Sunday, October 23, 2011

Post Accident Testing

We had Maddi’s in depth evaluations in September. I can’t believe we are knocking on the year mark door. Thanksgiving will be here before I even blink! It has taken me a while to figure out how to interpret all the technical terms and testing scores for the laymen reading this blog. I am very familiar with academic and cognitive testing through my profession as an Educator.

One thing I have learned with testing is that it is just one piece of the puzzle. It is information and predictive but not set in cement. I have seen kids who are brilliant but are terrible with follow through. I have seen other kids that work their tails off and outperform some of those spontaneously brilliant people. Testing doesn’t have much to do with REAL life and how things work, effort is the real indicator. Testing gives us information to help make pertinent and intelligent decisions that can influence the desired outcome.

We met with her neuro-rehab doctor and we met with the Neuro –psych doctor as well. It is really hard to explain all the details of these tests. The Rehab tests are the easiest because we could see Maddi perform the physical tasks she was asked to do. For example; stand on one foot, measuring flexibility, heel/toe walking, tiptoe walking, heal walking, follow her finger that sort of stuff.

The Rehab Doctor gave her a once over and proclaimed that Maddi had a “perfect” exam! What that means in laymen terms is that Maddi has successfully recreated or rewired all of the physical pathways from her brain to all the physical parts of her body. She can move her hands and legs; she has regained her balance and her ability to track things with her eyes. She has a delay in processing speed and her fine motor skills are not completely there but many non- TBI (Traumatic Brain Injury) people do as well as Maddi on that particular test. I personally would have failed it miserably but I have never asserted that I am normal. So the short story is Maddi’s recovery has been physically MIRACULOUS!

The Neuro-Psych doctor was a different kind of testing. His specialty is giving test that give information about what is going on inside the brain and how that affects Maddi cognitively, academically and logically. These tests are used to develop an academic plan for Maddi. It took a full day to complete the tests. Her appointment started at 9am and we walked out of his office well after 5 pm. These tests were specific and narrowly targeted. She actually scored extremely well in all areas except Math.

The only tiny detail is that all tests were given in a one-on-one setting with plenty of breaks. This has been a re-occurring theme in figuring out the best way to structure things so Maddi can learn. There are four things that affect Maddi and her abilities; distractors, attention, stimulation and fatigue. If any of these elements are in play her results are hugely different.

Based on these tests; Maddi scores in the NORMAL range for every aspect except Math. If you needed proof that God can intervene on your behalf, here it is. If you were wondering if MIRACLES happen today, not just in the “Bible”; Maddi’s recovery is a testament to the reality of miracles and a Living, Loving God in every respect.

I remember vividly wanting to pray for this kind of outcome but I feared I would be asking too much of the Lord. Instead we prayed to be able to accept God’s will in Maddi’s recovery. The only way Maddi was able to score this well based on her injuries is through God’s intervention!

There aren’t enough positive “CHANCE” cards on life’s Monopoly board. We “did not pass go, nor collect our 200 dollars” more often than not and we definitely didn’t have a “get out of jail free” card. I don’t believe in coincidences or fate and I don’t believe that we did anything to deserve this great blessing.

This MIRACLE was and will always be, because of God’s mercy and love for us. God, in his goodness, saw us in our time of trial and had compassion on us, just like he did for so many others in his earthly ministry. Faith was the only component needed. I knew God COULD, I just didn’t know IF he WOULD. That IF has been answered with a resounding YES!

Yet, even with this miracle there is work and struggle. Maddi isn’t 100% but she is more than half way there! Gratitude and the Miracle have not erased all indication of the brain injury, perhaps what is left is just enough to keep us from forgetting the MIRACLE.

Maddi’s biggest strength for learning is verbal language. The struggle is the duration of attention and the ability to keep information in her short term memory and retrieve it at the appropriate time. If she gets loaded down with too many things at one time the brain and memory tend to dump it all.

Maddi’s logic is good in the small details but she tends to miss the big picture especially when it isn’t blatantly specified and she is rigid in her approach to problem solving. Learning to alter her approach is needed.

She also struggles with social structures and language. She is very blunt and extremely literal without much tact right now but she will learn. The skills that were the most practiced and unchanging are the ones that have been relatively unaffected by the TBI.

Those skills that are constantly in motion are more difficult. Social things with people, in general, are difficult to navigate, but with teens, specifically the rules seem completely arbitrary with no predictable results. One person can say/do/wear something and it is deemed as “cool” but someone else is seen as inappropriate. How do you teach that?

Maddi reads, spells and comprehends above a high school level. Maddi was a great reader before and that skill was easily rewired or may not have been affected much by the injury. The experts can’t really explain it. There are big fluency and speed differences that affect how much information she can learn and understand in one sitting. She often uses the information to reference her answers. This is a result of that new and old information paradox. She isn’t sure if what she “knows” is based in the most recent information or if it is something she knew before. It is difficult to “verify” information in that context. It creates uncertainty in her decision making. Besides that little hiccup, Maddi’s short term and long term memory are within the normal range as well.

We are truly blessed to have her testing come out so well even though we understand it is just one blip on the landscape of information about Maddi. It is a MIRACLE for sure.

The most difficult are those four major issues; fatigue, attention, stimulation and distractors. They infiltrate all areas of learning. If she is fatigued her scoring falls to the severely impaired range.

  • Being unable to differentiate between superfluous dialogs in a classroom vs. important information hinders learning in a huge way.
  • If the amount of time she is required to attend to a specific topic, task or skill exceeds her “built in” timing the rest of the information tends to fall out of the brain.
  • Having lots of stimulation requires extraordinary effort on her behalf and that leads to……..fatigue.

She had a global (meaning in all areas) Traumatic Brain Injury which has produced global weaknesses but she also has some amazing strengths.

It is actually interesting that her strengths and weakness seem to be complementary. It is almost as if for every issue the Lord has provided her a work around; a way to compensate. If I didn’t understand the Law of Opposition before…….. I do now. If she can sort out the HOW then she will be unstoppable in whatever she decides to do. I know this is a lot of mumbo-jumbo but the long and short of it is:

Maddi can learn and be productive in all areas of life. She just has to do it a little bit differently with a little more fine-tuned approach, but ultimately she is capable of learning, doing and becoming anything she wants to be.

Here is the FAQ section.

  • Does she still have a Traumatic Brain Injury? Yes, but comparing the outcome to what could have been, we are thrilled with Maddi 2.0.
  • Is she back to normal? No, she never will be, but she will learn to be effective and productive regardless of the TBI issues. The newness will become normal for her.
  • Will this ever go away? No, as human beings, we are all designed to adapt and adjust and Maddi is capable of both. Fatigue, stamina, stimulation, attention and distractions will always be a part of her life. Knowing her she will turn them into strengths!
  • Can she go to college? Absolutely, but she may take two classes at a time instead of four, not a big deal we have at least 80 years of learning. Why are we always in such a rush? Geesh!
  • Does she still have recovery work to do? Yes. But in reality, don’t we all? We are all trying to adjust to our own insides. Learning happens in days, months and years.
  • Can she go back to school full time? The answer is yes, but would she be able to learn well in that environment right now, no.
  • She needs time to develop coping strategies and new tolerances for stimulation.
  • She needs one on one instruction to fully retain the content and she needs extra time to get it in long term memory.
  • Six hours of daily frustration would just convince her that she is unable.
  • Re-teaching everything after hours is not an option. As Maddi’s stamina and skills increase, she will increase her time spent at school.

Life is supposed to be about JOY!

Hopefully, I didn’t create more questions than I answered. Maddi is doing amazing! Life is looking good for her. It has been a long stretch on this road but by taking one moment and step at a time we are further down the path of recovery for Maddi!

I personally am glad we are here and not still there.

Testing Completed…………….Bright Future Ahead!

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