triennial review

That's what the school district calls it. The every-three-year battery of evaluations and assessments and testing that every kid with an IEP has to endure. Jacob's been going through his triennial review for the past two months. I spread things out as much as I could to make it easier on him, but quite honestly, he loved the testing -- he loved spending time with the teachers/professionals, he loved having a captive audience for his anecdotes, he loved getting to "work" (the boy is a work hound), he loved being the center of attention. He had absolutely NO idea why all this was happening, in typical Jacob fashion it never occured to him to ask, but he was having fun playing the "games". And he got to see some old friends from his Pre-K days. What's not to like?

Most of the testing I was not allowed to be present for. He had several days of assessments with the Speech and Language Pathologist. He had several days of testing with the Special Education teacher, which I WAS allowed to be present at (and which I thought, in watching the testing, would have resulted in more useful information than it did). He had two days of evaluations with the School Psychologist. The Occupational Therapist chose not to see him, instead evaluating him based on a sensory questionairre we filled out. (The truly amusing part about that is that OT is where Jacob's greatest challenges still lie, and where the most work still needs to be done.) We filled out forms for the school nurse and the social worker too. As well as a half dozen or so forms for the school psychologist.

While we were going through the testing, I was really OK with it. Mostly because Jacob was OK with it. And I thought perhaps we'd get some useful information or helpful insight from it, that might assist in our homeschooling efforts.

Then yesterday, the reports from the 3 folks who did the testing came in the mail, for our review in advance of our April 2 IEP meeting.

And that's when I realized that this whole thing was a colossal waste of time.

The report from the Special Education teacher stated the obvious -- that he had met or exceeded all of his Kindergarten Benchmarks, and that he has deficits in verbal comprehension and conceptual writing. (Which, by the way, completely blew my mind at the time they administered these tests -- the child hasn't even offically learned how to write, and can't even really hold a writing implement comfortably, and yet still they gave him written exams and asked him to write essays. HUH???) The report went into great detail on his specific problems with writing -- but given that he has not yet learned to write, I should hope that point was OBVIOUS? What the report didn't say was that Jacob did his darndest to do the silly writing assignments -- in fact, he completely blew my mind with what he actually was able to do out of sheer willpower and persistance. I think they oughta award the kid some sort of medal.

Her helpful IEP advice is to include pencil grips, and to work on his areas of weakness. Gee, thanks, I would have never thought of that on my own.

The report from the Speech and Language Pathologist was unbelievable. I mean that litarally, I find it hard to believe. I don't care what the testing says, Jacob is NOT at an average level for his age with regards to language usage. I've conversed with other 6 year olds, none of whom their parents claim to be child geniuses, and their use of the English language is fluid and understandable. They didn't use sentences such as "I went to go, but I had, and then done". Even I, his mother, have no idea what that means. Maybe the SLP is clairvoyant? True, he's made AMAZING progress since that particular SLP last worked with him. But average level for his age?? No. Average level for his development? (Which is around 3 years according to our RDI stages.) Yeah, I'd buy that. Her reccomendation for his IEP? Social skills group. Yipee.

Then there is the report from the School Psychologist, which is an award-winning work of fiction. I was astounded in reading through the report, not only wondering what kid she had been evaluating, but also who was impersonating me and saying such outlandish things as "Mrs Moon feels that Jacob will benefit from another year at home, after which he will be ready to return to school at the 2nd Grade level." HUH???? I thought I'd made it perfectly clear to pretty much everyone that we were going to homeschool indefinitely. I certainly never said anything about Grade 2. In fact, even if the world ended (which is what it would take for us to re-enroll him), we would insist that he start at the FIRST grade level, which is where I anticpate he'll be in another year or two.

She's new. Brand new. Jacob was her first evaluation in this school district, and perhaps, dare I say, ever. I'm guessing she's brand spankin' out of college. And obviously trying to make a good impression.

Amongst the more amazing of her proclamations, she said that she asked Jacob the question "What would you like to change about yourself?" and that he answered "My mind....the way I think." Ok, first of all, there's no way Jacob would understand that question at this point. He can't even answer a question like "Where would you like to go today?" yet -- too conceptually based, he needs more concrete definitions in his questions, like "Do you want to go to the playground or to Grandma's house?" Besides "what would you like to change about yourself?" being too open-ended for him to answer, I sincerely doubt he's considered that it's possible to change himself. Or desirable. In fact, I'm willing to bet pretty good money that he wouldn't know how to answer "What do you like about yourself?" at all. That whole "about yourself" thing is just not a concept he's got a grasp on yet. Second, "my mind"???? I truly doubt Jacob has ever even heard the word "mind" used in this context, so for him to pull that out of thin air is less likely than me winning the next powerball lottery. He certainly doesn't know that it means the way he thinks. In fact, "the way I think" is another one of those concepts that he's not got a grasp on yet.

The Map Man was a little more generous than me when reading that. He looked shocked, then said "was she feeding him answers?" Personally, I think she was just making the whole thing up.

What was obvious in her report was that she's done her homework about Autism. She neatly stated after odd test results that "although this is unusual for a child his age, it is not uncommon for children with Autism to have deficits in this area".

She did present some facts -- IQ tests (an amazing array of varieties), CARS (childhood autism rating scale), and other standard tools of the trade. His IQ scores ranged from Average (for Verbal IQ) to Superior (for Performance IQ) with overall score falling in the High Average range (no sticking her neck out there), and her results from CARS suggests mild to moderate Autism (gee, wasn't that his original diagnosis 3 years ago???) Interesting thing about CARS -- he scored in the "slightly atypical" category for all but 2 items, and both of those items were sensory related so he scored "extremely atypical" for those, dragging down his overall rating. I never did think that was a good measure of Autism (he tested as "severely autistic" the first time he took the test 3 years ago, we all laughed heartily). She did claim that he would be considered "high functioning" (she used the quotes and everything).

Of course, I didn't believe any of it. After the "What would you change about yourself question" I stopped trusting anything written in that report.

The reccommendations sections of that report is impressive. Modified inclussion classroom environment, preferential seating, private study areas, awareness of potential lighting and sound distractions, sensory diet, individualized help as needed, visual schedules, etc etc etc. It read like a textbook checklist from an article that would be entitled "How to Design a Classroom to Facilitate Inclussion of a Child on the Autism Spectrum". They were actually WONDERFUL suggestions. If we were putting Jacob back in school, I'd definitely want her in our corner. I do, however, think she's going to get laughed out of the IEP meeting by the rest of the professionals who profess that Jacob is "at age level" and ready to be thrown into the mainstream with the rest of the fish.

Should be a fun IEP meeting. Or not.

where the rubber meets the road

(A photo of my living room this morning -- Sensory Integration Therapy is a great excuse for making a huge mess!)

I'm here to report on the status of our RDI program. Our consultant has been helping us sift through the new Stage objectives so that we can figure out where we're at.

First, I have to say how massively impressed I am with these new objectives! Not only are they extremely specific, but they are amazingly geared towards the development of dynamic thinking, which, although RDI always purported itself as encouraging that, is the first time I've seen it laid out in such a logical, usable format. This is truly a dynamic processing model rather than just an Autism Remediation program. I'm going to get a lot of mileage out of these objectives with Zoo Boy, who is most certainly not Autistic, as well. Never has it been more true that RDI=homeschooling!

I've been biting my nails worrying that we were done with RDI stage work. That there was nothing left for RDI to offer us. Because, although Jacob has made amazing progress, and I truly don't think anyone is going to consider him Autistic anymore, I can still see major gaps in his dynamic processing ability. It's as though he has the ability to think that way now, but still lacks the drive to take it out for a spin and use it. I felt there was a lot more work to be done, but was fretting that RDI wouldn't be the best way to accomplish it.

I fear that no longer! These new objectives are chock full specific ways to get that dynamic intelligence revved up and rolling.

There are now 12 child stages (as opposed to 28 in the "old" version), in addition to parent stages which are seperate from the child stages, and really give parents a great education on child development and Autism, in addition to getting them quite prepared for designing and implementing their child's RDI program.

We started by looking at new Stages 1 and 2, which incorporates bits and pieces of things right up through the higher stages -- I recognized things that I worked on in the old stages 6 and 7 right off the bat, and saw things that, although Jacob has developed them on his own, I hadn't seen anywhere else in the stage work. By the time a family emerges from the new Stage 2, they are going to be well on their way to Autism Remediation.

I did, in fact, find an objective that I'm not sure Jacob has mastered in the new Stage 2. Not surprisingly, once we started looking at the new Stage 3, there were two objectives that built on that one that I also put question marks next to. This is where we're going to "begin" with our new RDI work, on this apparent "hole". The objectives have to do with Perceptions and understanding that other people see/percieve things differently than you do. Sound familiar? That's the old Theory of Mind thing, that I've always felt Jacob has been lacking. Now there's a structured way for us to work on giving him the opportunities to make this "discovery". I'm one happy camper!

By the time we got to looking at the new Stage 4, I knew that we didn't need to go any further. I've got question marks next to about a dozen objectives and "p"s (for "needs practice") next to at least a dozen more, in addition to the couple of dozen I have checked off as mastered. So that's where we're at! Stage 4 reflects the abilities of a neurotypical 2-3 year old, so we're still a bit behind where I'd like to be, but all of the stuff we're "missing" are things that just weren't addressed by the "old" RDI system, at least not during the first dozen or so stages. The things that were addressed are the items I've checked off. And the "needs practice" items are things that were not addressed, but that he just happened to develop naturally.

I'm SOOO excited that this new version has come out just in time for us, and I'm thrilled to have a definite direction to be working in! I have more confidence than ever that RDI is going to help us unlock all of Jacob's potential and open a world of opportunity for him. The sky's the limit!

appraising appraisal

Here's a photo of my "hula boy" that I'm pretty sure Jacob will be incensed about me posting at some point in the future....

Today I got a good glimpse as to where we're at with Jacob's appraisal at this point, so I wanted to talk about it a bit. I've talked about Jacob's problems with appraisal and how we're working on it here and here and here and here, amongst other places, in the past. It's been a real weak area for him, and we've done a whole lot of modeling and letting him borrow OUR appraisal. It looks like it's finally paying off, though, as the following interaction depicts:

Jacob's OT had set up a bowling game today that allowed me to see where he's at with his appraisal. There were several sizes of heavy balls available for him to roll down a ramp and try to hit 3 "pins" (soda bottles filled with water) set up at the bottom. He adjusted his position so that he was in the right spot to hit the center pin, then picked up a ball and let it go down the ramp. As he was picking up the ball, his OT commented "Oh, you picked the orange ball." He said "Yeah, I picked it because it's the heaviest one". (Great appraisal!!) After knocking down the center pin, he picked up another ball and let it go down the center of the ramp again. Of course, it missed the pins on either side of it. But before the OT had a chance to prompt him to think about what he needed to do to hit one of the side pins, he'd already adjusted his position (more appraisal!) so that the next ball rolled directly at one of the pins and knocked it down. He seemlessly shifted his position to optimize his next roll to knock down the third pin. He made a discovery about how his appraisal and choices affected the outcome, and adjusted as neccessary.

He's certainly made a lot of progress in the appraisal department! Which explains why he's making choices very easily now, and can tell us his reason for making those choices. Understanding his own preferences and the cause-and-effect relationship of the choices he makes has allowed it all to come together for him, and has opened up a whole new world of discoveries and learning for him.

Ain't RDI grand???

moving day!

I'm "moving" to my new blog (with an old name ) today. Along the Crooked Path is where I'm going to be writing about our homeschooling, family and farm life in general from now on. Among my person reasons (which I posted there) for wanting to make this move, I also wanted to give Zoo Boy equal billing in our adventures, and it didn't seem right for a family blog to bear the name of just one of the members.

I'll still post here about RDI, Autism and Jacob's remediation program as I find things I want to add, but I wanted to keep this blog pretty much intact for folks interested in reading about RDI, rather than let it get buried beneath years of more general type posts.

I'd like to invite each and every one of you to feel free to read at the new location. Hoping to see old friends and new there!

when does it stop being Autism?

Truly, I've been busy. I've been working my hind end off at my occassional-yet-amazingly-stressful job. But I probably could have found time to blog, if I'd really felt the urge. And I DID feel the urge. Only I wasn't sure what I'd say. I opened up this form more than once in the past week, stared at it a bit, even started a sentence or two, then closed it and went to bed or out to play with the ponies. I just didn't know how to put into writing what was running through my head.

What it boils down to, though, is that I've been pondering the above question. When, in the course of Autism Remediation, does the word "Autism" stop applying to the child?

Jacob's made such amazing progress in the last month -- the last two weeks in particular, that it goes beyond what is possible simply through a remediation program. The only explanation I can think is that natural development has kicked in, and is kicking butt. (Er, well, kicking brain I suppose....) Not only does his (old RDI) Stage 7 stuff look good, but he's suddenly not only co-creating with us (Stage 8), he's also doing HUGE amounts of collaboration (Stage 9). I'm not even sure what's beyond Stage 9 in terms of objectives and goals -- maybe he's doing some of that stuff too. Not only is he holding his own in interactions, but he's planning and carrying out projects, purposely involving us in them, trouble-shooting difficulties for himself and others, problem-solving, making discoveries based on self-designed experiments -- all for the first time ever. His brain has thrown itself into high-gear and there seems to be no stopping it.

The timing is interesting -- RDI is about to launch it's new Operating System and the"new" version of RDI ("5.0") which is a major overhaul of not only the way the stages are set up, but the way the entire program is run. The major goal of consultants and their existing clients right now is to figure out where in the set of new stages (which have been rearranged so as not to even resemble the original stages, and follows closely the various facets of typical development) and objectives (some 1600 of them, or so I hear) they fall. It'll take months. It's confusing, and it's scary for parents who have gotten comfortable with the old stages and where it put them in the scheme of things in regards to stage work.

For me, I'm not even sure where we fall in the old stages anymore. So I'm embracing the release of the new stages, so I can work my way through and see where we're at. Where do I think we're at? I have a strong suspicion that we're pretty much at a place a typical 4 year old would be. Maybe a 5 year old? (Tho I don't know many typical 5 year olds, so am having trouble comparing.) And we're definitely in the process of shifting into cruise control -- Jacob's making some pretty enormous developmental strides with me standing on the side lines waving my hand as he passes.

Coincidentally, just as I was starting to wonder how much longer we would even be needing RDI, I ran into an aquaintance of mine who was doing RDI about a year before I even found out about it. She got to know Jacob "before" (people who have met him since RDI have no way of understanding what he was like before), so she knows exactly how far we've come. We got chatting about RDI, and I found out that she'd dismissed their family from RDI some months ago -- she said that she was so confident in her son's current developmental path, she just didn't need it anymore. Of course, her family still lives an RDI-friendly lifestyle (it's more a parenting style than anything else, and is something that will carry on for the rest of their parenting lives), but she's not done any purposeful stage work in quite some time, and couldn't even tell me what stage her son was at. She then looked over at Jacob, sitting next to her son having a conversation about something that only could interest young boys, and asked me if I'd considered that it was time to move on with him, too. I admitted for the first time to anyone, even myself, that yes, that was exactly what I'd been wondering myself lately.

Does the word Autism still apply to Jacob? Do I even need to be purposely doing RDI anymore?

Some pretty big questions. I'll be spending the next couple of months trying to determine the answers. Stay tuned.

photos of OT/SIT session, part two

This is part two of my photo series on Jacob's OT/SIT session yesterday. Please read part one first.

Jacob is using a springy hammock (which he sometimes gets bouncy rides in) to stabilize himself as he jumps on the rim of the ball pit (which is comprised of truck inner tubes lashed together and filled with balls). He jumps for a certain number of repetitions, then jumps into the ball pit. More proprioceptive work, as well as muscle strength/tone and of course control and coordination of his body movements.




Half way through Jacob's sessions, he is told that he can invite Zoo Boy to join him. He then instructs Zoo Boy on how to do all of the activities he's done (more RDI work!), and he's responsible for making sure Zoo Boy gets any help he needs to accomplish it (even more RDI work!). Here Jacob helps his OT move the air pillow up and down and back and forth for Zoo Boy.




Jacob demonstrating the "sloth position" on the bolster swing. Like a lot of kids with ASD, he has a diagnosis of Hypotonia, which means that he has low muscle tone, and activities like this and many others that we do with him help him to build up his muscle strength and stamina. This sort of activity is something that he has quite a bit of trouble with.



Jacob enjoys using the massage mitten for a little tactile input after all that hard muscle-building work.






Here Jacob is using a blow pen to write his name. He has to blow with enough strength to get the ink to come out. Great "heavy work", and good for increasing airflow and encouraging rib-cage expansion.

photos of OT/SIT session, part one

I'm going to post a series of photos from Jacob's OT/SIT session yesterday, just to give a feel for what happens during his weekly therapy sessions. I'll have to do it in two parts, as blogger is only letting me download 5 photos at a time. I left out the first 15 minutes of the sessions, which involves the Astronaut Board work that I already posted about last week, and a few small-motor activities that I didn't think to photograph.

In this first photo (above) Jacob climbs a "mountain" of mattresses, inner tubes, and other soft structures. This works on balance and integrating his vestibular and proprioceptive systems.


In this photo (to the left), Jacob's OT offers him choices as to what to take into the dark "cave" with him. The choices consist of a rubber chicken, several squishy balls of various textures (some that light up, some that make noise, etc), and a flashlight. This is actually RDI work, choices and appraisal, and shows how nicely this therapist incorporates what I've asked her to despite the fact that she has absolutely no RDI training. Jacob initially chooses a ball that lights up, then changes his mind (once he sees how dark it is inside that cave) and chooses the flashlight instead (working on seeing the consequence of his choices).


Here Jacob enters the "cave", flashlight in hand. The cave is made up of inner tubes and hollow soft climbing structures, and is tight enough that Jacob has to really work to get through it, working on his proprioceptive system as well as his muscle strength and coordination. He later revisits the cave to hide "treasures" (various balls) for other kids in later sessions to find (more RDI work, anticipating other kids coming and how they will be surprised to find the treasures).


The cave exits at the top of this "hill", and Jacob rolls down (proprioceptive and vestibular work). He has to decide to roll the flashlight down first to free up his hands before he starts rolling (RDI planning work).





After rolling down the "hill", Jacob climbs aboard the air pillow and is rocked and bounces at varying speeds by the OT. More vestibular and proprioceptive work.

philosophical question, ala Zoo Boy

Looking down at his empty juice box:

"If a juice box is out of juice, is it still a juice box, or just a box?"

pillow talk and other victories

(To the left, Jacob gets a little drawing assitance from our new pup. I have oodles of stuff to update his art blog with, I'll try to get to that at some point today.)

We're getting close to mastery of RDI Stage 7. I can tell, not just because of the gains I've seen with the Stage 7 material, but also by the shifts and developmental gains in other parts of his life.

For Stage 7 (which includes both Self-Awareness and Caring For Others objectives), a good indicator for me was when the other night, while sitting at the computer looking at some photos I'd taken that day, Jacob suddenly left me when he heard Zoo Boy's cry of frustration from behind us. In a voice loaded with empathy, I heard him say "Oh, do you need some help with that? Here, I'll help you." He helped his brother assemble a piece of a toy, then rejoined me at the computer. I didn't need to spotlight this wonderful Stage 7 moment, Zoo Boy did it for me, with a "Thank you, Jacob!" as he dried his eyes.

But a surer indication to me of approaching mastery has been in Jacob's overall developmental growth in the past week. We're seeing new things, for the first time, on a daily basis.

For months now we've been dealing with a problem with Jacob not making it to the bathroom in time to pee first thing in the morning. He's always loved to lie around in bed after waking for an hour or so, chattering to himself, reciting lines from favorite videos or movies, quoting entire books, poety, singing songs, etc. We've never tried to discourage this -- I've always felt that his time prior to 8am (our official "get up" time) can be spent anyway he chooses to spend it -- the rest of the day is on MY schedule, that part of the day is all his. But as he's gotten older, and his bladder capacity has gotten greater, peeing in the pull-up he wears to bed has become problematic, as they just weren't designed to hold an entire night's worth of a 6 yr old's urine emptied all at once. So there's been lots of leaking, and consistantly I get up in the morning to a naked Jacob huddled under a sheet working on a puzzle. When I ask him WHY he's naked, he just casually mentions "Oh, my pull-up leaked" as if it's a crazy question, OF COURSE he didn't make it to the potty again, get over it Mom. Silly me.

Finally, a couple mornings ago, I decided to have a sit-down chat with him about it. He managed to tell me (via me guessing the right answer) that he's peeing because he wants to stay in bed and talk, etc. I suggested trying to make it to the potty as soon as he wakes up. So for a couple of mornings, I heard him make the mad dash for the bathroom in time, and then he came and told me about his success. Great! Then he crawled into bed with me and Zoo Boy and proceeded to cause enough disruption to wake Zoo Boy more than an hour earlier than he should have been awake. Not so good, it lead to some real over-tired ugliness out of the little dude during the afternoon hours. Last night, I suggested that perhaps he could get up to pee in the potty, and then go back to his OWN bed. "Oh, that's a good idea" he said. Yeah, I'll believe it when I see it, I thought.

But, lo and behold, this morning I heard him make the dash to the bathroom, then call out to me that he couldn't find any pull-ups. Oh yeah, I forgot we were out, I got out of bed to pull a new package out of the closet -- but there weren't any. As I dug around in the closet, Jacob informed me that he was going to go back to bed to go to sleep for awhile more once he got dressed. Good plan, I muttered as I dug through the closet, and came up with a few ancient pull-ups with a long-since discontinued pattern. We laughed at the "new" pull-ups, then I left him to his own devices while I groggily climbed back into bed, fully expecting him to follow close behind, secretly plotting ways to keep the kids occupied in the other room while I snuck in another hour's sleep.

But he shocked me by going to his own room instead. And shortly after I heard his voice. But instead of the usual barage of movie lines and book recitations and songs, the background to which I've become accustomed to drifting back to sleep, I heard this one-sided conversation: "I'm going back to bed, Teddy, do you want to come with me? I have on new pull-ups, look, they have Mickey on them, isn't that funny? There. Are you comfy?"

There would be no more sleeping for me this morning, as I listened to my son cheerfully sharing observations and thoughts with his Teddy Bear, tears running down my cheeks. All I could think was "it's happening, it's really happening!". 5 years of constant early-morning scripting has finally dissappeared. The RDI experts, those parents futher along in this journey than we are, had all told me this day would come, sometime between mastery of Stage 6 and mastery of Stage 8, the day where the scripts dissappeared. Where conversation, dynamic thinking, and true pretend play would replace the memorized rote lines. Are they gone for good? I'm not sure. I'm not even willing to guess. If they show up again, it's fine, because now I've seen that they WILL dissappear eventually. I have all the proof I need in the next bedroom.

for want of a dentist

The following heart-breaking news story, about a boy who died from a tooth abscess that spread to his brain, confirmed my worst fears:

http://www.msnbc.msn.com/id/17372104/wid/11915773/?GT1=9033

which is that the lack of a link between dental health and medical health has some pretty severe consequences.

We have medical insurance. (Such that it is, HMO, better than nothing!) However, we do not have dental insurance. So all of our dental care, both for us and our kids, has to come 100% out of our pockets. Yet, dental offices don't care, they charge us the same inflated fees they charge the insurance companies. (In fact, having seen the way insurance companies work with the professional offices they are paying, I'd bet you even money that the insurance companies are paying LESS than we are.) As a result, we can only afford to care for our teeth when we obviously need to. In other words, when a dental problem gets bad enough to actually be threatening our health, we find a way to get it take care of. (ie, we put it on a credit card and make minimum payments for the rest of our life on it, or beg a loan out of a relative and then make minimum payments to them for the rest of their lives)

Of course, by the time we get to the "medically neccessary" stage, it costs about 10 times as much to take care of it as it would have if we'd just gone to the dentist in the first place. Problem is, it's pretty hard to predict which problems are going to "turn into something", and MOST problems that could have been fixed would have needed to be caught during the "6 month routine visit". And we just can't afford for any of us to go to the dentist for a "routine" visit on any sort of a regular basis.

All of which made me wonder -- what happens to the people in worse shape than us, the ones who can't afford ANY dental care, health-threatening or not? Do they just let their teeth rot out of their heads? Do they die from dental absesses?

Obviously, that question is yes. And it makes me sick. The point they make in the article has to do with access and Medicaid. My bigger concern is wondering WHEN the medical/insurance professions are going to recognize the obvious connection between dental health and medical health, in a tangible form rather than just as a theory. I mean, ask any doctor or dentist, they'll tell you there is a direct link. Yet my medical insurance wouldn't even look at my claim for periodontal disease. I would have had to let the infection spread to my heart and threaten my life (no doubt leaving myself with long-term damage even if I survived the episode) before my medical insurance would touch it, and even then, they'd only treat my heart problems, not my teeth. When Zoo Boy had major dental surgery a couple of years ago (he was born with no enamel on his teeth, and his teeth pretty much rotted right out of his head), our insurance covered his hospital expenses, but all the dental expenses (thousands of dollars) came directly out of our pocket.

And what does this seperation of medical and dental coverage really serve in the end? The boy in the article could have been saved by an $80 extraction and a $20 antibiotic prescription when his tooth abcess first began. Instead, the child has died, and the medical community is stuck with a $250, 000 bill that has no way of ever getting paid. Can no one see how insane this is? Simple math tells us that we could save 2500 children for the same cost to the profession/medicaid/society (whatever!) as was spent to let this one boy die. Even for those not morally horrified that this happened, they should at least be financially horrified.

And that's my soapbox rant for today.