Kindergarten is great so far

So it has been a long time since I updated. I’m not usually superstitious but every time I started to write this post I felt like I might jinx something…

But here we more than half way through the school year and Kindergarten is going very well. The class (self contained special day class) has nine students and five aides.

One of my biggest concerns was R.’s escaping behaviors. I was worried she was going to walk out the front door of the school and try to find her way home. She did escape starting on her first day of school. There are classrooms adjacent to the recess yard and she instantly realized there were toys in each classroom and she wanted to see them. The amazing thing was, the teacher and aides did not freak out about it , no meeting was called, no outside behaviorist was called in.  The kindergarteners have three recesses a day, and for the second recess the teacher brought some toys outside. Talk about brilliant. Over the next few weeks the aides worked on showing R. all the fun things she could do on the recess yard and now it is not much of a problem at recess. She still does try to go exploring from her classroom, but they seem to be able to handle this.

Her school day is so much more interesting than in preschool. They go to the library, have pull-outs like music and garden. Even the work they are doing in class from the worksheets to the art projects is more advanced than preschool. The SDC class is mixed grades, K-2, but the kindergarteners do the same things that the general ed kindergarteners do and it seems to stay the same as they advance in grades.

R. is going to one of the general ed kindergarten classes for free play each day. I was getting notes that she was “playing” with the other students.  I visited one day, hoping to just spy in the window so I would not distract her. I peered in and I did not see her at all–just groups of kids. So I went in the back door, and there was R–hanging out with the large group of kids. From what I saw she was hanging out more than playing anything. But the general ed teacher told me she puts hats on the other kids, takes turns with marble runs and other toys and that the kids really like her.

And that is one amazing thing about this school, it is not just the teachers who seem to like R., the kids do.  I never felt like other kids really noticed R, beyond her differences and she only had limited interest in them. So this is really an amazing surprise.

R. is obsessed with clapping and getting people to clap, and she has a tendency to grab people’s hands to get them to do what she wants. I was concerned about how this would be taken by the other kids, especially at recess and discussed it with the teacher.  After a few weeks the teacher said that the kids don’t mind at all when R. has them clap, and some girls were taking R. by the hand and running around and laughing.  She told me that there were hula hoops on the recess yard and R. put a hoop on the ground, stood in the middle of it and spun her body around. A bunch of other girls watched and then all did the same thing. So I can say that R. inspired her fellow students to spin!

R. can follow directions so much better. I’m able to have her help with cleaning up her toys and similar tasks.  I discussed this with the teacher and she set up a recycling job for R. where R. and a student from the general ed kindergarten class take a box of recycling to the recycling bin outside. The children have to carry the box together, and work together to lift it into the bin. Talk about the most amazing way to work on joint attention skills, social skills and probably more. R. is super motivated to do this, the aide said that she hardly had to help them at all, they worked it out between them.

Getting it together to pay attention

Joint attention is very simply, the process of sharing experiences or information with another person using non verbal communication.

It seems that joint attention is really at the root of the common issues relating to R.‘s autism.   Not long ago I was wondering exactly what happens in my daughter’s brain when she is progressing developmentally.   It is a simple, and likely not complete answer, but it seems to me that improvements in her joint attention skills have led her to be able to speak, to imitate and process receptive language better.  It has helped her play skills and probably several other things.

I can’t help but wonder what exactly led to R. gaining joint attention skills.   Again, this is a simple and incomplete answer, but I think it has to do with sensory processing.

Back when R. was two, she was so overwhelmed by processing the sensory information she was receiving that she really could not process much.   She could not pay attention to much of anything in her environment completely because she was caught up in paying attention to herself.

At the time her running, jumping, crashing and other sensory seeking behaviors made her appear wild.   But in retrospect I realize that she was really quite determined to give herself the input that her body was seeking, and that needed to be fulfilled before she could process anything.

When she was three we dropped her nap, and I think things really improved for her after that.  It could be at least partly coincidence, but I do think that it did help her.   She has always been a good sleeper, but not so good at the waking up transition.  So when she napped, she was going through that transition twice, I think she lost a lot of time to that (and sleeping) that is now taken up by activity.

Shortly after turning three, she began to imitate and developed echolalia.   She also began to be anxious in some public settings and to exhibit her first sensory avoiding behavior – putting her fingers in her ears.

I don’t think it is a coincidence that when she was finally able to pay attention to more of her world, she found it kind of scary or at least overwhelming.  I think that putting her fingers in her ears gives her great power over her environment.

Ultimately I think that is the best answer.   R. is able to process sensory input because she has found ways to tolerate and likely understand the information on her own terms.  Even when she was at her wildest, I always had the impression that R. knew what kind of sensation or activity she needed.   As she gets older she is even better at knowing what she needs, and she seems to get her fill faster.

It makes sense that she has to learn how to process all of the information that she is receiving from her body and senses. For her to be able to pay attention to anything outside of herself means that not only does she need to be able to process this information, she has to process it in such a way that it is not distracting to her.

I also think that just because she can process her sensory information better, does not mean it is easy for her.  I suspect it also is probably not exactly the same for her all the time.  Some days things bother her more than others.

When we were on a general school tour the principal told us that we would be entering several classrooms in progress.  She instructed us to go all the way to the back of the room, so we would be out of the way.   I’ll admit my elementary school experience is decades old, but I could not figure out at first glance where the back of the room was.  The desks were set in tables, none facing in one direction.  The kids were sitting in groups all over the room, facing different directions.   I wasn’t alone in my confusion.  After the first classroom I went to the back of the line, so I could follow everyone else, and the same thing happened in every classroom.  Whoever was first just stood there, not sure what to do.

Maybe that is how R. sees the world, it is just a jumble of information that she has to find some way to understand.

As a parent I have to keep learning how to accommodate and encourage what she needs.   I can try to prepare her for new situations or offer familiar supports.

I also need to manage my own feelings about the behaviors.  I really should not get annoyed that she is running around dumping all her toys out.  I should realize that she needs some physical activity throughout the day, and if I don’t help her find something to do, she will decide for herself and I might not like it.

One of the hardest parts is being able to interpret R.’s behaviors and help her learn to communicate exactly what she wants.  Putting her fingers in her ears never means that she wants to leave.  Even crying doesn’t always mean that she wants to leave.

We went to a birthday party at Lemos Farm.   She cried on and off for half an hour, every time she cried we would be ready to leave.   We were just about to say good bye when she hopped out of the stroller and started playing.  She had a great time and played for over an hour.   I’m so glad that we waited.

It is hard to know what to do to help R., how to react to her sensory needs.   It would be nice if there was a specific solution to sensory issues.  A special swing or apparatus we could all sit in and magically get over ourselves and pay attention.   But that’s not how it works.  Maybe I should take comfort in knowing that there is nothing that I have missed, no secret technique.

Paying too Much Attention to Theory of Mind

I’ve been thinking about how to discuss autism in a way that is more than just a list of symptoms.   I would like a description that includes the seriousness of the disability but with terms that don’t indicate that having autism is a static unchanging condition.

It is common to read that people with autism have an impaired theory of mind.   Rachel Cohen-Rottenberg has an interesting take on this.  So does Patricia Harkins.

In the book Adapting Minds by David Butler, the author says that Simon Baron Cohen has argued that autism is evidence for a theory of mind module.    The author goes on to explain why he thinks this idea is incorrect.   He makes a lot of good points.

The main point of the author’s book seems to be to discredit evolutionary psychology, and he has an issue with the idea of modularity (as it relates to the brain) in general.   (Here’s an interesting evolutionary psychology primer.  The blog author was nice enough to answer my question in the comments.)

David Butler writes:
An essential characteristic of modules is that they function independently of one another.  Consequently if a module is impaired or malfunctioning, highly specific forms of cognitive or behavioral deficit should result.  These deficits should be confined to the domain of the module and should not affect cognitive or behavioral performance in other domains. 

David Butler takes issue with the false-belief test that is usually used to prove a lack of ToM.  He writes:

Rather than simply being an inability to understand the minds of others, autism appears instead to prevent individuals from being able to damp down the total array of irrelevant inputs to the brain.  

Thus, while autism does involve an inability to pass false-belief tests, it encompasses a wide-ranging array of cognitive and affective deficits relevant to understanding others.   The strongest confirmation of the theory of mind module hypothesis would come from a deficit that disrupted theory of mind but left all other abilities in tact.

If a theory of mind were acquired from some more general learning disabilities, rather than being embedded in a module, it would not be surprising that autistic children fail to acquire a theory of mind given their avoidance of interaction with other people and their inability to attend to complex and changing environmental stimuli. 

Here is a link by others that seem to have the same opinion.  And another.

I think part of what bothers me about the idea of defining autism as a lack of aToM module is that it seems to imply that the brain is static, and that ToM is either on or off.     The term mind blindness or context blindness is very similar.  Why can’t we call it context nearsightedness or mind farsightedness?  I realize that autism is a serious condition and that many individuals have significant disabilities.  But why should we use terms and phrases that are inherently negative and not completely accurate?

I wonder if it would be more accurate to talk about joint attention instead of ToM.  That is really closer to the root of the issues, and does not involve the idea of a self contained module in the brain.

In a review appearing in the October issue of Current Directions in Psychological Science, a journal of the Association for Psychological Science, University of Miami psychologists Peter Mundy and Lisa Newell summarize recent findings supporting a theory of joint attention dubbed the “attention-systems model.”
This model proposes that human social cognition is really the extraordinary result of two basic forms of attention. One type of attention, regulated by a specific set of neurons in the brain, involves paying attention to the external world and the actions of people. The second type involves paying attention to the self and is regulated by a different network of neurons.
Mundy and Newell propose that the key to human joint attention is that these two areas of the brain become interconnected throughout development and interact so we can simultaneously keep track of the direction of self and other’s attention. Interestingly, communication between brain regions, especially those implicated in initiating joint attention, is one of the main cognitive impairments of autism.

It seems to me that it is accurate to say that autism involves a deficit in processing information that leads to delays in joint attention,and the delays in joint attention lead to the symptoms we commonly associate with autism.

A description like this implies significant disability is possible.  But instead of describing autism as a lack of humanity, it seems to describe how what we call autism really is a natural part of the human condition.   It also offers a root cause (a deficit in processing), and the idea of developmental progression.  So contained within the description are ways to help an individual with autism.

Reference: Adapting Minds, David Butler, (The MIT Press, 2006) pages 191 – 193

Special thanks to L. for talking me through this and suggesting the perfect reading material.