I've seen similar threads but didn't want to hijack them, and just felt like our situation was a little bit different, altough not entirely ... Mostly I'm just feeling a little bit discouraged and like I'm just not meeting everyone's needs.
My 5-yo son is autistic and was being served by a private consultant who was costing us lots of $$ but was doing amazing things with our son. He was learning tremendous amounts and loving his therapy, which was about three hours a day. Our consultant recently took a position with our local Center for Disabilities and we are in the process of getting signed up on her caseload there, but she will be coming only for monthly consultations rather than daily therapy. The daily therapy now falls to me to carry out. I had posted a while back in a thread that I was actually considering this prior to her accepting a new position. I feel like when I do the daily therapy I have a much better connection with him, I enjoy doing the therapy with him, and I just feel more in tune with him in general. He did attend our public school preschool for a little over a year but due to his health status he could not tolerate the colds/flu bugs. He is immunocompromised and gets seriously ill with a simple cold.
The trouble I have is actually getting this done. We also have a 2-yo son who appears to be developmentally on target other than a possible speech delay. Of course, he loves everything his older brother does for therapy but is impossible to have around while I try to do this, at least in the manner that it has been carried out before. The therapy is an ABA program and typically takes 2-3 hours to complete each day (and that would be without the interruptions from our 2-yo). It requires reinforcements (in our case toys) to be given immediately after completing a task, having all the material for the session right there to maintain the flow of the session, etc. Of course our younger son is constantly trying to run off with material, trying to take toys (reinforcers) away from his brother as soon as they are given, and overall just being like a 2-yo should be. I have had a sitter in the past but I really can't afford to pay one. When we had a sitter we also had the therapist coming to carry out DS1's program, so I could actually get some work done during that time. I can't afford to pay her to care for DS2 if I am not actually working. Both kids still nap - DS1 takes a 2-3 hour nap and sleeps 11-12 hours a night because of his lung disease and the energy he uses to get through his day. DS2 absolutely refuses to sleep if I am not right there with him.
The only way I can see this working is if I can modify the program somehow so I can still teach the material but have it be more "generalized" for the whole thing. It will not be following the intent of ABA, which teaches in a discreet trial format, although this version is not as strict as the best known ABA anyway. It focuses more on natural learning and communication skills than the more traditional, well known ABA programs. However, until DS2 matures enough to either sit cooperatively and join us for the therapy (which is carried out in a very lively, fun manner) or entertain himself nearby I don't see how it will work. I absolutely cannot put DS1 back in the public school system - both for his health and because of our negative experience with them. We fully intend to hs both kids and any future kids we might have. So, I really need to find a way for this to work, even if it means following a less rigid schedule. Here are DS1's current goals - any thoughts would be so greatly appreciated!!
1. Gross motor imitation (currently trying to learn to jump - very difficult task for him and we have not been successful in even teaching him to flex his knees for the start of the jump.) This one is not so much of a problem with DS2, who loves to jump!
2. Imitation with object - currently brushing hair. (I model and he copies.)
3. Matching - associative matching (what does this go with? i.e. pillow with blanket, pants with shirt, etc.)
4. Discrimination - such as "touch car" or "touch toothbrush" with that object in the presence of other objects so he has to pick the correct one.
5. Instructions - following a simple instruction such as "brush hair" or "stomp feet"
7. Block design - copying a simple block design correctly - currently using only two blocks but will build as he is successful with this.
8. Open ended play - I model actions with play sets (such as little people or similar) and he copies.
9. Stringing beads - using various "strings" of different thickness/flexibility for fine motor development.
10. Puzzles - currently using puzzles with 7-10 pieces and can successfully complete the last 5 pieces independently (with the others already done for him).
11. Clothespins - putting on and removing from the edge of a plastic bowl - another fine motor skill - goal is to not just rip it off without squeezing first, and to not just try to shove it on without squeezing to open.
12. Handwashing - almost independent with this one - sometimes needs help orienting his hand correctly under the soap dispenser.
13. Nesting cups and shape sorter - maintaining skills on these, as he can do them independently.
14. Dressing skills including shirt/pants/socks/coat/hat/mittens.
15. Feeding skills - he is tube fed and has a severe oral aversion. We are working with baby foods right now and some days he will eat up to a jar or two of stage 1 foods in a day, other days not even a jar.
17. Communication - He is nonverbal. Currently using pictures to communicate and trying to work towards using picture symbols rather than exact pictures.
18. Toilet training. This is currently on hold as it was just too much and a very difficult concept for DS1 to grasp. Because he is 5, though, I really want to find a way to tackle this again in the very near future.
So, those are his current goals. Most of them I think could be addressed away from the table without such a rigid schedule, but again would not be following the instructional method so closely and this method has worked so well for him I don't want to jeopardize his progress. The play skills are done away from structured table time anyway, along with the eating, dressing and communication (which is done both places).
He also takes piano lessons, which is as much music therapy for him since his teacher has a background in music therapy so uses a variety of activities and techniques to teach him, and he has an OT come twice a month to help us with his feeding program. In the spring/summer/fall he takes therapeutic horseback riding lessons.
The other piece of the puzzle for us is that I also have to work, so I have to find a way to fit in 4-5 hours of work a day on top of this and the rest of the household stuff. I have not been successful with getting all of this done and the finances are really showing it, which of course causes more stress all around for DH and I.
Well, there's what we have going on. Perhaps this was as much of a vent as anything, since I know we will have to just work this out however it will work for our family, but if anyone has any ideas, ways that they handled any similar situations, etc. I would really appreciate it. Some days it just seems so overwhelming and then I just feel like a failure for not doing better at getting it all in.
Thanks so much!
My 5-yo son is autistic and was being served by a private consultant who was costing us lots of $$ but was doing amazing things with our son. He was learning tremendous amounts and loving his therapy, which was about three hours a day. Our consultant recently took a position with our local Center for Disabilities and we are in the process of getting signed up on her caseload there, but she will be coming only for monthly consultations rather than daily therapy. The daily therapy now falls to me to carry out. I had posted a while back in a thread that I was actually considering this prior to her accepting a new position. I feel like when I do the daily therapy I have a much better connection with him, I enjoy doing the therapy with him, and I just feel more in tune with him in general. He did attend our public school preschool for a little over a year but due to his health status he could not tolerate the colds/flu bugs. He is immunocompromised and gets seriously ill with a simple cold.
The trouble I have is actually getting this done. We also have a 2-yo son who appears to be developmentally on target other than a possible speech delay. Of course, he loves everything his older brother does for therapy but is impossible to have around while I try to do this, at least in the manner that it has been carried out before. The therapy is an ABA program and typically takes 2-3 hours to complete each day (and that would be without the interruptions from our 2-yo). It requires reinforcements (in our case toys) to be given immediately after completing a task, having all the material for the session right there to maintain the flow of the session, etc. Of course our younger son is constantly trying to run off with material, trying to take toys (reinforcers) away from his brother as soon as they are given, and overall just being like a 2-yo should be. I have had a sitter in the past but I really can't afford to pay one. When we had a sitter we also had the therapist coming to carry out DS1's program, so I could actually get some work done during that time. I can't afford to pay her to care for DS2 if I am not actually working. Both kids still nap - DS1 takes a 2-3 hour nap and sleeps 11-12 hours a night because of his lung disease and the energy he uses to get through his day. DS2 absolutely refuses to sleep if I am not right there with him.
The only way I can see this working is if I can modify the program somehow so I can still teach the material but have it be more "generalized" for the whole thing. It will not be following the intent of ABA, which teaches in a discreet trial format, although this version is not as strict as the best known ABA anyway. It focuses more on natural learning and communication skills than the more traditional, well known ABA programs. However, until DS2 matures enough to either sit cooperatively and join us for the therapy (which is carried out in a very lively, fun manner) or entertain himself nearby I don't see how it will work. I absolutely cannot put DS1 back in the public school system - both for his health and because of our negative experience with them. We fully intend to hs both kids and any future kids we might have. So, I really need to find a way for this to work, even if it means following a less rigid schedule. Here are DS1's current goals - any thoughts would be so greatly appreciated!!
1. Gross motor imitation (currently trying to learn to jump - very difficult task for him and we have not been successful in even teaching him to flex his knees for the start of the jump.) This one is not so much of a problem with DS2, who loves to jump!
2. Imitation with object - currently brushing hair. (I model and he copies.)
3. Matching - associative matching (what does this go with? i.e. pillow with blanket, pants with shirt, etc.)
4. Discrimination - such as "touch car" or "touch toothbrush" with that object in the presence of other objects so he has to pick the correct one.
5. Instructions - following a simple instruction such as "brush hair" or "stomp feet"
7. Block design - copying a simple block design correctly - currently using only two blocks but will build as he is successful with this.
8. Open ended play - I model actions with play sets (such as little people or similar) and he copies.
9. Stringing beads - using various "strings" of different thickness/flexibility for fine motor development.
10. Puzzles - currently using puzzles with 7-10 pieces and can successfully complete the last 5 pieces independently (with the others already done for him).
11. Clothespins - putting on and removing from the edge of a plastic bowl - another fine motor skill - goal is to not just rip it off without squeezing first, and to not just try to shove it on without squeezing to open.
12. Handwashing - almost independent with this one - sometimes needs help orienting his hand correctly under the soap dispenser.
13. Nesting cups and shape sorter - maintaining skills on these, as he can do them independently.
14. Dressing skills including shirt/pants/socks/coat/hat/mittens.
15. Feeding skills - he is tube fed and has a severe oral aversion. We are working with baby foods right now and some days he will eat up to a jar or two of stage 1 foods in a day, other days not even a jar.
17. Communication - He is nonverbal. Currently using pictures to communicate and trying to work towards using picture symbols rather than exact pictures.
18. Toilet training. This is currently on hold as it was just too much and a very difficult concept for DS1 to grasp. Because he is 5, though, I really want to find a way to tackle this again in the very near future.
So, those are his current goals. Most of them I think could be addressed away from the table without such a rigid schedule, but again would not be following the instructional method so closely and this method has worked so well for him I don't want to jeopardize his progress. The play skills are done away from structured table time anyway, along with the eating, dressing and communication (which is done both places).
He also takes piano lessons, which is as much music therapy for him since his teacher has a background in music therapy so uses a variety of activities and techniques to teach him, and he has an OT come twice a month to help us with his feeding program. In the spring/summer/fall he takes therapeutic horseback riding lessons.
The other piece of the puzzle for us is that I also have to work, so I have to find a way to fit in 4-5 hours of work a day on top of this and the rest of the household stuff. I have not been successful with getting all of this done and the finances are really showing it, which of course causes more stress all around for DH and I.
Well, there's what we have going on. Perhaps this was as much of a vent as anything, since I know we will have to just work this out however it will work for our family, but if anyone has any ideas, ways that they handled any similar situations, etc. I would really appreciate it. Some days it just seems so overwhelming and then I just feel like a failure for not doing better at getting it all in.
Thanks so much!
