Update: Almost Nine Months home, and one year

I had no idea how long I had sadly neglected our blog.  For those that participated in the journey to bring our son home from Bulgaria, I feel I should share how he is doing and what has been going on.  For those who might be considering starting their own journey, I know how helpful it is to read what happens when the curtain closes and the child comes into his or her family.  Sometimes, without meaning to, families simply close their blog.  I have vowed not to do this, but I must try to do a better job.

To begin with, Joshua is now past his 3 1/2 year mark and is steadily speeding toward his fourth birthday.  We have celebrated nearly nine months home in our family.  Two weeks ago, we also marked "Meetcha Day Part One", commemorating our first trip to Bulgaria to meet our son.  That trip was utterly surreal, as we stood in a foreign country and met a little boy who would become our Joshua.  The weather was brutally hot and we practically melted, even as Joshua was wrapped in at least three layers of clothing.  He was a delight then, and he continues to delight us today.

Physically, Joshua can nearly run, can throw a ball (though has trouble catching one!) and is in good health.  His height is still far below what we would like (5th percentile) and he has not put on much weight since his initial increase upon homecoming.  The pediatricians are aware of this and are not concerned.  He remains at 25th percentile in weight, wears a size 5 diaper, and 3T clothing (2T in pants!).  

Emotionally, Joshua's friendliness remains as effervescent as always.  He has a joyous smile, can appropriately greet people with a "hi!" and says "buh bye!" as well.  He hugs many people he meets and is content to sit on a lap and get tickled.  Though his emotions remain somewhat volatile and we note that he has trouble self-regulating, he is generally a happy child.

His eyes remain troublesome, but his visual acuity cannot be assessed at this time.  He receives some vision support at his preschool and we will continue to monitor his needs.  His eyes do tend to drift in a sort of "lazy-eye" way.  We are grateful that he has an abundance of vision, but we definitely believe he has glasses in his future.  

And yes, I said preschool! Joshua attends a developmental preschool four morning per week.  From the look of things, he's enjoying himself.

(That's marker or paint on his face!)

We are monitoring him for any signs of anxiety or regression as he goes to school.  He has been going for three weeks and thoroughly enjoys the bus ride. Each morning, we wait for the bus and Joshua stands patiently.  When the bus appears, he will say, "Buh! Buh!  Bee-Bee!" (Bye bye, Beep Beep) One of his speech concerns is his lack of ending consonants.  He will smile and greet the bus driver and then say "Buh bye!" to me and blow kisses.  

In his speech progress, he remains slow to acquire speech.  Receptively, he can label things more accurately and makes so many attempts to "say" things.  "Cah" (Cat) "Douh" (Dog) "No nooo!" (Oh no), "Uh oh" and of course, Mama and Dah-tee (Daddy).  It is clear that he knows so much more than he can say.  We are dedicated to ensuring that he receives proper therapy so he can begin to really speak.  He does not have a formal diagnosis other than a significant speech delay.  

But who needs words when you have these kinds of expressions?

Joshua became interested in putting on everyone else's shoes.  These are my daughter's shoes, while we were on vacation during the 4th of July holiday.

Joshua celebrated his first fourth of July as a US citizen and in our family.  It was a special day.  During that holiday, we took a short vacation to the beach, where Joshua actually saw the ocean for the first time.

Daddys are good things to have!

Joshua continues to improve, to shine, to amaze.  It is hard to imagine his little face anywhere but in our family.  We often tell people that, if there is a Bulgarian Adoption Lottery, we hit the jackpot.  We've never had attachment issues, sleeping issues, or other common adoption issues.  Joshua made and continues to make a smooth transition into our lives.  More than that, we see evidence every day that Joshua is emerging as the child he was designed to be.  The damage of his upbringing, coupled with the challenge of his special needs, will make things like intelligible speech, potty training, and going to a mainstreamed "typical" school difficult.  But these are not impossible things.

No, not every day is happy...

At the fireworks for July 4th - we left shortly after this! :)

But he is a beautiful child and we could not be more blessed to have him in our lives.  And we hope that he is just as blessed as we are...as he walks into his new future.

Joshua - (almost) six months home!

Where oh where has the time gone?  April and May were terribly busy months, but at last things have settled down and I'm able to provide an update on our Bulgarian Blessing.

Joshua continues to make progress in all areas of his development, though in some ways it seems that progress has slowed a bit.  In other ways, he continues to progress.

Health-wise, we have been blessed with little to worry about.  Joshua caught up on his missed vaccinations.  He is due for more blood work, but the last time we took him, his reaction was so terrible, we cannot bring ourselves to take him again :)

He continues to struggle with micronutrient deficiencies, which we address through multivitamins and extra vitamin D.

Developmentally, he continues to be the smiling boy we've known and love.  His personality is certainly that of a child who is clever, funny, and happy.  

He's been on another long airplane ride too!  Earlier this month, I graduated from college with honors and we all traveled to my college so I could participate in my graduation.  Joshua did not seem nervous on the plane. We had concerns that he might think we were returning him or that we were leaving him but he seemed secure and happy.

After graduation, we traveled to Disney World for the first time as a family!  This was a bit more difficult for Joshua to understand, so we made many accommodations in order to keep him as happy and comfortable as he could be.

He has made the most strides in his ability to chew.  I learned this when my finger was nearly bitten off in Florida at a Steak and Shake :)  He is chewing much better now and is able to eat a small hamburger (with help) and other foods of similar consistency.  This means we no longer have to create special "Joshua concoctions" for dinner, though we still do sometimes because his diet remains limited.  He struggles to self-feed, though he is using a spoon a bit better.

In language, he is still incredibly delayed.  His ability to produce sounds is improving and he IS spontaneously babbling.  It is a joy to hear him in his room making sounds now!  He has not learned many new signs, which is a bit disappointing.  But he is mimicking the intonation of speech even better now.  This sometimes causes frustration, as he comes to me as if he is "talking", but I cannot understand him.  He will look at us and say, "Ah AH ah ha!" or something, and we will not understand what he means :(  However, speech therapy is on the way, two times per week!

Physically, his improvements have been small.  Physical therapy is on the way too!  He hasn't seemed to gain much more weight since his initial rise when he came home.  However, he is growing a bit taller.  Joshua wears a size 3T shirt now and can wear 2T shorts, though they are a bit long on him.  His waist is also teeny tiny and his little chicken legs simply refuse to put weight on.  

Joshua was recently tested in on our early intervention system.  As expected, he tested far below standards in every area, including in cognition.  We have located a specialized classroom placement for Joshua where he can be with peers who are like him four mornings per week.  He genuinely likes people and we think this will be a positive for him.  However, we reserve the right to remove him and have therapy in our home if we find that the classroom environment is too challenging for him.  So it looks like Joshua will go to school in the summer!

Some have asked me if he is potty trained, and the answer is a resounding NO!  He doesn't seem to be aware when he's wet or dirty, though he learned the sign for "potty" and does like to imitate what we do in the bathroom.  Self-help skills are also improving.  Joshua will try to take his pants off and even pulls on his shirt.  He is starting to learn to take his shoes off, much to the chagrin of his Mommy :)  How often I hear the ripping sound of velcro and shout to the back seat, "Joshua! Leave your shoes on!"  He also allows his teeth to be brushed and even tries to help.

Receptively, his language is improving.  I recently said to him, "Joshua, come here," when he was not looking at me (thus, no visual prompt) and he came.  He was playing with a toy and I asked him to turn it off, and he did.  Progress! I'm fairly certain he has lost his ability to understand Bulgarian, as we play Bulgarian things for him on youtube and he doesn't really respond.  He still understands the few Bulgarian words we speak to him (hello, goodbye, here, etc.) but it seems his English language ability is growing.  

(A "Joshua meltdown" while in Disney World)

No, he's not always happy.  He's not always easy.  His progress has been hard-won and will continue to be so.  Special needs adoption is not for the faint of heart.  It is not for those who demand certainty and have expectations that aren't reasonable.  

Instead, special needs adoption is for those who are willing to work hard, prepared to fight for their child's needs, who know there will be late nights and even tears, but who also know that the most unique blessings come as we parent these little ones.  We are empowering these children to become all they are capable of being.  There is great joy in that.  

Joshua was rescued from a place where he had no future.  He was not even from a good orphanage.  Instead, he risked a bleak future and even potentially death.  The pale anemic boy with legs that bowed like new tree branches from rickets, who rocked against the fall and could not walk is no more.  

If you helped us redeem him, thank you.

Four months home

With the Easter holiday, it was tough to post at precisely the proper time.  Joshua has actually been home nearly four and a half months now.

He continues to delight us with his smiles and affection.

He loves to play.

He continues to make strides physically.  His weight has stabilized but he is starting to get a bit taller.  This is good news indeed!  He is very low on the growth chart for height.  His appetite remains healthy.  We provide additional vitamin supplements to help with his vitamin D and other micronutrient deficiencies.  

Joshua received his first Easter basket on Easter Day...

We brought him to his first Easter Sunday service.  We tried to get a "perfect" family picture, but quickly realized, we're not perfect and neither are our pictures.  So they are perfectly imperfect!

Joshua was finally evaluated for supportive services through our local "early intervention" type organization.  As suspected, he tested very low on the evaluations.  In some cases, he was not even on the chart (less than 1 percentile).   But none of this is a surprise.  Each of the evaluators were so impressed with how sweet and kind Joshua is, and how willing to mimic and learn he is.  

Yet, he continues to surprise us with his earnest desire to communicate and learn.  And, in spite of his challenges, he has such a blast!

(this was his first 'real' visit to the park!)

(I will do what I can to prevent him from becoming a baseball fan.  Football season is coming soon!)

Eating age-appropriately is still quite a challenge.  And, while his fine motor abilities have improved somewhat, he will benefit even more when therapy starts. We will have an IEP meeting for him in a few weeks that this will hopefully activate weekly services that will help him blossom even more.

For so long, Joshua has remained quiet, making few sounds and knowing only a few signs.  But over the last few days, he have finally begun to hear babbling!  It is not constant, but we have heard it several times.  The speech therapists have expressed a desire to hear him "play" with language, and he has started!

We are so happy for this new development and cannot wait to see what the next few months hold.  He may start a preschool in a few months, he will begin therapy, and he will continue to be the most amazing, precious little son a family could ask for.

Did you participate in this miracle?  If you did, can you see what you helped do?

Thank you for helping us redeem this beautiful, beautiful boy from a hopeless place to a place where he will shine!

Joshua - Three Months Home

Another month has come and gone, and our son from Bulgaria has been in home in our family for three months.

His transformation continues to surprise and delight us.  He remains friendly to others but listens more to us.  He no longer blindly goes off with strangers. Instead, he will try to greet them but will listen when I tell him to stay close to me.  His demeanor continues to be that of a happy child.

Verbally, he has begun to make "m" sounds with assistance and can say "Ma-ma".  He is also trying to say "more".  He fully uses the sign for "more" but we are working on his verbal ability.

Physically, he continues to gain weight but is still very short.  He has gained some height though and can fit into size 2T pants with the cuffs sometimes rolled up.  In shirts, he is sneaking into 3T!  He can descend the stairs ALMOST by himself and is working on climbing them without help.  He has a long way to go in this area.  He still enjoys rough housing and is starting to work on running through the house.

Behaviorally, the repetitive throwing has all but stopped!  Instead, he throws only when I am not looking, because he knows it will garner him a trip into the "time-in" chair.  He is friendly, cuddly, and anxious to interact.  Though he does not speak, he tries to hand toys to others and will "hum" an answer to a question. Everyone who meets him is struck by how pleasant and loving he is.

He is learning to feed himself with a spoon quite well, though he's often too messy!  We believe he's left-handed, which should be interesting!

He has been such a wonderful addition to our family, but the road ahead is still long.  Neurologically, he will be monitored.  Developmentally, his delays exceed common institutional delays by a wide margin, even in an orphanage like the one he was in.  The reason for this is still unclear.

In terms of his vision, we must take a "wait and see" approach as he becomes more accustomed to English and can help us know what sort of correction he needs.  We are grateful that he can see and grateful that he will receive the care he needs to have the best vision possible!

There were a lot of unknowns with Joshua.  This is the case in almost any adoption, certainly an international one.  The story of this child's life is still unwritten and unknown.  Cognitive delays, intellectual disabilities...these are real possibilities for him.  We knew this, of course, and love him no matter what.  

We talked as a family, as Joshua was grafted in, about at what point he felt like "ours".  We loved him the moment we met him, certainly.  But when would we feel as though he had always been a part of our family?  At what point would we stop feeling like we were babysitting this fabulous child and instead feel like he was always just....ours?

At this point, three months home, I can confidently say that we do.  Although there are times when we look at him and cannot believe he's here - cannot believe that we were chosen to parent him - most times, we just look at him and struggle to recall a time when he wasn't with us.  

Whether he is happy...

Thoughtful...

or mischievous...

The one constant is that he is ours - our son!  Unique in every way...uniquely OURS.

To all who helped us bring him home, thank you.  You have redeemed a life from a dark place; a life whose light can radiate. Please pray for the children who remain in The Bad Place and countless others Bad Places whose lights have yet to shine.

Joshua - Two Months Home

It's hard to believe that Joshua has been with us for two months.  In some ways, it feels like he's been here much longer, and in other ways, it feels like it's only been a week or two.  Joshua continues to inspire and amaze us.

Physically, he continues to gain weight and eat well. His diet is not entirely age appropriate, but he is eating textures (such as gently mashed sweet potatoes - one of his favorite foods).  We put whole wheat bread chunks into soup broths and have increased his protein with chili, baked beans, and refried beans.  These sometimes lead to some pretty incredible diapers (!!) but they are rich with protein and fiber, both things he needs.  He still only prefers to drink water and struggles to drink from a cup, but we are working on these things.  He loves to rough house with my husband and his smile simply lights up the room.  There is no one he  has met that he has not thoroughly charmed.

Emotionally, he is learning the routines that we've instituted and tantrums have decreased.  He understands that crying is not an appropriate way to make a request and has learned the signs "more" "help me" and "drink".  He knows the sign for eat, but only uses it when he actually sees food or hears us say "eat".  He also knows the sign "all done".  In language, we know he understands a great deal more of what is being said to him.  When we say "all done", he signs "all done" and then  hums, with proper intonation, what we are saying.  I often say I wish I could just "unzip" his mouth, because we hear so much humming in response to our language to him.  He will look at me and wag his finger (a sign for 'no') and then hum, "Humm-MMM!"  which is "No TOUCH!"

We use simple language with him in repetitive format so he can start to understand.  Redirection comes in the form of "No....[insert thing]."  No touch.  No throw.  No push.  No hit.  With each, we try to use a sign.  I have been forced to be incredibly vigilant because it's important to catch him in the undesired behavior as he's doing it.  Otherwise, he may not make the connection that we are correcting him based on an action.  I have literally stopped mid sentence, excused myself from guests, or stopped in the middle of cooking dinner if I observe an unwanted behavior.  There has been much progress in this area.  He has learned that there are consequences, and they are universally applied.  We employ a "time-in" chair for him.  When he does something he should not, he is approached, and the undesired action is reinforced, "Joshua, no throw."  Then he's placed in a chair in our family room.  We do not leave him alone, but do not engage him.  When time is up, we approach him again, repeat what he did, "Joshua, we no throw!" and then ask, "Okay?  All done?"  Then we get him up, give him lots of hugs and kisses and encourage him to "try again".  We try to go from that to a preferred activity that he enjoys so he understands that, while there are behaviors we will not tolerate, he is loved always.  Doing this consistently, the "time-in" chair is used less and less.

Because the consequences are so predictable, I knew we were making progress when I entered our family room and discovered Joshua sitting in the "time-in" chair without being placed there.  This has happened more than once.  Sometimes, I can ascertain what he's done (I may see a toy thrown, for instance) but other times I cannot.  When I don't actually view it, I don't allow him to sit there.  Instead, I might say, "Okay, Joshua, we don't throw, now let's get up."  I have to admit, this was also funny :)  It is clear that he understands our displeasure, as he normally gets a very sour face the moment he hears us correct him.

Having experience with a child on the autism spectrum, I'm not confident he's there.  There are some things that I see, but many that I do not.  He may very well be a child with some sort of intellectual disability and global developmental delays.  At each doctor's appointment, we are happily surprised.  His neurological work up was overall positive, another blessing.  He will be monitored, but his external hydrocephalus has done what it is supposed to do, which was recede around age 2.

We are waiting on several rounds of blood work, stool tests, and urine samples.  Some of these were done weeks ago but we have not yet received results.  We are also waiting on a developmental evaluation which will permit us to construct Joshua's IEP and receive therapy.  Finally, we're considering an educational placement for Joshua, but it must be contingent on his attachment to us.  Right now, he certainly prefers us but will still go off with obliging strangers!  This is not a surprise, but we don't want to put him in a school/therapy environment if this disrupts his ability to attach.

In terms of attachment, though, we are QUITE attached to him!

He had a haircut.  We chose to do it at home, because we feared he would be VERY  unhappy.  We were right!

Poor little guy!  The saddest we've seen him, except for his blood test :(

He's just so precious to us.  Thank for everyone who prayed for him and for us and continues to follow our story.  Redemption is beautiful.

One month home.

If you're still reading our blog, it's certainly not to follow our adoption process, because that is over!  It must be because you're interested in seeing how our little boy is doing and how our family is adjusting.

Joshua has been home just over a month (I'm late by a few days).  Obviously, coming home during the holiday season can be stressful for any family, and so we haven't scheduled all of the doctor and therapy appointments we might have otherwise.

Physically, Joshua has gained at least a pound since being in our care.  This was after he gained more than seven pounds since we received his original medical information in February.  And this is because of the care he received from his Baba and the improving conditions in Pleven.  (Note I said improving, not improved.  It is an evolving process).  In fact, he is (barely) on the growth chart now!  His diaper rash, which was the worst I've seen, improved within days of him being home with us from being changed regularly and using high quality diaper rash cream. I saw what they used in Pleven.  It is not their fault, but when the diaper rash cream streams out of the tube much like white colored water, chances are it won't be a terribly effective barrier cream.  I also know his Baba changed him more frequently, but when diapers are at a premium and there are so many children, it is obvious why they wait in dirty diapers so long.

Joshua eats.  Oh, how he eats.  We feed him generally 4-5 times per day.  He doesn't request to be fed, but when he sees me beginning to prepare a meal, he gets very excited. It is hard to keep him safe around hot food when he is constantly at my feet, doing what we call the 'food hum'.  Since he's non-verbal, he sometimes hums (or mimics the intonation of what we are saying).  The 'food hum' is one I only hear when I am preparing a meal for him, a rhythmic, three beat hum.  We are teaching him the sign for "eat".

His diet is still very limited.  We have experimented with foods and have had mixed results.  Josh appears to chew, though not effectively.  He knows how to use a spoon, but is so messy with it that sometimes I have to discourage him from feeding himself.  We've had great success with a mixture of mashed potatoes and crushed up sweet potatoes.  He eats this often and really loves it.  Puddings, fortified with additional calories, are also good.  We've modified soups to be more like what we had in the orphanage, using broths and small noodles and breaking up 2 pieces of whole wheat bread into the broth.  He has no taste for vegetables.  He enjoys overcooked spaghetti noodles in mild red sauces and applesauce with rice cereal.  Yesterday we tried baked beans.  He ate, though not in the quantities he normally does, and then refused the remaining half of the bowl.  He recently tried oven baked potatoes that were soft and seemed to enjoy a few of these as well.  He is eating oatmeal in the mornings, with additional calories added.

Drinking is problematic.  He cannot drink independently and seems to want nothing other than water, and not much water at that.  We try to include applesauce and broths to boost his liquid intake.  He has gone through brief bouts of constipation because of this.

Our visit with the doctors about his eyes was incredibly encouraging.  The reports from Bulgaria were simply inaccurate in many ways.  The risk of his vision being dramatically decreased is gone; in fact, his eyes have been declared structurally correct.  This is in contrast to his medical information, which suggested a pale colored optic nerve, indicative of serious vision impairment.  Instead, his optic nerve is pink and healthy.  He does have strabismus and, though the doctors in Bulgaria didn't believe he had nystagamus, he does.  I suspected this too.  Beyond that, he is very healthy.  We have neurology appointments in a week to determine if there are underlying issues related to his external hydrocephalus.

Behavior-wise, he is exactly what we expected.  Mischievous!!  He knows right from wrong in many cases, as evidenced by the smile he gives us when he tell him 'no'.  It's a different smile from the genuine smile we receive when we come into his room in the morning.  He has learned the gentle concept of "time out", which for him is not the same as it is for our daughter.  We do not leave him or sequester him to a part of the house.  Instead, we sit him in the room with us and explain in very simple, repetitive terms.  "No.  No touch.  No.  No throw."  Over and over we use these words and we can tell he is comprehending them.  When told "No throw" he will often put a toy down.  He is also very friendly and loving.  He enjoys being held and rocked.

Verbally, he is non-verbal.  He mimics the intonation of many things we say.  He was non verbal in Bulgaria too.  However ,he has learned the signs for "more" and "help" and we are working on "eat" and "drink" and "me".  He uses the sign "more" very often when bringing us toys or things he wants.  He still reverts to the 'easier' behavior of crying or dragging someone to an object he wants, but he's making good progress.

An interesting thing is how he reacts when Jon comes home and greets me.  If Jon and I embrace in the kitchen and he sees that, he will run from wherever he is and scream and hit us.  He is sometimes quieted when we pick him up and embrace all together.  For a period of time, even this didn't help.  He was very attached to Jon and if I even patted Jon on the arm, he would get very angry.  Some of this is dissipating.  Generally, when we embrace and he gets upset, we pick him up and put him between us, give him kisses and hugs and then Jon and I will kiss each other or hug each other while he is with us.  We like to show him that we all have love for each other, and just because Daddy and I love each other doesn't mean that we don't love him too.  Interestingly he doesn't seem to care if we kiss, hug, or hold Chelsea. It's only the adults (primary caregivers!).

He is able to sleep in his own bed now.  Co-sleeping did not work for us.  Our bed was too small and after a nasty spill, we realized it was just not possible.  Thankfully, he was able to transition to his own bed easily.  He still does not make much noise when he wakes; a sad reminder of his institutional stay.  But he has begun to "bang" a little bit on his crib to alert us.  Of course, we come as soon as possible so he knows that when he cries out, we will be there for him.

He smiles and blows kisses.  He seems to know when we are with him and looks for us, though he will just as easily go with others at this point.  This gives him the impression that he is friendly (and he certainly is!) but also that he does not yet truly "prefer" us and know that we are his Mommy and Daddy, provider of all of his needs.  His eye contact is poor and we have concerns (which we had in Bulgaria also) that he may end up with a diagnosis of autism.  However, he demonstrates some very good skills that give us hope.

Love is not enough in adoption.  It is not enough to love a child when you adopt them.  LOVE IS NOT ENOUGH!  No, children don't "just need love".  They need stability, commitment, resources, and many other things.  PATIENCE, oh dear heavens, patience!  But it is doable and worth it.  He is definitely worth it and overall, after exiting his orphanage just over a month ago, doing as well as anyone would hope.