Back to the New Year

Christmas vacation felt long, but not as bad as anticipated.   R. seemed ready for a break.  She enjoyed lounging in the morning and asking for ice cream after breakfast.  Of course I give it to her.

I think we went to the zoo six times over the break.  She has a really short attention span for the playground lately.  She runs around, plays on the equipment that she is interested in and then is ready to leave.   We have been to several different playgrounds so it is not that she is tired of the same one.

We were at a playground and a little boy hit his sister and his mother was just screaming at him.  Of course we were walking by them the moment the mother yelled We have to leave this playground right now.   R. grabbed my hand and headed for the exit.

Inspired by Jim at Blogging Lily I blew up the air mattress and she just loved it.  Every afternoon she wanted to play on it, and she would prefer to have all of her clothes removed.

She is very into playing a hello-good-bye game.   I think I have said Hello and OK bye 12,000 times over the past two weeks.  I’ll gladly say it a million more.

I was worried about getting her up this morning for school, she has been so lazy in the mornings.  But as soon as I told her that she had to get up and get ready for the bus to go to school she sat up and said take the bus.   She even ate breakfast with no encouragement.

I’m kind of avoiding the idea of New Years, because every time I see 2012 I think the year she goes to kindergarten. I’m pretty confident that more is going to happen this year than that, but it is hard to get past it.

I do hope everyone has a marvelous year!

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.

The many gifts of the ipad

There are so many things that R. has learned that can at least be partially attributed to the ipad.

She started to point purposefully after she learned to use it.  I’m sure the ipad is not the sole reason, but it seems to have helped.

Her receptive language has increased and it seems like she is picking up words (especially labels) faster and with less trouble generalizing.   I know that school and the techniques the ABA therapists are using deserve the most credit.  But I also know that the ipad is helping to reinforce these words -pun intended.

I think it also has helped with her auditory processing, she is pronouncing some words better.  I suspect it is because of apps like Bob Books, where she can hear the phonetic letter sound as many times as she wants.  She is touching the letter, seeing it and hearing a sound.

I have posted about how her youtube video selections seem to mirror what is happening in her life.   She will finish with her ABA session where they were working on the prepositions on top and under and go to youtube on the ipad and find Sesame Street videos that are teaching the same concepts.

She has stopped playing with her spit on the window (big hooray for that one!).  I really think it is because she can get that same sensation from the ipad.

She is writing letters, numbers and shapes.  She asks me to show her how to draw things -shapes and letters.   Of course they do this in school, and I give her teacher plenty of credit for helping to teach her these skills.  But I think that the ipad helped her focus in a way she could not before, and those positive experiences give her confidence and motivation.

She doesn’t have to to it all the time, but she will share the ipad with a friend, and even negotiate turn taking.   I never thought about the ipad as something that she could do with a peer, silly me.  They seem to do it themselves quite naturally.


Noisy feet, happy kid

We went to the zoo over the weekend.  It has been a few weeks since we last visited.  R. was really excited and wanted to get out of the stroller almost immediately, which is rare.

She walked the entire length of the zoo.  She was running, skipping, prancing and doing this stimmy feet dragging thing she does.   It was bugging me because she was getting out of control and prone to tripping often.  Which is not the end of the world, but the concrete at the zoo is particularly good at ripping jeans.

After I told her many times to slow down and walk nicely she looked at me and said No, no no and pinched my mouth.

I realized that I was annoying her as much as she was annoying me.  I also realized that I was trying to get her to act normal.

So I found places where she could run.  But when we were walking around the zoo looking at the exhibits l insisted she go slowly but let her skip and shuffle to her heart’s content.

She was so happy, she smiled and laughed and talked (some of which I actually understood) and had a great time.

I read this post Quiet Hands today.   Our ABA therapists don’t use those terms.   But it made me think that I need to consider what it is that I am asking R. to do or not to do.  As a parent sometimes it is hard to know when to draw the line.   I’m so grateful that she is starting to tell me in her own way when I’m being controlling.

Why does she do that?

I’m sure every parent has to deal with some annoying habit or behavior from their child.   I think this is more challenging when your child has limited or no verbal ability.   I try to think that everything she does has some purpose behind it, no matter how strange it seems to me.   It can be hard to strike a balance between figuring her out and not spending all my time analyzing every move she makes.

Dealing with her sensory seeking behavior is easier for the most part.  She usually seeks out the same types of activities, and if I let her or redirect to something similar she usually gets it out of her system after 10 minutes or so.  Even a year ago she could spend 20- 45 minutes jumping on the trampoline, laying/rolling on the beanbag or under cushions.

She has been really obsessed with water play.  She will not let me do the dishes, wash my hands or anything involving the sink by myself.  She actually shoved me and said my turn.   This gets old quick, but it is better than playing with her saliva on the window which was a favorite activity just a few weeks ago.   Sometimes when I have totally had enough water play I can redirect her to play dough.    I think school is partly to blame for this obsession.  They have a water table and the teacher has them wash dishes and cars and dolls and their clothes.  She makes it very fun.

The chewing seems to come and go in intensity.  Sometimes I think it is in reaction to being overwhelmed.  Other times I think it is boredom.  She is getting better about not chewing on her books, chewy toys and access to toothbrushes have helped with that.  She also understands that she is not supposed to chew on books and will stop when she is caught.  What drives me crazy is when she chews on her sleeves.  I don’t know why those slimy sleeves bother me so much, but they do.  She was doing that all the time over the summer.   Now it seems like she only does it when her sleeves are wet.  And of course she hates having her sleeves pulled up to play in the water, so with all the water play her sleeves are wet fairly often.  I have found the cure is to change her shirt.  She can’t stop chewing on the wet sleeve, but she doesn’t chew the dry shirt, at least for the moment.

One of the most difficult behaviors to decipher is throwing.  Throwing things just for the heck of it can be fun, at least for small children and definitely R.  She likes to hear the sounds that different objects make, and she likes to watch where and how the objects fall.   She will throw things in anger, or sometimes it seems like she throws things just to exert control over something.

When she throws something in anger, I try not to show a lot of emotion unless it she’s tossing chairs over (thankfully that phase is mostly over) or doing something dangerous.   I have been working for years now on getting her to say something instead of throwing, hitting or screaming when she is angry.  I started with just saying Ohh or Arrggh, now I’ll say Hey or Stop.  I am hearing her say hey spontaneously occasionally.  I’m sure it will take a long time for her to learn to express anger.

The throwing that seems to be for no reason, or when she sweeps everything off a table or a shelf can be maddening because of the mess and because of my desire to know what she is thinking.  Autism Mommy Therapist wrote about her son in the post Ninety-Nine Questions, and  this helped me come to a better understanding about this type of behavior.  She writes:

I try to derail him from his compulsions to reorganize and recatologue because he can’t ever seem to force his configurations into coherent order. His attempts,sadly, seem only to leave him in greater distress.

With R., I don’t get the sense that she is in distress, it is like a restless seeking.  Sometimes she seems more frustrated than others.  But the idea that this behavior is an attempt to reorganize her world seems to be accurate to me.   It helps me decide how to respond.  I would like to let her do what she wants, to an extent.  At home I’ll let her go to town with one group of items – the contents of her toy box or a book shelf,  but I will put them away when she goes on to the next group.  Some people say that you should force the child to help with the clean up, but that is counter productive with R. at this point.  I find if I put things away, she will join in at least half of the time.  And I have actually seen her put a few things away on her own, although she does then often knock them back over.

This kind of throwing behavior is usually the worst on rainy days off when we are mostly stuck inside.  I think it means she is bored.  She is usually quick to become frustrated or angry during those times.   Often after school and therapy she just seems to want to do what she wants, she wants to knock things over and throw.  But she is incredibly happy, laughing, talking and singing, and engaging in some appropriate play along with the throwing.

The Magic Disc

The fitball disc

I bought a fitball disc for R. recently.  It is very similar to the sitting/balance discs in the therapy catalogs.  It is a little larger and one side has raised nubs and the other side is smooth.   I thought it would be useful for R. to put her feet on to give her extra sensory input.  I also hoped she might stand and balance on it or at least walk on it.

She did not know what to do with it at first and wasn’t real impressed when I sat or stood on it.   I stood it on one end and made it spin, and that became a favorite game. She would let me use the disc to give her pressure on her back or feet.   Then one day I found her happily running back and forth in her room landing on the disc in the middle each trip.  I noticed she had pulled the plug out and completely deflated it.  She wanted to use it flat and she fixed it herself.  I inflated it just a little bit and she has been finding all kinds of uses for it on her own.

She always seems to know exactly which side she wants to use.  She sits in her beanbag or in my lap with her feet on the disc.  She sits on it bottom down, lies down on her belly or back and even rests her face on it.  She puts pillows on top and then lies down or rolls around.  It gets most use as a stomping pad in an obstacle course.  She recently found her old baby changing pad and a wedge that goes under the crib for newborns and added them to the obstacle course.

Wonderful, wonderful trampoline

We were lucky that our former speech therapist found a trampoline on her street. None of her other families needed it so she gave it to us. It really helped during her long days of in home therapy. She had an outlet for her energy and the jumping helps to regulate her senses. I never thought about all the different ways that a trampoline could be used until one became part of our household.

Of course she can jump on a trampoline. She can jump barefoot, wearing shoes and socks, or just socks or even fuzzy socks. She can land on her feet, crash onto her knees or bottom. She’s not ready for hopping or fancy footwork, but sometimes I’ll catch her leaving toys on the trampoline and jumping around them. Sometimes she likes it if we hold her hands while she jumps -she gets even stronger stimulation. I will put a fuzzy body pillow on the trampoline and she will crash onto it. She came up with the idea of piling up all her stuffed animals on it and then crashing and rolling.

The therapists always called this game popcorn. We will place small toys on the trampoline and bounce them from underneath. She loves this, especially when the pieces go high and fly off onto the floor. She will collect them all and set them up in the middle of the trampoline, even standing them up if it is possible. We have used rubber ducks, small plastic animals, little people, letters, legos, pegs – almost anything will work. I always say ready set or one, two and she will fill in go or three. She’s starting to say all three words when she wants me to do it again.

When we were first teaching R. to use PECS, we would put the trampoline up against the wall and leave the trampoline icon where she could reach it. She really wanted to play on it so this worked really well.

We also use the trampoline as a table/platform. She will set up her dishes and cups on the trampoline although lately she prefers the dining room table. She will bring toys and sit on the trampoline on her own to play. It is also a great place to bounce balls and test the bounce-ability of objects. We also roll balls, spin tops and send cars racing across it.