Autism...Blind Faith Calling

I rarely post about my 320s or autism in general these days, but I happened to read a forum post asking for help with a student with autism who displays aggressive behavior. This one regular poster said something I thought was so true, deep, and inspiring. After giving great recommendations, she said:

"Being a therapist is a calling. We don't often get to pick and choose our caseload. It is normal and it is okay to have a few students that cause you stress, a few that you would trade in a second, and even a few that you don't like. But, in the end, we are there because they need us. Try to put your job into a different perspective. Look at all that you do accomplish, and all of those parents and patients/students that are better because of your effort. Call upon your sense of professionalism and just do what you can for a difficult student. Know that all across the world, therapists, teachers, nurses, and counselors are also only doing what they can. We are humans, too. We have a life outside of our jobs. Focus on the time you give to that student that is difficult, then put it away until the next session. It is your responsibility to find a place in your career for difficult days, difficult students, etc. as well as for good days, sweet students, fast-learning students, etc."

I am rarely compelled to post on this forum but once in a blue moon, I do. Actually, one of the first few posts is how I got connected with BSILF!

Today, I felt compelled to post in response to the cry out for help and share what I've learned through my most trying year. I wrote:

I certainly agree with what everyone has shared and just wanted to add on.

I, too, strongly urge anyone working with individuals with aggressive behaviors to attend the Nonviolent Crisis Intervention (NCI or CPI) training programs. As the previous poster said, restraint is used only as a last resort, but by being professionally trained to restrain protects us from any litigation, so long as we adhere to the NCI procedures. Without being certified in NCI (2-day training), one is not to restrain anybody (unless they aren't afraid of getting hurt and being sued). In addition, the training (lightly) prepares you on how to prevent aggression or de-escalate the situation once it has occurred with behavioral techniques.

You mentioned that the student's aggressive acts had decreased from 15-20 to 3, but are now increasing again. Does anyone know what changed? E.g., environment, routines, adults, home situations, medication. Does your district have a Board-Certified Behavior Analyst (BCBA) that you can collaborate with? They are trained to conduct a functional behavioral assessment (FBA) to determine the function of a behavior. Results and behavioral recommendations are then worked into the Behavior Support Plan. (This is moreso an effective but long-term procedure that involves interviews, collecting data, experimenting, etc.)

When I first worked with my most aggressive student (head butt, scratch, hit hard, and pulled my hair once), I had to experiment a lot and consistently do certain things with blind faith. I know every child is different, but what worked for me was a multitude of strategies:

1. visual supports -- can't stress this enough. Also using the Pre-Mack Principle with visuals: "First...Then..." [First, (picture representing speech time -- same picture used on their visual schedule), then (picture of taking a walk -- a reward he chose)].
2. give him choices of order of speech activities and rewards.
3. environmental arrangements: e.g., I sat across from him with enough room behind me to spare if he leaned over the table to try to hit me. If necessary, the paraeducator sat behind him so that he couldn't get out of his chair to come around to attack me. e.g., Working in a secluded area (e.g., use wall/room dividers so there are less visual distractions and somewhat less auditory stimuli).
4. using a prompting hierarchy and giving the student enough time to respond before prompting again (generally 5 seconds before repeating stimuli + additional prompt...if we don't give them enough time to respond, some of them get auditorally bombarded which can lead to frustration and aggression).
5. working with OT to incorporate sensory strategies or breaks. E.g., give student a 3-5 minute sensory break before speech or incorporate mini-sensory breaks in speech sessions.
6. Working with the child during his snack time. While working on language (requesting, labeling) with the use of his own snacks as reinforcers, the student establishes that you are the Provider of Goodies...and theoretically/ideally will not want to sabotage that relationship. This really worked well for two of my most aggressive kids. Once I was fit into their routine (twice a week) by providing their snacks, they somewhat generalized their "good" behavior to the speech setting. (Clarification: the parents pack the students their snacks and lunches; I just hold onto their snacks and have them request for it with "good" behavior, such as "quiet sitting," and appropriate language.)

Because your student is young, you might even just begin with "quiet sitting" -- getting him to sit for 5 seconds (if that, or longer if he can) with quiet hands, quiet feet, and quiet mouth and incrementally increasing the time. After all, we need our kiddos to be able to attend before we can really work on other things.

I work with middle school students with severe autism and I can't stress enough how important it is for us to get the behaviors down while they are young (even though we are not behavioral therapists...but we implement a lot of behavioral techniques, whether we know it or not). Once they're in middle school and high school, they are so big and strong (even the small, skinny ones) and what with hormones, the aggression can really get outta hand and will take even more energy, time, and people to work with one kid.

On a less serious note, the main student that I based this post on...has totally become my favorite! I've been working with him for a year and for the first new months (fresh out of grad program, thinking, "I didn't learn how to work with these kids nor did I sign up for this!"), I dreaded seeing him 3 x 30 min/week because of the behaviors and unsupportive, untrained staff. After many consultations with other professionals, lots of trainings on visual supports, numerous trial-and-error, and consistency with blind faith, he rarely displayed any behaviors around me after a few months. Actually, it's a 180 from him hating speech (and/or me) to now literally making a bee-line towards me whenever I enter the room (and tries to smell or kiss me...which is something else I am working on avoiding now!).

After feeling like I did something good by sharing what I've learned with J320, I looked at my profile:

Group: members
Posts: 13
Joined: 12-July 07
Member No.: 737

13 posts in 1.5 years? That's it?!? I bet 2 of those 13 were in response to BSILF's same post. Dang, I'm lame.

Happy New Year!

Male Translation

So this one's a different post -- it's still work-related, but it's not about my kiddos. It's actually about some adults I work with.

This year with the 320s has started off quite smoothly since That Crazy Lady is gone, there is a new teacher, and 2.5 new aides (the .5 was here from September through December of last year). Lately, the teacher's been giving me a hard time about the .5 aide who tries the same line on my every single time he sees me (even though he's married with a kid and knows my status, too). Today, I realized his predictability reached a whole new level.

This morning, I e-mailed the 320 teacher to ask if I could use their second classroom to see my regular Special Ed kiddos. I also gave the heads up that during 7th period, I was going to pull in a girl with ASD who has an aide...and I bet the .5 Aide was gonna go back to the teacher and be like, "yo, did you see her??"

So my session began and as the girl and her aide were walking in, the teacher hustled the staff, including .5 aide, out of the room and closed the adjoining door. Not a few minutes later, the .5 aide came in from the outside door. I was already in full swing but stopped my student, stood up, and said, "Mr. [.5 aide], can you close the door so I can turn on the A/C?" He did, got his drink of water, and then left. In my mind, I was like, c'mon, did he really have to get a drink of water right now and distract us, knowing that we were in session?

After my session, I went to debrief with the teacher.

320 Teacher: Oh, I didn't put 2 & 2 together! I thought the aide was your student's mom and you were about to hold a meeting.
Me: no, no, that was the aide...
320T: Yah, [.5 Aide] caught a glimpse of her and told me that she's not the mother, but she's an aide here, too. I said,"well, did you introduce yourself to her?"
320T: He said he met her.
Me: Wait, what? No he didn't.
320T: Yes he did.
Me: When? Just now when I was working??
320T: He said YOU introduced them.
Me ROFL: You know what I said? I said, "Mr. [.5 Aide], can you close the door?" You call that an introduction?!

Classic case of a male interpreting a simple statement to feed that macho ego of his. That was pure comedy!

~~~~

Okay, I can't resist telling a quick story about one of my 320 kids. This one has a tendency to script, vocalize to stim, and cuss people out (i.e., echolalia). He's also been getting a bit grabby with me, like he'll grab my arm with a good grip even though he's a little guy.

So I was at the teacher's desk looking over attendance logs when I felt a hand on my rump! I quickly turned around and saw 320J looking up at me and saying in a loud and clear voice, "Hiiiii!!!!"

If he hadn't gotten my attention inappropriately, I would've been giving him the hugest social praise party; the kid spontaneously initiated an appropriate greeting with clear, purposeful intent! He walked all the way from wherever and "touched" me to get my attention (vs. hitting, kicking, screaming). Too bad it just wasn't with the right kind of touch...

My Favorite

It's no secret (on this blog) who my favorite kiddo is. BF used to ask me all the time, "Who's your favorite?" When I finally realized and admitted that it's J320, he stopped asking me.

Now, he often surveys, "What is your favorite thing that J320 says (or does)?" I had a hard time figuring it out b/c J320's speech can be a messy chunk so by the time I get home, I forget exactly what he says.

Today, I finally figured it out -- and remembered.

That Crazy Lady and I had been in a relatively short IEP (2 hours...vs. 3-4) but we knew that J320 had been acting up all that time...b/c we could hear him on the other side of the wall and we could feel the room shake whenever he jumped. When the meeting adjourned, we went into the classroom. His aide had gone on a break so J320 got even more antsy so TCL decided to take him on a walk. Before she did, she had to tell an aide something so he stood there, starting to whine. I walked over to him (whence he invaded my personal bubble) and I said, "I need to tie your shoe." He stood still and let me tie his shoe so TCL partially prompted, "What do you say?"

J320: I-nee-hel-plea. (translation: I need help please).
We both try to stifle our laugh and TCL prompts again, "No, what do you say?"
J320: takeawalk!
Me: Give me your other foot... [he stomps a little and then lets me tie his other shoe.]
TCL: What do you say?
J320: Iwa'mee-A!

I was laughing so hard at this point! He said, I want Miss Liang! Poor baby probably doesn't even know what he just said but it totally made my day.

This is just a classic case of him getting his language all mixed up due to anxiety and anticipation of his reinforcer. He ends up spitting out every learned phrase contextually related even if it's not in the appropriate sequence. So it's not that he "wants" me per se, but he was just trying so hard to say the "right" thing (i.e., Thank you) that he ended up recycling every possible phrase that he thinks he's supposed to say until he gets it "right." (Yes, it's my job to help him discriminate and get it right on the first try.)

In retrospect, I am actually surprised that he said my "name" without a prompt! (My name went from "Mi'Lee-A" to "Mi-Mee-A" and now to "Mee-A." Sigh.

My favorite thing that J320 says is my name. Sometimes, instead of spitting it out in a chunk like he usually does anytime he talks (except during group therapy during snack time...and apparently, it's beginning to generalize! Woohoo!), he'll kind of elongate it like he's singing, "Mi-mee-Aaaa."

Throwing in the Towel Update

Perhaps That Crazy Lady has regained an ounce of sanity since she decided on quitting. I have to give her props -- since she set her mind on leaving, her attitude and collaborative effort have been totally rad. She's truly achieved the "I quit" zen, where she just doesn't care any more...and that carefree spirit has really decreased her stress and anxiety level...to the point where it's benefiting me in so many ways! For one, I am hearing less crazy theories. Secondly, she has been on the ball when I need her support.

Today during group therapy (i.e., snack time), J320 was a mess. He didn't get much sleep the night before, so he was throwing a tantrum or on the verge of one pretty persistently through the morning. The moment he sat down for snack, he was fake crying and whining to an even louder extent. I prompted for quiet sitting, but he wasn't having it. So I said, "Okay, you're not ready," and turned to the next kiddo. He acted out even more (mini-extinction burst) so I looked at TCL, and she immediately took him away for a time-out. When she came back I told her that the second he demonstrates "quiet sitting" (whether he realizes it or not), run like crazy to bring him back to snack (differential reinforcement).

Mind you, his time-out area was at the other end of the classroom. I went about my ways with the rest of the kiddos, and then I noticed that it was quiet at the other end of the room. She saw me look at J320, and she immediately sprinted over to him and brought him back to snack.

He was a SAINT for the rest of snack!! High-five to TCL (and J320)! :D

Also a high-five to myself b/c I have gotten good at keeping snack time within 30 minutes. Not to mention both on Friday and today, N320 has needed less prompting for a louder voice for making his snack request to me.

Group therapy during snack time continues to rock!

Hormones

I often allude to the fact that my kiddos are in a "funny" stage in life. They are growing so fast that sometimes, I feel like they've sprouted an inch since I last saw them a week ago. For many, the hormones are raging...and most of the overly-confident boys aren't afraid to make comments about girls around me. I try my best to remain professional and mature, but sometimes, I can barely stifle my laugh.

This morning, I saw my two boys CV and DA. I hadn't seen CV in two weeks so I entered my typical teacher-conversation-mode:

Me to CV: Well, hello! I haven't seen you in forever!
CV: Yeah, maestra! You got any food? I'm hungry!
Me: No.
CV: Any gum?
Me: No! What did I tell you about coming in here hungry?
DA: I'm hyper! I ate breakfast!
Me: You're hyper?

[Great! DA is naturally very hyper! When I first started seeing him, I seriously thought he had undiagnosed ADHD.]

Me: Well, I'm glad to hear that you ate breakfast for once, but not exactly thrilled that it made you hyper.
Me turning to DA: Well, I saw you last week alone since [CV] wasn't here.
CV to DA: You did? You saw her alone?
DA says with a totally suggestive tone and facial expression: Yeah, A-LONE.

[And he flashes the hugest, goofiest, toothy smile.]

I was like EEK!! Stop! Way to get me fired over false allegations of sexual harassment!

Moving forward, I must've told them "stop" at least 10 times today! I had them working on formulating sentences and at least half of them ended with, "...in bed" or something totally PG-13. When the session ended, my grad assistant turned to me and said, "I don't know how you deal with them. I was ready to kill them for you!"

Later on in the day, J320 walked by with TCL so I joined them so I could further confer with TCL about my insane session with N320 today. The bell rang and so tons of kids started filling the hallways. Out of my nervous nature, I slightly extended my hand out so that J320 could hold onto my pinky for security. I never know how he is going to react to the typical kiddos. Sometimes, he gets so excited that he squeals, jumps, and takes off running. TCL was holding his other hand, when he suddenly let go, gently swung his arm around my neck...and pulled me in as if he was going to kiss me!

Again, I completely and immaturely freaked out and ran to the other side of TCL! Then it took me a few minutes to recuperate from laughing so hard!

Yay, Finally!

I had a really comical speech session with J320 this morning.

J320 is a crazy, extremely lovable kid. (I can't imagine what life at home must be like.) Not enough words could describe this kiddo; you just have to be there to get the full effect. He is what we might consider high maintenance; one must always keep an eye on him or else he will get into trouble! I often come home with stories about him and find myself echoing some of his unintelligible speech.

For instance, he often says, "shoshofee." None of us knew what that meant until last week, when I had a breakthrough J320-interpretative moment. I asked him a function match-up question, "What do you wear on your feet?" He spat out, "shoshofee!" I had a sudden revelation/J320 interpretation! He means, "shoes on feet!" Which totally makes sense b/c he likes to take his shoes off...so what do adults constantly tell him? "Put your shoes on your feet!"

Fast forward to today's session -- too bad I can't remember everything about our session that had me ROFL. I do remember that at one point, when I was delivering his reinforcer (a food item), it went like this:

Me: What do you want? Sausage, pancake, or strawberry?
J320: I want strawberry please. [Only, he is not as intelligible and he speaks in "chunks" so it comes out more like, "Iwanstrabewyplee!" but I was thrilled that he used "all his words" without a prompt.]
Me: Oh, good asking! Here you go...
J320: Yay.

I was like, WHAT?! Did he really say, "yay"?? If he did and he meant it, then shoot, I should have packed my bags and called it day! It would be an appropriate, social comment!

Then when speech time was over, I said, "Ok, take your breakfast and go to the table to finish." He stood up and picked his tray up and impulsively grabbed a strawberry to stuff in his mouth. I stopped him and said, "Wait. First bring your breakfast to that table and then you can eat." He followed through with the two-step direction, so I was thrilled (we are also working on the "wait" concept b/c he can be quite impulsive). As he approached the table, one of the paraeducators asked, "All done with speech?"

J320 says, "Finally." We were dying! (Sometimes, we carry on conversations with the kiddos as if they are typically developing. And sometimes the things that the kids respond with makes us wonder if they get the best of us!)

This is probably one of those 'you had to be there sessions.' Never a dull moment at Little Kid School, especially on Mondays and Fridays.

It's Raining, Where's Mom?

Today was our monthly meeting with N320's team, which consists of the 320 specialist and case manager, That Crazy Lady, N320's Mom, NPA Behavior Therapist, the paraeducator/1:1, and me. Now that I'm a future BCBA, these meetings have become increasingly interesting and meaningful...not to mention, I've grown, learned, and contributed a lot since our first meeting so I've earned my place at the table. (1/2 j/k)

This time was especially interesting and sad b/c we discussed the "bipolar episodes" in depth. (I was just kind of annoyed b/c I caught That Crazy Lady rolling her eyes a few times whenever the 320 specialist dissected issues; they have an ongoing behind-the-back-slandering thing). We think we pinpointed the interesting antecedents to the behaviors that have recently escalated (or replaced others). I gave my piece about how his behaviors have been so difficult for me that I now have his paraed in close proximity, especially after the elopement incident.

Before Mom left, N320 sprinted over to me and almost stuck his hand down my shirt twice and tried to jam his fist into my crotch. She was mortified and screamed at him to stop. I felt really awkward afterwards b/c I could tell that she felt awful about it all. I didn't want to leave without saying good-bye so when she looked like she was about to leave, I awkwardly said please don't worry, you are doing such a "good job" being a (single) Mom of three boys including one with a disability. I immediately felt like such an idiot for saying something like that! I meant to say something much more eloquent, articulate, and deep! Being a Mom of a child with a disability is not a job with performance reviews, especially a review from a 28 year-old with no child of her own! Ugh! I could have hid under a rock.

She just kept profusely apologizing for his behavior and expressed how she felt so bad about it and didn't understand why he does that...and then I saw the tears well up in her eyes. I really wish I could have eloquently articulated that it really is okay and that she should not feel bad.

Instead, I asked if I could hug her and we did.

I wish I could tell her how much I love seeing Mom and N320 together. When I see them greet, hug, and kiss each other, I know that no words are needed to express the mother-son love that they share with one another. That Crazy Lady thinks that Mom gets too caught up in the emotionalism of the disability and how it comes out 'inappropriately.' Despite having to look at it from a professional point of view, I disagree with That Crazy Lady. Mom often holds side conversations during the meetings to quietly ask, "Why was he crying?" In a way, it's her 'professional point of view' to probe; she's his mother for crying out loud. And I feel so much for her when she does ask. I know that it's not an accusatory interrogation. It's an innocent question bred from love. The pain and anguish is evident in her eyes -- she knows her son is experiencing something so sad...yet he isn't capable of expressing what he is feeling and why.

Instead, he cries, "It's raining, where's Mom?"

...

P.S.

I've been asked to help him identify his emotions and their causes during therapy. Should be interesting and challenging especially since he doesn't cry around me...unless That Crazy Lady is around. (Imagine this hypothetical script: "Oh, I see that you're crying. Are you sad b/c That Crazy Lady is here?") Usually when he's with me, he has the most devilish look on his face! I've caught him looking at me from all the way across the room! It is craziness. I am tempted to create a Boardmaker symbol with the happy face and two red horns and pair it with, "Oh, I see that you are feeling mischievous. Is it because you are getting ready to grope me?" j/k In all seriousness, I've become immune to the groping; if anything, I am actually embarrassed that I don't have an effective way of dealing with those behaviors. Moreover, he has recently figured out that he can grab onto my hand or fingers and not let go.

This is so Ironic!

My "not programmed to lose boy" drew me another picture today. His drawings are quite vivid and imaginative. I'll post them as soon as I remember to take pictures.

Anywho, I thought about him earlier this morning when I worked with J320 because Programmed Boy also randomly laughs and says really loudly, "This is so ironic!" all the time.

Random: Secretly, I think it is interesting that his language appears to be above average when compared to his SDC peers (I assess him for his tri in a few weeks), but if anything, I really need to work on pragmatics with him.

Anywho, the soOoo ironic part about this morning was when I went to with J320 this AM. It was a little unplanned so that was already not in my favor. I was originally scheduled to see N320, but he was having one of his "bipolar breakdowns," crying up a storm, repeating, "it's raining." (I originally thought it was mean for That Crazy Lady to say N320 was having a "bipolar episode" whenever he started crying like that, but tonight, I saw a commercial for a medication for Bipolar Disorder...which he just happens to be on and his dosage was recently increased.) Anywho, since N320 was in his rainy day mode, I cashed in on the opportunity to work with J320.

I've been so pleased with how J320's been doing these couple of weeks. This AM, however, he seemed a little feisty...possibly in part because his great 1:1 was MIA again (and I waltzed in at an irregular time). So when I approached him, he was lazily laying on the bean bag (which is never a good thing for me, based on past traumatic experiences). So I gave him my usual transitional verbal prompt and visual cue.

Well, he had been laying there stimming (or as ABAs would say, engaging in automatic reinforcements), and he ironically whacks me while simultaneously saying/echoing, "No hitting!"

I can't remember if I chuckled at the irony, but I remember thinking, For crying out loud, how in the world do I respond to that?!

I guess that was more of a rhetorical question b/c I know that I need to just ignore (not draw attention to it therefore reinforce the behavior), which I think I did...but it's always like this -- after the first hit, I'm traumatized for the rest of the session.

I also ran out real quick for a lasik eye surgery follow-up appointment mid-day. Left eye is between 20/30 and 20/40...and borderline eligible for an enhancement procedure. Not sure if I should be thrilled about that. I need to wait to see if my vision will stabilize some more (hopefully at 20/20) and go back in 4 months for another check-up. I told BF that if I get the lifetime warranty insurance, I would only want to get it in my left eye. I totally should've done that! Would have saved myself $150. =P Of course that would have sucked if I got insurance on the wrong eye...

Security!

Despite the ridonkulously crazy schedule that I set for myself today, I was really proud of myself for finally sticking to my schedule, in addition to fitting in testing and 2 make-up therapy sessions. Shoot, I was in the autism classroom even before they got off the bus -- that's how on top of it I was!

First, I worked with 320J for his usual morning session. I was really happy b/c he did exceptionally well (and his behaviors were barely a challenge today!). He even followed my point to his classmate across the room (joint attention) and greeted his classmate with minimal verbal prompts! I was thrilled!

Next, I worked with the highest functioning of the 320s. I got lucky b/c when I worked with 320M, the 320 psychologist brought a parent over for a transition interview (I will get the incoming sixth grader next year) so the Mom got to see a little bit of how "normal" therapy can go. Unbeknownst to them all, I am also lucky b/c I happen to remember this kid from when I observed one of my mentors a few months ago; this kiddo will be the highest functioning if he does transition into this classroom next year.

Snack time was next so I worked on picture exchange with 320P, my nonverbal kiddo. He cracks all of us up. I love working with him at snack because it's so fascinating to see his idiosyncrasies (well, all of theirs for this matter).I.e., he loves mini-Oreos...but he takes them apart, licks the cream, and discards the cookies. He nibbles Chips Ahoy cookies just to get the chocolate chips and refuses to eat the cookie. I asked Mom to start packing him gummies b/c he is always stealing 320J's so today, he had a bag of gummy bears. He gave me the symbol card, but I quickly learned that he only likes the white gummies (I don't blame him -- the white ones are my favorite too!). Some of the gummies had melted together so there was a big blob of 2 white and 1 red gummy bear. He nibbled the red off, spat it out, and ate the white. Ha! Hey, we're all selective eaters to some extent, right?

I rushed back to check in with my grad student and to harass one of my kids to bring back her IEP invite and then I went back to see my last 320, the busy hands one. Rewind: I had an absolutely disastrous session yesterday for all sorts of reasons (excuses). I typically see this one before lunch b/c food is his big reward/motivator. Yesterday was all jacked up b/c the NPA Behavior Therapist declared the day before that he was coming in a 2-hour window to observe me and That Crazy Lady. So we saw 320N right after snack, when he conveniently loaded up on sugar. In retrospect, I don't feel like a complete failure b/c the NPA BT couldn't even manage 320N's behaviors. I am just bothered by the idea that this mofo might go back to Mom and narc that I am completely clueless on gaining control of the session (which is extremely likely -- long story). I'm sure it didn't help that I completely grilled him beforehand (in as sweet a way as I could) about all that ABA stuff. I mean, he's supposed to be the autism behavior therapist consultant...yet I could tell that his type is why I am fortunate enough to get my BCBA tuition reimbursed through the SELPA.

Anywho, so I saw 320N again today. We were doing SOOO well for the first 20 minutes. He tried to grope me a lot but we got past it each time. Then he got up and ran to the door. That's always potential drama. I stood up, took a few steps, and did the prompting hierarchy to get him to sit down. We worked a minute, and then he bolted for the door again. I started the same procedure...when he flung the door open and took off running. I freaked out! I looked towards the other room, where everyone else was, but knew that if I opened the door to scream for help, 320N could be anywhere on campus by that time. So I ran out and saw him around the corner, about halfway down the corridor. He saw me walking towards him so he ran off again, stopped, turned around, and shrieked with excitement. I knew that if I ran, he would sprint, so I kept calmly walking towards him.

It's like the movies when a negotiator has to calmly approach a suicidal person about to jump off the ledge, "Don't come any closer or I'll jump!"

He took off running anyways and I panicked some more b/c it was lunchtime so half of the campus was at lunch while the other half were in their classrooms while this kid was running down the hall loudly shrieking. The second he turned his back, I sprinted towards him and firmly grabbed his wrists. The problem is that I am never strong enough to keep the grasp so he got loose and ran off again. I caught up and he pulled me to the corridor hall. I think he sat down in defiance...which was to my benefit. I quickly kneeled on his feet and held his wrists down so that he couldn't get up nor move.

I'm sure God was laughing and then decided it was time to intervene...but still wanted some comic relief b/c then my most clueless student comes walking towards me, "Hi Ms. L____." I cannot emphasize how clueless and forgetful this baby is. I swear I almost keeled over from shock when he remembered and said my name just a few weeks ago! I said in as calm a tone as I could, "B___, I need you to help me. Please go to Room 44 and tell the teacher, Ms. J, that Ms. L___ needs help. Tell her that I'm here." So he's about to take off when he asks, "You mean the room next to Ms. P__?" (His teacher's.) I'm like, Crap! Way to confuse this confused boy! "No! I mean, room 39 or 41!" Crap, why tell him both room numbers! That's too many things for this boy to remember! Sometimes, he evidences the short-term memory of a goldfish. (His teacher and the psych will attest to this.) "Go to Room 39 or 41 and tell the teacher to come help me please!" "Okay!" and runs off in the wrong direction! (LOL) "B___, the other way! It's the last classroom on the other end of this hall!" I was so sure that he wouldn't be able to follow this complex instruction embedded with clauses and was already looking around, trying to devise a Plan B. He runs off and I calmly talk to 320N. He keeps shrieking and struggling to get up while I continue to freak out.

Not a few minutes later, I see his 1:1 coming from one direction and TCL coming from the other direction (Starsky & Hutch style, she likes to call it)...and 3 campus security guards getting nearer, yelling into their walkie-talkies, "Situation is under control!" I was mortified but relieved. The aide and TCL took over and I kept looking at B___, with his big droopy eyes, and I just about jumped up to hug him. Before I could, I turned around and saw 320N sprinting away, but TCL got him and we all went back to the classroom.

During the debriefing, the aides that were still in the classroom re-told how adorable little B___ came into the classroom, out of breath, garbly (like he usually is) and trying so hard to relay my message. Mind you, this kid is diagnosed with mental retardation, language disorder, dyslexia, and recently Autistic Spectrum Disorder and so it was like telegraphic speech, "Ms. L___; she's over there...and there's a boy, and she needs help." LOL Fortunately, TCL is quick on the uptake and knew right away that 320N and I were not in the room next door any more. Not to mention, she told me this morning that this same type of incident happened just a few days ago.

When we finally settled down, I was completely wiped out. 320N's aide attested that he has really been acting up this past week so don't feel bad. We talked about B__, and I emphasized how I was so proud of him for being able to follow through!! TCL was, too, so she went over to his teacher to tell him, in hopes that she would reward him. I later went over to see some of her other kids and told her again how grateful and proud I was of B___. Sadly, she was too annoyed by him to appreciate the situation. Poor baby. I am totally going to acknowledge him next week. Seriously, if you knew this kid, you would totally appreciate what he did...much more, his ability to follow through!

Goes to show that these kiddos will continue to surprise us in the ways that we least expect it.

As mentioned, I am wiped out. I don't know how I managed to get through the rest of the day, but I did. I should have a drink or something, but it would be wiser for me to read and study my textbook... :(

Thank goodness I have two three-day President's Day weekends coming up. I certainly need it!

Crazies

I know I'm crazy, but I don't think I'm seriously crazy-crazy.

I really think that at every workplace, there is at least one Crazy-crazy. Where I work, That Crazy Lady (TCL) is always introducing crazy hypotheses -- but when she talks, she sounds like she is sharing The Truth or talking about scientifically-proven theories.

Today's crazy antic from TCL is that JB's 1:1 is a meth addict. How in the world did she conclude that based on his absences? I just went along (e.g., eyes got big, incredulous, "really?!" followed by a lame remark of "well, you better watch your wallet.")


I remember when I was in junior high, the thing that ended my long-time best friendship was b/c she always stole my ideas and claimed that they were her own. I feel bad about that now...

Back to TCL -- she is also one of those crazies that takes the knowledge that someone imparted to her and throws it back at a person as if she was the first to learn it and then she shares it with you like you're an idiot. A few weeks ago, I explained to TCL that individuals with autism often see/think without the Gestalt effect (pieces do not form wholes; wholes are wholes, pieces are pieces) and she was absolutely mesmerized by 1) I used a big term and 2) the concept. I.e., JB eats oranges -- including rinds. One day, I de-rinded an orange slice and handed it to him. He looked at it like I had handed him something completely foreign and inedible, and he threw the orange wedge aside, grabbed an orange slice with rind, and popped it in his mouth like he typically does.

Today during his lunch, I started to de-rind his tangerine to see what would happen. He still requested for his tangerine (with a verbal prompt), but TCL said to me matter-of-factly, "Don't take the rind off. He won't eat it. He won't recognize it as an orange b/c they see things in wholes..." I'm like, okay, hello, I was the one that told you that! In my defense, JB actually de-rinded the tangerine and ate the pulp wedges...and then ate the rind separately (overanalyzing: perhaps it's b/c it was a tangerine and not an orange?).

She did that before when she stole her nemesis' knowledge that JB will run and wrap himself in a nasty bed sheet for a sensory break (block out visual stimuli and get a tactile stimulation). The crazy thing is that her nemesis had told me that a few weeks before, but TCL says to me one day, "I figured out why he runs off and wraps himself up! He's overstimulated and needs something to calm him!"

That is crazy talk. Is it bad that I do my best to stay on her good side b/c I don't want to deal with melodramatic craziness? The last thing I want is for her to spread the word that I'm a drug addict, too.

It's Raining

I wasn't expecting it to rain today (nor 2 nights ago), but it was a pleasant surprise. I told BF, "it's raining," but rather than saying it in my excited tone, I said it with a flat tone, reminiscing about one of my 320 kiddos.

I found out on Wednesday that when my 320 boy with unquiet hands is sad (or experiencing any negative feeling), he says, "it's raining" with a soft, flat tone. (Teacher says that this kid is scared of rain so when he says that it's raining, it means he is sad.) I'm not sure how true it is since attaching meaning or communicative intent is hit or miss, but to her defense, we had a tough session that day and the little big kiddo kept alternating every few minutes between, "It's raining" (when he was clearly upset and crying out of control) and "It's not raining" (when he calmed down/temporarily stopped crying). So it did seem appropriate.

I also thought about my very first 320 kiddo (in on-campus clinic). One time, he was scared out of his mind. He heard a vacuum in the distance and completely freaked out, grabbing me tightly out of fear. Vacuums were his worst nightmare incarnate. BF often wonders about him, as do I.

Autism is such a mystery that only God understands.

Busy Bee

This week has been exhausting. Aside from seeing as many of my kiddos as I can in a day, I was out a total of 2 days for trainings and meetings. On Tuesday, I was out all day for a County training (and had a snazzy, yummy candied walnut 3-berry salad at the Nordstrom Cafe) and then I had two IEPs and a District meeting on Wednesday. On Thursday, I attended another District meeting; come to find out, it was training on a program that I had previously received 3.5 hours of training for through the County.

One thing (maybe the only thing) that I don't like about working for the County but acting as if I work for the District is that there is a lot of confusion on policies, and I end up going to trainings...on the same things.

Yesterday was my VTW's first day with me, so she observed me trudge through my pulling-teeth-sessions. I'm not too confident she'll learn kosher therapy techniques from me. I find myself cashing in on "teachable moments" every few minutes while throwing in a potpourri of cognitive therapy, just b/c my poor potatoes need so much language stimulation. Luckily, she was MIA for my disastrous 320 session. It was so bad that two aides and the teacher kept intervening to help me get the student to sit with me. Not to mention, the head honcho 320 teacher specialist was there to observe...so I got lots of constructive criticism (translation: lots of homework for me this weekend). Needless to say, I felt like the worst therapist.

On the other hand, the feelings I've had between yesterday and today are similar to this one time in my grad program when Former Dept Chair cracked down on me hard about how I am capable of doing better and he expects nothing less (not that I was slacking off; I tried my darnedest to get an A in his class and couldn't). So, after a total of 14 hours of sleep (I took a nap this afternoon), I am feeling revived and mentally ready to tackle my workload in preparation for next week.

Despite having a disastrous day with the 320s, I still enjoy working with them. The thing is, it's like they are so forgiving. They have their off-days, just like any of us (only, we can communicate that to others effectively). But when the sun rises the next day (or on Monday), we all start anew and put the past events behind.

P.S. I am having a blast shopping for sensory toys for my other 320 kiddo that I am starting PECS with.

Taboo

I am loving my new career. :) Despite all the chaos and cramming days into minutes, it is rewarding and fun. Not that I've made any life-altering changes with my kiddos, but there have been small things to celebrate.

For my regular S/L caseload, some of the kiddos come in a real funk and/or cop a real attitude. Although I am secretly nervous and praying to God that it doesn't show, the sessions usually turn out all right in the end, thanks to Hasbro! It's amazing how Cheryl's Language-Building Version of Taboo can really break barriers. My kids are having a blast (as am I). E.g., I was totally surprised when two of my stoic kiddos in two separate sessions actually wanted to do one more round! Yesterday, the younger brother of one of the stoic kiddo's stopped by my room and actually asked, "Hey, when are you going to call me in again?" This was coming from a kid who asked to close the door the first time we met, likely b/c he didn't want anyone to know that he was coming into Ms. Liang's Speech Room.

As for the kiddos on the other end, I've made some leaps from a behavioral POV. I've quickly learned that with these kiddos w/ severe autism, I have to go through hazing with almost every one of them. It's not fun, but it's absolutely necessary. I am fortunate to say that after 2 sessions, Baconnator (he perseverates on "bacon" when I do DTT with him) has stopped whacking me upside the head. It was pretty scary when that happened. I had flashbacks of when I was in Downtown LA and a random girl clocked me really hard on the side of my head and then ran off, yelling, "stop following me, b!tch!" As for Happy Hands, hazing was relatively quick, too! His 1:1 was so shocked (yet pleased) that she high-5'd me the other day and hugged me the next day. I only had to chase him the first time. The next 2-3 sessions, he stayed put. Today, his mom snuck in and fortunately, we had what I hope is a "normal" session from hereon.

The sad news is that Mr. Where the Wild Things Are has transferred out. I am still getting updates since my friend is now working with him.

Okay, this blog post is called task-avoidance. I need to get going on updating tx goals and writing an assessment report. I know I'm not supposed to work from home or work OT, but that's impossible until I get some assistance. The good thing is that my assistant should begin in 2 weeks or so!