Autism's answer

I was watching a whole range of laughing babies on YouTube with a friend yesterday, and then I thought hey, why not speech therapy? I came across various videos of speechies doing all sorts of sessions, and then came across these ABA autism videos...I think it's from a group of people in Australia. One video (one of many made by this YouTube user) was viewed quite a bit more than others. The parents of the child featured on this video appear to be advocates of ABA therapy, or to say it in other words, their child appeared to benefit from ABA therapy. And yes, I think it's great, but not for everyone and you have to really know what you're doing. My struggle to understand ABA and its place comes up when I see how it is based on behavioral theories, strictly observational...but then see how communication, one of the largest difficulties with autism, is so much more than simple cause-effect...so much to communication is subtle...I see so many kiddos that do benefit from ABA, but then hit a wall...they can say a whole bunch of words and will stop and listen when told, but then don't initiate...that's the huge wall that needs to be climbed. Can ABA teach a child to initiate? Another issue to want to know more about is, how does ABA address language function and use? They can teach language form and content just fine, but to use language in a social context...that is lost. What then is knowing language if you don't use it? It's so hard to untrain rote phrases and the idea that if I say something, I'd get something...communication is so much more than that...it starts with intentionality--attention, just knowing that there a communication partner around, and then goes all the way up to complex conversations still with that other human being. The child may be able to say his/her name and age and I love you with perfect enunciation when asked, but can he/she say it within context, in play with a peer or when given a hug by mum. I learned early on that the phrase 'I love you' is one that parents hope for, and ask a speechie to train in once the child shows signs of verbal communication...and yet, ironically, it's one of the hardest phrases to teach...it has all those higher level phonemes in it, it's a whole 3 words, and it's an abstract concept.

Out of the womb into gloved hands

I had an eval with a little one who was very very delayed...and it was hard cause you actually knew what the cause of the delays were (but then again, it's also frustrating when you don't know what the causes are). But he was a real cutie...and his parents thought he liked me :) That's always helpful in an eval...but he still didn't show me everything he could do, and was quite upset most of the time...all this poking and proding :C Poor baby. Anyhow, this just reminded me of how many kiddos I've come to know that are whisked off into the world of therapy and appointments and doctors since Day 1 of Life. Truth be told, early intervention is great, and the sooner the treatment, most likely the better the chance of 'catching up.' But then I think of the parents who hardly knew a normal childhood for their kids because of all this intervention and the children who never knew a normal day as a child because of all this intervention. You can tell a therapy child a part...at least a therapist can...therapized. I wonder how many parents still remember the one more treatment solution called the miracle. A miracle that will solve everything overnight. After attending meeting after meeting and one search for answers after another, how many still carry that glimpse of hope, that one day, everything will just click, that that unexplainable miracle will occur, just as it does sometimes for people with more concrete medical problems like cancer, etc. I think it's harder to remember because we're usually talking about long-term therapy care, years, probably ending at 9-12 years of age, if it's just an artic issue (or less depending on the delay), and going well into the teens years if it's language/learning disabilities, and probably a life-long process if it's cognitively based (e.g. autism, MR, etc.). I know I forget sometimes, after thinking and working on goals for the next 6 months, 1 year, 2 years, long-term, projected outcome, etc. But then I remember that, s***, we, as a profession, don't know squat about the ins and outs of how things work...we only know what we can see and what science can prove, and what our human experiences tell us. Sure it's a lot, but then again, who knows what the entire picture is like? Who knows if we're missing a critical piece except for time and trial-and-error? I wonder if the future therapist will read back into today's journals and say, oh, yeah, that's just like when they knew there was mass, and mass was made of something, and one day, discovered atoms weren't really the smaller unit of matter. The knowledge that we don't know everything drives me to believe that I need God in my therapy sessions. I need Him to work in the lives of these kids, patients, whether it be healing them, making progress, performing that miracle, or using their lives to teach the people around them...God knows exact what's wrong and how it can be resolved. And with the little we know and can do, He will work His magic and use our gloved hands to do His work.

Empathy

I was in a consult today whereby the parents were told they could expect their child to be in therapy for many years. It wasn't a quick fix, and the road ahead was long. Severe disorder, may not be completely resolved. And that was the truth as far as today could tell. And the mum started to cry. This is not the first time I've been involved in a case whereby a less than preferred prognosis was given and there were tears, but at some degree this was my first case whereby I play a significant role. I feel that responsibility as least. Today was preceded by the few years in which this battle has been fought, since birth. And I recently joined in. It's frustrating not being able to provide a cure. It's even more frustrating for the child, frustrating for a parent not being able to solve and alleviate the child's frustration. And even more frustrating knowing that the child understand what's wrong and is constantly affected by it at such an early age.

And then I got an email that a colleague's mum had passed away. A colleague not so far off in age from my own. I realized that times have indeed changed. It used to be grandparents that passed away, now it's parents. Friends don't live with their parents, they live on their own, independent decision makers.

On a separate note along the same line

I have a pretty tricky client...simple put, really tough. I guess I didn't put two and two together when I decided to work at a sensory integration clinic. Anyhow, one of my more sensory kids, the ones that don't know what input they need and you have to ease in the input without them running away, stayed with me for 15 minutes without being distracted internally or externally. Whew...AND *drum roll* imaginative play came out today!!!! That is super super exciting to see, I have not seen it in his age group but once or twice here since I started, all my clients being pretty low. And once I got the play initiated, gave a starter idea, he took it and ran with it...granted, it was just one more main idea added, but that is GENIUS! I am sooo proud of him. And I got the look on his dad's face when he did it, pure joy :) This is the child that ran the opposite way when he saw me...we'll see how this goes, hopefully continue in the right direction. And perhaps it's the hardest ones in the beginning that gives you as the professional the most satisfaction in the end. We'll see.

Bright sunshiney day

Yesterday I got news that a parent said she felt that her child had a connection with her, and that "I got her." That's one of the biggest compliments I could get from a parent, and that totally made my day, my week, my month, actually, the first positive affirmation deal since I started working. And it came the day after I thought I couldn't do this anymore, that I wasn't up to par, that I just was hitting the ceiling again and again and couldn't learn from my mistakes anymore, and just plain making mistakes. That compliment lifted me up again. And I know God knew I was at the end of my rope and needed something. I cry out to my God and He answers me. In all my sins, despite all my shortcomings.

I wonder what my role is in this field. The way things are going doesn't necessarily reflect how I thought things would be. Since the day I left Calvin, things have gone differently that I imagined it to be. I know I want to specialize. In what, I'm not sure...what I thought I would be, I don't see it coming anymore...maybe it will come back.