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Wednesday, January 21, 2009

Handy hint – the power of touch [the nudge]

Inferences are a stumbling block for many children and some autistic ones. These difficulties crop up in both language acquisition and in practical day to day life. For instance, on a cold day I might hold and open a jacket for one of my children. The visual cue of the jacket as well as the ambient cool temperature, just before school, may prompt many children into the ‘correct’ response of putting on additional clothing. However, that is not the case around here. Many parents use additional scaffolding to help their children navigate many of these hic-cups, such as verbal cues and or PEC’s.

All too frequently, in my limited experience, parents such as myself, miss an obvious step, skip ahead of ourselves or fail to note the obvious. Now although my long term memory isn’t as good as many, there is one thing about my youthful days that I can still recall. It was a morning ritual. My mother would crouch down to help me put on my shoes. She would say something like “well put your foot in it then!” I would look down at the top of her head. I could not see my feet. I could not see my shoes. My toes would wiggle about in search for the invisible shoe. My mother found it very frustrating. I think I also found it frustrating but probably more confusing than anything else. Because of this experience I make sure that when I help my own children with their shoes, that they have a clear view of both their feet and their shoes, although they generally sit on the ground. Standing on one leg is generally an advanced skill for many children.

One of the main differences between my experience and my children’s is that I was highly motivated to please my mother, to be a good girl, whereas this, until fairly recently, has not been a motivating force for the boys. Dressing, is not a high priority for them, they are indifferent. In addition, shoes are positively hateful, aversive. The combined effect is indeed a challenge.

If you need any hints on how to make shoes more fun, then I have a list as long as your arm, however these days, they are much more co-operative, so I am able to skip the step of hanging their shoes on my ears. Nonetheless, the visual and other prompts often fall flat. There is still a glitch in the executive function. It may be helpful to think of this as inertia:- everything is set up in place, ready and willing, but they need another little nudge to get the ball rolling in the right direction and overcome ‘stand still.’

So there I am on the floor, in front of my sitting child with the right shoe in front the correct foot. I say the right words in an aurally attention grabbing manner and yet no movement is forthcoming. It is easy to lose it completely at this moment, having already prompted, cued and encouraged every teeny tiny step of a morning routine for over an hour, times two. However, for my boys at least, I find that a gentle tap on the back of the calf, nudges the leg into that first movement. That’s all it takes. It’s like kicking away the brakes and away we go.

I don’t know where your child is on the spectrum. However, it may be that you can avoid the many "mistakes" that I made. One of my "mistakes" was my efficiency. I deemed my children incapable of anything. Teaching basic skills was way too time consuming and my attempts caused no end of tantrums. Therefore it was quicker for me to do everything for them, and I mean everything. As a result they remained helpless for far longer than they should have done. If you find yourself similarly situated, then maybe some small but significant and manageable lesson could begin. It is challenging to know exactly where to start with children who are unable to dress, toilet or eat by themselves.

It may be easiest to begin with something that they can already do. This may take a change in "perspective." For example, the one thing that my children did quite marvelously was to remove all their clothing, frequently. I viewed this habit as a highly frustrating negative, especially since they were completely unable to dress themselves. I found it infinitely ironic. It took a long time to redress, each of them, many, many, many times a day. In fact to be quite honest, usually towards the end of the day I would simply give up, exhausted, hopeless, helpless and "useless."

Then I learned about tactile defensiveness, just a little bit, just enough to give me a clue, a very tiny clue.

It was one small part to tackle. If they were without clothes then their bodies were available for contact and sensory diets came into our lives. Shortly after that the reality of ‘generalization of skills’ also made it’s impact. They learned, gradually, to enjoy sand play and other more obscure pastimes. One obscure pastime was a huge box filled with garbanzo beans, to waist height. Body painting, shaving cream, chocolate spreading and no end of different textures to explore, as we tried to desensitize them. There was ample opportunity, due to a lack of clothing. It took a long time and even sand play became fun, but it was only fun at home. It was not fun at day care, nor the beach, nor the park, because generalization also has to be taught.

I made many, many mistakes as I learned, because one child was a sensory seeker and the other was hell bent on avoidance. I learned brushing skills, but I am still very bad at it.

As usual I digress.

As I write, I am mindful of the fact that this will never reach those whom I would most wish to reach. Those people do not blog. They have no time to blog as they are far too busy doing what needs to be done, alone, just like I used to be. If they’re lucky they may have a few friends, but those friendships have dwindled in number and thinned in frequency. But in conclusion I would like to say that no matter how difficult some days can be, better and brighter days become more frequent, hopefully for all of us.

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