This morning I'm working on a social story for a child who 'knee walks'. She folds her feet behind her, holds them with her hands, and walks on her knees. This might be OK in the ball pit at McDonald's where a frontal wipe-out would be minimized, but on the floor, at home or school or church, could be really dangerous and painful!
Thinking about other dangerous situations that elementary aged children might face, I begin my list with the "Do Not Walk" sign that you'd see at an intersection. This particular child knows that crossing the street when the sign is on is dangerous. Add: looking both ways before crossing the street; riding a bicycle without a helmet; jumping out of the swing at the park; running with untied shoe laces. Coming up with a list that is customized to include activities that commonly occur in the child's life helps to link many potentially unsafe activities into one category ~ what is dangerous.
That will probably be the title of the book ~ Dangerous! The story will start out by saying that Kelly* likes to walk on her knees. It will go on to explain that feet are for walking on, and knees are for bending as part of the walking motion that helps move us forward. The next couple of pages will show what can happen when Kelly walks on her knees. She can fall forward and hit her nose and face on the floor ~ OUCH! She might accidentally fall into someone else and cause them to fall, too ~ double OUCH!. Then I'll add pictures or line drawings of the other dangerous situations specific to this child's routines with simple sentences that tell what's going on and why it's unsafe.
Including several activities that are unsafe in the book on knee walking helps the child create a category related to danger and it adds several dangerous activities to this category. As more, different, unsafe behaviors emerge, parents and/or teachers will be able to draw on the activities already in the danger category to directly connect the known with the unknown. Typical kids most often make these connections with little effort. They're able to process IF/THEN scenarios. But for someone on the spectrum, who can't automatically make the connections, this kind of direct instruction is necessary.
Every time I write a story, I think of Temple Grandin's book Thinking in Pictures and how that title applies to the effectiveness of social stories for children. Thank you, Temple!
Make it a great day.
~ D
* not her real name, of course!
Tuesday, October 30, 2012
Saturday, October 27, 2012
Oblivious!
Well, that's a broad title to give an article about the many facets of autism...oblivious! To typical people, autistics might seem to be oblivious to many things, and sometimes they are, but other times they're just taking in information in ways unfamiliar to us. In fact, I'm still not sure how it happens, but I am sure that it happens differently for each one.
Dylan is like that. He uses his peripheral vision to input visual stimuli. He will not, voluntarily, look you in the eye. When prompted to do so, his body shifts like a crab ~ a bit sideways ~ as he attempts eye to eye contact. This is almost always the case, but not always!
His behavior changes around girls! Doesn't that just figure? And he doesn't discriminate for or against any girls ~ regardless of age or color ~ he likes girls. Whether you're 3 or 33 or 93, if you're a girl, it's likely that at some point, you will draw his attention. It's the same for color: he makes no distinction among girls, whether they're African-American, Asian, Hispanic, caucasian or somewhere in between ~ you're just a girl to him. And he will attempt to look at you eye to eye and to engage you in conversation.
Thus the title of this post: oblivious.
As the responsible adult, I cannot be oblivious to the sometimes obvious discomfort Dylan causes when he talks to little girls. He's over 6' tall, and despite the fact that he makes no distinction based on age, the little girls and their parents very often do. As a result, his behavior though never inappropriate, is troublesome. So, I'm thinking that a new Social Story might be in order.
This time, though, I decided to use real pictures instead of line drawings. I'm no artist. Trying to draw the developmental nuances among really young girls, teenage girls and older women was just beyond my simple line-drawing expertise! I started out with pictures of females who were familiar to Dylan. A friend's 5-year-old daughter, a pre-teen we knew from baseball practice, my friend who's in her late 30's, our neighbor who's in her 50's, and my aunt who's in her 70's. A pretty good range of female subjects to represent different age ranges.
So, I started the story out by saying that Dylan likes to talk to girls. I described the situations in which he might meet girls he wanted to talk to: school, church, baseball, zoo, bus, restaurant, etc. Then the story told him that we talk to different kinds of girls in different ways. I went through the rest of the 'book' using the pictures and descriptions of the different kinds of girls and then how to talk to them. The little girls should always be with their mom and/or dad. The pre-teens might talk back, and they might not. If they did, he was free to talk to them nicely; if they didn't, he needed to understand that they just didn't feel like talking and leave them alone. This went on up through the rest of the 'girls'. At the end of the book, I reminded him that girls at different ages should be talked to in different ways.
He was and still is oblivious to the concept of age. For anybody!!
I tried describing girls by how tall they were. I tried describing them by what grade they were in (this was incorporated as a question he could ask them when initiating the conversation) or where they worked. I used pictures of complete strangers taken from the internet and just taped the new pictures over top of the original pictures in the original book, so Dylan would have a library of pictures for each age range.
But none of this worked! He would still go up to little girls and talk to them like he was their age! When friends came to visit, he sat right next to our friend, Debbie, and fussed over her the whole evening. She's in her 50's! He did the same thing when his grandma came to visit, and she's 85 (though, to be honest, I don't think he knows that she's his grandma because he's only seen her a few times in his life). This is a conundrum.
He still has the Social Stories book, and we look at it every now and then, but I'm convinced that his brain just doesn't register the developmental differences that indicate age. For the time being, I'm using sign language for "NO" along with a head shake when we're out in public and he's walking a fine line with younger girls. I don't want to verbally scold him in front of strangers. He gets upset and does the 'tongue pop' thing, but it is an effective strategy. Having said that, I won't be with him forever, so the problem solving and research continue!
Perseverance.
~ D
Dylan is like that. He uses his peripheral vision to input visual stimuli. He will not, voluntarily, look you in the eye. When prompted to do so, his body shifts like a crab ~ a bit sideways ~ as he attempts eye to eye contact. This is almost always the case, but not always!
His behavior changes around girls! Doesn't that just figure? And he doesn't discriminate for or against any girls ~ regardless of age or color ~ he likes girls. Whether you're 3 or 33 or 93, if you're a girl, it's likely that at some point, you will draw his attention. It's the same for color: he makes no distinction among girls, whether they're African-American, Asian, Hispanic, caucasian or somewhere in between ~ you're just a girl to him. And he will attempt to look at you eye to eye and to engage you in conversation.
Thus the title of this post: oblivious.
As the responsible adult, I cannot be oblivious to the sometimes obvious discomfort Dylan causes when he talks to little girls. He's over 6' tall, and despite the fact that he makes no distinction based on age, the little girls and their parents very often do. As a result, his behavior though never inappropriate, is troublesome. So, I'm thinking that a new Social Story might be in order.
This time, though, I decided to use real pictures instead of line drawings. I'm no artist. Trying to draw the developmental nuances among really young girls, teenage girls and older women was just beyond my simple line-drawing expertise! I started out with pictures of females who were familiar to Dylan. A friend's 5-year-old daughter, a pre-teen we knew from baseball practice, my friend who's in her late 30's, our neighbor who's in her 50's, and my aunt who's in her 70's. A pretty good range of female subjects to represent different age ranges.
So, I started the story out by saying that Dylan likes to talk to girls. I described the situations in which he might meet girls he wanted to talk to: school, church, baseball, zoo, bus, restaurant, etc. Then the story told him that we talk to different kinds of girls in different ways. I went through the rest of the 'book' using the pictures and descriptions of the different kinds of girls and then how to talk to them. The little girls should always be with their mom and/or dad. The pre-teens might talk back, and they might not. If they did, he was free to talk to them nicely; if they didn't, he needed to understand that they just didn't feel like talking and leave them alone. This went on up through the rest of the 'girls'. At the end of the book, I reminded him that girls at different ages should be talked to in different ways.
He was and still is oblivious to the concept of age. For anybody!!
I tried describing girls by how tall they were. I tried describing them by what grade they were in (this was incorporated as a question he could ask them when initiating the conversation) or where they worked. I used pictures of complete strangers taken from the internet and just taped the new pictures over top of the original pictures in the original book, so Dylan would have a library of pictures for each age range.
But none of this worked! He would still go up to little girls and talk to them like he was their age! When friends came to visit, he sat right next to our friend, Debbie, and fussed over her the whole evening. She's in her 50's! He did the same thing when his grandma came to visit, and she's 85 (though, to be honest, I don't think he knows that she's his grandma because he's only seen her a few times in his life). This is a conundrum.
He still has the Social Stories book, and we look at it every now and then, but I'm convinced that his brain just doesn't register the developmental differences that indicate age. For the time being, I'm using sign language for "NO" along with a head shake when we're out in public and he's walking a fine line with younger girls. I don't want to verbally scold him in front of strangers. He gets upset and does the 'tongue pop' thing, but it is an effective strategy. Having said that, I won't be with him forever, so the problem solving and research continue!
Perseverance.
~ D
Hearts and Minds ~ It's How You Use Them That Counts
What do you say to a school bus driver who asks if your 3-year-old child is autistic?
She was smiling when she asked. Nobody else ~ doctors, teachers, therapists ~ had ever suggested autism. He already had a diagnosis, Tuberous Sclerosis. So, that's what I told her. Somewhere in the file cabinet in my brain I filed away 'autism'. That file was the 'elephant in my brain'. I added information to it, but I didn't dare take it out and open it up. I couldn't examine it up close because that would be admitting to myself that I actually thought that bus driver was on to something. And she wasn't the only one.
When Dylan was in second grade, he got to sit in the back of his classroom and draw pictures for most of the day. At that point in time, he perseverated on birthdays. So, he drew many pictures of birthday cakes. Creative, yes; beautiful, YES, but not so academically challenging. Towards the end of the year, we wound up in mediation with the school district. The result was to include preferential seating in his IEP (among other things), so the teacher could be close and keep him on task. This was early April. By the middle of May, he was still sitting in the back of the classroom with the other special education students. WOW!
By now, he was almost seven and still almost non-verbal, though he was pretty good with the sign language we'd learned together. But it was time to pull out that file again, to look at and process everything we'd done with Dylan for the past six years. What worked, what didn't, and where we'd go from here. Now, I had to look at autism. I found SARRC, the Southwest Autism Research and Resource Center and signed up to take a class there. Baby steps. The facilitator just happened to be the classroom aid attached to a couple of the other special education students in Dylan's class. She asked me how in the world I'd dealt with Dylan's autism for all these years without help. Double WOW! I'd just been following his lead and doing what he showed me he needed help with, but now, it really was time to get some professional evaluations to help figure out where we were going.
I knew where we'd come from, and thankfully, over the years, we'd had a few therapists who were 'out of the box' thinkers and excellent practitioners who looked at the child rather than the diagnosis. One particular Occupational Therapist comes to mind, Phyllis. Not only was she really good with Dylan and the rest of her "kids", she knew about sensory integration dysfunction (SID).
I didn't know it then, but SID was common in kids on the spectrum. When she'd see Dylan, the first order of business was some deep pressure into his joints. This process started from the top down, literally. Then came the 'brushing', using a rectangular, white plastic brush just like the ones doctors use to scrub their hands prior to surgery. I've saved one of those brushes to remind me of just how far we've come, and how much progress Dylan has made in his life.
This tactile pressure calmed him and allowed him to focus on the work he'd be doing in therapy ~ which meant he got a lot more out of the therapy session. Dylan responded so beautifully to this protocol, I asked if I could learn to do it to help him relax before bedtime.
I was a willing student, and Phyllis was a willing teacher. Dylan was the beneficiary! I've often wondered if his early school years would've been more productive if the OT's at school had known about and used deep pressure and brushing.
Let's go back a few years to put the results of the deep pressure/brushing into context. From the day he was born, he never SLEPT like other babies. In fact, he hardly slept at all, which meant I hardly slept at all. Talk about sticking your finger in a light socket ~ or feeling like doing it, anyway. That's how most days felt for me! Can't imagine what was going on in that little brain to make it stay "on" all the time. To be able to use the deep pressure and brushing to calm him after bath time and just before bed was a Godsend. This was an every night routine that we both looked forward to ~ we both got to SLEEP afterwards!
In writing this, I think of the Zombie books Dane is reading right now. That would've totally been what our house looked like back then. Zombies!
A little more sleep meant a little more study time for me, and lots of smart people were working hard to come up with strategies to help kids like Dylan. The gratitude I feel to these early advocates is immeasurable, especially Temple Grandin, whose name is now synonymous with autism, and Alfred Tomatis. Temple figured out that she needed 'deep pressure' and devised a machine to help her out with that, and Tomatis developed a method of auditory integration training that helped Dylan move from single word expression (cookie) to a 14-word-sentence over the summer after second grade! More on that and another social story dilemma later!
To all of Dylan's 'out of the box' therapists ~ THANK YOU!
~ D
She was smiling when she asked. Nobody else ~ doctors, teachers, therapists ~ had ever suggested autism. He already had a diagnosis, Tuberous Sclerosis. So, that's what I told her. Somewhere in the file cabinet in my brain I filed away 'autism'. That file was the 'elephant in my brain'. I added information to it, but I didn't dare take it out and open it up. I couldn't examine it up close because that would be admitting to myself that I actually thought that bus driver was on to something. And she wasn't the only one.
When Dylan was in second grade, he got to sit in the back of his classroom and draw pictures for most of the day. At that point in time, he perseverated on birthdays. So, he drew many pictures of birthday cakes. Creative, yes; beautiful, YES, but not so academically challenging. Towards the end of the year, we wound up in mediation with the school district. The result was to include preferential seating in his IEP (among other things), so the teacher could be close and keep him on task. This was early April. By the middle of May, he was still sitting in the back of the classroom with the other special education students. WOW!
By now, he was almost seven and still almost non-verbal, though he was pretty good with the sign language we'd learned together. But it was time to pull out that file again, to look at and process everything we'd done with Dylan for the past six years. What worked, what didn't, and where we'd go from here. Now, I had to look at autism. I found SARRC, the Southwest Autism Research and Resource Center and signed up to take a class there. Baby steps. The facilitator just happened to be the classroom aid attached to a couple of the other special education students in Dylan's class. She asked me how in the world I'd dealt with Dylan's autism for all these years without help. Double WOW! I'd just been following his lead and doing what he showed me he needed help with, but now, it really was time to get some professional evaluations to help figure out where we were going.
I knew where we'd come from, and thankfully, over the years, we'd had a few therapists who were 'out of the box' thinkers and excellent practitioners who looked at the child rather than the diagnosis. One particular Occupational Therapist comes to mind, Phyllis. Not only was she really good with Dylan and the rest of her "kids", she knew about sensory integration dysfunction (SID).
I didn't know it then, but SID was common in kids on the spectrum. When she'd see Dylan, the first order of business was some deep pressure into his joints. This process started from the top down, literally. Then came the 'brushing', using a rectangular, white plastic brush just like the ones doctors use to scrub their hands prior to surgery. I've saved one of those brushes to remind me of just how far we've come, and how much progress Dylan has made in his life.
This tactile pressure calmed him and allowed him to focus on the work he'd be doing in therapy ~ which meant he got a lot more out of the therapy session. Dylan responded so beautifully to this protocol, I asked if I could learn to do it to help him relax before bedtime.
I was a willing student, and Phyllis was a willing teacher. Dylan was the beneficiary! I've often wondered if his early school years would've been more productive if the OT's at school had known about and used deep pressure and brushing.
Let's go back a few years to put the results of the deep pressure/brushing into context. From the day he was born, he never SLEPT like other babies. In fact, he hardly slept at all, which meant I hardly slept at all. Talk about sticking your finger in a light socket ~ or feeling like doing it, anyway. That's how most days felt for me! Can't imagine what was going on in that little brain to make it stay "on" all the time. To be able to use the deep pressure and brushing to calm him after bath time and just before bed was a Godsend. This was an every night routine that we both looked forward to ~ we both got to SLEEP afterwards!
In writing this, I think of the Zombie books Dane is reading right now. That would've totally been what our house looked like back then. Zombies!
A little more sleep meant a little more study time for me, and lots of smart people were working hard to come up with strategies to help kids like Dylan. The gratitude I feel to these early advocates is immeasurable, especially Temple Grandin, whose name is now synonymous with autism, and Alfred Tomatis. Temple figured out that she needed 'deep pressure' and devised a machine to help her out with that, and Tomatis developed a method of auditory integration training that helped Dylan move from single word expression (cookie) to a 14-word-sentence over the summer after second grade! More on that and another social story dilemma later!
To all of Dylan's 'out of the box' therapists ~ THANK YOU!
~ D
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