Thursday, March 16, 2006

On My Toes

Upon waking this morning, Oliver decided to mix things up a bit. Of late we have had trouble getting him to change his shirt. It takes a lot of coercing, cajolling and distracting but we always press on because, after all, one can't go around wearing the same shirt day after day. But this morning it was the pants that he refused to change. He had me going for a moment; I thought we were going to slide easily into the day. Since Oliver has mastered the task of dressing and undressing himself (except for the socks, which I'm not pushing because he is only 3!) I have started getting him to take it one step further and take the clothes that he will wear from the closet. First one article from the pile of shirts, then one from the stack of pants. I was pretty happy that he seemed to get the concept after the first time and now notice that he will even demonstrate a preference for one shirt or pair of pants over another, pulling one from the middle of the pile or putting one back and choosing another. Of course his sense of color coordination has occassionally left me wincing but I figure he gets that from his father's side of things.

I don't know why he gets stuck on changing an article of clothing. And why now? It isn't a problem if the shirt is dirty or if it is time for a bath, but otherwise, lately, it has been a struggle. And sometimes if we do manage to change the shirt with a minimum of tears then even one glimpse of it -- even ten minutes later -- will cause another fit of tears. After experiencing this the hard way a couple of days in a row I now immediately hide the shirt when it comes off. With Oliver, though, I notice that he maintains these sort of behaviors for a few weeks and then suddenly discards them and just as suddenly something new will take his interest for good or bad. So usually just when I have figured out how to handle one situation we are on to the next. My boy certainly knows how to keep me on my toes!

This morning, though I didn't even bother dealing with the pajama pants. A teacher in-service day meant no school and so Nik and I were splitting the day at work. I left the house at 7am and returned by 11:30 so that Nik could work all afternoon. But when I returned home I found Oliver laying lethargically in front of the TV. Since Sunday when Oliver first developed a fever he hasn't been back to normal. Although his fever left him Monday morning he has not yet recovered. Watching TV has always been a sport for Oliver. He isn't one to simply watch a video -- he engages with it. Our television screen is fully of nose prints, finger prints, hand prints -- and lately, for some reason, knee prints! Oliver imitates the characters of his favorite videos, he narrates along, he presses his nose to the noses of the children and other characters, and in general is just very, very animated. There is no sitting to watch TV. And certainly no laying down with his head on a pillow, which is why I observed him so fretfully this afternoon. I almost would have felt better if he had a fever because then there would be a clear explanation for his lethergy. Having your child not be able to tell you what hurts is hard.

As I have written before, the main focus of Oliver's ABA program is PECs and I have, at different times questioned this strategy. The whole idea of teaching him to communicate using pictures when what I really just want him to do is speak seems counter-intuitive. My instinct is to encourage and reward speech and so if Oliver can say "apple" or "water" I haven't always felt confident that reinforcing the use of an icon rather than the word itself was, in fact, beneficial. But communication is about so much more than being able to demand objects that are visible, as Mary, our lead therapist always reminds me. And PECS is more about teaching communication than vocabulary. This hit home to me as I tried to get Oliver to eat a few slices of banana at lunch time and wished that he could tell me: "My tummy hurts and I'm not hungry." The leap between what he can say: "I want banana." and what he can't: "I don't want banana." is much more vast than one word would indicate.

Oliver spent twenty minutes eating a muffin, crumb by crumb, and then I laid down with him in his little toddler bear bed and soon he was fast asleep. An hour later I woke him and he returned to the couch and laid there looking at the box to his favorite video. I relented and let him watch it. While he was laying there looking so miserable I stole the opportunity to run to the neighbors house and borrow a video rewinding machine. Our VCR has simply stopped going backwards and by the end of each day our choices have grown more limited and by this afternoon we had only two left. When I returned about three minutes later Oliver hadn't moved an inch but was wearing a scared look on his face. Even before I looked I knew what happened: the smell was a little offending. And all I can say is: Thank God for my new handy, dandy Bissell carpet and upholstery cleaner!!

Two pairs of clothes and two baths later Oliver seemed to recover a bit. He playfully bounced on my bed and ran back and forth to the window as we kept watch on the street below for Poppi's red car to turn the corner and park at the curb in front of the house. When Nik did finally arrive with RT in tow the usual chaos of early evening ensued: fussy children just this side of bedtime, broken bits of conversation, me cooking dinner -- all punctuated by the frequent ring of the telephone and a decidedly female voice on the other end asking for an almost-13 RT.

Oliver went right to bed at 7pm and was asleep within moments. He has already stirred once declaring loudly: "I want in the bathtub!" -- a mantra of his that has nothing to do with getting in the tub -- and I soothed him back to sleep with only one refrain of Twinkle, Twinkle, Little Star, a kiss on the forehead and a wish for sweet dreams and sweeter tomorrows.

9 comments:

  1. Tobin had a mysterious illness a couple of weeks ago. About 3 days of high fever, and zeven after the fever broke she was lethargic and clingy. (Oh so clingy!)

    If it helps at all, Tobin can't tell me what's wrong when she's sick either. She'll just cry until I'm able to guess.

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  2. I think its great that Oliver can dress and undress himself and that he is imitating things he sees on the TV. TV has become a very powerful stim for Alexander and we try to limit it now. I wish we never purchased Baby Einstein video's when he was an infant. He was so fussy as an infant and nothing seemed to calm him but those damn video's. If I knew then what I know now, I wouldn't have bought them.

    PECS- Have you looked into AVB- it's similar to ABA but approaches language differently. Alexander talks now, although not at his age level (3 months behind, although I expect that disparity to grow as he ages). PECs is taboo in AVB, he the child has words. The mand (request) is the first thing worked on in AVB. It took two solid weeks of screaming from Alexander when he first started AVB before he began to mand. Then he became a manding monster. Since I don't know Oliver's language impairment, I can't say whether PECS is right or wrong for him. There are many things I disagree with about both ABA and AVB and the further along we get into this, I'm insisting that we go by what my gut tells me, which is usually to approach Alexander based on what I think his strengths are and use them to teach. For instance, Alexander plays with toys somewhat appropriately. However, he is not interested in pretend play toys like Weeble town or Dora's village. The consultant wants Alexander to learn to play with these. I have squashed that idea because I don't think that we need to "program" pretend play and besides, I didn't like those types of toys either as a boy and I think playtime needs to focus more on learning to share and cooperate. Playtime should be used to pursue his interests. Right now its spelling words with puzzles which he seems to love, if this turns into a "stim" (which I suspect it is), it is a useful stim and I think we maybe able to use it to help him learn to read.

    I'm learning to trust my "gut" and I feel he is making small progress in the areas we work out outside the ABA/AVB framework.

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  3. Instead of writing PECS is taboo in AVB, he the child has words, substitute "if" for "he".

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  5. We started with PECS, but if he used his words all the more better.

    Yes, these guys of ours really keep us on our toes!

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  7. Henry's gone to school LOTS of times in school pants and a pajama shirt. Some days changing his shirt is just too much for him to bear. At this point I couldn't really care less if it looks silly, and obviously Henry cares even less than I do. Sometimes I put the school shirt on OVER the pj shirt...

    Henry also likes to get physical with the TV!

    It's really great that Oliver can dress and undress! Henry still doesn't like to, and I am an enabler.

    I'm a few days late on this. Hope Oliver is feeling all better by now.

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  8. This post so reminders me of Charlie and of days I've spent with him (down to the lethargy and the stomachache, and the bath/s). He'll often want to wear the same article of clothing over and over and we work on varying his clothes---just another way to practise flexibility.

    I always had the same response as you about PECS--that we should just be teaching actual speech. From many conversations with ABA and speech therapists, and from listening to and watching Charlie, I've learned that PECS (and/or other visual stimuli) can be a powerful way to prompt speech and build in communication skills. We did add some verbal behavior programming to Charlie's therapies when he was 4 and that really helped a lot with his expressive speech. With Charlie, we've always had to try everything.

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  9. Sorry Christine, I took down my blog. You can get my email from Kristina or Gretchen so I can explain.

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