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#1 of 25 Old 09-06-2008, 11:38 AM - Thread Starter
 
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Hi, this is sort of a spin-off of a thread on the Vax Board. Ds (3.5) was diagnosed with autism this past spring (we suspected it for a long time). He just started a center-based ABA program and I have mixed feelings about it because I have read (here and elsewhere) that the autism community is sort of divided on the issue of "treatment" and I was hoping for some feedback on both sides of the issue.

To give a little background on ds, he had a severe vaccine reaction as a n infant, which I believe led to his autism diagnosis; whether its actually autism or "autism-like" symptoms... who knows, and I'm not one to sweat the details He is more toward the high-functioning end because he has a very big vocabulary, but he has unusual speech patterns, gross-motor delays, lots of vocal and visual stims, sensory-processing issues and extreme social "impairment."

I like the school and ds is doing pretty well; half of his day is one-on-one with his teacher, the other half is a group activity with the other children in the program and their teachers. He does well with the one-on-one time, but not the group time.

I made it very clear to his teacher that we aren't looking to "cure" him or anything, but that we just want to help him be better able to better function socially and hopefully ease his sensory issues; the stims are just part of who is he is and we're fine with that. One thing did happen at school yesterday that...ds is obsessed with sewers and loves to throw rocks into them; his morning routine is throw a rock into the sewer at the end of our driveway, and now throw one into the sewer outside of the school. His teacher took him for a walk around the building but kept redirecting him from throwing a rock into the sewer, which upset him. It broke my heart because I know how much it means to him!

Anyway, what are your feelings about ABA? What other approaches are you all taking, if any? Do finances have any bearing on your approach? I ask because we can't afford all kinds of biomed-types of things (especially if they may or may not work) and the state is paying for ds' ABA...
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#2 of 25 Old 09-06-2008, 12:10 PM
 
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from my standpoint, as an autistic and as a parent of an autistic;
I see no point in redirecting "weird" behaviors, save your energy for redirecting and educating about harmful behaviors. We're always going to be weird, you can't "therapy" that away. Help him stay safe, help him do what he wants to do, the weird part is just always going to be there (and rightly so)
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#3 of 25 Old 09-06-2008, 12:53 PM
 
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Redirecting him from throwing a rock would really bother me too. I've never tried to keep either of my sons from things they enjoy unless it harms someone. The only redirections we've done with Andrew are self injury type things.

Because your son regressed and has motor delays....many regressions are due to metabolic disorders. Many kids with metabolic disorders will present with developmental issues and gross motor stuff (particularly muscle tone issues). http://www.mothering.com/discussions...d.php?t=734501 Take a look at this thread I made a year ago after we got our son's diagnosis. Any regression needs a metabolic work up.

We decided against ABA. We did floortime (cheap..I taught myself and helpful) and then switched to RDI/relationship development intervention (expensive though partially insurance covered for us but has been very worth it). http://www.autismweb.com/education.htm Here is a link that describes all the methods basis including the two I mentioned and ABA. You'll be able to see how different those two are compared to ABA. Neither floortime nor RDI are going to change who a child is of course (neither will ABA). My son has made a lot of discoveries developmentally he wouldn't have otherwise using those programs. And they are gentle, respectful, build relationship approaches. I do nearly everything I do with Andrew with his typically developing twin Caleb because Caleb wants in on the fun too. But my point is they are approaches you can do with any child and I have no concerns about using them with my spectrum kiddo.

I hope you'll look into metabolics. My son has benefitted greatly with treatment.

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#4 of 25 Old 09-06-2008, 02:57 PM
 
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You can search for a lot of past threads discussing this very issue.

I am trained in ABA and use it with my students very successfully. I also use other methods and don't try to "cure" them of anything.

I don't have time to type it all up now but ABA consists of techniques that can be used in many ways. Yes, there are "sitting at a desk repeating the same motion over and over as the child gets it right with help and then gets rewarded with jellybeans". But there are many other ways to use the technique that don't involve the same thing every day.

I use it to help my students develop skills they want or need in small parts they are able to accomplish successfully, so that it is a very positive experience for them. I figure out where their intersts and skills are NOW and work from those. I pay close attention to their emotions, sensory needs, individuality, and make sure that we do many activities that they enjoy, and learn during those.

I redirect behavior if it is harmful to the student or others, preventing them from learning, or if it will prevent them from engaging in an activity they like because of other people's reactions, or because it physically hinders the activity. I never try to stop them from stimming.

I also do a lot of RDI-type of activities to teach communication, and while I may use behavior analysis to break down what communication steps they need to practice, I teach those steps during meaningful activities rather than in isolation.

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#5 of 25 Old 09-06-2008, 03:38 PM
 
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We do a type of second generation ABA called Verbal Behavior. It's more naturalistic and not so much into the DTT (discrete trial training). There's some DTT in Verbal Behavior but it also parts ways from the Lovaas ABA. It's been the one therapy we've done that has helped from the start. It's not going to change DD. But it's going to help her understand how to function in the world. The sad thing is the world isn't going to change for her. She has to learn how to function in a world where people's brains are wired differently from hers. We've all seen a HUGE improvement since she started VB. She can sit for circle time. She is getting better at following directions. She says 5-6 word sentences when she wants to. Her vocabulary now is too large for me to count. We're working on preschool skills now like imaginative play, conversational skills. I love VB.

How do we afford it? We've had to make big changes. We have cut down all our discretionary expenses. Going out now means spending $25 max for all of us. But we're not in debt doing this because we probably do about 25-30 hours a week with the therapists and DH/I do about another 5 hours on our own with DD. The therapists leave all their materials at our home so that means we can use those when they're aren't here. After we've watched them work with DD for a while, we got a sense of what to do.

Here's a previous thread about ABA. http://www.mothering.com/discussions...&highlight=aba

You have to find someone who knows what she's doing. There are some people who say they know ABA or VB but they don't.

The biomed approach has been a big thing for us. I don't think the VB would have worked as well without the biomed things we did.

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#6 of 25 Old 09-06-2008, 04:54 PM - Thread Starter
 
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Its tough because I had a choice between 2 schools (with all of the funding and resources in my area, classes fill up very quickly, so space is limited). The other school used an RDI approach, but my concern was the class size; he'd have only 2 hours of one-on-one teaching (but not in a seperate, quiet room) and the rest of the day would be in a class of 15 children (a mix of autistic and NT). Ds doesn't function well in a group setting so I feel like he would have been lost in such a large group.

The school we chose uses ABA, but its mostly one-on-one, while the group activity is with just 5 other children, and each teacher guides their student in learning how to interact. I get that they are trying to redirect his attention to more "constructive" things... but he's only 3.5! To him putting rocks in sewers and opening and closing doors is constructive. I just have such mixed feeling about this whole thing...
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#7 of 25 Old 09-06-2008, 06:53 PM
 
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RDI can't be done in a classroom like that. RDI is not with groups (or even two kids really until much further in the process) and it is parent/child rather than therapist/child. I'm confident that other school cannot legally claim to be doing RDI.
But I see your struggle.

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#8 of 25 Old 09-06-2008, 07:26 PM
 
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I don't know about the rocks in sewers - CAN that be dangerous? If not, then fine, he should do it. But if so, then maybe redirection is a good thing in that case.
And is he actually throwing the rock, or just dropping it? Because throwing it WOULD be dangerous - if his aim is ever off, he could really hurt someone.
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#9 of 25 Old 09-06-2008, 08:02 PM
 
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I stayed away from ABA for a couple years, mostly because of what I have read here. Then I looked into it further and talked to BCBA's and ABA therapists here and changed my mind and started ABA about a month ago. So far, it has been great and my son loves it! He gets excited when he sees his therapist, he likes the activities and he has learned a lot! I chose who I felt comfortable with. There were some that didn't really line up with my beliefs. So no matter what their success rate was I passed on them. My friend has a BCBA that told her some things that I strongly disagree with so I would have passed. I just think it is a shame that ABA is thought of sitting at a table for hours, sitting on your hands and being a robot. It isn't that way for my son and he is amazing us with what he has learned.

Like any therapy etc, you have to have a good match. For me with any therapist, I agree with some things and disagree with others. Then we talk and come to an agreement.

Did you ask why she re-directed throwing rocks? we had a therapist that kept suggesting a weighted vest. But when I asked why and how it would benefit MY son she couldn't give me a good enough answer so I never did it with my son. I had another OT suggest it and gave me good reasons for my son so we tried it at home and he always took it off so I just abandoned that idea.

I guess all I am trying to say is one technique isn't right for everyone. And one ABA program or floortime program etc is right for everyone you know?

So long story longer, I am not trying to suggest ABA is right for you. Just try to see the schools and see which one is right for your child.
Good luck!!
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#10 of 25 Old 09-06-2008, 08:40 PM
 
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I that if overall he enjoys it and you feel the program has been good for him, then I would probably just talk with the teacher about how you don't want him stopped from doing things just because they are weird or delay him for a short period of time, and use the rock throwing as an example.

Sherri
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#11 of 25 Old 09-06-2008, 08:57 PM - Thread Starter
 
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I don't know about the rocks in sewers - CAN that be dangerous? If not, then fine, he should do it. But if so, then maybe redirection is a good thing in that case.
And is he actually throwing the rock, or just dropping it? Because throwing it WOULD be dangerous - if his aim is ever off, he could really hurt someone.
Its just dropping the rocks into the the sewer; he likes to see it splash. It was so sad because it was too muggy to go for a walk after school so he sat there making splashing motions with his hands

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RDI can't be done in a classroom like that. RDI is not with groups (or even two kids really until much further in the process) and it is parent/child rather than therapist/child. I'm confident that other school cannot legally claim to be doing RDI.
I just realized I was wrong; the school actually used the Delacto method for the 2 hours of one-on-one time and tasks, and the rest of the day was group time.
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#12 of 25 Old 09-06-2008, 09:02 PM - Thread Starter
 
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Did you ask why she re-directed throwing rocks?
He has 2 obsessions: opening and closing doors (being an enabler, I sometimes take him to Home Depot to check out their doors for a change)
and dropping rocks into sewers...its gotten to where it is interfering with simple everyday activities and its all he talks about.
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#13 of 25 Old 09-07-2008, 12:56 AM
 
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He has 2 obsessions: opening and closing doors (being an enabler, I sometimes take him to Home Depot to check out their doors for a change)
and dropping rocks into sewers...its gotten to where it is interfering with simple everyday activities and its all he talks about.
from my sister, who is trained in ABA and getting her PhD in Special Ed...

Quote:
Most kids with autism have "OCD tendencies," "narrow-" or "fixed interests," "repetitive behaviors," etc. In ABA you look at the function of behavior. Something is reinforcing this behavior. With repetitive behaviors, the function often seems to be self stimulatory, i.e., there's no external reason why they're doing what they're doing, something internally reinforces the behavior (e.g., it feels good, it relieves feelings of anxiety). If the behavior is self-reinforcing, then every time it occurs, it is being reinforced, and hence will continue, probably at an increasingly higher rate. This is the long, technical reason of why I would try to interrupt or redirect the behavior. It's probably just going to get worse.

The clinical reasons why I might interrupt or redirect this behavior are: it's stigmatizing (who's going to be friends with the 13 year old kid who stops paying attention to your conversation, darts across the street to get a rock, then darts back to the sewer to throw it in?) or it's interrupting learning (e.g., the goal is to be learning how to safely cross the street and he can't because there are too many sewers distracting him), or it's dangerous (the child can't learn to safely cross the street or darts into traffic to access rocks and sewers).
So, I would probably systematically redirect the behavior. Shape the behavior into something else, preferably something more functional. E.g., Spot the rock before the child, ask him to pick it up (you know he's going to, you can reward following instructions), ask him to show it to you (social interaction, joint attention, kids with autism generally don't "show off" like other kids, so this might be a good skill to teach, conversation initiation skills, etc.), then let him drop it in the sewer (which is, apparently, reinforcing; so now hopefully allowing him to drop it in has just reinforced all those other social behaviors). Systematically, I would require different responses, e.g., giving the rock to me, throwing the rock somewhere else, kicking the rock, having a contest to see who can kick rocks the farthest, starting a rock collection, classifying rocks... See where I'm going with this? Use something he knows and likes and go with it.

Trying to block it directly will probably lead to a tantrum (especially if he "has" to do it), so it really has to be slow and systematic.

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#14 of 25 Old 09-07-2008, 08:35 AM
 
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I think ABA can be very beneficial for some kids and some behaviors. But I've notice with sensory stuff, ABA really lacks in that area. I'd be okay if my son got 10 hours a week of ABA, but was also getting Sensory Integration therapy and sensory feeding therapy as well. ABA just isn't the end all be all like I once thought it was. I keep an open mind and try lots of things
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#15 of 25 Old 09-07-2008, 01:48 PM
 
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Well we use ABA, but we don't ( and will never) use it to address behaviors. Gabe actually really doesn't have too many behaviors that I consider to be problematic. nothing that is age appropriate anyway. We simply use ABA for skills and mastery. right now his program is addressing daily living skills, namely teaching him how to brush his hair and teeth and how to tie his shoes. There is some other academic stuff in there too. So there is always the option of using ABA to help him leanr how to be more independent.

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#16 of 25 Old 09-07-2008, 05:35 PM
 
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Originally Posted by ShaggyDaddy View Post
We're always going to be weird, you can't "therapy" that away.


I have seriously been considering adding "what ShaggyDaddy said" to my sig line... but it's already kinda busy...

We are definitely going to take a tour of the local private school that specializes in kids 2-21 with autism (not every city has that after all) and talk to them about V and hear what they have to say about ABA.

But since we had never planned to send V to school, we're going to really give it some serious thought. We wouldn't be enrolling her at VIA with the goal of mainstreaming her into PS when she gets older. We just want to help her communicate better, stay on a more even keel mood-wise if poss. and teach her ways to stay safe that don't involve me constantly running and saving her from danger.

We could probably just join their parents' support group and maybe get some training that we can implement at home. Since I have no idea what they would be training me to do (and what I would in turn be training V to do?) it is all very up in the air. Right now I'm just trying to keep her happy and safe and keep myself sane.

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#17 of 25 Old 09-08-2008, 01:19 AM
 
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ASusan--I like how your sister explained why she would redirect the behavior. It makes sense. I'm not positive how I fell about the redirecting, but it did make sense! lol

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#18 of 25 Old 09-08-2008, 11:07 AM
 
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Originally Posted by ASusan View Post
from my sister, who is trained in ABA and getting her PhD in Special Ed...

"The clinical reasons why I might interrupt or redirect this behavior are: it's stigmatizing (who's going to be friends with the 13 year old kid who stops paying attention to your conversation, darts across the street to get a rock, then darts back to the sewer to throw it in?) "
I have a few problems with this line of reasoning. One is assuming that at 13, the person will still be displaying a 3 year old fixation/behavior. Another is assuming that if they did, no one would be friends with a 13 yo who throws rocks down sewers.

It seems like a benign behavior to me, so I would be upset if someone tried to redirect my child from doing it.

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#19 of 25 Old 09-08-2008, 11:37 AM
 
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I still have all (or most) of my fixations from when I was a kid (the ones I can remember from age 4 at least). The computer one, cryptography, and probabilities ones pay the bills, the chewing on clothes one I redirected by myself with gum, the car/engine one is what allows me to fix my own (and other people's) vehicles or at least not get "taken" at the mechanic. The super hero one is satisfyed with all the blockbuster movies and shows hollywood has bestowed on us of late.

So what if my parents had asked themselves: Who is going to be friends with a kid who only wants to stare at a computer screen? Who is going to be friends with a kid who only wants to talk about the rocker arm ratio for a pushrod motor? Who is going to be friends with a kid who only wants to talk about mutant powers?

Well I go to the Drag strip on the weekend sometimes, and there are plenty of people who could talk about the valvetrain of a motor untill they are blue in the face. There are plenty of people at my work who love to hear about tweaking the AI on our probabilities algorithms.

If you try to change who you are in order to attract friends, you will never attract real friends. If you try/succeed in changing someone else so that they can attract friends, they will never have real friends OR be able/allowed to acknowledge their real selves.

Helping someone be comfortable is one thing, but taking charge/control of someone else's personality in order for them to meet your social goals seems really dangerous to me.
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#20 of 25 Old 09-08-2008, 12:57 PM
 
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The mamas on here have way more experience than I do regarding the differences between ABA and Floortime. However, since you mentioned your son is high functioning and has a big vocabulary, you might want to look into the stuff Michelle Garcia Winner is doing with high functioning ASD and Asperger's kiddos.

I'm a speech pathologist (as is DH)and he is totally thrilled with her approach. I just read a book by her, and her basic premise is that a lot of treatments commonly done with kids on the spectrum goes right toward behaviors but not the underlying thinking skills that are needed.

For example, rather than tell a kid over and over again "look at me!" to gain better eye contact, she instead EXPLAINS the thought behind it. I.e. "Your eyes are like arrows. They point at what they are interested in." And extends that not only to explain that when someone is talking they like you to think about them with your eyes, but also that you can often figure out what someone else is thinking about by looking at where their eyes are pointing.

Thats just one example. Her ideas really resonate with me though, because it always feels we are skipping a step as therapists to go right to the behavior to work. And the kids never seem to get "why."

Of course, for children on the spectrum with other cognitive impairments, this would not be as feasible. But a higher functioning kid with good language skills might really grab onto this approach.

Anyhow, this is her website if you are interested:
http://www.socialthinking.com/

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#21 of 25 Old 09-08-2008, 01:55 PM - Thread Starter
 
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Its complicated because he has the big vocab of a child who is more on the mild end of the spectrum, but in most other areas he has the characteristics of more severe autism...

I hadn't thougt about it before but I guess the sewer thing is presenting a danger because he will literally dart right into the street or parking lot if he sees one. Dh and I are proactive and try to anticipate it, but I worry what could happen if... especially since its usually just me out with ds and baby.
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#22 of 25 Old 09-08-2008, 09:03 PM
 
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from my standpoint, as an autistic and as a parent of an autistic;
I see no point in redirecting "weird" behaviors, save your energy for redirecting and educating about harmful behaviors. We're always going to be weird, you can't "therapy" that away. Help him stay safe, help him do what he wants to do, the weird part is just always going to be there (and rightly so)
Thank you for that. I feel like that's where I am with ds1. I got so tired of his teachers at his speech center school trying to "maintain boundaries" and "keep authority" and redirect every single little harmless thing that I took him out and now he's doing one on one speech therapy with a really laid back teacher who knows my goal is for him to improve communication, not become the perfect "sit in a desk and color until I say stop" student.

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#23 of 25 Old 09-08-2008, 09:15 PM - Thread Starter
 
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I still have all (or most) of my fixations from when I was a kid (the ones I can remember from age 4 at least). The computer one, cryptography, and probabilities ones pay the bills, the chewing on clothes one I redirected by myself with gum, the car/engine one is what allows me to fix my own (and other people's) vehicles or at least not get "taken" at the mechanic. The super hero one is satisfyed with all the blockbuster movies and shows hollywood has bestowed on us of late.

So what if my parents had asked themselves: Who is going to be friends with a kid who only wants to stare at a computer screen? Who is going to be friends with a kid who only wants to talk about the rocker arm ratio for a pushrod motor? Who is going to be friends with a kid who only wants to talk about mutant powers?

Well I go to the Drag strip on the weekend sometimes, and there are plenty of people who could talk about the valvetrain of a motor untill they are blue in the face. There are plenty of people at my work who love to hear about tweaking the AI on our probabilities algorithms.

If you try to change who you are in order to attract friends, you will never attract real friends. If you try/succeed in changing someone else so that they can attract friends, they will never have real friends OR be able/allowed to acknowledge their real selves.

Helping someone be comfortable is one thing, but taking charge/control of someone else's personality in order for them to meet your social goals seems really dangerous to me.
I absolutely agree! Am I safe in saying that the goal should be to channel his fixation into a useful activity, instead of trying to curtail it? His other fixation is doors, and we aways joke that he can always fall back on being a doorman in the city; they've got a union and everything!
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#24 of 25 Old 09-09-2008, 09:22 AM
 
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Originally Posted by Proverbs31 View Post
I absolutely agree! Am I safe in saying that the goal should be to channel his fixation into a useful activity, instead of trying to curtail it? His other fixation is doors, and we aways joke that he can always fall back on being a doorman in the city; they've got a union and everything!
I like the way you think seriously people don't see that someone somewhere is making money off being completely obsessed with doors, and they design doors for home depot, or install doors, or open doors, or wash them. There are a million positive things your child can do with a door obsession, and all of them are better than teaching him to constantly restrain his feelings about doors just becuase most people don't share that feeling.

A doorman who does it because there is a union and he can eek out a living opening a door will have a significantly less happy life than a doorman who wakes up every morning with gleeful anticipation of each creek, each swing, each pull, and each satisfying pressure change at the closure of his door. I would venture to say that those of us who are lucky/stubborn/obsessed enough to make a living doing exactly what we are fixated on are some of the most job-satisfied people on the planet.

Having said all that, I am not sure what the average parent will see as their role in a child's fixation. Personally I don't really feel the need to push Jet toward any more productive utilization of his fixations, and indeed neither did my parents for me. The last thing I want to do is take something he loves, then modify it for "productivity" so much that he loses interest in something he truely loves.
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#25 of 25 Old 09-10-2008, 02:06 AM
 
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If you try to change who you are in order to attract friends, you will never attract real friends. If you try/succeed in changing someone else so that they can attract friends, they will never have real friends OR be able/allowed to acknowledge their real selves.
You are very wise!!!!

Here's me I married then we had dd15 , dd11 , ds10 , and then and now we and I blog!
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