It's been a few days, so I suppose I should update.
Friday Sarah was absolutely horrible at the clinic. She didn't want to do anything they asked. If I had to guess, I'd say it was because the first "non-preferred" food they gave her was baby oatmeal mixed with regular oatmeal. Even the therapist feeding her said it looked and smelled awful and she wasn't going to push something that disgusting. I'm guessing it set her mood for the day, but who knows?
I met with the psychologist shortly after the feeding, and we went over some things to do at home. For one, we need to establish clear consequences for misbehaving. We have to work on "time out" so she knows when she misbehaves, that's what she's doing. That way, when we have the baby, she'll learn quickly that you can't hit the baby, kick the baby, etc. They use time out in the playroom (she got one today for hitting one of the playroom ladies), so that should make it easier for her to understand. The psychologist said as far as the fear of animals goes, it's a phase. If we ignore her complaints and show her we're not bothered by the animals, she should get over it pretty soon.
We had a busy weekend. Saturday morning we went out to breakfast where I'm pleased to report that Sarah even ate her diced pears in oatmeal at the restaurant. I'm glad that's not something she is restricting to the clinic and home only. That afternoon, we went to a birthday party. The moms there brought vanilla pudding, just for her. I thought that was sweet. The party was at a movie theater and we saw "Bee Movie." It was cute, and Sarah was pretty well-behaved.
Saturday night we went out to dinner with Rob's dad and my parents because it was Grandpa's (Rob's dad's) birthday! Sarah was pretty good at that restaurant as well. We hung out at our house for a bit afterwards, and Sarah had a good time seeing her grandparents.
Sunday was low-key. She ate almost an entire ounce of diced pears in her oatmeal that morning! We were very proud.
Monday started her fourth week at the clinic. I only watched breakfast because I had errands to run, mostly for her birthday party. She did great at breakfast. She ate a fair amount of diced pears in her oatmeal, a few bites of "chunky" pears (meaning not quite pureed to baby food consistency), her usual yogurt, and she even licked syrup off a french toast stick.
Today I only saw breakfast, taking the day to relax at home. She didn't behave as well as yesterday, but she did okay. She seemed to really enjoy putting Cheerios back in a bowl, but didn't really want to "kiss" them or lick the crumbs.
She's gotten too smart lately for what they're doing with the behavior modification. She's figured out that the video is coming back, and she's not terribly bothered when the video is taken away. So, the psychologist and OT and I talked and the psychologist came up with three ways to get her motivated again.
First - easiest - Take the video away longer. Right now it's off for 15 seconds or so. They're going to increase it to 30 seconds. We'll see what happens with that. I doubt that will have much effect, but we'll see.
Second - middle ground - Take the video away when she doesn't listen. She has to "earn" back the video by doing something with a non-preferred food. They can cut back on what they're asking, but she has to do something. For example, if she won't lick the crumbs of a graham cracker, the video goes off and she has to "kiss" the graham cracker. If she won't "kiss" the graham cracker, the video goes off and she has to touch the graham cracker. If I had to guess, I'd say that will be what works.
Third - possibly too harsh - Limit preferred foods. She can have five bites of a preferred food, and then no more until she does something with the non-preferred food. Both the OT and I think Sarah will likely decide she'd rather go hungry.
Anyway, so that's where we are.