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I am overwhelmed with joy today.

Dr. Ricki Robinson had invited me to follow her at her office, where I met a remarkable 19 yo young man with autism and his mother and witnessed them doing facilitated communication together.  All the mother did was lift up her son’s elbow slightly after each word he typed to “reset” his brain as a prompt to type the next letter.  I was so amazed at the beautiful things he wrote, as his behavior was so incongruent.  He came in and sat on the floor to finger some Lion King action figures.  He could scarcely utter anything intelligible.  But he explained through typing that he loves those action figures because they remind him of his childhood.

So I asked Ricki who had been teaching facilitated communication for this family, and she referred me to Darlene Hanson.

Well, I finally got my appointment today with Darlene.

She started out giving Peter a keyboard on her iPad and asked him to tell her the state he lived in.  Just by gently applying some resistance after each stroke to bring his hand back into neutral striking position, he typed out “California,” with two type errors that she immediately told him to fix (he then hit “delete” and made the corrections without further prompting).  I was stunned.  Next she asked a more ridiculous question.  “What state is Las Vegas in?” “Nevada” he typed without a hitch. We had just been reading a book about snails, and she asked what other animal has a shell.  He typed “turtle,” with one prompt for the first letter.  Then she tried a more advanced close-ended question.  “What political party does President Obama belong to?” she asked.  “Democrat,” typed Peter.  We would have never guessed he knew his geography about California and Nevada, let alone politics (we have talked about all these things, but never addressed Peter directly about them except that our state name is California- even then we only introduced him to CA for California, not the entire word).

Then I got to try.  I had him do a straight dictation and type “paper” which he did with one type error.  I did not need to guide his hand at all, only grasp his right forearm (the side he types with) and pull back and up slightly after he struck each letter.  Then I asked something harder, “What animal has a shell and swims?”  He immediately typed “turtle” with one type error.

After that, Darlene took a turn again.  This time she only applied a bit of resistance and upward motion on his proximal arm.  She asked, “How did Mom do?”  Peter typed, “It was good,” a full sentence.

Next Papa tried.  He asked, “Where do you want to go when we have a carride?”  Peter typed, “Carride.”  “But where, Peter?”  asked Papa.  “Gymnastics,” said Peter verbally.  Darlene asked Peter, “Where do you go to gymnastics?”  Peter needed help with the first letter, but then typed, “Championship gymnastics.”  I didn’t even know he knew the name of the gym, and he did make several type errors, but it was still impressive.

Darlene asked Peter, “How did Papa do?”  Peter typed, “Very good.”  I thought I’d challenge Peter and switched the iPad keyboard for his Vantage.  “You know how to say that on the Vantage too, Peter; would you type it please?”  Peter put his head down on the table and wouldn’t budge.  (He knows how to navigate it via icons.)

Darlene gently replaced the Vantage with the iPad keyboard.  “How do you feel about the Vantage, Peter?” she asked.  Peter typed, “Icons have no purpose.”

At that point, Papa fell off of his chair, and Belinda and I looked at each other in utter amazement.

I didn’t even know Peter knew the words “icon” or “purpose,” let alone that Peter could answer an open ended question like that in such a scientific and concise way.  I guess he really didn’t need the icons- he apparently can spell!

I was mystified.  “But Darlene, I protested, we’ve put a keyboard In front of Peter millions of times, and he needs lots of prompting to even spell simple snack items he loves and wants to request.  I didn’t think he had a good visual memory for spelling.”

“He just needed that physical touch to reset him and the rhythm.  It’s a dance you do with him to get his motor system going to translate what’s already in his head into typing on the paper.  This doesn’t work for everyone like this.  But you guys have input lots of functional language through using the Vantage and other methods through the years, so all that is already imprinted on his brain.  This is rate limited step here, getting the brain reset automatically to strike the next key.  Our goal is to fade this physical prompt, but for now it supplies the need.”

We all felt so humbled and so grateful.  How intricate and mysterious is the brain such that one small glitch presumably in the basal ganglia could so lock in a child for all these years?  But thanks be to God that we did not assume an insurmountable cognitive deficit, but kept slogging away, reading him all kinds of books (I’ll have to go up considerably from those lst grade readers) and hammering in nouns, verbs, adjectives, and prepositions with that Vantage.  And thank goodness for open minded parents and therapists who are willing to try whatever works for their child, and have therefore made this method facilitatedcommunication_1available for our child.  Peter can physically navigate his Vantage without anyone holding his arm.  Who would have guessed that typing would be so different for him?

All I can say, is listen to the experience of others, and go ahead and try their creative ideas, even if they don’t make sense with what you know.

Because none of us knows very much.

 

Is this a dream?  I’ll try it again tomorrow and let you know if I wake up.

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Laurie LeComer takes task analyses to a whole new level in her terrific book, “The Socially Included Child,”  published by Berkeley Books, 2009.  She describes a strategy to help your child with autism enjoy social events such as playdates and birthday parties.  First you introduce the activity by previewing what is going to happen with your child.  For example, you might give your child a little tour of his new school before it starts.  You might read a book about visiting the dentist ahead of time, or make a social story about a playdate before he goes to his friend’s house for the first time. Next you detail exactly what you expect your child to do.  For example, before a birthday party you might list expected steps for your child such as saying hello to the birthday child and his mother, handing the present to the child, jumping in the bouncehouse with the other children, coming to sing “Happy Birthday” when called, eating cake and ice cream, etc.   Next you evaluate your expectations, and decide which goal(s) you want to concentrate on.  For example, do you want to expend your energy assisting your child with interacting with the other children in the bouncehouse, or work on eye contact in greeting his hosts?  Next you get your accomodations ready such as putting the noise cancellation earphones, gameboy, or gluten free dessert alternative in his backpack (some of these are my examples).  Last you list all these components so you and your child can remember them and refer to them in a visual aide, such as a visual schedule with or without a reinforcement schedule.  By thinking and planning ahead, you can help your child navigate the social world more enjoyably, and learn more from each experience.

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Two of my favorite books for interactive game ideas are by Fern Sussman. More Than Words is  published by the Hanen Centre, Toronto, Ontario, 1999.  It’s sequel is Talkability, published in 2006 by the same Hanen Centre.  The game “Follow my eyes to the prize” is detailed in “Talkability” on page 32, adapted from the original game by Steven Gutstein.  His book of interactive games is called Relationship Development with Young Children, published in 2002 by Athenaeum Press.  These three books are outstanding resources, full of ideas of games and activities you can use to enhance your child’s interactive skills and social development.  Both authors organize their suggested activities by developmental stage so you can easily find games that match your child’s level.

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