Time for Peter’s triennial IEP. For those of you with children with autism, you know that means lots of testing. (For those who don’t, the IEP stands for “individualized educational program,” and every three years, the school does comprehensive testing to help direct the construction of the child’s curriculum to match his/her level and capabilities).
It was the end of a two hour testing session. Peter and Belinda, his typing aide and beloved tutor, sat across from the psychologist.
“Peter, I’m going to tell you a story, then have you retell it.”
(The following story has been modified to protect the test.)
The psychologist typed: “An ant wanted to cross a stream, but the water was running fast. The ant was scared. So the ant hopped aboard a duck, and rode on its back across the stream.”
Peter read the story. Then the psychologist put the story away.
Peter started humming and flapping. He typed, “I need car ride please.”
The psychologist said, “We’ll be done soon. Let’s talk about that car ride after you finish this last story. It begins like this, (and she typed) ‘An ant wanted to cross a stream…'”
Belinda put her hand on the back of Peter’s right shoulder, as her usual sign of support, and Peter commenced typing, “But the water was scary so…”
Peter started humming louder and looked around wildly. Belinda let go of his shoulder, wanting to relieve the pressure of working, thinking Peter needed a break.
Peter lunged toward the keyboard, “hevgot a car ride.”
“Just a moment, Peter, it’s okay. Just see what you wrote,” said Belinda as she placed her hand back upon his shoulder.
“no. duck ride,” typed Peter, as he self-corrected.
Looking on as an observer, I found this episode fascinating. Clearly, Peter understood what he read, and could retell it. But more interesting than the test result itself is how he did the test. The interaction between Belinda and Peter said a lot about the importance of relationship. During other parts of the test, when Belinda would remove her hand upon Peter’s shoulder, Peter would simply stop typing. He would flap and hum and look dysregulated until she gave him that encouraging look and place her hand upon his shoulder, as if to say, “I’m with you, I will hold onto you, we’re in this together.” As a whole separate reality going on apart from the testing, the looks and smiles they gave one another were a beautiful thing to behold.
When Peter was getting tired and hungry at the end of the test, that relationship was crucial for Peter to hold himself together to make that last big effort to concentrate on higher level cognitive function. When Belinda released her hand, it was as if Peter’s basal ganglia released the gate to automatic thinking, and what came out was what Peter types for the most, “car ride,” his favorite regulating activity. When Belinda came back into the picture, restoring the support of the relationship, tangibly with her hand upon his shoulder, Peter was able to switch back on his higher cognitive pathways, self-corrected, and finished the test.
What this episode so clearly illustrated for me was the profound truth of a fundamental floortime/DIR principle- the critical importance of the relationship. Our children face such overwhelming challenges and obstacles. Peter was hungry and tired. Trying to complete that test required huge efforts to overcome his bodily sensations, maintain attention, tax a short working memory, overcome dyspraxia in order to type, and use language, which is always difficult. Watching that scene, I felt as if Peter was flying a plane, and his relationship with Belinda, her love and support, was his gas. No Belinda, and the engine cut out. Truly, relationship and affect are the glue that holds a child together and through an interaction or task, the fuel that powers development forward and makes it possible.