We have a new at-home therapist who will round out Oliver's service program. He now receives therapy for various amounts of time six days a week from five different therapists. This is in addition to the specialists at school: his teacher, the OT, the speech pathologist, etc. As we have been filling in the blanks of his program I've had an on-going dialogue with his lead therapist: How do we know if he is being too taxed? How do we know if he can handle more? Research indicates that a 40 hour/week program of behavioral therapy yeilds the best results. What family can sustain that kind of program? What else can we do to create the on-going learning environment that he needs?
It is something to get used to: inviting people into our home on an almost daily basis and integrating them into our daily life. Most of the therapists are young, college-aged women, each with their own strenghts and abilities, but all of whom have a love for working with children like Oliver. They also know more about autism than I do as they have each worked with children who are variously affected with ASD. So far I have been impressed with their enthusiasm, energy and inventiveness -- all of which are valuable assests in teaching children who need to be constantly motivated and reinforced. Oliver has adjusted well to the new routine at home and seems to enjoy working with each of the therapists.
I have also come to realize how important it is to, as much as possible, make every moment count as a learning experience for Oliver. There is so much that typical children learn from their environment and through imitation that he just doesn't pick up. The best way to teach new skills has so far been the "hand over hand" technique in which we sit behind him and physically get his hands to do what they need to in order to accomplish whatever task: using utensils, turning on faucets, coloring, etc. It doesn't take many repetitions before Oliver has picked up new skills and the sense of reward it gives us -- and him -- is golden.
It is a different life than I had imagined for Oliver. I always believed I would provide for him the unstructured full-of-fun childhood that I remembered --a far cry from the one that is taking shape. Because he is so young, the teaching methods are mostly play-based but they still require him to work at accomplishing certain goals. During therapy sessions I keep busy in the next room -- out of sight but not earshot -- and I often hear the now familiar phrase: "First work, then play!" It is a strange that it is my three year old son to whom they are talking. But with the right therapists the work turns out to be fun and this is hopefully what will keep motivating Oliver, and us, to move forward.