Finding Ourselves on the Autism Spectrum

Posts tagged ‘Speech and language pathology’

Then and Now: Pictures, pointing, and a deliberate sound

I’m amazed as I’m looking back through my journal how many lessons I learned back then that can still be applied in some way today. Trying different options, building on what seems to be working, and being willing to aim at shorter-term goals that are within reach apply just as well to working on social skills and schoolwork strategies as they did to trying to facilitate beginning communication. The details of the situation have changed, but the principles remain the same.

We started using some baby signs with Simon when he was a non-verbal toddler, but we also began introducing pictures to help interest him in communication.  According to the therapists, pointing with the index finger was a big deal, so we were working on that, too.

August 11

A little more responsive with LC, the speech therapist, offering her raisins and watching closely while she did a finger play. Schedule running a little late. We put up a picture of a balloon on the door of the room where the balloons are kept.

August 13

Simon became very energetic and playful right after breakfast, and did okay with B from Parents as Teachers, although he was more interested in his own activities than the ones she brought. He did really enjoy pushing a tennis ball through the “X” slits in a coffee can lid. Seems to want very frequent attention, like he’s making up excuses as he goes to get it (e.g., will pull me out of my chair and then wander for a minute before deciding on something to ask me for). Indicated pictures (with a little prompting) to get both his pacifier and some juice.

August 14

When I show Simon a picture of balloons, he seems to know to pat it to make a request. Just have to take him to the frig when I think he’s looking for pacifier and he’ll pat the picture right away. Need to start getting more pictures together, but still to take things slowly.

August 15

Simon behaved very well at the grocery store, even in the cart, partly because I gave him a grape on his request every few minutes. In the morning, he seemed to want to see the microwave, and when I said “microwave” a couple times, he started waving (since he heard me say “wave”). After we had a little spat and made up, he came out to see me in the kitchen, handed me the two pacifiers he had, and went back in the other room. Not sure if it was a peace-offering or he just wanted them in a safe place while he wasn’t using them. Doing well using the photos if I take him to them, and will point to a teddy bear and an apple in his Baby Minnie’s Busy Day book when I ask him. Does most pointing with his whole hand, but some with the index finger after he thinks about it a minute. Had lots of fun playing on an unplugged phone. He wanted me to pretend to talk, but then he’d take the receiver to see if he could hear anything.

August 16

Getting lots of pictures taken for Simon. Hope they turn out. Used his whole hand to point to the stop sign in Baby Minnie’s Treat book a couple of times, and he let me take his index finger to point to a couple of things. Went through a chapter of the Fowler book LC loaned me that discussed the advantages of the way we’re working with Simon (cognitive strategy) over a purely behavioral approach (ignore gestures and reward verbal). He had fun playing at the library and even helped clean up blocks with only a verbal request, but he was very unhappy to leave. Didn’t want to sit back down in his high chair after standing up in it at lunch, but when I verbally insisted several times, he made a sad face and then sat down, for which he received much praise. Used his whole hand seven or eight times to point to the kitty on different pages of Where Is Baby Donald’s Kitten?, and pointed with his index finger once to that and once to the pacifier in Goodnight Baby. Said a very deliberate “ba” looking right at us in response to sounds we made to him.

August 17

Lots of babbling today, especially that “ba” sound. Did very well having lunch at Applebee’s, even though it took a long time to get the food. Daddy had the idea of photographing food found on kids’ restaurant menus so Simon could learn to choose his own meals there. Took Simon out after a big rain, and he absolutely loved the puddles. Played with water and rocks and had a great time.

August 18

Did really well with LC today. Played telephone with both of us and let her help him take slippers on and off. He really liked when she made one of the slippers act like a puppet. He waved as she was leaving even before we said goodbye or waved at him. She suggested he might like to start getting into the alphabet. First Steps play group (which I tell Simon is “school”) starts tomorrow. Meanwhile, I have two rolls of film being developed at Wal-mart of pictures for him. Covered almost every food, and a lot of activities. When asked to choose his nighttime books, he actually put the ones he didn’t want back in the basket and handed me the ones he did want.

Looking back:

We used whatever was of the most interest to Simon to get him interested in using signs and pictures – favorite toys, drinks, food.  The idea was to focus on communication, rather than just verbal speech. Simon didn’t really start saying whole words until the following spring, when he had been receiving speech therapy for about a year and a half. And even then, his motor planning difficulties made it difficult for him to make himself understood. That also made first learning to point with just his index finger a challenge. Having other ways to communicate during this time did a lot to relieve his frustration and ours.

Then and Now: More about signing

 

We did a lot of signing when Simon started showing some interest in communicating but was still not doing much in the way of making different sounds. He would make an “eeeee” sound that changed depending on his mood, but he didn’t make a lot of other sounds. We learned later that he had apraxia, along with his other motor planning issues (which I believe are collectively called dyspraxia) and actually had trouble learning how to form different sounds. At this point in my journal he was about 20 months old and had been in speech therapy since he had been about a year old.

August 3

In the morning Simon took great interest in the cats and played with them by swinging around the “bird” toy in their direction. He laughed while they chased it. He brought me his juice cup to request more juice. Simon also used his index finger to point to the pacifier in the book upon request again. Twice I spent a few minutes putting his hands under the running faucet or handing him a small open cup of water to drink alternating that with saying “water” and moving his hands to make the sign. He seemed very interested.

 August 4
  
Simon let me repeat my “water” lesson of yesterday and even made the sign on his own three times to get more water. The same thing happened later in the day, and he also made the sign for father when his dad brought out a glass of water, asked if he wanted some, and I prompted with the sign. Seemed a little confused about my not responding just to “more” for more water. We need a little practice.
 
 August 6
 
Wandering around looking for something while doing his “more” sign seems to mean he’s looking for his pacifier. Plans to work on a sign for pacifier. Getting much more consistent sign for “water” (still showing him how to make the sign and putting his hand under running water or giving him a glass of water and repeating this several times in a row. We did the little turtle finger play several times, and he wanted to hold onto both of my hands while I went through the whole thing, which was new.
 
August 7
 
 Zoo Day. He was pretty quiet all day – seemed to be taking everything in. Most interested in the sea lions, which moved around a lot and made lots of noise, and the ducks he could chase on the sidewalk. Went up to a little three or four-year old girl and offered her M’s bottle of water. When she didn’t want it, he tried the little one in the stroller. The baby (about ten or twelve months) was very interested, and Simon held the bottle like he does for his dolly at home, and the little one put it’s mouth over the cap at the end. Extremely cute. The other interesting thing was at the playground, which Simon liked very much and didn’t get to spend much time at. He came across what looks like a stand up version of toss across and turned every single one to the “O” side. (M had to point this out to me, and we got a little on tape.) Another kid messed them up a little, so Simon went back and did it again. Lots of “water” signs around the more watery exhibits.

 

Had a wonderful time at the K’s later. K thought he was doing just great and that we were doing all the right things. Said to try just inundating him with communication options, especially pictures on the frig to make choices from and to communicate with people who may not know his signs, and to make sure the picture is always paired visually with the actual word.

Looking back:

I still look back on Simon having to have all the letters matching on that board as one of our early autism indicators. At this point, he still didn’t have an actual diagnosis, other than a speech delay, although we had experienced therapists who could see that there were indications and kept that in mind when working with him.

K is the wife of someone who was, at the time, a co-worker of my husband. She worked for and is now the board president of the Autism Society in our state. I had expressed concerns about whether to focus on signs or on pictures in trying to communicate with Simon. She basically said to do everything and look to build on what was working for him, and to this day I consider that one of the best pieces of advice I’ve ever gotten.

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