Internet Resources

Last night we had our more-or-less-once-a-month family night at school, which basically means many of the parents from the three levels of autism classes (Pre-K, K-2nd, 3rd-5th) get together at school either with the teachers or with outside experts from the community and discuss a particular issue that we’re all struggling with. Not surprisingly, the issue we choose to focus on for the month always fans out into a multitude of other things we’re dealing with.

These are always great evenings, both for learning so much from each other and for fellowship with other parents. It often connects us with some great resources in the community, too. For example, we’re meeting in a couple of weeks with the special needs trust attorney we connected with at a previous family night.

One major issue that dawned on me last night was that without these nights at school there’s so much valuable expertise and information we’d miss out on. The collective experience between the dozen or so families that regularly come to these, the teachers and therapists, and experts from the community who come speak to us is amazing. We get together in the room and share what we know, have learned from our own experience, or found out from our research. We are in a sense passing down an oral history of what we’ve learned to each member in our little tribe of great parents.

It’s a godsend that we can do this, but it’s also incredibly inefficient. We’re all the time reinventing the wheel. Someone goes through the process of filling out paperwork for disability services or getting a handicap placard or resubmitting claims to Medicaid, learns a lot, but that learning isn’t easily preserved. So the next person who goes through it may not know which of us to ask, tries to get some part of the way down the road themselves, gets as lost as the person before them did, gets frustrated, and so on. Eventually they’ll find a person who has already been through whatever the problem is (well, assuming someone has), talk to them, and start to get unstuck. But in the meantime, so much time and energy is lost – time and energy none of us have to spare. Facebook groups, listserves, forums, Twitter, blogs, etc. all have an equivalent problem – little of the information posted is preserved in a way that can easily be accessed later by the entire autism community.

But how do we preserve this knowledge? I’ve given serious thought to developing a wiki for our school. That would at least be a start. Obviously there’s information everywhere online, but that’s both a blessing and a curse. There’s so much information scattered everywhere, but it’s rarely that organized, often out-of-date, wrong, or perhaps even intentionally false, and quickly too overwhelming to do anything with. I don’t need eleventybillion pages of information about something; I just want someone to give me the freakin’ answer to my question.

I dream of a central repository of process knowledge, “How do I do X?” sorts of information and instruction sets. Yeah, I realize that a lot of our challenges aren’t easily reduced to instruction sets, but a number of things can be. For many other issues, at least people can generate a few, high-quality ideas to get people started or nudged a few more feet down the path. I know it’d be a monumental undertaking, but collectively we are wasting God knows how many billions of hours a year trying to find information we need about how to do everything from the simple to the complex.

Would it be possible just to have some resource that filters out all the roaring noise about vaccines, causes and cures, controversial treatments, and whatever else and just gives practical, day-to-day information we need like how to fill out this frackin’ form for disability services or what the hell all these acronyms mean? The end result of all of our yelling and infighting and carrying on is that this sort of resource does not exist because what energy we have left over after being parents is consumed by all this other stuff. And it’s great that we are spending so much time and effort on the critical work of educating the world about autism, but it’s also essential that we remember to educate each other on how to live and do the best for our children.

I know it’s unrealistic to expect one site to handle everything, but humor the ideal a little. Even the process of aiming toward that goal should yield something a bazillion times better than what we have now. I’d rather have potentially ridiculous and unrealistic goals than have all of us keep pounding our keyboards in frustration.

Anybody interested in talking about this further? It would obviously be an enormous undertaking requiring a whole lot of people, but there are more than a whole lot of us out there and I know we’re all tired of banging our heads against our computers trying to find what we need. Maybe one of the greatest gifts we can give each other is saved time. Together we are stronger than we are on our own.

Oral traditions eventually developed writing, libraries, and ways to communicate large quantities of information quickly. In a way, maybe that’s a roadmap for us, too. Perhaps we don’t even need a map. Maybe all we need is to just sit down and start writing and connecting the dots for each other.

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A Tale of Two Speeches

by Tim on August 9, 2010

One of the inevitable things you do when you have another child after one who’s diagnosed as autistic is frequently compare the development of the two. You try not to – or at least not overdo it – because you want each of them to be their own person. I think we do a decent enough job in our house of letting the J-Man and Dale Jr. be on their own timetable for things and not see one as developing ‘better’ than the other.

One of the areas the J-Man has struggled the most with is communication in pretty much every form. While we’ve gained solid ground in areas like picture communication, verbal communication is ground gained inch by inch. We have no doubt that an endless reservoir of insights, wisdom, and thoughts live within him just looking for a way to be expressed. You can even see it when he says, “I want” and then pauses, gets a very intense look on his face, and clearly tries to work out how to communicate what it is he wants. But he often doesn’t have a word for it yet, and to say that’s emotionally difficult on all of us is a huge understatement.

As we’ve said repeatedly in the past, we probably wouldn’t know ‘typical’ development if it jumped up and bit us. With Dale Jr., we’ve rarely worried about it. If there could be two more polar opposite children in a family, I haven’t met them yet. It’s really a brilliant gift to receive as parents because you know you get two wonderfully unique little people out of the deal. Much of the time we only wonder “do children normally do this at this age?” when Dale Jr. does something new that boggles our minds.

I guess it’s that we’re so used to having to really parse and analyze and guess about every verbal and non-verbal cue that when Dale Jr. just comes up to us and asks for something, it often startles us. I sometimes wonder if we’ve gotten so good at interpreting word approximations that so much of what he’s saying makes sense to us, but regardless, the way he uses language to ask for things and identify objects and people is really quite amazing for a child who just turned 15 months. He even uses the J-Man’s food picture board to ask for toast!

We learned way back when that the order in which the J-Man has developed individual sounds (phonemes) was largely ‘backwards’ from the textbook sequence kids on average go in. Normally ‘b’ and ‘m’ – and similar sounds – come early. It took a while for the J-Man to get ‘m’ and to this day he still doesn’t do ‘b’ or ‘p’ sounds. He does this guttural sound for those instead, which we know is his way of doing a ‘b’ or a ‘p’.

For example, if we’re in the living room and he says, “I want” followed by two of these guttural sounds together we know he means “I want pillows.” (i.e., “I want you to lie down next to me on the pillows because I need to regroup.”) What fascinated a lot of people is that his first consistent sound was ‘k’, which is one of the late ones on the development chart. For a while well into his third year, everything on earth was ‘kuh-kuh’.

Dale Jr. picked up ‘b’, ‘p’, ‘m’ and a host of others very quickly starting several months ago. We did get to wondering whether he is following the ‘normal’ pattern and order of speech and phoneme development that the J-Man has largely done in reverse, with the J-Man moving from very advanced sounds back toward the basics.

Just for giggles, I did a little digging around for benchmark kinds of resources for what sounds theoretically could show up and when. If you want something that reads like a specifications manual for your child, skim through “Neurological and developmental foundations of speech acquisition” by Sharynne McLeod, PhD and Ken Bleile, PhD. The information geek in me was appropriately geeked out by this, though a big part of me was like, “Just let him be a kid, sheesh,” but I wasn’t the intended audience I’m sure.

Found another, much simpler, resource from the National Institute on Deafness and Other Communication Disorders. You’ll see “How do I know if my child is reaching the milestones?” and a set of interactive checklists to choose from below that. Click any of them and a new window/tab will appear that asks you some simple questions to give you an idea of whether your child is struggling in particular areas. If you have any concerns about your child’s speech and communication, this looks like a good place to start.

One last site I found was speech-language-therapy dot com, and it’s one you can really browse through for a long time and find a variety of good stuff to read. Some highlights include a semi-technical “Typical Speech Development”, the “Freebies” resource section, and some free “Phonology & Articulation Resources” that offer some worksheets and exercises that might work for your child depending on where they are on their verbal communication.

Back to our kids, another difference between them is the ‘syllable back-and-forth’ method – still haven’t come up with a good term for it – we’ve used for a long time with the J-Man to get up to our own version of full sentences. The following is a typical sentence exchange. Note that all the sounds come in pairs. The first in the pair is him talking; the second is Mary or me.

“I / I / wuuuuah / want / nuh / nuh / geh / gets.” (Translation: “I want [chicken] nuggets.”) Discovering that this worked was a revelation a couple of years ago. We worked up to a couple handfuls of basic sentences doing it this way, though all pretty much begin with “I want” or “I need”, but hey, that covers a lot of ground. We keep hoping to find any other parents who’ve experienced this with their child.

Dale Jr. has in recent weeks started to take the next step and put different syllables together without having to go back and forth like this. (note that ‘mama’ doesn’t count because it’s the same syllable twice) The most impressive one of recent days is ‘apple’, which he says plain as day (‘aaah-pulll’!) when looking at a bowl of applesauce that he wants. He’s developed a great repertoire of very useful words for things he wants or just wants to identify around the house. In the last couple of days, he’s made clear requests for ‘TV’, which as they say may be the beginning of the end. :-) It is amusing also that he’s picked up a few of the J-Man’s speech cadences.

I want to make sure I make something clear here, and if you take nothing else away from this post at least remember this: Verbal communication or the lack of it is not an indicator of whether someone is more or less intelligent than someone else. Do not assume that because a child or an adult cannot talk or talk much that they are not intelligent. If autism had commandments, this should be one of them.

What’s been really awesome lately are the times where Dale Jr. tries to engage the J-Man in play and they start interacting. They love playing chase together, even if that usually means Dale Jr. coming at him full gas and the J-Man running for his life, though they’re both laughing hysterically the whole time. As much as Dale Jr. is soaking up words from us and the J-Man too, it seems to us that the J-Man is starting to pick up some things from Dale Jr. I don’t get a sense that he sees it as a competition of ability. The J-Man’s sibling competitiveness is much more about not wanting to share Mama and Daddy, but that’s a post for another day.

For the most part, our two kids really do bring out great things in each other. We hope it turns into continued speech improvement for both of them. But most of all, we just hope Mary and I and the boys all realize what a gift they are to each other and to us. And we’ll keep working on the rest.

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Today is the birthday of Fred Rogers, better known to everyone who grew up watching him as Mr. Rogers. He would have been 82 today. To say he’s had a profound and positive influence on generations of children is an incredible understatement.

Today is also World Storytelling Day. Having these two celebrations on the same day is so fitting.

So tell your kids a great story, and go watch some archived episodes of Mister Rogers’ Neighborhood on the PBS Kids web site.

Also, go read about the life of Fred Rogers on Wikipedia. Interesting factoid: His middle name is McFeely. I didn’t know that’s where Mr. McFeely’s character’s name came from.

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Is “Asperger’s” on the way out?

by Tim on November 5, 2009

It’s that time again when they update us on the progress of how the clinical definitions of autism may be redefined in the next version of the Diagnostic and Statistical Manual of Mental Disorders, or DSM. (Read more about this in our The Clinical Definitions of Autism, Asperger’s, and PDD-NOS post from a while back.)

The Neurodevelopmental Disorders working group for the DSM-V (V = 5th Edition) has an interesting list of issues related to ASDs that they are trying to reach conclusions on before the 2012 target date. (Note this is an older version of the list, but it’s still a fascinating read.) To say that whatever is ultimately approved for inclusion in this manual will affect the lives of both parents of autistic children and autistic persons is a serious understatement.

There has already been a lot of commentary and some controversy about this process. It does seem, however, that the working group assigned to revise the DSM for autism have tried to be methodical. careful, and sensitive to all the issues involved. Honestly, I think they were given an almost impossible task here. We won’t really know how well they succeeded until we see the first draft.

This NY Times article describes the latest controversial issue in this process as well as some ongoing ones. This most recent one has already drawn a ton of reaction and might easily be among the most talked about when the draft is released.

The big question being discussed now is whether Asperger’s as a specific, separate diagnosis will be left out of the next DSM. ‘PDD-NOS’ may also be going away. Without the draft actually existing yet, it’s hard to really dig into the real-world meaning of this, but for whatever these are worth, here are my comments about this and some other points.

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I’ve been following a series of brilliant posts written by Bev at Asperger Square 8 about her reflections and development of a checklist regarding neurotypical privilege.

For parents like us who live in a very insular world of toddlers and early elementary school children, we tend to completely miss the broader conversations going on about what kind of society and culture our autistic children are growing into. And by being so focused on everything going on in the present (though understandably so) we also miss out on seeing all the possibilities that are waiting out there for our children’s futures. Within the chaos of everyday life, perspective is hard to come by. But this – among many other reasons – is why if you aren’t reading blogs written by autistic adults, you should be. (Asperger Square 8 can – and should – be one of your first stops.)

But enough of my typical rambling preamble. Check out her latest draft of “The Checklist of Neurotypical Privilege” – it’s eye-opening and challenging and brilliantly written. And for me at least, it is one of those landmark, defining pieces of writing I’ll be coming back to over and over again for both a swift kick in the butt and some real perspective on how to be the best possible parent to the J-Man and advocate for autistic persons of all ages.

Biggest lesson I’ve learned so far from reading her work? I have a lot to learn.

Note – You should be able to follow future revisions to her checklist at http://aspergersquare8.blogspot.com/search/label/privilege.

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[Personal note: I know I haven't blogged in eons. The chaos of work, the J-Man going on break from school, the serious need to work on some of his behavioral issues, illnesses, and the overall bedlam of baby-parenting have been exhausting. Just wanted to let people know we haven't died or something!]

The adjustment to life as the Flashlight Four has been a challenging one to say the least. Our primary concern has been how all these changes would affect the J-Man as – not surprisingly – even small variations in routine can be difficult for him, and a new baby in the house is decidedly not a small variation in anything.

Things were going along more or less OK, but then we started noticing some significant changes in his behaviors at home. Nothing aggressive or in any way what you might call ‘negative’. It’s that he was so completely overloaded that he would run around screeching, stimming like crazy, spinning in wild circles, and pretty much literally bouncing off the walls. He couldn’t sit still for more than about two seconds for anything, not even for his favorite shows (which is a sure sign something is amiss).

When his teachers said they were noticing similar changes at school and that it was really affecting him there, we knew we needed to concentrate our full attention on finding something to help him get through this.

His OT at school suggested trying out a weighted vest at school and at home. If you’ve never heard of this, it’s worth getting some background information as we’re now total converts to weighted vests as a tool that may help sensory-overwhelmed kids. (BTW – To use one at school here, it has to be ‘prescribed’ and supervised by the OT as otherwise it’s considered a restraint, which is not permitted. Don’t ask; I don’t understand that rule either.)

I found an article (“Weighted Vests for Children with Sensory Issues”) and some additional information on commercial sites at eSpecial Needs and WeightedVest.com. (Note: I’m not endorsing their products as I know nothing about them, nor about anything advertised on these sites. We made our own vests – more below.) Research on the broader effectiveness of weighted vests hasn’t really been conducted to any real degree, so your mileage may vary for sure. All I can say is that our recent experience has made believers out of us.

We tried a weighted vest about a year ago, but the J-Man just walked around like a drunken sailor with it on. His gross motor skills were much less developed then, and the overall experiment was more or less an interesting failure. I think the added year of development and the resulting additional body weight made a big difference toward the success of our recent work. The OT last year did say that before age 3 is early to be trying this out and expecting to see much benefit. We’re very glad we tried it again now.

We borrowed the vest the OT had (I think her mom had made it) and used it both at school and at home for a couple of weeks. He’d wear it for about 20-30 minutes at a time about every two hours. We always tried to do some heavy proprioceptive sensory work while he was wearing it.

(For those still struggling with autism terminology – ‘proprioception’ is basically the sense most of us take for granted that helps us be aware of where our bodies are and what the various parts of ourselves are doing. Example: I’m aware that I’m currently sitting in this chair and that my butt is firmly in contact with the seat of this chair. Now imagine the chair slowly fading out of existence such that you are still in a seated position but you feel it less and less until you don’t feel it at all. Bet you’d seriously flinch and jump to your feet. Know that sensation of falling you sometimes get when you’re in bed and half asleep? Imagine that your kid feels that way all the time, which they very well might.)

At school, they often have him carry heavy objects around (e.g., old encyclopedias) or jump up and down on the mini-trampoline. He loves our little mini-trampoline at home (more accurately, in the kitchen), so he climbs on it and jumps forever. His current record is 13 straight minutes… And he much prefers it if you sing “Supercalifragilisticexpialidocious” and hold his hands while he’s doing it.

The change has been really quite remarkable. One of the teachers said something to the effect of, “We’ve got our old J-Man back!” He really has seemed so much more like himself.

Since commercial weighted vests can be very expensive, we decided to make our own. Or more accurately, we decided to sweet talk Mary’s mom into making them. :-) The basic construction of it is fairly straightforward, but neither of us know how to sew worth anything. Essentially, we (more the ‘royal we’ where we = Mary’s mom) got some heavy denim fabric and some thinner, more decorative fabric to go on top of that, made it into a long vest, and then rolled up the bottom and sewed in pockets to put weights in. Velcro along the back helps fasten it around his body.

Here are some pictures of the J-Man modeling. I thought the chili peppers were an inspired choice.

jman_nemo_vest.jpg

jman_chili_pepper_vest.jpg

For the weights, we took the 1/2-pound inserts out of some adjustable ankle weights (like these) and put one in each pocket. We think these are still too bulky – they make the waist really poof out and hard to velcro closed – but they are still less bulky than the other things we tried such as BBs, sand, pennies, and sinkers (fishing weights). Next things we’re thinking about trying are dense modeling clay and buckshot. (FYI – a digital kitchen scale is a huge help in figuring out the weights and getting them balanced all around the vest, something that’s very important.)

Between the weights and the heavy fabric, the whole thing weighs about 2 1/2 pounds. I’ve heard varying recommendations on how much weight to use, but the consensus of what I’ve been told seems somewhere between 5-10% of the child’s body weight. We’re kind of on the lower end of that right now.

I’d be interested to hear the experiences others have had with weighted vests. If any of this has made you want to try this out, talk to your occupational therapist. You shouldn’t start putting weighted anythings on your child without the supervision of a trained OT who can tell you whether this is appropriate for your child and their needs and what sorts of ‘heavy work’ would be most helpful to them.

As with most things, so much of our learning comes through trial and error, but we definitely feel we have trial and success here!

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Happy World Autism Awareness Day!

April 2, 2009

April 2nd is World Autism Awareness Day. It was interesting to go back and read my reflection last year about this day, especially since it came just a couple of weeks after we got the J-Man’s diagnosis. Looking back, my awareness of the public landscape of autism for parents was pretty spot on, which honestly [...]

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Handy Handouts

March 13, 2009

[Post edited 11/6/2009 as the Handy Handouts site has undergone a major upgrade.] While talking to the J-Man’s teacher about getting some picture communication gear, she told me about Super Duper Publications. They have an extensive catalog of useful products (haven’t ordered anything yet, but probably will), but our link for today is for their [...]

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