From Facebook:
"Day 3: Frustration and discouragement. Couldn't get Ryan "emotionally regulated" in order to get some productive interaction. We did circle time first and he did well, but it was downhill after that. We had to call it a day at 10 AM. :( "
The day started off with promise. We got there a bit early again, and I took some time in the Rainbow Room (gross motor skills) to try out some of the items/activities with Ryan. He liked the slide and a nubbly ball like the one we already have at home. However, he got mad as soon as I made him stay in the single treatment room with me so I could take some notes/do some recording for this week's "homework." Once I allowed him out to wander the Rainbow Room again, he was fine.
Today, we tried to do circle first instead of later, to see if it was the timing that was bothering him: Was he too worn out for it at 10:15? It seemed to work very well. Ryan was picking up the pieces and placing them on the stories and Velcro boards (with some prompting) for "Bear Went Over the Mountain," "Where are the Farmer's Animals?" and "Brown Bear, What Do You See?". During "Wheels on the Bus," he (with prompts) high-fived the therapist [Shall we call her L.?] for "The horn on the bus goes beep beep beep," and he (without prompts!) lifted my hands up and down for "The windows on the bus go up and down." The other mom made an observation, which surprised me, but I realized she was right: Ryan seems to get upset as soon as we do "The Itsy Bitsy Spider"! It's near the end of circle, like the 3rd-last song, but it still seems to set him off. Weird.
Then we went into the Blue Room, which is where we work on fine motor play and sensory (we also have snack in there at 10 AM). We were still trying items to find what reinforcers Ryan likes there, to show him the appropriate way to play with certain items, and to see if he would attempt some of our goals for him. Those goals include making choices by reaching for one item over another; imitation of how to use the item; picking up things he had dropped; handing things over when someone requests them; putting only "Ryan's reinforcers" into his mouth, and responding well when we blocked him from mouthing other items; etc.
On another point, we are going to try getting some kind of clip-on chewy thing for Ryan that he can mouth whenever he wants. That way, he won't get upset when we block him from mouthing inappropriate items, and he can get that comfort and sensory input whenever he needs it.
In the Blue Room he was starting to get tired and was leaning back on L. and I, but we got some interaction. One time he rolled a car across the floor after I showed him a few times. We found out he still loved the dried beans, and now dried pasta, for running his hands through (this guy is what they call "sensory"; he loves stuff that gives him sensory input--texture, flashing lights, vibrations, spin, etc.) L. also tried to have Ryan hand her things, but he responded better when Mommy asked for it. He handed a little train car to me 2 times in a row when I held out my hand and said, "Ryan, give it to me."
Suddenly, though, Ryan reached his breaking point. He went from tired but participating to total meltdown. He was sobbing and trying to lay down on the floor, and refused to participate any longer. We tried his reinforcers, but that didn't calm him. We tried cuddling, but that didn't calm him. We tried just leaving him alone and letting him wander for a minute or two, but that only calmed him for a minute or two.
I had told them today that Ryan's favourite activity at home was the rocking chair, and asked if they had anything like that in the Rainbow Room (gross motor). Yes, they did. So, we took him out to this little rocking/teeter-totter type thing and put him in. He was crying off and on most of the time, but L. and I could both see that it was helping Ryan a bit. When L. sang softly and rocked him, he responded a bit better; he also liked it when she rocked him kind of silly and tapped on the rocker while she sang a silly song at the same time. During that time, when he'd have a calm moment, L. was trying to get him to give her high-fives when she would pause and hold out her hand, and give a verbal prompt. He did it a few times, in between the bursts of sobbing. She also handed him a plastic bowling pin and tapped it on the rocker, while he held one, to see if he'd imitate; I think he attempted once or twice.
By that point, Ryan was just a mess: exhausted, bawling, snot everywhere. L. said it was time to go home.
As we got ready to leave though, L. and I both noticed something: Ryan started to settle as soon as he saw Mommy getting the coats. When I had put on his coat and grabbed our bags, he actually smiled. Then he laughed. L. and I realized, at the same moment, that Ryan just might be playing us here! Perhaps he has figured out that if he cries hard and long enough, he gets sent home. Well, if that's the case, then we're onto him! We looked at each other and she said, "Okay, if he seems fine once you get home, and stays emotionally regulated [no roller coaster mood-swings], try some of the things we were doing here today. If he responds well and doesn't get upset, we may be in for some rough times ahead. We may have to just let him cry and cry, and tough noogies!" I responded, "Tough love?" and she said, "Yep."
Guess what? Ryan was happy 95% of the car ride home (only got fussy when I stopped for a coffee), was in a great mood since we got home, and gave me several high-fives and great eye contact from the comfort of his rocking chair at home. Oh, boy. I think we are going to be in for some tough days ahead. I was already sweating and stressing today when he kept crying. What will I do when we have to ride out morning-long, recurring tantrums from my normally even-tempered, easy-going little guy?
Someone I know had warned me that his wife (they have an autistic son) said the hardest part of this is watching your child get upset, forcing them out of their comfort zone, knowing you are doing it for their own good, but still . . . It is hard to see them so upset. I know now he was absolutely right.
On a physical note, we are torn between whether Ryan is physically weak, used to being lazy, or a combination of the two. He always wants to slump back against someone when we do circle or play on the floor, and when it's time to stand up, I have to pull him up. We tried to prompt him to stand up on his own (because we know he can!), but he stood half way up with me holding his hand and L. holding his butt, and it took about a minute before he would fully stand on his own. (?) We are going to try getting him to stand, when prompted, from sitting on a chair tomorrow.
One last thing: we finally have our assessment with Dr. Saunders on Saturday. We were supposed to do this before we started Unity, but it didn't work out for us. I am very curious to see what he has to say about Ryan's diagnosis. Ryan hasn't been formally assessed in almost a year and a half, and diagnoses can change. I am especially curious to see if Dr. Saunders will be able to unravel the mystery of Ryan's intellectual abilities, or if it's still too early to know. We shall see.
No comments:
Post a Comment