Vestibular, proprioceptive, sensory integration, crossing midline, pincer grasp, motor planning... all big words pertaining to therapies for Jack. Although the words are intimidating, thankfully the "work" is not, because it's all play-based. Here are some of the strategies we're implementing for his autism:
Playgroups: At least once a week either Hans or I take Jack to a professional supervised therapy playgroup with other autistic kids. These playgroups are always an interesting and unpredictable mix of personalities and autistic traits: some kids are overreactive, some underreactive, some respond to stress by flicking the lightswitch up and down or slamming doors, some by seeming to go to sleep. It's sometimes tricky to get these kids to interact, but when they do we've witnessed some good social growth.
Occupational/sensory therapy: Our home-based work can be just about anything -- on a daily basis Jack manipulates playdough, moonsand, laces with string, builds with blocks and legos and train tracks. These assist with fine motor control. Outside he plays with the hose, draws letters and numbers with chalk, blows and pops bubbles. These two books (Starting Sensory Integration Therapy and The Out-of-Sync Child Has Fun) have lots and lots of new ideas we'll be trying in the coming weeks, like bean bag tossing, pounding with hammer and nails, playing with shaving cream, balancing on a wobbly beam... enough ideas for months.
Motor planning (and self esteem): our best therapy is bike riding. Jack is so good at it and enjoys it greatly. We do it every day, for miles at a time. We're pondering purchasing a full-size trampoline; they are pricey but I think he would get a lot out of it (and I've always wanted one).
Soon we'll be starting speech therapy, floortime work with a home helper, and occupational therapy with an expert, so we'll get lots of new ideas.
It's hard to believe that we've only been working on his issues for less than three months (I had to double check the calendar because I didn't believe it myself). How has Jack changed?
In early May, when Jack would come home from preschool, we'd ask him about his day. What did he eat for snack? Who were his teachers? What did he do? He would answer each question the same way, "I don't know." We were at the playground one day and three of his classmates were swinging a few feet away. "Who are those buddies?" I asked Jack. Same answer, "I don't know." Virtually all he would talk about was numbers. He had a "hand clock" -- his two hands would make number shapes and he would hold them up in front of his face and count. Constantly. His favored toys were numbers from a puzzle.
Two months later, Jack sits at the dinner table and tells us a few details about school -- maybe one child he remembers having snack with, a project he did with a teacher (whom he will often remember by name), and what food was tasty for snack. On a day after playgroup he will spell a child's name with letters in the bathtub. We haven't seen the handclock in weeks. He does still fixate on numbers, particularly when stressed and at the end of the day, but Jack now has the capacity to talk about other subjects, spontaneously show interesting things to us, and bring a toy for admiration to a visiting adult at home. Instead of playing exclusively with numbers, he plays with just about everything. His old show-and-tell standbys, the number puzzle pieces, have been replaced with a favorite book, one of his nuts and bolts, a small car, plastic animal, etc. While in the past he would most often relate to his numbers as if they were people, he's now moving through an obsession with babies. I can see this drifting toward a better understanding and acceptance of kids as playmates. It's coming, I'm sure of it.
In May, conversations were fragmented and illogical. When asked why, he would be unable to respond, or would say, "that's just the way it works." Now Jack can often respond with reasonable logic. He can now accurately recount the details of a bicycling adventure or explain how an argument started and was resolved.
Jack's sensory awareness has grown. He was previously underreactive -- I'm convinced that's why we've had so many problems with potty training (it's getting better, but most of the time he's still not aware when he needs to go). Now he wanders into the kitchen and says, "I smell something yummy." We have some work to do with his sense of touch, but overall he's more sensory aware.
Only one month ago, when asked to draw a circle he would switch the crayon from one had to the other; now he uses only one hand (usually the left) to complete circles, and is willing to cross midline (this helps to establish the dominant hand and is important for beginning writing).
He can and will throw epic tantrums when he doesn't get his way. But he's learning that a stack of blocks that gets knocked over can be fixed. One favored toy can be shared back and forth with a preschool buddy (he did this yesterday and I thought I would fall over -- He and a friend from school were both grabbing for the bubble bear at the same time and Jack said, "we can take turns."!).
I think his biggest improvement is eye contact. A few months ago he would not look at us unless we begged him to. Then eye contact was brief and perfunctory. Now he looks at everyone and has learned the joys of nonverbal communication -- his eyes sparkle again like they did when he was a baby. When he is fully absorbed in play it can be difficult for him to break away and make eye contact, but overall he is much better.
We still have a lot of work ahead of us. Jack's empathy is not great and this can lead to big blow ups between us, like the other day when I badly cut my finger and stumbled around looking for something to staunch the blood flow while Jack screamed about wanting cherries and needing me to count to 9 RIGHT NOW. Less than ideal.
He is creatively mischievous and tests boundaries constantly. His top trick last week was to remove the running hose from the splash pool and place it inside the house, flooding the bedroom. That was not a fun afternoon. Both at home and school he seems compelled to rather violently dump stuff and then is never willing to pick anything back up. Perhaps encouraging more structured dumping (a small backyard sandbox?) will lessen the impulsive dumps. I have to remember that emotionally he is lagging behind a bit, and also that a little misbehaving is not the end of the world.
We love him deeply and are so happy that the work we've started is already helping. Onward!