When Christine e-mailed me to write a guest post for her blog, I was humbled.
I am a speech language pathologist in the public school system. I have only been out of graduate school since 2005, and before entering into the public schools I worked in a nursing home and at a rehabilitation hospital. I just don’t consider myself an expert in this area.
I guess my interest in autism first started while working at the rehab hospital. It was there that I have my first memories of working with autistic children. One boy was 16 years old at the time, if I can recall correctly he had some good language skills, enough that he could answer questions and communicate his basic wants and needs. He wasn’t one of my patients though and I only worked with him a few times. I do remember observing his hand flapping and rocking back and forth, which are both red flags of autism. He constantly rocked and flapped his hands; I never saw him sitting still.
Another child at the rehabilitation hospital was adorable. He had a loving single mother, who always brought him to therapy and sat in the therapy room with his younger sister trying to observe what the therapist was doing, so she could carry over the same skills at home.
I love parents like this, those that are truly involved and want to help so bad. His therapist was teaching him sign language because he would not talk. I observed so many of their sessions and was amazed as he slowly began to learn some sign language. Again, I observed many of the red flags and this child needed many sensory breaks during the session. Pushing these little colored bears into the play-doh, and smashing down the bumps that it created was his most favorite activity. You wouldn’t think that this would create a lot of language skills, but it can.
Words such as “big, little, soft, cold, smooth, roll, flatten, bear, more, please, up, down, my turn” and more can all be taught with just a little bear and some play-doh!
I left the rehabilitation hospital, because my husband had a job change. I knew that we’d be starting a family, so I decided to work for the public school system so I could have summers and holidays off with our little one, once he/she arrived. 10 months after starting my job there, we welcomed a little girl.
Of course, I was worried about autism, and did some research on vaccinations, but we immunized her on schedule. Except when she was sick around 15 months of age and we didn’t know what was wrong, just that she was having gastrointestinal issues. Finally, around 20 months, she was fine and we had solved the problem, so we vaccinated her. At 2 years of age, she is right on track developmentally, and I feel very blessed.
Through the last three years in the public school, I’ve had a chance to work with many children with autism, be it preschoolers, school-agers, or those in high school.
I have learned one thing; no two children with autism are exactly the same. You can’t give them the same treatment, they all have different needs and skills. They all make progress in their own time, and they all teach you something.
I guess I should get on to the one student I really wanted to write about. He’s a 4 year old preschool student, who just started attending one of the public preschools that I provide therapy for. As far as I know he wasn’t receiving public early intervention. Usually when a child receives early intervention from birth to three, they are evaluated by the public schools and placed into appropriate services by their third birthday. But, this child wasn’t evaluated until he was 4. He didn’t meet the requirements for head start, so he came to this other preschool.
I received his information packet and his IEP (individualized education plan). First look at his goals, and I assumed he was a pretty high functioning kid. His eligibility was language disorder. I walked into the preschool his first day, and asked where he was,
when I saw him, red flags immediately started to pop up into my head. He was running around the room, echolalic (repeats what you say), and very into his own world, he didn’t follow the routine of the other kids when they went to circle time, instead he was fascinated by spinning an object around. In my mind, he was autistic.
As soon as I got back to my office, I dug through his file further.
I saw that he had received private therapy services, and that there were concerns of possible autism, so I sent home permission for us to do further evaluating.
Evaluations in the public school may consist of: a social/health/developmental history form, an observation by a special education teacher, testing by the school psychologist, etc. Once evaluations are completed a case conference committee meeting is held to discuss the findings of the evaluations and make recommendations.
We found this student eligible for services under the eligibility of ASD (autism spectrum disorder) as well as language impairment.
It is important to note that a school does not give the diagnosis of Autism, only a doctor can do so.
We recommended for the student to continue attending the public preschool setting, speech therapy services 1x a week, as well as occupational therapy on a consultation basis.
On my end, progress appeared to be slow. He required cueing to follow the classroom routine, and a picture schedule was recommended. We worked on action words and nouns, allowing him to perform each action word. We used a chair to get him to sit beside me at circle time. He continued to love helicopters and spinning of objects. Slowly over time, he’d look at me more and more. He began to bring objects over to me, naming them, and showing me how interested he was in them- which is a red flag of autism, but it also showed some joint attention, that he wanted me to care about the same things.
After Christmas, his class was divided and moved to another classroom. He was able to stay with the majority of his class and his old classroom teacher. We had two weeks off at Christmas, but the day I went back, I saw a different kid. I mean, he was starting to follow the class routine; he was sitting on the carpet during circle time! Of course, he was still flying his helicopters and spinning them around. But, he was also very interested in dinosaurs, which I hadn’t seen before.
Over time, he began to actually sing some of the songs they were singing at circle time. Although, he quietly sang them, still he was muttering the words. He began to perform the motions of the song. He would help clean up and was following class routine.
Spring Break finally rolled around, and this child was making great progress! He started to be more affectionate- giving hugs and soft kisses on my cheek, he was making more eye contact, and beginning to imitate the actions of other kids.
That’s what I’m most proud of. We have been working for several months on having him to acknowledge the presence of others. He won’t wave “hi” to me, he won’t even say “hi”, nor will he wave “bye” or say “see you later!” But, the last time I saw him, the girls in his class were all over him, and I had them wave to me and tell me “hi”, and you know what? He waved to me too! He waved because he saw the other kids doing so. He imitated that very appropriate action and I was so pleased! Afterward, his teacher was getting volunteers, and guess what? He raised his hand!!!! He wanted to be a part of it! She overlooked him, and I was bitter. Why not reward that behavior! But, then she pulled out other pieces to help with, and he got to be the “sun” in their song. He held the sun to his face, and did exactly what any other child would do- he smiled and sort of danced around. He was so happy to be the sun!
That was one of my proudest days working with him, because I could see the small steps of progress he had made!
I left the building that day, bragging to the director how well he did. He was outside on the playground, standing by the fence with 3 other students. I walked to my car, backed out, and guess what- the girls were waving bye to me. The little boy looked at them, watched them, and started to wave too! That action made my day a million times better than it already was!
I won’t have this student next year. He’s going to kindergarten. He’s going to an autism classroom, where they work on the STAR program. I am confident that his language skills will increase next year, and I’m hoping that he’ll be placed in a mild disabilities classroom. I’m really hoping he’ll be placed in the classroom at my school, so I can have him back!
I think early intervention is key to increasing skills in children with autism.
I also think that being around typically developing children is important. And, as a parent, you should give your child the most opportunities as possible. I applaud all of you that have children with autism. I applaud your strength and your courage and the fight that you take on for your child, and I honestly thank you for that.
I want to thank Elaine for her guest post!! Please stay tuned to our next post where we will talk about different treatment options!!
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