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Research

Do It Yourself at Do2Learn

by Tim on November 15, 2008

If you’re trying to figure out the ins and outs of picture schedules and picture boards, get some actual pictures to use, get a home learning area or classroom set up, find some ideas for home art projects, come up with cheap but good learning activities, or keep saying to yourself, “is there someplace I can download and print something like that?” (whatever ‘that’ is) there’s a good chance that Do2Learn is the place you want to go first.

Their web site is a gold mine. You can wander around it for hours and regularly find yourself saying, “Wow, they have that too!” I found all kinds of stuff we needed, but I also came across things I wouldn’t have ever thought of needing until I saw they had it. How cool is that?

Best thing – most of the resources on their site are free. There are some products for sale, too, that look both good and affordable if you decide you need them.

This site is geared toward serving a broad range of special needs, not just autism. What they provide is brilliant. Here are just a few of the resources I found:

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If your child is somewhere on the autism spectrum and you live reasonably near a university, it’s not unusual to get notices about research studies you can participate in. In our case, we live about 45 minutes away from UNC-Chapel Hill – home of TEACCH and all manner of ASD resources – so we receive notices a LOT. We get them about once every month or two as the toddler age range is, not surprisingly, an important thing to study in autism. All the notices we get sound quite interesting. We automatically rule out any that are in any way invasive or excessively stressful (e.g., medication-oriented ones or ones that required a significant disruption of his normal day), but so far I don’t think I’ve seen any of those.

The one we’re in now is largely done in J-Man’s pre-K classroom at the elementary school, and the whole classroom is participating in the study. They send evaluators in from time to time, do some skills assessments, take some video of the sessions, and collect their data in a way that quite seamlessly integrates with his normal routine there. The study’s official name is insanely long, but the short version is “Autism Spectrum Disorder Treatment Comparison Study” (see link for an overview – and check out their links page while you’re there).

As I understand it, the basic gist of the study is to compare preschool classrooms that use TEACCH (that’d be us) with classrooms that use LEAP with classrooms who are ‘controls’, though I’m a little fuzzy on what the controls are doing. As I understand the purpose of the study, they are looking at what ‘interventions’ produce the most improvement in preschool-aged autistic children in these comprehensive classroom environments. There are sites in various parts of the country. Apparently it will be at least 2011 before findings are published.

I’m a huge believer in participating in education-based research studies. Anything at all that we can do to further the knowledge of how best to help our – and all – autistic children grow into the best people they can be seems like a worthwhile effort.

That said, we have a boatload of self-evaluation forms to fill out tonight as they are coming to meet with us tomorrow for an interview, see whether we had questions about the forms, etc. Among these forms are two just for the parent (yes, singular). Why they are looking for just one of us to fill out the forms – rather than giving each of us our own set of the forms – isn’t clear. As the stay-at-home dad for the past three years (even though Mary works from home now), I’m usually the one who gets to fill those out since my answers are typically more what they’re looking for. Anyway, based on the questions, it looks like they are interested in how much stress and perceived demands being a parent of an autistic child puts on us.

I was surprised about how uncomfortable some of the questions were for me. What they’re asking for is not anything top secret or whatever, so it’s not uncomfortable like if they were asking about whether I secretly enjoyed watching Bambi’s mama die to the point where I’d rewind the DVD repeatedly or not or something (I don’t, by the way). They’re more questions like, rate from strongly disagree to strongly agree, “Being a parent is harder than I thought it would be.” or “I find that I don’t have many friends anymore.” or “I’ve had to give up more of my personal aspirations than I thought I would.” or “My child does things that really frustrate me.” I guess these and others turned out to be questions I’d rather not be thinking about.

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The Information Fire Hose

by Tim on March 29, 2008

(Buckle in. This is a long one.)

One thing we’ve already figured out is that once you get an autism diagnosis, whatever the secret code is for the Autism Parents Underground Society gets embedded in you like the security tags they use to keep you from stealing stuff from the store. The big positive with that? You start getting helpful information from people who have been down the road you’re on, instead of just getting information about autism from TV, well-meaning friends and family who also got their information from TV, or Tom Cruise.

Our driving principle: Do whatever it takes for J-Man to realize his full potential and be the best little man he can be, but do so armed with all the possible knowledge and wisdom and feedback we can stuff into our brains. This may mean that he ‘loses his diagnosis’ someday, or it may not. Whatever that will look like eventually, we want to help him discover all of his gifts and talents and loves and then express them as far and wide as he can. This means we have a lot of work to do, and there’s no shortcut to it.

You quickly learn that there are a lot of debates in the ‘autism world’ that remind me of philosophical or religious debates where people argue endlessly and stop talking to people who don’t agree with them. It’s like watching another form of religious fundamentalism.

A few people I’ve met are getting more invested in movements and doctrine than their own child. I understand the emotional investment parents have in their children’s improvements – and thank God for it – but right now I find all of this debating a distraction. If you want to argue cures vs. neurodiversity, that’s fine. Just do it somewhere else for right now. None of that means jack to me when my son is flapping his arms like mad in the back seat of the car. Luckily, the number of people I’ve personally come across in this category are in the minority.

We’ve been reading and researching for two years about feeding issues, sensory integration disorder (or sensory processing disorder depending on who’s talking to you), physical therapy, reflux, speech delays, apraxia, and every freakin’ therapy you can think of around them. This has been great practice for discerning what therapies and ‘cures’ for autism have some potential for success and which are pure excrement. The latter looks to be winning in a rout at the moment, but that’s another story.

Thankfully, the anecdotal suggestions from strangers (“We know a parent who had their kid piss into a strong, North wind every morning for a month and got him cured!”) has been pretty minimal so far. We’ve developed pretty good BS detectors, which is one of the most important skills for a special needs parent to have.

I also classify certain therapies under the heading of ‘well, it couldn’t hurt’, so I’ll try some of them even if some seem a little odd. I’ll give serious consideration to many diets, vitamins, or supplements, even though we’ll do a lot of research into them before we dare try them with J-Man. This will likely mean we’ll dismiss ones that seem invasive, dubious, completely unproven and untested, and anything else suspicious.

I’m skeptical of many vitamins and supplements because, with all of my own ‘issues’, supplements have at best made marginal, imperceptible, or no improvements for me. None have caused me any real harm as far as I can tell, so there was no reason not to try many of them. A couple made me sick to my stomach for a couple of days, but that was about it.

There’s a whole lot of stuff in the Whole Foods home chemistry aisle that appears to lack everything but a salesman on a soapbox. You can’t easily tell what really could be helpful and what would be more cheaply achieved by gnawing on an Amazon.com box. Again, you gotta research. There are no shortcuts.

There’s a lot we don’t know about how supplements work, and some of the ones that involve some fringe-sounding stuff may cause problems for little people with developing brains. If they’ve been tested for all of about a day and a half on ten kids, you have absolutely no idea what good it could do, not to mention the possible long-term harm. You have to read, talk to people you trust, read some more, and then decide.

To me, one of the best ways to do your first pass at weeding out options is to look at two pieces of information about these or any other therapies: 1) Has it been tested on a sample size of more than three neighbors’ kids, and 2) has it been around for longer than a five minutes. Not to be overlooked: Does the person advocating it have a financial stake in it? That should eliminate about 3/4 of the possible therapies right there.

Notice I never said, look for studies where the scientists have medical degrees and lots of acronyms after their names. There may be all sorts of correlations between therapies and improvements in autistic kids (we’ll do ‘correlation vs. causation’ some other day), but degrees and acronyms isn’t one of them. I may not know a whole lot yet about therapies specifically for autism, but I’ve been researching everything else for two years and much wisdom and common sense carries over. The biggest difference is that our emotional investment in improvement is even higher than before, and that’s saying a lot.

Just to be clear, I’m not saying none of them work; I think it’s safe to say that some of them do help at least some kids. I’m saying that I begin with healthy skepticism and then work toward being convinced or unconvinced. I’m not sticking any old thing into my kid’s body unless I have some sound evidence that it might help and it won’t hurt. There’s at least a “first do no harm” principle here.

Some therapies really intrigue me and seem worth a try. Music and auditory therapies might work well for J-Man because he’s such a musical kid. I couldn’t carry a tune in a bucket, but my iPod is like my portable therapy device, so I won’t discount the value of it even if I have no clue how it might work for him.

His OT is trained in one kind of auditory therapy so I’m interested in giving it a try. Getting him to wear the headphones might be the hardest part. Again, this falls under ‘it can’t hurt’. Currently, insurance and Early Intervention are financially supporting much of this part of the effort so now is as good a time as ever to try something like that.

It’s that and we’ve learned that we can truly trust his therapists and preschool teachers because they are smart, caring, and always have J-Man’s best interests in mind. If they tell us something is worth trying, we’ll listen. The best thing you can do is develop a network of professionals, family, and friends whose advice you trust and know is sound. They will help you separate the wheat from the chaff better than just about anything.

All this is to say, we’ve learned a lot over the past two years about how to sort out much of the snake oil, ‘breakthrough cures’, and outright loony crap from the stuff that has some reasonable, scientifically-based chance of working. I’ll even go as far as to say that anything that is sold as easy will be struck from my list of things to try. I’ve learned in life that there are rarely any shortcuts.

I wish there was an autism Santa Claus, but I know better. It’s depressing, but I know I have to make my peace with this.

For someone who has been unable to sleep for almost two weeks, feels emotionally spent, and who thinks beer and ice cream sounds like a good dinner tonight, I feel oddly lucid and confident about our ability to differentiate between hope, helpfulness, histrionics, and horseshit. And the fact that I can string four h-words together right now just astounded me.

I know I haven’t talked about education, behavioral work, and the other therapies in the standard repertoire. I feel confident in the approaches we’re already taking and feel like we’re getting great advice on what else to try. I’m less worried about this. Perhaps I’m approaching this by weeding out all the junk first so we can see what our best options are. Distractions are my nemesis, and God knows there are a lot of them here.

And in case this point wasn’t clear – there are no shortcuts.

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