More PLAY tips

1.)    WAIT...ALWAYS WAIT (can't be said enough times)

2.)    Go for AFFECT. (Whatever will make child smile, light up, pay attention)

3.)    Make sure 'circles' are towards PEOPLE, not THINGS.

4.)    Ask yourself, "Is this fun for ____?"  If not, stop and join.

5.)    Label actions, words, and feelings.

6.)    Express your affect as SYMPATHY, not control, when they want to do something you don't want to do or is not allowed.  ("Oh--you REALLY wanted to go in there!  I'm sorry that we can't.  Not today.  Maybe another time.  I know it makes you sad and I'm sad too.  Let's try _______ [something to redirect])

7.)    Figure out 10 things that can be done with a comfort zone object and try doing them. (Think prepositions:  up, down, in, out, over, around etc.)

8.)    Don't be afraid of the "Dark Side" play--especially for higher level children.

9.)    Try to make sure CHILD is opening first circle...wait and make child take responsibility for the relationships.  Remember that a circle can start with just a look, gesture or word.

10.)   Share child's problem in play.  "It's hard to know what to do.  Hmmm...what could we do with the train?"  AND WAIT.  

Huge Successes in Small Moments

Recently, a 15 year old that I've been working with for about 3 years had an amazing breakthrough.  He is a highly anxious kid, non-verbal, and tended to resort to self-aggression or aggression towards others (pulling hair, clothing, pushing etc.) when in a situation that caused him anxiety.

An example:  Three years ago, he had to be pulled out of a restaurant by his dad, screaming, because a piece of his food fell on the floor and dad didn't want him to eat it.  Taking him out in public was very hard and usually had the parents on edge.

A few weeks ago, we were at a restaurant.  He ordered Lemonade on his communication device (CD).  (Even though I suspected he really didn't WANT lemonade and wanted coke, I wanted to respect his choice.)  After eating and barely drinking the lemonade he was clearly waiting for the waitress to bring him a coke.  I asked him what he wanted (via CD) and he pressed Coke.  I told him that he ordered Lemonade and that when he orders something, he has to  go with it--he didn't have money to get another drink.  I KNEW that this was risky, because he could've had a full meltdown and the place was packed.

He stood by our seat while I went to pay and I kept an eye on him, praying he would continue to be calm.  When I finished paying, I gave him his coat.  He hung it back up.  I gave it to him again.  He hung it back up.  I explained that it was time to go and that we could get Coke at home.  He put on his coat and took a few minutes to get out of the door.  All during this time he was quiet (normally there would've been SOME vocalizations.)  

Once we got out the door, I breathed in a HUGE sigh of relief and told him that I was SO proud of him and gave him a high five and a hug.  As we walked towards my car, he would stop and look back at the restaurant as if deciding whether he was going to go back in and get a coke.  I kept telling him how mature he was and how proud I was of him.  He got to the car and got strapped in and realized what he had done and he became proud of himself.  He was so excited and proud. It was a HUGE moment.  I got very teary-eyed when recounting it to his parents because very few other people would understand what a GREAT success that was.

Interesting article on Vaccines

http://www.ageofautism.com/2010/01/vaccination-black-and-white.html

Happy New Year!

Well, we are only 6 days into 2010, but it has been uplfiting, so far.
 
My newest client ( a 4 1/2 year old girl) is doing VERY well.  I've PLAYed with her for less than 10 hours and her mom reported that not only has SHE seen an improvement, but the extended family has even noticed a difference.

 Yesterday, I received a voice mail from the father of a former client (we worked together for a little over a year.  I haven't seen her in 6-7 months) to thank me for helping them apply for the Children's Waiver.  They qualified and are now getting many services that they couldn't have afforded (or even known about), beforehand.  It was such a pleasing surprise to get that acknowledgment.

My morning boy (just turned 2) is doing so well--he is imitating sounds now and just greets me with a big smile and a hug. I saw him later on, when I was taking another client (age 11) to PT at the same place his brother was getting speech. 

I had 4 clients yesterday, with a total of 7 hours PLAYing.  I thought I would be totatlly exhausted when I got home (especially since last client lives 45 minutes from me), but I was wide awake and ready to roll.  

Today I am subbing in a general ed high school classroom.  I forgot how boring it can be.  At least I have another kid after school for 4 hours.  That will bring my energy level up.


Happy New Year!

A wonderful essay

 Check out this essay, "My Children Want You to Know".

Static vox

The Camps

I believe a whole new, eclectic field of autism treatment/intervention is due.  There are too many "camps"  that are in opposition to each other: Bio-medical vs. Behavioral, Behavioral vs. Play/Floortime, Vaccines vs.Genetics,etc.  Each "camp" believes they have the best intervention or information.  Sometimes, they believe it is the ONLY  "true" intervention. (Sounds like religion, doesn't it?).

The therapists, who are open-minded enough to listen and learn from other disciplines, will be of the most help to their clients.  The parents, who are open minded enough to learn from other parents, will be of the most help to their children.  The communication between parents and therapists is vital.  The communication between therapist and the child, even more so. 

"But my child/client doesn't TALK, " I hear you say, exasperated. That may be true, but I GUARANTEE you that the child DOES communicate.  Tapping into the child's mode of communication is vital for both the parent and the therapist.  Why do we see aggression in many non-verbal kids?  Because NOBODY has bothered to learn their mode of communication!    Success with a child will be fast and furious when they are with someone who "understands" them and communicates that understanding, back to them.

Up until this year, I was a pretty solid member of the "genetics triggered by vaccine camp"--our 22 year old niece exhibited a regression after her vaccines.  Nearly every child I came across, in the past 10 years had a similar story.  Then, this year, I started working with triplets--not ONE of whom have had a vaccination--EVER!  They were preemies and the parents, having medical backgrounds, refused to permit it.  Two of the three are definitely on the Spectrum.  So--if it wasn't vaccines, what was it?   

People who don't believe in a genetic aspect, are not researching genetics.  Just because you don't have any relatives with ASD, doesn't mean you don't carry the gene. Are there any "quirky" relatives in your family?  Anybody with ADHD, Obsessive Compulsive Disorder, Tourette's?   Autism genetics is much like alcoholism:  If you have the alcoholism gene, but don't drink alcohol, you will never have alcoholism.  We know alcohol is the trigger for that gene.  What we DON'T know, is WHAT is the trigger for ASD?  I now believe vaccines can be A trigger, but are not THE trigger.  I also believe that the parents of the ASD kids, being the first "fast food" generation may have a gene that got changed, due to diet and environment.  [A great show to watch, regarding this is "The Ghost in Your Genes" on PBS (usually during pledge week).]  What our parents ate or didn't eat, could have affected our genes. Nearly all Americans, under 40, always had a microwave in the house, had a regular diet of artificial sweeteners, and ate more processed food than any generation before them.  Could these things have altered their genes, just enough, to afflict their children?  These are questions that need to be answered, but not assumed, and not argued to the point of dismissal.  We just don't know.  Yes, you know for YOUR child--but what about all the others out there?  And why more boys than girls?  Is testosterone the issue?  Then why girls, at all? 

I believe, in the next 10 years, they will conclusively know what  most of the causes of autism are and how to treat them.  And I think they will find a link to Bipolar Disorder and some other "quirky" things we see in people.

If I had it to do all over again, my 19 year old would have had a LOT less vaccines.  I found one of his vaccination charts (his 5 yr. shots for Kindergartedn) and he got 7 (SEVEN) vaccines at one time!  That can't be good for anybody, much less a 5 year old at the 50% in weight and 25% for height.

Diagnosis: Autism Spectrum Disorder (My advice to parents of the newly diagnosed)

First, allow yourself to grieve.  For you AND your child.  You did not "sign up" for this and neither did your child.  It is NOT your "fault".  Do not search for blame, but for hope and recovery.   Your hopes and dreams for your child will change.  You have a long, arduous, but rewarding journey ahead of you.  Grieve, but prepare for that journey.  EVERY intervention is going to take time,dedication, and probably some funds.  Do not invest in a program that you will not be able to follow through with, personally.  Most interventions will take at least 1-2 years or more, depending on the degree of autism your child has.  There is NO "quick and easy fix".  Anyone who tells you there is, is someone for whom you need to exercise caution.

Do not keep the diagnosis a secret from family and friends.  They will find out sooner or later--it doesn't get better overnight.  The sooner people know, the easier for you.  You will need their support.  Find at least 1 or 2 trusted people whom you can use as a sounding board.  Ask them to fill this role--to play devil's advocate, but to also support you in your decisions regarding your child, even if they don't agree.  YOU know your child best.  Remember that there is no ONE "cure".  Go to an ASD Support group in your area to learn from parents who have been doing this awhile.

ALWAYS do only one intervention/treatment at a time, so you will know what is working and what isn't.Eventually, you will find that adding one thing to another is helpful, but give each therapy a chance to work on its own, so YOU know how to best help your child.

If you feel vaccines had a part in your child's autism, I, personally,would not vaccinate again.  If you choose to vaccinate, find a doctor who will give vaccinations singly, instead of 3 or 4 different vaccinations in one shot. 

Next, I would see if diet has anything to do with your child's autism.  This is the easiest and least expensive intervention/treatment option.   I would first eliminate Gluten.  Do this for 6 weeks.  If you see no dramatic change, (i.e. increased eye contact, more babbling or talking, more initiation, less stimming) introduce it back into the diet.  After two weeks,  eliminate Casein.  Again, if there is no dramatic change after 6 weeks, the diet may not be the culprit. Do not be discouraged--yes there are accounts of kids whose autism gets "cured" (I prefer to say, "put in remission") with diet changes.  (I have only witnessed one child, in my practice, who dramatically improved,(i.e. much more initiation, eye contact, and attempts to communicate, both verbally and gesturally, but was far from "cured".)  If the diet changes do not bring you to where you want to be, I would next implement Floortime.

Obviously, I am a definite proponent of the PLAY (Play and Language for Autistic Youth) Project.  It is inexpensive (i.e 3-4K a year compared to 10-20K for other interventions) and I have seen AMAZING results in young children (under age 7).   I have also seen good results in older children, but they don't happen as quickly as they do in the younger children and the Project does not target older children.  It is an early intervention tool, but the principles of it work for any aged child.   If you cannot find the 20-30 hours a week needed to play, try to train family and friends.  Using a PLAY tutor is also an option, but adds to the cost--although most PLAY tutors are less than $20 an hour.
 
If PLAY does not bring your child to a level that you are satisfied with, you may then want to try ABA--(Applied Behavioral Analysis) or RDI (Relationship Development Intervention).  I believe both of these are more appropriate for children over the age of 7, who have had few years of Floortime.  Both are intense, expensive,(not usually covered by insurance) and "puts upon" the child i.e. not following the child's lead or intentions.  When a child's intentions are ignored, early on, you WILL see behavioral problems.  Remember:  BEHAVIOR=COMMUNICATION.  Once a child is 6 or 7, they can be "put upon" more easily, especially if they have had the Floortime background.  We are seeing more ABA therapists trained in Floortime and that helps, significantly.

Another option is homeopathic remedies.   Find a DAN (Defeat Autism Now) doctor in your area or an M.D./D.O., who is also a homeopath.  Parents have reported improvement with NAET, biofeedback,acupuncture,chiropractors, sensory integration, and other alternative practices.  However, many of these are not covered by insurance so it is imperative that you find professionals familiar with autism, who have had success that they can document.  There ARE charlatans who will take advantage of your desperation.  This is when you need to use your "sounding board".   I am currently in contact with a NAET practitioner who is treating some children on the Spectrum, for free, and I am interested in seeing how they do--again this is a long term intervention.  I will report back on this when she has had at least a year with them.


Most children on the spectrum will also need occupational and speech therapy.  Some will need physical therapy.  A lot of OT and speech can be incorporated into a PLAY session.  Many of these therapies ARE covered by insurance, depending on your insurance company.

If your child is 2 1/2 or older, they may be eligible for an Early On intervention with your local school district.  This is where they may get some OT, PT or speech, if needed.  In Michigan, we have the Children's Waiver, which allows parents to get respite care of THEIR choice and occasionally other therapies.