Sunday, April 1, 2007

24 Months to 36 Months

Fall 2000: 2yrs old
This was quite a busy, sad, and overwhelming time for all of us. Leo’s 2 year birthday party at our house brought tears of despair to our eyes. On a beautiful October fall day, about 6 peers played together outside while Leo, not even looking, was sitting alone on the steps staring at his firetruck. We couldn’t take it away, as he would’ve been miserable without it. We even got the fire dept to drive over a real firetruck for the kids to see and take a ride. Overwhelmed by the party, Leo had no interest in the fire truck. His dad made him go on it. Leo sat on his lap and tolerated it for a few minutes.

Yale evaluated him two weeks after his 2nd birthday. Even though you know what they’ll say, you never forget the moment they tell you your child has Autism (2 years old). They were so understanding as I shook and cried in their office. They described in great detail how Leo must be taught what comes naturally to typical children. That he’ll never learn these concepts and skills on his own.

They gave us proven direction on how to teach him while minimizing his stimming behaviors. They described how we need to engage and redirect Leo 24/7, every waking moment –until these skills can become his own. We needed to draw him out every moment possible.

At this time his imagination play time was approximately 2% of his day, prompted. Leo also was in poor physical shape at that time. He began the DAN! Protocol shortly after his testing.

Schedule: Kiddie classes 3X /wk, play dates at least 1X /wk, daycare 3 afternoons a week (6 hours), and 0-3 therapy 2 to 3X per week (home and daycare), and parent sessions 2X per DAY.

I decided to bite the bullet and force Leo into as many social situations as possible. I went back to having at least one outside social activity every day with kids his age. I’d insist he participate, or at the very least observe, constantly pointing at what he should be looking at. Ex: “Look at the teacher’s face. What is she saying to do?” My goal was to keep him with us, never letting him stim. 0-3 came 2 times per week, training me and Leo. I was so sick of having to be a two year old model for my son. He hated it, I hated it, but it was great.

I copied the therapists by working with Leo just like they did, 45 Min each morning that they didn’t come at the table. I also did this at night unless my husband was home early enough to do it. My husband concentrated on gross motor skills and confidence on the weekends by doing guy stuff, taking him to the playground, etc. He also did swim class with him, which Leo hated.

He cried through an entire semester of a kiddie class at our Rec Center. Preferring to sit alone, I’d carry Leo around with kids holding hands and dancing at Music Class. At a pre-nursery school class where parents came too, he’d try to isolate himself, making a beeline right for the trucks as we entered the room. I asked the staff to hide the trucks during our session, and I kept him engaged, constantly directing him to appropriate play, or telling him what to say to another child. We started Gymboree again, and this time I made him do everything the other kids did. I’m sure the other parents thought I was a hovering crazy woman, or that I was really competitive, but I didn’t care. Needless to say I didn’t make any friends that season.

I gave each caregiver at daycare a ‘one sheet’ on how to engage Leo, and to keep him with the other kids as much as possible. I explained to them that his disorder is no excuse to not participate or do tasks. He was expected to do what all the other kids do. I worked with them each week, each time there was a new person, making sure there was carryover as much as possible. They were complete angels and wanted to help. 0-3 also worked with them regularly while regularly working with Leo at the center.

Sample day: The first 20 minutes:

Leo wakes up, bathed in sweat due to his unusual chemistry. I change his diaper, grab his milk, and take him into the bathroom so I can shower. He happily sits down on the stool, knowing the routine. I give him 3 books to look at, placing them in front of them while I turn on the water.

Leo excitedly starts to take all my shampoo bottles and soaps, wanting to hold them. While shampooing, I constantly redirect him away from the bottles, trying to get him to look at his books. He keeps at the bottles. I then take an almost empty bottle, and challenge him to practice taking the twisting the cap on and off. He balks at first, then tries since I did give him one bottle to hold. He gives up quickly, and tries to hold and stare at it. I take it away. I rinse and start drying off. He cries, but after we talk about the sizes and colors of the bottles, what we use them for, I prompt him to say “yellow”, “big”, “little”, and “blue”. He says “yellow!” and I say “Good job Leo, you used your words!”

Happy with “yellow”, I move on to the books while I comb out my hair and brush my teeth. He starts to read Pickle and Blanket. He stops midway and stares at a page with a purple background, a favorite stimming color. I ask him to point to the little boy’s face, then the bear, and tell him about the picnic they are having. I ask him if he wants to go on a picnic one day.

We move into the bedroom so I can put my clothes on. He finds a ball that was under the bed and immediately starts spinning it while lying on the floor closely staring next to it. I can’t believe the ball found its way into my room, but shrug my shoulders, pick it up and talk about how we use balls. While bouncing, I say in my cheerleading voice, “We can throw them and bounce them! This is the right way to play with a ball.” I redirect him ten times, he stops spinning and actually bounces it twice. I smile and say “Good job!” I pull the shirt over my head, grab the laundry and my water glass, tell him 3 times to put the ball down, and walk to the stairs.

Each minute of our day is similar to the first 20 minutes. We eat breakfast, go to a kiddie class, put him down for a nap, grocery shop, make dinner, put him to bed. All the while I keep him present, listening, engaged, and playing appropriately every moment I have with him.

January 2001: 2yrs 3 months
Social schedule: 7 hours of daycare, 4 mornings a week classes or play dates, same 0-3 and Mom sessions.

Leo makes incredible gains. The DAN! Protocol makes a big difference is Leo’s physical well-being. His mind is now clear and as healthy as he’d ever been. His eyes, his skin tone, his face looked great. 90% of the time he would attempt speech rather than grunting or whining. Full sentences came quickly. His behaviors continued to decrease while his tolerance for novelty
increased. 5% of his day was imaginary play, sometimes without prompting. He was more tolerant of novel things. He actually
went over to his therapist who’d just arrived and eagerly looked in her bag to see what she’d brought!

The caregivers at daycare said he was a different kid. We couldn’t believe it. The Counter-Intuitive Parenting style worked. He started to parallel play with other kids. The old Leo would have headed in the opposite direction. 0-3 worked more and more with Leo at daycare, helping Leo in the social environment which clearly was the biggest challenge. They reported he was so pleased with the help. For example, one day he and another kid were fighting over a toy. His frustration escalated and he grunted and whined. The therapist gave him the words to say “Can I have my toy?” He turned to the other child and repeated “Can I have my toy” clearly, prompted to look at his face. The kid gave him the toy. He was DELIGHTED. It was like he thought, “Hey! It worked!” He was so pleased with himself. His self confidence, always an issue, increased as his success rate increased. It was one of those defining moments. He was no longer completely intimidated by children. Once a kid was jumping on a trampoline, smiling at him inviting him to join. The old Leo would have walked right by as if she didn’t exist. He
jumped right in.

EX: Since September, words have been coming faster and faster. The breakdown of the simplest of words seemed to have boosted his confidence. He will try 90% of the time to say a word. He enjoys talking and likes the attention he gets. He now says sentences regularly, and says words more clearly and completely. Examples: “Mommy get blue bus please”. “Daddy Wolfie’s ball please”. Bup is now Up, Uhm is now Come, etc. We still prompt for words, but not nearly as much. He comes up with his own combinations and new words that we’ve never prompted before. He always answers questions. Oddly enough, in the last couple of weeks he started saying “bye bye Mommy” or whomever. I find it interesting that he said Bye Bye last, after using full sentences. Most kids say it first. Although we are pleased language has replaced the whining, he is constantly repeating himself for his wants. We find he tirelessly tries to use language to control his environment.

EX: 5% of his day will be doing imaginary things, such as feeding a stuffed animal. So it’s a slight improvement. He likes to sweep and vacuum, which may be a perseverating/movement thing. I'm not sure. He has come up with scenarios that we’ve never shown him. He seems to enjoy them more and more. He is playing more often with little people toys and playmobil toys, and riding a stick horse both with and without his father, and enjoying it.

EX: Leo was jumping on a mat. Another child came up and started doing it too. Rather than walk away, Leo smiled and started jumping even faster. He followed her for a very short time. This has never happened before. He participates in circle time, art projects, whatever the rest of the kids are doing. Before he would watch from afar or participate rarely. This is true in his Music Class, Gymboree, and Pre-Nursery School class that Mom attends with him. He seems less intimidated and has
more confidence. We have worked very hard in training ourselves and day care staff to constantly keep Leo engaged, and we feel strongly this has paid off.

February, March 2001:2yrs 5 months Leo continued to make rapid progress as we tried to keep up with him, challenging himas much as possible, “putting the screws to him” every waking moment. One therapist said “One major part of my job is to convince parents their children are capable”. And this was true. He surprised us at every turn, meeting every goal quickly, eager for more explanation, information on how to communicate and interpret on his own. He was and still is like a big sponge. Leo began going to daycare 2 days a week for a 7 hour stretch each time. It was working so well so we added more. He really liked it now.

April 2001:2yrs 6 months Very encouraged that Leo tested age appropriate for speech. Hired a full time nanny for the baby that was due beginning of May. We gave Leo this first month to get used to Sylvia. Sylvia also got used to all the prohibited behaviors, etc. We took her to the grocery store, every class, all our hangouts like Duchess and McDonalds, the mall, Playzone, etc. We kept Leo going to daycare, naturally. She became comfortable driving our big car and learned how to navigate herself through our town. Our plan was for the nanny to keep Leo’s schedule completely intact, taking him to every class, to the park, etc., until I recovered from my planned C-Section. After that I would resume working with Leo constantly, keeping him on his schedule, until the baby became mobile.

May 2001: 2yrs 7 months As expected Leo regressed significantly for about 4 months. Relieved I had Sylvia in place, she took care of the baby while I kept up with our one-on-one. 0-3 recommended I add an extra day of daycare to provide extra relief for Leo. This worked really well for all of us, as he was either crying or whining for 4 straight months. Literally.

June thru Sept 2001: 2yrs 8-11 months Leo made his way slowly back to his previous level of functioning over the summer. Having me available most of the day to keep him present and challenged really helped. It wasn’t easy, as I was nursing exclusively, so I had to pump twice a day so I could leave the baby with Sylvia. His imaginative play really blossomed. He loved copying me by nursing and holding his baby doll, taking her for walks in the stroller around the circle. He also became fascinated with his sister, and found her amusing and an easy audience.