There’s no ruler when it comes to autism. It’s crazy! It’s not one size fits all, shares Stefan. I am happy that people acknowledge autism and are working towards better understanding it.
Christian Rosales was born on October 28, 2016 to parents Stefan and Isabelle Rosales. As Christian neared his first birthday, his parents noticed that he wasn’t responding to his name or making eye contact, and was behind in other milestones, including crawling and speech.
When they went to Christian’s 12-month check-up in the fall of 2017, Christian’s pediatrician recommended he begin Early Intervention Services, including physical therapy, occupational therapy, speech therapy, and developmental intervention to work on his fine motor skills. She also recommended he see a neurologist at Children’s Specialized Hospital (CSH) for a more formal evaluation.
“We brought our concerns to our doctors, and of course they want to hope for the best,” shares Stefan. “But in the back of our minds we always knew that there was something happening. We saw signs including hand flapping, covering ears, and high-pitch screams, etc.”
Both Stefan and Isabelle were familiar with Children’s Specialized Hospital, as Isabelle’s mom, Olivia Encarnacion, was a nurse at the Mountainside and New Brunswick locations for over twenty years, so they felt very comfortable coming in. “We were referred to Dr. Eveline Traeger,” shares Stefan Rosales. “When we met with Dr. Traeger, the first thing we did was have Christian observed, along with having a hearing test to make sure that his hearing was developing and not contributing to his speech delay.”
Along with the speech delay, Christian had also developed food and texture aversions as he neared his second birthday. Isabelle is a licensed speech therapist and during that time began doing all she could to assist with Christian’s feeding.
“Christian was always a good bottle drinker and eater, even showing interest in feeding himself pretty early on,” shares Stefan. “But he came down with a bad cold and he didn’t want to eat any solid foods. Once he recovered from the cold, nothing changed and he was refusing foods and his sippy cups. He was back on pureed food and the only way we could get him to take in liquids was if we spoon-fed him.”
In February 2018, Stefan and Isabelle brought Christian in for a formal Occupational Therapy evaluation at CSH. “He loved using all the 
sensory equipment, including the swing, slide, exercise ball and ball pit. We came up with some sensory and feeding goals and started outpatient therapies a few weeks later,” shares Isabelle. At that point they learned that he demonstrated hypotonia, or low-muscle tone, which contributed to his not crawling or walking.
BEGINNING THERAPY
With Christian’s low muscle tone, he didn’t begin walking until after his second birthday, and when Stefan and Isabelle brought him back for his annual visit on May 13, 2019, they received the official autism diagnosis. “He was going into Pre-K and I knew we needed that diagnosis to get the right services set up for him at school.”
Christian began outpatient occupational therapy with Morgan Buckley at Children’ Specialized Hospital’s Mountainside location.
“I have known Christian and his family for about 3 and a half years now and I’ve had the pleasure of working with them through two episodes of care,” shares Morgan Buckley, Occupational Therapist. “Our main focus during both episodes of care was self-feeding, which he made amazingprogress with. When he came to me the first time, around 15 months old, he wasn’t able to feed himself at all. During our first 5 months together, we got to the point where he was consistently feeding himself with his fingers and picking up his cup. I got the chance to treat him again a few years later, when he was almost 3, and we started working on accepting liquids from a cup and feeding himself with utensils. After about a year, he was able to feed himself with both a fork and a spoon with only a little bit of help. Christian was always so much fun to work with and his sweet smile always made my day!”
“He loves Miss Morgan! His favorite thing about therapy is probably the jungle gym and obstacle courses and of course the swing.” Stefan shares that he and Isabelle bought a similar swing for their basement and have created sensory room and play area for Christian so they can continue with at-home activities to reinforce what he works on in his therapy sessions.
“As busy and hectic as your day may be, it’s extremely important to carryover whatever is worked on during therapy,” shares Isabelle. “Having experience working with kids as a speech therapist, including early intervention services, I stress to parents how important this is. Your child isn’t getting only one hour of therapy for the week, they should be getting it 24 hours a day if there is carryover.”
Christian has made incredible progress during his time in therapy, including meeting his fine motor skills goals, like being able to pick up pegs. He also continues working on his eating and is able to eat more solid foods.
“Isabelle and Stefan are the most amazing supports for him and their dedication to carryover and practice of strategies was key in his progress,” says Morgan. “Their homemade gym in their basement was a godsend during the pandemic and virtual therapy. I give them all of the credit for Christian’s progress. It really is what is done at home that helps the child make the most progress in therapy.”
CONTINUING ON
Today, Christian is four-and-a-half years old with a bright-smile who loves watching Disney movies. “Some of his favorites are SOUL, Frozen, Coco, Moana, and basically anything with music,” says Stefan. “He also enjoys playing soccer, swimming in the pool and splashing at the water.”
Stefan also shares that Christian is doing well socially, and even though he isn’t talking, he can communicate his needs. “He uses the iPad with Proloquo2Go, which is a program that helps him express his wants and needs. He also knows how to show us things; if he wants the channel changed on the TV he comes over to us with the remote or pulls us over to the television to show us. He also wants to interact with other kids, which is great!”
When asked what advice he would have for other families who are embarking on similar journeys or recently received an autism diagnosis, Stefan shares. “It’s not the end of the world. Your child is still your child. There are no directions that come with parenting. I have one child, a son, and he has autism. This is what I know when it comes to raising him. You have to do what’s right for your family, you can’t have back-seat drivers telling you what to do, because they’re not living it. Build your team of support and do what you have to.”
Christian graduated from therapy last year right before the COVID-19 pandemic hit, but Stefan and Isabelle believe he still would benefit from more services and have started that process. “Christian recently had another evaluation for speech therapy and occupational therapy, because he’s not progressing with what’s happening in school,” shares Stefan. “We want to update his IEP (Individualized Educational Plan) because he still hasn’t mastered certain things like drawing and holding scissors, he still demonstrates hand-over-hand.”
Stefan continues to share that his greatest hope for Christian is for him to be able to talk and communicate. At Christian’s most recent annual check-up, Stefan was happy that he demonstrated smiling, responded to his name and was holding eye contact, but would love to hear him talk.
“There’s no ruler when it comes to autism. It’s crazy! It’s not one size fits all,” shares Stefan. “I am happy that people acknowledge autism and are working towards better understanding it. At the end of the day, I want to do everything I can for Christian to set him up for success and I appreciate everyone that’s on this journey with us, especially all the therapists and physicians at CSH. Everyone is just awesome.”