Conflict ideas for Floortime play?

[ErinYay]

I'm hoping that maybe you'll all have some good ideas for bits of conflict to mix into DD's Floortime.

Quick background: she just turned 2, has moderate speech and severe social delays. We suspect she's on the spectrum, but won't even be getting a referral until tomorrow. We've been doing Floortime-lite for about a month now.

She is verbal but has very little meaningful speech outside labeling things. She's very difficult to engage in any "real" play, so we do a lot of dumping, pouring, and playing with stuff, like rocks, pasta, rice- lots of sensory play. I'm out of ideas for building little conflicts to get her to respond and initiate interaction with me. Putting my hand over the cup she wants to dump is getting old and she doesn't particularly enjoy that. Adding trucks, dinosaurs, or other toys to the mix causes her to abandon that activity. She actively avoids touch, so hooping arms around her leads to meltdowns.

We're hoping to get a consult with one of the 2 DIR professionals in our state soon, as I really feel like there's got to be more to Floortime/DIR than just dumping rocks all day. Could she just be at the developmental level where that's all we're gonna get? Like, that she allows us into her world is all she can give at this point, and we can't hope to draw her out? 

I dunno. I feel stuck- I don't expect her to explode with joy and wrap her arms about my neck, but it'd really be nice to have her look at me without my head being literally inches from the floor.

Thank you.

[christinelin]

I don't have Floortime experience, but we have done RDI, which is philosophically similar. What they recommend is slowing interactions way down and making very exaggerated reactions (I am obviously very much simplifying, but that is the gist). So, in the midst of pouring games, you might vary the items being poured or the containers. You might use something surprising to pour and react accordingly and stick with the reaction until she responds (a NT kid will likely look right away; an ASD kiddo might take minutes -- literally -- to respond at all). I think RDI folks would said that rather then provoke her, you are trying to share an experience with her and have her enjoy seeing your reaction and you enjoy seeing hers.

I think I would also say that at this stage you likely are going to start with initiating the interaction yourself and having her respond. Once she can do that more consistently, she will likely start to initiate some on her own, too.

One more thing that RDI emphasizes is coordination. Can you try to pour with her (both holding something)? It's okay, too, to show disappointment when the coordination fails. That's part of life and part of building an emotional connection.

I might also consider modeling pretend play for her, even if she isn't doing it yet. Both strictly realistic stuff (pretending to be a construction crew) as well as symbolic play (using a toy as a tool of some sort) is helpful, since ASD kids typically have delays in this area.

Does that make any sense? Is that at all helpful?

[ErinYay]

That's *very* helpful!

It occurred to me a few weeks ago that maybe she doesn't pretend play because we'd never really taught her. (Add this to this list of things we didn't realize some kids need to be "taught," like hugging...) We do a little pretend play each day- making her sock monkey a sandwich with play food, playing with her doll house, etc. She's far more willing to pretend with another pretend object- she'll feed the monkey a sandwich, but not momma, and said "bye-bye, doll" to her little doll but she won't say "hi, mom/dad," so I really try to involve a toy interaction-surrogate, if you will, whenever possible. I haven't done much at all in terms of playing with using a block as a phone, etc, as she's very literal and doesn't really "get" that level of play yet, but it's probably something that just doesn't come naturally, so I'll add a bit of this each day, too!

You made a good point with trying to surprise her- she's a very cheerful kid, but almost never laughs for us unless we're doing something very intense and physical, like tickling. Being silly simply doesn't get a rise out of her at all, but maybe we've been giving up on her reactions too soon. I'll totally try that tomorrow.

Thank you very much!

[Linda on the move]

My DD liked play dishes and play food at that age. It was a nice thing to add to the doll/stuff animal play.

Pretend play was another activity that she needed to be taught, rather than spontaneously arising.

One thing I've found difficult over the years is just how long one simple activity is a happy activity for my DD. Lining up rocks, for example.

[KimPM]

Yeah, we had to teach DS how to play, and later how to pretend. First he started just repeating whatever we were doing, but then he caught onto it. He was older than your DD when we were doing this, though. I'm not sure he would have picked it up at your DD's age. If any of it frustrates her, I'd back off on it for now and try a different way.
Edited by KimPM - 12/19/11 at 4:23pm

[nayma]

this probably isn't *exactly* what you're looking for, but might be helpful in some way.  with my dd (who' now 5 and has asperger's) at that age, she was really into books.  i would read things that i thought would teach her things she didn't "see" as typically as other kids - i.e., what moms and their kids do together - kissing, hugging, taking care of each other, saying certain kinds of things.  i read books that were VERY literal- almost like a step by step explanation of what it means to have a friend, be a family, etc. - and even when the book wasn't literal, i'd ad lib to make it so.  another thing i did when reading to her(which is a bit RDI) is changing something very obvious, then waiting for a reaction from her - i.e., seeing if she looked at me to signal she'd noticed, etc.  if not, i'd a bit exaggeratedly point out what i'd switched up ("did the monkey really EAT the car????  nooooooo, that's be CRAZY!!)- it was like this completely exaggerated silliness, and an attempt to get her to interact on some level.  does that all make sense?...  at this age, her play was very rigid and intense, so for a while, i just sat and watched a good bit- almost trying to allow her to trust me before i changed things too much.  sounds like you guys are doing a really impressive job!!

[foreverinbluejeans]

It sounds to me like your little one may be just fine. Children can develop late and be just fine. It doesn't matter so much at what age a child does certain behaviors but that they do them. My oldest son didn't talk much at all until he was 3 and it seemed my second son was born talking. My oldest walked at 9 months and my second well after a year. The oldest read at 4 and my second son didn't read until he was 12 (we homeschooled). They are now adults and they both went to college and have good jobs working together at the Red Cross Blood Bank (if that is a measure of success).  

I live with my grandson and he turned 3 in Sept. I was concerned because he wasn't speaking in sentences along with some other developmental delays and unusual behaviors. I got out my DSM-IV and psycholoy books from grad school. I decided he has tactile issues that are common in our family but that I didn't think he met the criteria for any other disorders. Now it seems he is talking better every day and using longer sentences. He used to ignore other people and I was shocked about a month ago when he told an elderly neighbor I was talking with all on his own, "my name is Marcus." He had never said his name before and then he says it to a stranger?! For a few days after he was telling his father, "my name is Marcus." My son would tell him that he knew who he was. It was funny in such a nice way. He calls me Bamma and my Chihuahua Tabo (Taco) Bell.

You might want to read more about sensory processing disorder. It is as if each person with sensory processing disorders has their own constellation of issues. A common complaint is clothes being itchy, too tight, too hot, too cold, ect. Some people are light and sound sensitive. One of my sons doesn't like food textures. Yet some people crave sensory situations. My grandson likes to jump and spin in chairs. There are long lists of the "weird" behaviors that people may have. The behaviors can be a minor part of a person's life or cause the person to be disabled. Occupational therapy can help many problems. Counseling can help older kids and adults cope. Things like teaching even young children yoga and meditation may help.

There is a book called Leo the Late Bloomer that helped my kids. It is about a lion that can't do anything as well as the other kids. His mother tells him he is a late bloomer, then one day he can do things just like everyone else. Its the kind of book that has a positive message for parents also.

[ErinYay]

Thank you, everyone! Such good information!

Foreverinbluejeans- she has an OT eval on Monday to determine exactly which sensory issues she has- she's primarily hyposensitive and sensory-seeking. We're very familiar with sensory issues, as I have them as well (though I'm primarily hypersensitive) and we have been meeting her extreme needs for movement, spinning, jumping, feeling, and tasting her world months ago.

I do have to gently say, though, that the special-needs board is a support board first and foremost. I imagine every parent who posts here has, at one point or another, had to struggle with what DH and I are struggling with: people trying to tell us, with kindness and support, that she's "just fine." And, frankly, in my opinion, it's one of the most difficult things to hear, especially at the early point of the process of determining why one's child needs help, and how best to provide it.

She's *not* "just fine." She's a wonderful, curious, clever girl, but she is not a typically-developing child. We had a crappy pediatrician appointment yesterday where he only gave us a referral to a neurologist because I broke down in tears when he said to "just stick with Early Intervention for a while-" she'll be getting 1 hour of speech a week and nothing to support her social issues or to help us help her engage. Our 3-month-old is more engaged with us than she is. If I hear one more person tell me, "She'll be fine, Einstein was a late-talker," or "she's only 2, what do you expect?" I might start tearing my hair out.

Late bloomers make their needs known early. Late bloomers still seek comfort from their parents from the time they're babies. Late bloomers still look at faces to gauge the tone of a situation. Late bloomers care if their mother is in the room, is in the house. Late bloomers understand facial expressions and gestures. Late bloomers will still offer affection without prompting.c

My daughter is not a late bloomer. She has delays that are impacting her life in a negative way. I was "just fine" as a child, only, I wasn't. I have Asperger's syndrome, diagnosed at 30 after years conflicting dxs, years of thinking I was just broken. Her 14-yr-old half-sister has Asperger's syndrome- she was dx'd at 12. 12 years of thinking she was just broken. I refuse to allow anyone to tell me that my kid will be fine when nothing about her development suggests a wait-and-see approach. She is beautiful and perfect, but she is not "just fine."

[Linda on the move]

Originally Posted by ErinYay 

I do have to gently say, though, that the special-needs board is a support board first and foremost. I imagine every parent who posts here has, at one point or another, had to struggle with what DH and I are struggling with: people trying to tell us, with kindness and support, that she's "just fine." And, frankly, in my opinion, it's one of the most difficult things to hear, especially at the early point of the process of determining why one's child needs help, and how best to provide it.

She's *not* "just fine." She's a wonderful, curious, clever girl, but she is not a typically-developing child.

I agree. I hated that, and still do. It seemed to go along with the notion that if only I did something a little different, then we would see that she is fine, and the problem was just my parenting of her.

Telling a parent that their child, who you have never met, is fine, is a complete load of crap. You haven't done a full eval, heck, you aren't even qualified to do an eval. Telling parents that it will all be fine in an attempt to make them feel better but with the implication that the parent doesn't need to take action -- solid action like therapies and specific sorts of work with the child -- could deeply hurt the child in the long run.

Some kids need extra help, and to discourage their parents from getting that help is wrong. Wrong. Wrong.

My DD, who is on the spectrum, is doing great right now. Partly because I ignored people who said she was just fine.

[KimPM]

If I had "just stuck with Early Intervention", my DS probably wouldn't be eating solid food today, seriously. EI came here for about a year, and that was one year too long. No progress happened at all during that time. Once I found an independent speech/feeding therapist, things started to move. Now, in other places the EI may be good, but it didn't work at all for us. If you are not satisfied with them, by all means, find something better that really helps! Follow your instincts.

[foreverinbluejeans]

I believe it is an unreasonable expectation of parents that their child be normal. Few children are. I think it is "just fine" to be not typical and have a wait and see approach when there is no pathology that is severe enough to be diagnosed. Children have a wide variety of personalities that emerge soon after birth. You don't want to wait and see but even if there is something that can be diagnosed as "wrong" with your daughter there may be nothing that can be done to "fix" her right now.

Being a late bloomer is having developmental delays. That is how you describe your daughter (speech delays, social delays). Late bloomers don't make their needs known. They don't know why and may not care that they can't do things others can do. That's why I say a simple book like Leo the Late Bloomer is good for parents. It shifts the parents' view of the child away from the medical model (pathology). She just turned 2! Having mild delays that young does not have long term impact on a child's life. You aren't describing severe delays. 

Maybe here all the mothers have been told over and over their special needs child is just fine but that isn't the case in the "real" world. Mothers who have had a difficult time getting a diagnosis may seek out discussion boards like Mothering. Mothers often have to be convienced that there is something wrong with their child. If several doctors or experts are telling you that there isn't any reason to worry about your child they may be (not 100%) right. If what other people say about your child's development bothers you there is an easy solution, don't discuss it.

I understand your frustration with your experience with the medical and psychiatric system. Just because you and your sister have Asperger's Syndrome doesn't mean she will also. Mothers with Asperger's Syndrome may be hypervigilant or have anxiety about their children. This may be something to discuss with your MD or in counseling. I don't want to upset you and I am trying to respect you. I may be all wrong. I hope I have been of some help. 

[ErinYay]

Red seems like a suitable color for my replies...

Originally Posted by foreverinbluejeans 

I believe it is an unreasonable expectation of parents that their child be normal. Few children are. I think it is "just fine" to be not typical and have a wait and see approach when there is no pathology that is severe enough to be diagnosed. Since you're privy to her doctor's notes, medical records, and EI evaluation, I clearly need to fire and report all of them due to gross privacy violations. She *has* a diagnosis, thank you. Children have a wide variety of personalities that emerge soon after birth. No personality-type includes never making eye contact in 11.5 months of nursing. You don't want to wait and see but even if there is something that can be diagnosed as "wrong" with your daughter there may be nothing that can be done to "fix" her right now. I do *not* want to fix my daughter and to insinuate that I do is beyond offensive.

Being a late bloomer is having developmental delays. That is how you describe your daughter (speech delays, social delays). Late bloomers don't make their needs known. They don't know why and may not care that they can't do things others can do. That's why I say a simple book like Leo the Late Bloomer is good for parents. It shifts the parents' view of the child away from the medical model (pathology). She just turned 2! What was that I said about tearing my hair out? When you raise a child from birth who has never once in her two years offered you physical affection, you can yell at me for the tiny part of me that's kind of sad about it. Having mild delays that young does not have long term impact on a child's life. Again, since you know that her delays are mild, which is contrary to the opinion of the actual professionals who have actually met my child, it does hearten me to think that may be so. You aren't describing severe delays. I'm not describing severe delays because I have *only* talked about her specific abilities and interests in regards to play. But since you're so familiar with her, maybe just check your notes.

Maybe here all the mothers have been told over and over their special needs child is just fine but that isn't the case in the "real" world. Good. I guess I can tell everyone I know in the real world who tell me everything is fine with a child they see twice a year that no one in the real world is says this and that they are unique butterflies. Mothers who have had a difficult time getting a diagnosis may seek out discussion boards like Mothering. Also mothers who *have* a diagnosis may seek out message boards. Also people who like cats. What's your point? Mothers often have to be convienced that there is something wrong with their child. Some do. I don't. If several doctors or experts are telling you that there isn't any reason to worry about your child they may be (not 100%) right. Our ped doesn't see autism, but he  doesn't take it upon himself to dx or not, and does realize that *we* know her best and is referring us to the proper professional. The PT and DI from Early Intervention state that she has moderate speech and severe social delays, but I guess since you think she's fine, she is. If what other people say about your child's development bothers you there is an easy solution, don't discuss it. Wow.

I understand your frustration with your experience with the medical and psychiatric system. Just because you and your sister have Asperger's Syndrome doesn't mean she will also. My sister doesn't have AS, my bithdaughter does. I *know* my 2-year-old does *not* have AS as one cannot have AS and a speech delay *and* because there will be no AS in the DSM-V, which will be out by the time she's old enough for that dx. Mothers with Asperger's Syndrome may be hypervigilant or have anxiety about their children. Oh, good. Tell me more about this. I wasn't aware that you are an expert in the field of moms with AS. Where have you been published? I'd really like to read your work as there is very little clinical research about adult women who are parenting with AS. This may be something to discuss with your MD or in counseling. Certainly. I typically do take unsolicited advice on what to discuss with my hypothetical therapist from strangers on the internet. I don't want to upset you and I am trying to respect you. Too late on both counts. I may be all wrong. You are. I hope I have been of some help. You have not.

[Emmeline II]

Originally Posted by Linda on the move 

I agree. I hated that, and still do. It seemed to go along with the notion that if only I did something a little different, then we would see that she is fine, and the problem was just my parenting of her.

Telling a parent that their child, who you have never met, is fine, is a complete load of crap. You haven't done a full eval, heck, you aren't even qualified to do an eval. Telling parents that it will all be fine in an attempt to make them feel better but with the implication that the parent doesn't need to take action -- solid action like therapies and specific sorts of work with the child -- could deeply hurt the child in the long run.

Some kids need extra help, and to discourage their parents from getting that help is wrong. Wrong. Wrong.

My DD, who is on the spectrum, is doing great right now. Partly because I ignored people who said she was just fine.

foreverinbluejeans
I live with my grandson and he turned 3 in Sept. I was concerned because he wasn't speaking in sentences along with some other developmental delays and unusual behaviors. I got out my DSM-IV and psycholoy books from grad school. I decided he has tactile issues that are common in our family but that I didn't think he met the criteria for any other disorders. Now it seems he is talking better every day and using longer sentences. He used to ignore other people and I was shocked about a month ago when he told an elderly neighbor I was talking with all on his own, "my name is Marcus." He had never said his name before and then he says it to a stranger?! For a few days after he was telling his father, "my name is Marcus."

I'm sure there there are posters here, including myself, whose child did something "normal" or impressive when they were having concerns about that child's development...it didn't mean things were "fine", and it often contributed to a delay in diagnosis/treatment. Do your grandson a favor and stop trying to evaluate him yourself--a facility like this should provide a thorough evaluation.

[Emmeline II]

Originally Posted by foreverinbluejeans 
 

I believe it is an unreasonable expectation of parents that their child be normal. Few children are. I think it is "just fine" to be not typical and have a wait and see approach when there is no pathology that is severe enough to be diagnosed. Children have a wide variety of personalities that emerge soon after birth. You don't want to wait and see but even if there is something that can be diagnosed as "wrong" with your daughter there may be nothing that can be done to "fix" her right now.

  You really have no idea what you are talking about. Though it is possible a child this age may not get a specific diagnosis that does not mean there is nothing that can be done to help the symptoms that are present, which is what Early Intervention is about; they only help children under 3 years old so if a parent waits much past 2yrs old there is a chance they won't get help from EI at all. There are posters here with infants receiving therapy through Early Intervention.

Being a late bloomer is having developmental delays. That is how you describe your daughter (speech delays, social delays). Late bloomers don't make their needs known. They don't know why and may not care that they can't do things others can do. That's why I say a simple book like Leo the Late Bloomer is good for parents. It shifts the parents' view of the child away from the medical model (pathology). She just turned 2! Having mild delays that young does not have long term impact on a child's life. You aren't describing severe delays. 

Yes, it can have a long term impact, because what looks like mild developmental delays can actually be signs that there is something more significant going on; something, like Asperger's, that may not be diagnosable until years later.

Maybe here all the mothers have been told over and over their special needs child is just fine but that isn't the case in the "real" world. Mothers who have had a difficult time getting a diagnosis may seek out discussion boards like Mothering. Mothers often have to be convinced that there is something wrong with their child. If several doctors or experts are telling you that there isn't any reason to worry about your child they may be (not 100%) right.

Ok, I'll admit my name isn't really Emmeline II, but I have a real name in the real world and a real child that is special needs, the first of which were not diagnosed until he was 6.5 years old--it's not that his problems were not there (obviously) it's that he was labeled a "behavior problem" and I was labeled a bad parent.

If what other people say about your child's development bothers you there is an easy solution, don't discuss it.

It's oh-so-healthy to keep your worries and concerns to yourself all the time .

Mothers with Asperger's Syndrome may be hypervigilant or have anxiety about their children. This may be something to discuss with your MD or in counseling.

Another "nervous mother" comment AND a "you should get some counseling" comment -- a twofer!

[RiverTam]

Originally Posted by foreverinbluejeans 
. I don't want to upset you and I am trying to respect you. I may be all wrong. I hope I have been of some help. 

If you want to respect a mother, the place to start is listening to her when she says something is wrong with her child. 

[christinelin]

OP, regardless of what is going on with your DD (and it sounds like you have terrific instincts), nothing you are doing and nothing the rest of us are suggesting will harm her. You are simply playing with her -- perhaps in a more focused, deliberate way than most parents -- but really just playing. Don't let anyone talk you out of following your gut and working with her to develop a stronger connection with you and others and better play skills. That will never be the wrong choice.

I wish I had seen my son's challenges earlier. He is doing terrifically well, but I can't help but think he would be doing even better if we had started intervention at 2 years old instead of 5 years old.

[ErinYay]

Thank you all *so* much for the support and advice! Out of darkness can come light etc etc...

christinelin- that's one of the many things I love about Floortime- it's *only* good for a child, NT or not. If I decided that, hey, I was a great dog trainer, let's try some diy ABA, now that would be a disaster and quite possibly really damaging, but no kid can be harmed by having an attentive parent playing on the floor all day!

I sort of hate asking for advice, and I'm sure many of you can relate, as you end up talking about only the deficits and delays. It's hard for people to see how much you adore and cherish your kiddo for everything that makes them who they are when all they see is a list of weirdness and oddity. Our girl is incredible. She just has different ways of interacting with us and her environment. You've all given really good advice, and I thank you for it!

(We had her OT eval from EI today- she was too busy to come out when the others did, and she lost her mind at what a great sensory set-up we have already. It really is a good morale boost to hear from experts that, yeah, they see what you see, and you're doing pretty well at mitigating those things.)

[LynnS6]

I'm chiming in a little late here, but I wanted to add that at this age, remember that NT kids are doing mostly parallel play. That means you don't necessarily need to worry about getting her to initiate pretend play with you right away. You can work on getting her to notice you while playing, imitating some of the things that you're doing, and initiating interaction. It sounds like you're doing a good job in initiating pretend play with her, and that you're on the right track in terms of working on her playing "with" you, rather than just near you. I just wanted to give you a gentle reminder not to set the bar too high!

[ErinYay]

Thanks, Lynn! I'm primarily looking to just get some gaze-checking and "hey, mom, lookit me," going on. It's really weird when I play with other little kids, like 12-24 months, when they LOOK at me so much! Like, what's so interesting about my face, kid? I'[m so used to V really concentrating on her activities without looking at anyone that it's a little surreal to play alongside other kids. Even our 13-week-old initiates and sustains interaction- my husband and I were agog the other night when she was cooing and sticking her tongue out and laughing- clearly trying to keep us engaged with her. We never had anything like that with V (and yes, we try our damnedest to keep from comparing them, but we are humans...) when she was tiny, or, really, ever.

MOSTLY though, I made a big breakthrough last week in just accepting her. I think I understood acceptance intellectually, but not emotionally, until then. Like, this is our kid. And we love her. And she's connected to us in her own way, and that's okay. She *is* "only two," and we have a lot of time to help her connect with the world, but our very most important thing to do right this second is to always show her that we love her, understand her, and want her to be and act exactly as she feels she should. The world isn't so loving and accepting, and if she doesn't get that unconditional acceptance and love from us, she really won't stand a chance later. So, I guess I now know what it really means to "enjoy your kid."

Thanks again!

[RJ11]

I just read the end of this thread and am touched by your comment about acceptance. Beautiful. I still struggle with that when my son and I are having a bad day. I'll have to remember your thoughts.

Funny, my 18 month old girl (seems NT) looks at me in the eyes all the time and I'm like, what?! Now that I am used to it I love it of course. This may sound silly but my son as a toddler used to love when I would whistle - that would always get that "check in" look.