Why I Do What I Do

Yesterday was one of those days that reminded me why I do the work I do. I was working with my first little kiddo, who's almost 2 years old. A little history on him is that I've been working for the better part of a year on just getting him to initiate intentional communication - ANYTHING intentional. He has been diagnosed with Autism, which is the youngest child I've ever worked with to have been diagnosed with it. During therapy, I have modeled the sign for "more" (requesting is usually a good place to start) and given this little boy hand-over-hand assistance for signing more about a gazillion times. I've taught him other things as well, which he has been learning. In the beginning, he wouldn't even tolerate me touching his hands, then he slowly would let me help him, then, within the past couple of months, he got to the point where he would reach for my hands so that I could help him. At that point, I figured he knew what I expected out of him, but just was being over-reliant on my help. Around that time, another parent of a child I work with gave me an excerpt from the book "Overcoming Autism". The authors are very knowledgeable and work with children on the spectrum. They give very practical advice on how to teach a child to communicate. One of the things they mentioned was that a nonverbal child will go through a routine of behaviors to indicate that they want something. If they get it, fine... no need to verbalize. If they don't get their needs met, they keep going down their list of behaviors to try to get a desired item or activity. So, in order to encourage a child to either vocalize or verbalize, you have the desired item, model the verbalization that you want to teach the child, and let him/her go through the repertoire of behaviors, never giving in until they produce the modeled verbalization. This approach, while it seems mean to some, made sense to me. After all, what child is going to expend more effort than necessary in order to get what they want? For that matter, what logical and reasonable adult will?

I was having such a hard time with this one boy that I thought "what the hell, I'll give it a shot". This was three weeks ago. His repertoire of behavior was to reach for the item he wanted. When I held it just out of his reach and modeled what I wanted him to say, he would sit back. Then he'd reach for it again. When I wouldn't give it to him, he'd begin to whine. He reached for the item again, and his whines turned into full out crying (with real tears and everything). Still, I did not give him what he wanted, but continued to provide models of what I wanted him to say. At times, the crying episodes would last as long as a half hour, at which point it was difficult to calm him. Each week, we went through this routine. Sometimes, I was not prepared and he would simply walk away from me to avoid the pain. Most of the times, I either blockaded him in a corner or put him in his high chair so that he could not escape. I was just beginning to question my decision to keep up with this approach when we had a breakthrough yesterday. I read a book to him and was having him point to pictures in the book. When we got all done with the book, I took it away from him, but held it in front of him to see what he would do, then asked "what do you want?". He reached for the front of the book and tapped it with his fingers, and I still held onto it. I repeated my question - "what do you want?". He looked straight at me, made the sign for "more" and said "mmm" (which is what I had modeled for him). I looked around as if to check if anyone else saw this miracle! Then my heart proceeded to do flip-flops in my chest, and I had to choke back the urge to cry. We've been working on this so long and I've tortured this poor boy for 3 weeks! Finally.... intentional communication AND a vocalization! This was a huge reminder for me of why I do what I do.