Day 2 2016: B is for Behavior

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B is for Behavior

All behavior serves one of 4 functions:

To gain attention

To escape a situation

To gain access to something (usually tangible)

or

A response to an internal stimuli such as hunger, illness or exhaustion.

Seriously.  Just 4 reasons anyone does anything.  Think about it–you won’t come up with a 5th. I have tried.

Of course, if it were that simple we would all live in harmony.  However, there are some times it gets tricky.  For instance, when a behavior is triggered by something internal, it can be incredibly difficult to identify.  So if a child with autism likes to clap his hands near his ears is it because he likes the sound?  Or is it because he likes how his hands feel when he claps them together?  Or is it because it creates a little wind near his face which he likes?  To make matters even more complicated…a behavior can change function midstream and without warning.  So that same kid who liked hearing the sound of his own clapping next to his ear and his parent rushes over to him and holds his hands and tells him “stop!  Lets play instead”….her reaction may have just inadvertently changed the function of the child’s behavior from internal reasons to external. Perhaps it becomes a great way to get his parents’ attention now too.  Such is the nature of human existence…including humans on the Autism Spectrum.  It is easy to judge others without understanding when looking at their behaviors through our own lenses.  So next time you see a child having a tantrum in public or seems out of control, bear in mind that the function of his behavior may not be attention like you might be used to from a bratty kid. He may be responding to sensory overload and needs to leave or perhaps if you hang out long enough you may come to find it may be screams of joy because he has no other way to express it.

Autism Awareness Month. P is for Pediatrician

Day 16

P was hard because there are so many things P can be for us. Passion, Pediasure, potty training, poop, persistence (in a good way). But if this is about awareness, this is critical.

Early conversations over time had with doctors about both A1 and A2: Me: “He’s sitting up already but his hands are still in fists and he can’t grab anything-something doesn’t feel right. ”

Doc: “Wow. He’s just really uncoordinated.”

Me: “He can say way more than I think he understands-so I had a speech therapist look at him and she validated that, what is that?”

Doc: “That’s impossible. That therapist doesn’t know what she’s talking about.”

Me: “Since our move I’ve noticed he doesn’t babble in his crib any more and he only smiles at the microwave and the lamp, but not me.”

Doc: “You just moved…he’s getting used to his environment don’t worry about it (at 8 mos. old).”

I wish I could say that we just had a doctor who was incompetent  (and no, the picture is not of the ACTUAL doctor which would potentially explain how things would be missed), but I hear things just like this in my private practice all the time.

All. The Time.

If your gut feels off about something and you are dismissed by your pediatrician, get a second opinion. Seek out information online about early symptoms of autism. All the research points to early intervention as the key component to long term success with the symptoms of autism. There are programs that are now identifying autism in infants. Lack of eye contact, failure to meet developmental milestones (especially language), lack of responsiveness to their name, repetitive motions such as flicking hands in front of their face are just a few. Even outside of classic symptoms, there are some not so classic ones.

Both as a social worker, but also a mom, if you have a nagging gut feeling….”let’s wait and see if he grows out of it” may waste precious time.

Autism Awareness Month 2015. K is for Kismet.

Day 11

In the month of our 15 year anniversary, I can confidently say we have embarked on a journey neither of us could have expected.

In some ways I wonder if our trek is easier than others since we never had musings of what our unborn children would be like or what kind of parents we would be.

…or if we would be parents at all….

I believe in a judicious balance between predestination and free will. Sort of like walking into a movie complex. You can pick the movie you will see, but once you choose it, the plot and ending remain the same. It is up to you if you decide to leave the theater to get popcorn or simply decide that movie is not for you and you should have never listened to Siskel and Ebert’s reviews to begin with.

All marriages require a gentle balance between cohesiveness and independence….and especially with families like ours. Stress is a constant, sleep deprivation a given, and child rearing? Well, throw out everything you ever thought you knew about that. Not everyone can do that.  Usually, the stronger is left holding the bag on their own.  I know too many families like that and watch in awe as the parent left behind carries the weight of her world.

Through thick and thin we give each other the space we need, recognizing we are in for the long haul.  Our children are who they are supposed to be.  We make the same mistakes as every other parent in every other union, but with the knowledge we must be united as forever parents, even long after we are gone.  And for that, perhaps we are luckier than most.

Autism Awareness. Day 5 E is for Elopement

Day 5

E is for Elopement

“Check water first”. The most terrifying emergency directive a parent can hear….and this is the protocol for children with Autism who go missing. Elopement, wandering, bolting, fleeing. 48% of children with autism elope. Drowning is the leading cause of death in kids under 14 with Autism. We are lucky-A2 only gets distracted and wanders to find things that are interesting without regard to safety or whether a familiar adult is nearby–but he does not run from us–which prevents so many families from being able to go in public safely with their child. One of the things that makes A2’s non-elopement complicated as that he is not a risk…. until he is.  He can go a full year with staying in eye shot and then one day out of no where he will simply leave the house. With no warning. He also cannot tell anyone his first and last name with consistency or clarity.  He does not know his address or phone number despite years of practice.  He knows my full name, but unless you are a trained listener. you will not understand him.  We all know to approach a young child who appears to be lost, but most would not think to approach an older child or young adult. Be aware–this is one way we can all be a village to our families!

Unfortunately, there are limited ways to actually prevent elopement behaviors.  When we assume the function of behavior is escape we may be missing out on other factors.  Does he bolt and laugh while doing it as he watches you chase him (attention)?  Is he fascinated with streetlamps or water or heavy equipment and feels intense compulsion to go check it out (access or internal attenuation)?  Does he seem to leave only in specific situations or with specific people?  If you have a child that is a runner, consider tracking the behavior for antecedents and response or consequence (even when unintended), track the time of day and what was happening around him at the time.  Track WHAT the elopement looks like…does he run or is it more like walking away?  Does it change what it looks like based on the situation?  Besides lockdown and direct supervision, understanding your child’s behavior through data collection is your best preventative defense.

As far as what else you can do if your child is an elopement risk…again, limited but both high and low technology options can be lifesavers. If your county or police department have a special needs registry, register your child. There is a national initiative and grant called Project Lifesaver that your police department can utilize and get wristbands with gps or radio signal your child can wear. Keep an up to date photo of him on you at all times. Create a card he can carry with him with his information and use discrete trial training to teach him to hand it to someone if he cannot find you. Consider a cell phone and GPS tracking or the Find My iPhone App. There are tracking devices like http://www.angelsense.com available for a monthly fee. These attach to the inside of clothing.  Go online and search for other high and low tech options they are out there.

GPS tracking device reviews:  http://www.safewise.com

List of tracking, ID and safety products (not an exhaustive or all inclusive list): https://www.autismspeaks.org/family-services/resource-library/safety-products

It is easy not to move forward because we do not want to assume the worst…..but like for so many of us in many aspects of our lives with our kiddos…we have hope for the best…but plan for the worst.

 

 

Day 4. D is for Details

Day 4

In grad school I learned this neat little thing called a ecomap…and then saw another mom post a personal one in a blog. A year ago, I decided to make one for the kids (for sake of privacy, a fourth of this map is not shown) For us, that means 37 total IEP objectives and 19 ISP service areas to track, 44 providers, 12 clinics and 6 agencies we are in regular contact. All before work and caregiving. When you meet a parent of a child with special needs–and if you run into them somewhere and they don’t seem to recognize you….or you already know one who seems extra high strung or flighty or snarky….well….cut them a little slack. Not everyone is built to keep this much in their head all the time.

Day 3 2015. C is for Coping

Day 3

In the most typical of situations sibling issues exist. For sibs of those with significant impairment, these kids are often the invisible bystanders. Their issues and needs sometimes take backseat to the immediacy and reality of their sibling with Autism needs. We ask them to deal with leaving fun events earlier than they would like, let embarrassing situations roll off their backs and stifle disappointment. The rate of having more than one child with neuro diversity is high. Sometimes, the less impaired child is asked to cope and step up in ways that would challenge even the most typical and mature of children.

Day 1. A is for Aides

Day 1

A is for Aides.

Though I can’t find pictures of all of them, they have all made a significant impact in our lives. Without them, A2 would not have made the gains in language, socialization and self care that he has. They have cleaned vomit out of their cars, do not ruffle at the idea of diaper changes, and have endured power struggles with grace and maturity. They are the extra eyes and hands in a world where we have none but need 20. They are young and move on with their lives from us but we have always known that we sacrifice longevity for love and are happy that so many reach out to stay part of our village.

B is for Boredom: 2015 Autism Awareness Month

Day 2

While A2 is the most fun loving, joyous person you will ever meet and lovess to be on the go–like many children with Autism he struggles with extreme boredom since he requires adult intervention to choose, initiate and maintain activities. His explicit expression of wanting to play with other kids is emerging but often it leaves him alone knocking on the back door window as he watches children playing unsupervised across the street.