Doctors and such

Last Thursday, we met with April from the P.L.A.Y. Project, and we have more goals to build upon with Max:

1. In his play, increase the interactive range of affects and emotions when problem solving (like bad acting). 
2. Use pretend play and drama. Use the stuffed animals for fighting.  Make sure ideas are guiding the play.  Enter Max's ideas through his make believe world as a character in his drama using words and actions together.
3. Play tag.  Freeze tag.  Simple motor play.  Simple rules.

We also received a write up of all the pre-assessments they had done prior to accepting us into the program.  They will compare this baseline information with re-assessment at the end of our time together.

All of these goals build upon things we do a little of, but we need to step things up a bit.  There was a lot April talked about that we can do in play that will prepare him for how to handle peer interactions in school.

Yesterday, Max had his Kindergarten physical.  Silly me, I thought, for the first time with either of our kids, that I would let Scott take him.  I was still scarred from holding him down when they tried to find a vein for his bloodwork, I figured I had earned a time off just this once.  I tried my best to prep Scott, but he did let his guard down in between rounds of shots.  Max actually bent a needle in his leg when he slapped it about.  Also, Scott and Dr. Farinas had some conversation regarding vaccinations, and Max came home WITHOUT having been given his MMR.

{pause to let that sink in}

Let me give you more of the story.  I was at Zumba and Scott called from the Dr.s office and suddenly told me he wasn't sure about the vaccines.  To which I replied, "Just get the vaccines.  The vaccines did not cause the autism.  Plus he HAS autism!"  So, I call back an hour later to hear about the bent needle and the chat he and the good doctor had.  Apparently Dr. F. wasn't that big of a fan of giving so many vaccines at one time.  That did not help the situation.  So now we have this form stating we knew about the vaccines but we opted out of one of them.  Eventually, I am sending someone's A$$ back to the doctor's office for the MMR. 

I am not an irrational person.  Had we discussed this prior to the eleventh hour, and decided it together, it may have turned out the same way.  It's just that, when I relinquish control to someone else, and this happens, it sets me back on the whole delegation thing.  Plus, if he gets measles, mumps, or reubella, someone better be ready to bail me out of jail.  Enough said?

So today's appointment was seeing the eye doctor for Kindergarten.  Amazing, isn't it?  Dentist, physician, optometrist...all before Kindergarten.  I believed, again, that others had control of this, and I would take a back seat to the professionals.  I didn't need to control the situation.

{pause to let that sink in}

Well, I should have known when the assistant pulled up a string of letters and asked Max what letters he could see that I was in for trouble.  Or when they had him look at a picture of a clown and several other things and asked him what he saw... yes, again, I needed to step in and instruct.  The doctor herself was not bad.  Just a few cues from me, and she got it.  Have my son, whose expressive language is a year delayed, POINT to a PICTURE of what he sees.  Voila!  20/20.  It was a rocky start, though.

So, now Max is set for Kindergarten, as far as the medical/paperwork requirements are concerned.  Just one, big roller coaster ride.  Lots of hills.  I need to scream at the top of my lungs more, though.  I think that's what's missing...

Summertime!

Summer is upon us at the Plato household. Memorial Day is Monday, and Ignatius has two more school days this week before he is officially sprung. Max and I are both done with our obligations of school... Max finished up ECE at Colene Hoose on May 21, and his last day at Little Jewels was Thursday. I completed my tenth year in District 87 and my nineteenth year of teaching in total. Feels weird typing that!

On Friday, Max and I spent our afternoon in the backyard at our friend, Krystal's, house. She just got an in-ground pool installed this spring, and the kids were loving it (OK, the adults were loving it as well). Here is a photo of Max exploring one of the many areas on the side of the pool.

We also met with April, our PLAY consultant, on Thursday. This session consisted of "meeting" Max where he was in play and using techniques from the program to get more out of his communication experiences. Our previous goals remain the same, and now we will be building on them:
1. use "taffy pulling:" stretch the interactions and keep them going by gently teasing or making funny sounds; this engages him and makes fertile ground for his use of language to fulfill his needs
2. use affect in voice in play; continue with simple words, no more than three words at a time; no questioning; use voice intonation to "create" a question
3. use a sense of humor, suspense, and surprise; find ways to make him laugh (pretend you are sleeping and wake suddenly when he gets close; use slapstick humor)

It really requires conscious effort to remember to incorporate this, but there are many times throughout his day that lend themselves nicely to these. Some of these are things that many parents use with much younger children. When he was "of age" for the crazy affect in voice (akin to when you play peek-a-boo with an infant), he was not engaging. So, to a degree, we are backtracking to meet him where he is and guide him forward.

The idea of using only a few words has proven very powerful, and, to those who know me, this is the MOST difficult part for me. :) I have been finding that the most frustrating times involve those moments when I am using way too many words.

April videotaped parts of my interactions with Max and will be sending me the DVD and transcript. She also gave me a DVD of our "baseline" play-based interactions from the first session. She also indicated that, from the looks of how he was engaging in problem solving, she was seeing definite cognitive strength, and she thought he might not have a struggle with the academic part of school based on what she was seeing. That was unexpected, and quite frankly, a relief. We shall see how that transpires over the next few years. She was really impressed with his problem solving ability. We spent a great deal of time at our gate in the back yard. We did "taffy pulling" to get him to express what he wanted (help with opening the gate). When we were not being particularly helpful to him, he found a nearby stick in the yard to help him in his goal. While he didn't completely open the gate by himself, he showed a LOT of efforts in trying to communicate his needs without a whole lot of screaming going on.

I realized that I was getting really good at Max's "language." However, responding to him based on what I knew he was conveying is not enough. I will not always be there to interpret for him, and he must start using words more to assist in allowing others to know his needs. As a family, we have become enablers to a degree... I think that was based on survival.

So, onward we go with our many summertime pursuits. We will be starting the summer reading program at the local library this week. I have plenty of things to keep the boys (and me) very busy!

P.L.A.Y. Project

We are fortunate to be participating in a research study of the P.L.A.Y. Project. Our local Easter Seals is partnering with the University of Michigan to research the effectiveness of the program, developed and directed by Dr. Richard Solomon.

P.L.A.Y. stands for Play and Language for Autistic Youngsters. According to the media information provided on the project's website, the mission of the P.L.A.Y. Project includes:

~Promote early identification and early intervention
~Educate community regarding National Academy of Sciences recommendations:
~~Begin interventions early (18 months to 5 years)
~~Use intensive intervention 25 hours per week
~~Have a teacher/play partner to child ratio of 1:1 or 1:2
~~Use interventions that are engaging
~~Have a strategic direction (e.g. social skills, language, etc.)
~Use community based approaches to promulgate Developmental, Individualized and Relationship-based interventions (DIR®)
~Support families in a parent-professional partnership
~Scientifically evaluate effectiveness of program

We are participating in the final part of the mission: the scientific evaluation of its effectiveness.

Our journey began a few months ago when the Autism Society of McLean County sent an e-mail on behalf of our local Easter Seals. They were looking for families with children under age 5 to participate in the study of the P.L.A.Y. Project. I was first contacted by Jim Runyon at Easter Seals for a phone interview. He sent me some information about the different areas of the study and asked many questions about Max. Over the past few months, I have completed instruments that have assessed me as his primary caregiver (one parent has to be selected for that) and Max. We both went to Easter Seals for some baseline information gathering.

This week, a P.L.A.Y. Project consultant came to our home and did some baseline videotaping of Max engaging in play from a box full of materials. April, the consultant, will be working with us for the next two years as we implement the facets of the project. She will leave us with three goal areas to work on for the month. From her observations in her first visit, she left us with these three P.L.A.Y. suggestions about engaging in play with Max:
1. Be with him. (power of the pause...no words needed)
2. Keep language simple - no more than 2 word sentences
3. Mirror his actions in play

During the day, we are to find 2 hours to engage in play with Max. This time can be broken up throughout the day. During these times, we are to be mindful of her three suggestions. She noticed that in the videotape, I used a great deal of verbal with Max when we play, but he shuts me out after two or three words. He's done. That's where suggestion #2 came from. Now, for those who know me, you know that will be the most difficult part of the month... :)

Mirroring his actions in play is actually really interesting. Tonight, Ignatius and I both mirrored him taking a chopstick and pretending he was in a car wash (the photo is of Ignatius playing with his brother). We laid down on the floor beside him and copied what he was doing, sound effects and all. It was fascinating how much he engaged. For about an hour (half with me and half with Ignatius) he repetitively played, re-enacting one of his favorite activities. The chopstick was the water pipe that sprays water and cleaning fluids on your car during the wash.

He was completely engaged while we were playing with him, and that's a tough thing to say about Max, especially about that duration of time. We were meeting him where he was, allowing the control of the play to be his, almost being "permitted" to enter his world of play. It was completely different from the play we usually try to force on him. I am really interested to see where this goes, and I am very glad that he was chosen to be in the intervention group, rather than the control group. More to come!