NBC4 Washington reporter Chris Gordon (and videographer Lance Ing) helped us share our experience having Max attend the Bender JCC preschool via telepresence robot.

One of our favorite parts of the story:

You can read the full story at NBC's website: Robot Allows Maryland Boy With Degenerative Disease to Attend School, Connect With Classmates.

Check it out! Max and a friend are on the cover of the March 2017 edition of Center Scene (the magazine of the Bender JCC of Greater Washington). The cover story describes how Max is attending the Bender JCC preschool via Beam telepresence robot.

​Our gratitude to the JCC and everyone involved for helping us share this cool story more widely with the people in our neighborhood.
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A BEAM of Light at the Bender Early Childhood Center
by Andrea Kronzek

​“It’s fun to have Max in our class. I like that Max doesn’t bump into too many kids with his robot. The robot helps him learn with his friends at school.” —Sahil, Max’s classmate

Meet Max, a 3-year-old student at the Bender Early Childhood Center. Max has spinal muscular atrophy (SMA), a motor neuron disease which leads to degeneration of the muscles that help the body to move. Because Max’s mind and sensory nervous system are unaffected, he thinks like a typical child his age.

Kristen and Yahnatan Lasko, Max’s parents, knew that in order to help their bright, differently-abled little boy reach his full potential, they needed to find a welcoming preschool community with teachers and staff who were willing to step into unfamiliar territory. They approached the Bender JCC preschool to discuss enrolling Max.

“The administration was willing to join us on the journey and quickly set about making this a reality,” says Yahnatan.

Because respiratory infections pose a significant risk to children with neuromuscular weakness, Kristen and Yahnatan proposed a telepresence robot as the best idea for how to get Max safely into the classroom. Thanks to cutting-edge technology, Max now attends preschool at the Bender JCC via BEAM, a telepresence robot. Max’s BEAM is his daily “avatar” in the classroom; through it, he learns and interacts with the class.

“Max’s teachers, Allyson and Victoriya, prepared the class to explore what it meant to welcome someone new,” Kristen explains. “Max quickly became a beloved member of the class.”

Every day for up to two hours, Max “BEAMs” into class. He loves art, music, chasing friends (and being chased), and talking with his friends.

“We talk with Max about what he is learning in school and marvel at how the interests of the class influence what he chooses to explore at home,” Kristen remarks.

“Having Max join our class through his BEAM robot has been an incredible experience,” says Allyson Levine, Max’s teacher. “The relationship that has formed, and continues to deepen every day between Max and the other children, is inspiring. The children went from being extremely excited about having a robot in our class to simply being excited to have Max in our class. It’s as if they don’t even see the robot anymore. They are all constantly finding new ways to connect with him.”

To his classmates, Max is a good friend who has much to contribute. Eli loves being Max’s classmate. “Max helps us learn about him and his robot. I never want to take my eyes off his robot because it’s so interesting.”
Eli’s mom Elizabeth says that it’s great that we have this technology to allow kids to interact and be exposed to children with differences. “I think it’s a fantastic opportunity to meet a child they might not have otherwise met.”

Kristen and Yahnatan say they are extremely grateful that the Bender JCC Preschool has welcomed Max, helping him to learn and grow. “The Bender JCC Preschool surpassed our best hopes.”

By the same token, the Bender JCC is grateful to the Lasko family for choosing our preschool and meaningfully enriching the lives of our students, teachers and all who come in contact with Max.

A local news story on the FDA approval of Spinraza, the first treatment for spinal muscular atrophy, features Max. Here are a few quotes:

• [SMA] attacks motor neurons, so things like coughing and holding your head up, Max Lasko can't do. ... But, the Laskos like to focus on what Max can do, like play music, communicate through an emphasis on syllables or movement of the eyes, and bring joy to people.
  
  
• The FDA approved Spinraza months before the go-ahead was expected, but for the Laskos, who provide Max with round-the-clock care, this is a long-awaited moment. "When we got the news, I looked at my wife and saw tears rolling down her cheeks,” said Jonathan Lasko, Montgomery County resident. “...it will take time to see how it helps and to what degree it helps him and many others, but we're hopeful, we're very hopeful."

Click here to watch the full video:

Max is the face of SMA research at Towson! We are very pleased to have participated with Towson University's SMA Tiger Research Team in 2016 and are looking forward to new breakthroughs in 2017!

Click the image below to learn more about SMA Research at Towson and or make a gift of financial support.

We're FINALLY ready to show off Max's amazing new powerchair!

The Permobil K450 is not the chair we thought Max was getting...it's even better! Here's how it happened.

Summer 2015: Max's 2nd birthday. We reached out to friends and family to help us get Max a power wheelchair which would enable him to drive himself. At the time, we had completely spec'ed out an order for a Permobil M300 (midwheel drive). We thought the paperwork was all submitted, but to our great surprise, it turned out we still needed a few more signatures before applying to insurance. One of those signatures was from Max's physical medicine doctor, who surprised us further when she said that she wasn't ready to sign off on it yet. She had two concerns: (1) that insurance would deny because Max was too young to safely operate a powerchair and (2) that Max would be better off with a different model than the one we were applying for.

Disappointed, we set about gathering more evidence to respond to issue #1. We had already done several trials where therapists came to our home with a special motorized platform that Max could "drive" while secured in his custom seat. It took a lot of coordination to schedule these appointments, and Max didn't really have a way to practice beforehand. We found that the video clips from these trials might be less than convincing to someone worried about safety. Furthermore, it takes a lot of learning to find a control method that works. We were worried that Max might be unfairly penalized for poor performance due to controls that weren't well-suited to his abilities (e.g. joysticks, whereas Max does better with a switch) or age-level (imagine a single switch with a complex timing synchronization requirement, like "when the arrow on the screen points right, click the switch to go right").

We set about trying to build something that would let Max practice at home. A month later, we had a prototype for controlling a power wheelchair: two switches to go three directions (right to go right, left to go left, both at the same time to go forward).

Just as we started working on an idea for adding motors to the indoor base of Max's adaptive seat, we were contacted by Lollipop Kids Foundation with some amazing news: they had a power wheelchair in their equipment closet (a Permobil C300) which would be perfect for Max!* This began a few more months of investment: replacing batteries, experimenting with various controls and head supports (some borrowed, some purchased out-of-pocket), getting the wheelchair properly adjusted just right for Max, and getting Max accommodated to using it. By the beginning of 2016, we actually had Max driving himself around our first floor in that powerchair.*

Max's physical medicine doctor was very pleased with the evidence we had generated for Max being able to safely operate a power wheelchair. But she urged us to take a look at a different model, the Permobil K450, because its unique design allowed the chair to lower all the way to the floor, and she felt this would be best for him developmentally. At first, we were skeptical. To support this lowering-to-floor feature, the K450 is a rear-wheel drive, which makes it harder to anticipate turns properly and challenging to get in and out of tight spots. Wasn't Max being able to drive himself easily more important that being able to lower himself to the floor?

We started asking around the SMA community. At first, it seemed that very few kids with a diagnosis of SMA type 1 were being recommended to get a Permobil K450. This increased our skepticism. Finally we found one family whose daughter had a K450. Their glowing review of the chair really helped to change our viewpoint. We decided to see for ourselves and scheduled the equipment company bring the chair out to our home to try it in various positions.

While the K450 was 2" wider than the C300, it still fit in our van the way Max's stroller did. However, there was no doubt that we would need to put a second door into Max's room (something we had already talked about) to get the chair in and out.  Also, the handrail on the back of the K450 appeared to be an ideal mounting point for Max's many machines (something that had been a real challenge with the C300 and would not be any different with the M300).  We decided to go for it. And so we spent the rest of spring and summer of redoing paperwork, sending emails, waiting, garnering more doctors' signatures, and even more waiting...

On September 15, we got the amazing news (via a letter from our health insurance) that Max's powerchair had been pre-authorized for purchase. The order was placed, and delivery was scheduled for mid-October.

The chair was delivered pre-adjusted for Max. However, there were still plenty of tweaks that needed to be made. The biggest task by far, though, was fitting all of Max's machines onto the chair. Amazingly, it only took one late night -- plus a few therapist and technician followups to "tighten up the screws" -- to get all the machines mounted onto the chair in a way that was fit for travel and convenient for caregivers. (This was no doubt due to the many lessons learned and accessories acquired for Max's Zippie Voyage stroller, his Permobil C300, and his "dune buggy" beach wagon!)

It's hard to put into words how amazing our first outing with the Permobil K450 was. We took Max to the birthday party of one of his friends. At previous birthday parties, we tended to pick a spot where Max could see all the action and settle there (because his stroller was heavy to push around and also kept him high off the ground). This time was different. With just a tap of the joystick, we were able to move Max right up into the action. It felt so empowering to us as parents to be able to lower him down to the same level as his friends. He sat next to the kids picnic table while they all ate brunch, and then he rode over to the sandbox where some other friends were playing.

At the end of the party, the kids ran to play in a pile of leaves. "Do you want to play in the leaves?" we asked Max. When he indicated yes excitedly, we drove his K450 straight for the leaf pile. One of the kids threw some leaves at Max, and he loved it, so then all his friends started throwing leaves up in the air around Max, while he just laughed and laughed. When we finally had to go, Max cried; he didn't want the fun to end. Later that day, he couldn't stop talking about playing with his friends in the leaves and his new chair.

Thank you so much to everyone who pitched in to help us make this possible to Max. Major thanks to Max's therapists who made numerous visits to ensure that everything was the way it needed to be. And a heartfelt thanks to the team at NuMotion, whose dedication to doing everything necessary to get Max his chair (and patience with our weekly email ping, much like a parent listening to their child ask over and over: "Are we there yet?") all came out justified when the chair was approved by our insurance on the first try.

To other families of children with special needs working their way through the arduous process of ordering and getting insurance approval for a power wheelchair: we hope our story is helpful. If you have any questions, please don't hesitate to contact us through this website. We especially want caregivers of trached and vented kids with degenerative neuromuscular diagnoses to know that the K450 can be an ideal platform for "on the go" living when your child's life includes an array of medical machines.

But don't take our word for it. Without further ado, here is the final product: Max's Permobil K450, "fully loaded."

Coming in 2017: Max driving his powerchair himself!

Bonus: we got the K450 just in time to incorporate it (and its movable tray) into Max's Halloween costume. Presenting...the Amazing Max-stro!
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We've had some amazing nurses over the last two years. Unfortunately, we've suddenly found ourselves desperately short on nursing coverage. Our nursing agency, APNT, Inc, is working night and day to locate some new nurses in the MD/DC/VA area to work Max's case. However, we decided to add our own personal touch in hopes that we might locate some great new nurses through Max's social network!

MAX IS LOOKING FOR an LPN or RN to handle the following kinds of Max-specific duties:

• Familiar with caring for patient on pulse ox and vent (Trilogy 100)
• Can detect when Max needs a cough, effectively administer assistance using Cough Assist T70, and suction trach by oneself with proper timing and suction depth (night nurses: in low light setting). (Will train!)
• Administer respiratory treatments, g-tube feeds, medications
• Can do an emergency trach change
• Likes using the latest technology (eyegaze communication, assistive tech, therapeutic approaches, etc)
• Prior pediatric experience a plus!

These videos shows a sampling of Max's daily activities:

​Check it out -- Max's new home automation setup was featured on the Samsung SmartThings blog!

** Many thanks to the MAC Foundation for paying for the monitor at Max's new nurse charting station (shown in the above picture and the linked video).

Every birthday is a gift for a child with SMA. The second birthday, however, is uniquely significant.

When parents first hear the news of their child's SMA diagnosis, doctors often cite this devastatic statistic: "Most children with SMA type 1 don't live past the age of two. " Thanks to breakthroughs in treatment for newborns with SMA, this tide is beginning to turn. Nevertheless, no SMA family takes a 2nd birthday for granted.

For Max's second birthday (on August 1), we have the opportunity to give him two amazing gifts:

• a power wheelchair, which will give him a new level of independent mobility at home and outside the house, and
• an eyegaze device, which will enable him to communicate with others at a level appropriate to his above average cognitive abilities.
  

Max's condition prevents him from sitting up independently, much less moving from place to place. A power wheelchair will can change that by supporting Max in comfortable positions while enabling him to choose where he wants to go, steering by means of an adaptive joystick or switch.

SMA has also had a profoundly disabling effect on Max's ability to speak, as muscle weakness in his jaw prevents him from being able to close his lips to form consonant sounds. In spite of this, Max is highly expressive, and his speech therapists tell us that he is extremely bright. Each day he chatters away, and while it is easy to understand him when he is repeating words, phrases and sentences back to you, his attempts to speak longer phrases or sentences lead quickly to elaborate yes/no guessing games. An eyegaze device will allow Max to speak his mind, thoughts, and wishes in his own voice to his friends, family, teachers, and caregivers.

While the expense for these two devices is considerable, for Max they are probably the two most important devices for empowerment and maturity for the rest of his life. For individuals with Max's diagnosis who live into their teens and 20s, power wheelchairs and alternative assistive communication (AAC) devices become the primary means through which they interact with the world.

Will you join with us in celebrating Max's two years of life by contributing $2, $22, or $222 to help us buy Max a power wheelchair and eyegaze device?

For details and to donate, click here: 

            http://www.youcaring.com/maxs2ndbirthday

Here is a video showing how a Permobil power wheelchair gives one of Max's friends, Nora, the gift of independent mobility: https://youtu.be/in-JqkiVPXo

To see Max using a (loaner) eyegaze device: https://youtu.be/GM-utcIsE7k

Last year we shared how Max's cousin Joel was raising awareness and support for families affected by spinal muscular atrophy (SMA). This year, with the help of his mom (Max's great aunt), Joel got his entire school in on the act!


Moved by Max's story, Columbia Academy's eighth grade class selected SMA support and awareness as their year-long legacy project. Activities included:

• A school assembly where teachers bid on 8th graders to do their bidding for a day to benefit SMA, raising over $200.
• For the middle school dance, $1 from each ticket sale was donated towards SMA support.
• A Family Bingo Night (sponsored by CA's PTSO), which raised over $2000 for an SMA-related charity!

We put together this video to thank Columbia Academy for all their efforts this year to help people with SMA.