and each doctor would end our twenty-minute exam with, “we recommend that you follow up with…”

So, we would follow up with one specialist after another, chasing the “perfect” explanation of what is the cause and how to treat it. We rounded out with a total of seven different physicians and specialists. Our Ninja was examined by his Primary Care Physician, a Physiologist, an Opthomologist, a Neurologist, and a Pediatric Behavioral Specialist. He also was evaluated by an Occupational Therapist (OT), and Physical Therapist (PT).

It was a lot of paperwork, followed by a lot of questions. No words can describe the feelings I had when family, friends, and the school staff wanted answers that I didn’t have, which only added to my self-doubt. Nobody could give me definitive answers. Once we had the OT and PT evaluations, we had direction and a “this is what we can work on” but no firm diagnosis.

My point—because I do have one—is that after three and a half years, we still don’t know how what or why. My Ninja has been described as an enigma. So, for now, we have two “working” diagnoses. One so he can receive the OT and PT he needs. The other so he can qualify for an IEP at school—which required evaluations by two separate Speech Therapist, and another Phycologist.

Our journey started out bleak, the light at the end of the tunnel was not even visible. Now it is a tiny pinprick, but halleluiah! It’s a light! Don’t doubt. Don’t give up. Do whatever you need to do for your Ninja! Even if that involves closet crying and screaming into a pillow—I’ve done both—but don’t you ever let the doubt win! Why? Becuase like my Ninja, your’s is just a brilliant, empathetic, brave, hardworking, loving child, who just wants belong and needs your help to overcome their individual challenges. It’s worth all the paperwork, and it’s priceless when you see that glimmer of light in their eyes!

photo credit: Bruce Guenter

Can you see that: A Closer Look at Vision Processing (part 2)

Vision has a very complex sensory job to do. It helps our brain to remember, identify, and judge where our physical body is within our surroundings. If our visual processing is flawed or taken away entirely life will become challenging very quickly.

If you missed the first half, I recommend you read part one and then come back. Because Vision Processing Disorder (VPD) is an involved topic I broke it down into two parts and today am finishing the review of the remaining four issues:

What are visual processing issues?

  • Long or Short-Term Visual Memory Issues: Children with either long-term or short-term memory issues can struggle to remember what they’ve seen. Reading and spelling will be challenging as well as using keyboards, calculators or even recalling what they have read.

What would you say is the one word that would cause you nightmares? Mine is, SPELLING! Why? Because studying spelling words each week is a living nightmare. The one thing that has helped most is a free app called “Spelling Bee.” He is far from perfect, but 8/20 is an incredible achievement! Also, one of the games he plays on the app has sliding letters across the screen from the left and right. After working with this app for a little over a year, my Ninja can successfully track and pick out the letters he needs to spell a word. HUGE deal!

  • Visual-Spatial Issues: Children with visual-spatial difficulty will struggle with judging where objects are in space, i.e., how far things are from them or each other, and where characters or objects are located in a descriptive narrative. Some children may also find telling time or reading maps difficult.

After our full evaluation came back, it was SHOCKING to see in black and white my child described as “floating in space.” Visual-Spatial Processing is a huge roadblock for our Ninja. It was also relieving to finally understand why he had to touch everything around him all the time, or why when we would be out for a walk, he would stop in the middle of the road and not at the corner as instructed.

Honest moment here: I truly thought he was just a boundary-pushing punk. Yes. I called my child a punk because that’s the best way I can describe his behavior before I understood. Obstinant and defiant. It turns out that he couldn’t judge where he was in his space. I felt about 1″ tall for a month, but now I have perspective, understanding, and knowledge, which has empowered me to advocate for my “seeking” child!

  • Visual Closure Issues: is when a child is unable to identify an object that is missing part or parts of it. i.e., a bike without wheels, or a drawing with missing details such as a bird without its beak.

When given an evaluation for Occupational Therapy (OT) my Ninja was asked to complete the look of a shape. He sat very studiously (well for him that is) which means he was bouncing here there and everywhere while attempting to complete the other side of a triangle with a square in its center. It was a mess. I am happy to report with a lot of hard work on his part and a fantastic occupational therapist that he can now complete the other half. Not neatly, but with better accuracy than on his first trial.

  • Letter and Symbol Reversal Issues: Children that switch and substitute letters or numbers when writing is age-appropriate until age 7. If they continue to struggle with correct letter formation, it will begin to affect reading, writing and math skills.

Children with VPD may not know that they see the world around them differently. In fact, many VPD issues get misdiagnosed as Dyslexia and ADHD. Because a child will exhibits classic ADHD or Dyslexia symptoms such as the struggle to maintain attention, reading, tracking and sustained focus.

To avoid being misdiagnosed, I would encourage you to research and understand VPD. I would also urge you to find a Developmental Othomologist to evaluate your child. (Check out www.covd.org to find one in your area) Be sure to express any concerns you have when making an appointment.

Should your child have Sensory Processing Disorders (SPD) it may present some challenges during your exam. However, with time, a patient and kind Othomolgist, they will be able to obtain the visual information they will need to make a proper diagnosis.

Never forget to advocate for your child’s healthcare needs. I took our Ninja to a well respected and noted Othomolgist in his community. After our first follow-up appointment to discuss results from testing (that he did not even perform), I didn’t agree with his assessment and course of suggested treatment. So, I took my Ninja to get a second opinion. I’m very thankful I listened to that “mom voice”! I found another well-respected Othomolgist, waited on her new patient list for a month, and had an entirely different experience. She was hands-on and worked with us at each appointment. We were able to put in place a treatment that has helped my Ninja.

Don’t be afraid of that shine plaquet on their walls. Speak up (respectfully), and ask questions. Doctors are human too and capable of error. Being a voice for your child never wrong!

photo credit: Dmitry Ratushny

Did you see that: A Closer Look at Vision Processing (part 1)

Vision is a sensory that goes far beyond the concepts of how well one can see. The information from the world around us is utilized and processed by our brain, not eyes. We all knew that, right? Of course! It was a well-taught fact when we learned about the five senses in grammar school.

Logic would lead us to the next question: how does our brain use the information it is receiving every second, of every waking moment, of every single day? Well, we use vision in everyday life for things such as visual motor skills and visual planning, visual memory, fine motor skills and hand-eye coordination.

WOW! Our eyes and brain do this all on their own, without us having to do a thing (other than look at the world around us). Sounds like another thing we “just do”, like breathing. We don’t think about how we see; our body just does it.

What are visual processing issues?

Understood.org breaks it down beautifully for us. I’ve summarized it here…with tidbits from my Ninja’s experiences with Sensory Processing Disorder (SPD) and visual processing issues.

There are a total of eight possible visual processing issues. No one is limited to just one, in fact, my Ninja has a few. Because this is a huge chunk of valuable information I’ve decided to cover the first four now and the remainder in a follow-up post. They are as follows:

  • Visual Discrimination Issues: This means that a child will mix up letters or shapes, and the orientation of objects, i.e., “d” for “b”, left from right, and top from bottom. So a child might write a letter “d” in place of the letter “p”.

While Visual Discrimination appears to be dyslexia it is in fact not. Dyslexia is a language-based learning disability, that cannot be reversed. While Visual Discrimination can be greatly improved with vision therapy based exercises to help strengthen eye control and movement as well as visual processing.

  • Visual Figure-Ground Discrimination Issues: Kids with this specific issue will have difficulty finding shapes or items on a page of information or maybe a specific toy from a large pile, as well as being able to pull a shape or character from its background.  The “Where’s Waldo” books might cause more frustration than joy, and Waldo will probably remain lost.

Thankfully, this is not a big stumbling block for my Ninja. He will at times struggle, but that happens more often when he is tired. It’s also one of his sensory triggers that we have learned to avoid or work through.

  • Visual Sequencing Issues: Children with this type of issue will have a difficult time seeing the order of symbols, words or images. They may skip lines when reading or writing and struggle to copy information from one source to another. They may also reverse or misread letters, numbers, and words.
  • Visual-Motor Processing Issues: Children with this issue will struggle with writing, and their ability to coordinate the movement of other parts of their body. They may be clumsy and have difficulty copying text.

Before my Ninja received physical and occupational therapy he was very clumsy. As an infant, he crawled or walked right into walls and furniture. Sometimes, he would bump his head or hand on the object again before moving to the side to avoid his stationary roadblock. Can you even begin to imagine what a crowded room would do to him visually? It caused frequent toddler meltdowns.

Conclusion

Even though I’ve only covered four visual processing topics, we already get a clearer picture of how essential it is for our eyes and brain to work in tandem. The struggle for children with SPD and or any Visual Processing Disorder (VPD) is a compounded daily struggle.

I would like to encourage you,  the next time you notice a parent struggling with a child, not to jump to conclusions. Please, keep in mind they might be facing challenges such as SPD or VPD.  No matter how good a parent might be, children can express themselves in ways which present as “acting out”. It could be a coping mechanism; with parent and child doing the best they can.

I don’t have perfect children—all kids have bad moments. Either way, having perspective, and knowledge is a powerful set of glasses to help us all be a little more patient and kind to those around us.

photo credit: frank mckenna

Finding Joy in our Sensory Journey

The other morning I had brunch with a new friend whose child, like mine, has some Sensory Processing Disorders. We were chatting about the school our kids attended and I shared with her some of the struggles we had with my son’s second-grade teacher and the school’s principal. It was the time in our process of attempting to “diagnose” a cause for the behavioral struggles, and find ways to support him. He would get up and leave the classroom without permission, avoid bring home his work folder, and obstinately refuse to do certain class assignments. He would essentially just shut down.

These behaviors resulted in trips to see the principal and losing recess privileges. There were many pre-conclusions about what was wrong with my son. Most of those circled around behavior correction, compliance, and comparing him to a “normal student” with an expectation that he should be able to behave more like his peers.

It wasn’t pleasant and left a very bitter taste. I remember feeling that he was misunderstood, and I felt sad and alone in the fight for my child’s success. Unkind words were said by both teacher and administrator. I experienced a huge low.

As I relived some of those moments with my friend, I was shocked to realize how much my son and I have grown and overcome together the past couple years. While the sting of days past is still felt, I also have peace for them as well.

The struggle to understand, sleepless nights, frustrated tears, exhausting worry, anger and my resentment at unkindness, have shaped a hope I wouldn’t have imagined possible. Oh, believe me, I can for sure muster up some of those old friendly feelings, but I also feel so much accomplishment and freedom from it. Maybe I’ve learned to let go a bit, to shrug off the annoyed looks or words; we get them often from people who just don’t know or care to be patient. But for me, I have chosen to seek joy in our successes.

We have difficult days ahead, but more and more often they are 100% filled with fantastic bliss. That feeling is priceless, I hope you can build on that, and cherish it. When those bad days come-because they will most certainly come-take a moment to remember the victories you and your child have won. That’s what will make all the difference in how you face new challenges. 

photo credit: © Terri Moore 2017