Separately, there are things for Tricare hwere I have had to take in a school IEP to get a referral. But it is not always like that -- it just depends.

Hi! Skipping down..... my son is on Tricare and we were still able to get a referral for him to have neuropsychological testing last year. I am not exactly sure how we got it..... but I talked to the nurse who does referrals. The nurse who does referrals can know more than the doctor. All she does is referrals! She had to call and talk to the insurance people, though, she did not know the regulations off the top of her head. She called back and forth. She requested the referral. She called and ask if I could get a note from school or a therapist to submit to insurance. I did. Then it went through. But I think it went through before the letter got sent in. So I think it went through anyway. Sometimes with Tricare you just need to keep asking. If they say "blah blah," you say "blah blah" back. We went for dysgraphia and my son is diagnosed with dysgraphia. He had many signs of dyslexia and I did dyslexia reading programs with him. But on his testing (this is after 3+ years of working with him) she said "his early reading problems are largely resolved" and doesn't say dyslexia. Fine with me. I did not pursue anything like this when he was younger. He fits "difficulty with phonemic awareness" to a tee, it is spot-on for him, and I thought I had a good direction to go with him. I do not think he would have received adequate,sufficient help through school (he is in public school, and I like public school, but locally they are not equipped to deal with dyslexia at a young age, in a way that is acceptable to me). Another thing I have found with the doctor/Tricare: if you say your child is having a secondary problem, like anxiety, poor behavior, social difficulty, etc, and you think it is related to the primary issue, then I have found that to be taken more seriously. Even though to me, I might not think to bring that up. But I think it is worth mentioning.

I agree a lot with that. Little things like being able to set the microwave, or help me to make pancake batter, mean so much to my son. He also likes to peel carrots. When I get baby carrots, he says "these carrots don't need to be peeled" in a disappointed way. He loves to be a helper and to be thanked for his help. A lot of our best opportunities are in the kitchen. It is a smaller space and more naturally hands-on (for me to help) or close-together. When there is a larger space or more need to move from one area to another, his focus and "following directions" make it harder. And, I think there is not the same "look what I did" feeling as he gets from things in the kitchen, where the result is really obvious. He also is great at helping to rake leaves.

My son had 2 years of school-provided speech therapy with no progress. Then the school speech therapist privately told me to try to get him into the university speech clinic, that I had no idea existed. It turned out my insurance would pay for it. He made a lot of progress that year (1st grade), but it was hard work for him also. It was a little stressful. But he had problems from his lower intelligibility. We had done a lot, a lot for his math facts over the years. I think part of it was that he was ready. But he was also very resistant to working on math facts in a way, sometimes, and would not really get too much done. But he was more willing to do Reflex Math. I think it is a good program, but it was also just the right thing at the right time for him, and something he was willing to try. He thought it was better than flashcards with mom, lol. Or anything where he had to write by hand.

Some other ideas are to keep it a shorter trip, have it be at a good time of day (not tired, not hungry for sure, maybe after a walk or some other activity that is not too active). If she would like it, give her some very important grown-up responsibility to help with the list or with coupons or something. Pretend you can't see something and then be appreciative when she can point it out. If there is anything she can hold or carry, that is good. Go over the plan before you get out of the car.

It was never his diagnosis, but my older son (now 10) cluttered and still has little bits of it, but he exited speech services at the end of 1st grade. He really had a lot of articulation problems and his main thing was "phonological processes." He fits a lot of things for dyslexia, and he had a difficult time learning to read, and I did a lot of dyslexia approaches with him. We did a lot of things for math facts, and the last thing at the end was Reflex Math -- a computer game. He liked it at first and then didn't like it. But I had him doing it every day for about 5 months or so, and he made a lot of progress in that time. He still has a long pause, but he does basically know them. He doesn't have the super-fast recall. My son still has little bits of the cluttering, but the speech therapy he did for phonological processes really helped his overall intelligibility so much, that even though speech therapists might say he does it, he is totally intelligible now. I do not have much to add, really, just to say, that I have heard of cluttering, too! It is one of those things where I would feel like nobody had heard of it! And the name is a little odd

There are probably 5 other strategies/ideas this good in the book. They are towards the middle if you want to skip and just read that chapter, maybe you can tell from the chapter title, lol. My son's therapist likes cute things, too, btw, and we have not done this, but she has had kids who like pizza. She makes them a chart that is a pizza tray, and then the tokens are pizza slices. They have a target behavior (this is for one desired behavior that they would like kids to do either independently, or cooperatively, depending on the goal), and for each time the child does the target behavior, they get a pizza slice. When they get all the slices, they get to go out for pizza. I think she has done it more for, like, an older child who completes homework or a chore, so it is possibly to get one slice a day, and then get pizza after about a week. With this kind, you can have multiple reinforcement schedules going at the same time, it is not all just one thing. This can be good if there is a time of day that is going well, and then a time of day that is going poorly, so you can keep positive reinforcement for those good times, it is not all lost to the bad time. This way there can also be a mix of short-term little treats, and long-term big treats. My son is very far from being able to get a token towards a more long-term goal. Right now, a long term for him is about an hour. He is not ready for multi-day things. But to teach multi-day goals, you can start by having a mix of short-term and long-term goals, and have the long-term goal be better than the short-term goal. The child can start to see "oh, I will get the long-term goal, it just takes time." It is teaching in a way. He talks about this some in this book, he has some cute ideas, too, iirc.

She sounds so sweet and creative! Break cards are an evidence-based practice. I have had to learn a lot about them and ask questions. The good news though, there are a lot of really cute "break card" templates on google and Pinterest and stuff. She is young for it, too, but not too young to model it if you want.

http://www.amazon.com/Everyday-Parenting-Toolkit-Step---Step/dp/0544227824/ref=sr_1_2?ie=UTF8&qid=1439210370&sr=8-2&keywords=alan+kazdin This is the book for that style that I have read, because it is in our library. I have read both books by this author. It has a lot of ideas along the lines of the pom-poms. It is similar to a lot of things for autism, but it is not sufficient for autism. There is too much specific to autism that is not found in this book. But still, it has a lot of good ideas for the pom pom thing. Here is some information, though. For a lot of kids, you might want to separate your "positive" -- getting a pompom, from your "negative" -- losing a pompom. If losing a pompom works, then I don't have a problem with it at all. In general there is a risk of kids deciding they don't care about earning pompoms if they might lose them ----- some kids are like this. If your daughter isn't, she isn't. But if you were to see a sign of this, then you could respond by no longer removing pompoms, and having something else you did instead of removing pompoms. Here is another idea with pompoms that might help (if she is capable -- and I think it is hard to know, what kids are capable of, and what we wish they were capable of, and what they are capable but we don't give them a chance). You set a target behavior. If there is something specific, that she has a pattern of doing. If there is a short list of desired behavior you want at a certain place..... You tell her: "we are going to x place, and here is the behavior we need." Then if she does good for 2 minutes, give her a pompom, and say "I like how you are doing x,y,z, just like we talked about." Then after 5 minutes, do it again. Then after 3 minutes. You want to start out doing it a lot, and at random times. Whatever "a lot" is for her (based on how long she can usually go without doing something impulsive -- this is why you have the record, so you can see how long she has between impulsive behaviors in various places -- you want to make sure to give a "good job" pompom before the amount of time when she usually would do something impulsive). If you are very impressed, give her more than one pompom. If she is amazing and you can't believe it, give her a handful. For this, you are using pompoms to reinforce the absence of an undesirable behavior, at a time it has not occurred (or is not occurring). But you talk about the desired behavior, not the undesired behavior. In his book he calls it "a positive opposite." This is how we got my son to be able to go in stores without grabbing at things or refusing to walk or hitting me. I took tiny candy in the first place (like Nerds, or something that can be broken into little pieces like a cookie), and he got little treats throughout. Then once he had a good habit, we quit doing it, it was no longer needed. While we were doing it, a huge success was a trip to Hobby Lobby when he did not grab for anything, and the check-out clerk complimented me on my kids' behavior. I also was able to take him and my daughter to pick a live Christmas tree, and he stayed with me. After he did so well with those two, we could cut way back on it. At the time, he was not at a point where he could do something so difficult for a token (a pom pom will be called a token, but he usually has stars, stickers, smiley faces drawn into circles, fingers -- like "5 fingers" and he holds his fingers out one at a time, pennies, etc.). So instead of a token, or a secondary reinforcer (saying good job, high five, a hug, obvious pleasure in your child's behavior), he still needed a primary reinforcer at that time (food, candy, flavored water, chocolate milk). But if pom poms are working, that is great, there is no need to go down to a lower level. But if there is something where she has shown it is very, very difficult for her, you can consider going back to a lower level for a certain thing. But here is the other big weakness of this book that is needed and found in autism books, but apparently really not necessary for many children. Why is the child having the behavior? Is she overwhelmed? Can't express her needs? Doesn't know how to recognize her needs? Very confused about what is going on? Anxious? Is there a skill gap? Etc, etc, etc. This book does not go into that much detail. It is just about "here are some great strategies for using tokens." And, I think it does have some great strategies. I think it is worth a check-out from the library, just to see if there are any ideas or tweaks that might be helpful. It also does not replace reading the Ross Green book about The Explosive Child. I have heard of too many people having good results with it, even though it is a slightly different kind of approach. But I can think of it like the "target behaviors" that you choose are the "Basket Number Whatever" behaviors from the Ross Green book. I have not really done much with the Ross Green book, mainly b/c I went to all-autism books. I have a good impression, though.

I am glad it is helping your son with his glitches. I know you have been concerned about that for a while. Sounds like it is going so well!

I have had a good experience with straight-up autism-specific approaches with my son with autism. Other things have not totally worked for him. It is not necessarily what I would do with my other two kids. Not that it would be bad for them -- but it would not be the best choice. The thing about autism-specific ----- they can be a big hassle in some ways, and especially starting out. It is a big system to learn and try to implement (or was for me), there is a big learning curve at the beginning. When I have tried many other things, had them not work, and feel like it is time to go to autism place...... and then I see that it is effective....... well, I am highly motivated to deal with it. I have seen other people who thought they should start it, but then it seemed like they got into it and it was more than they needed, and so it was more trouble than it was worth for them. At the beginning my son did not understand the concept of negative attention, he could not tell that attention could be positive attention (yay!) or negative attention (stop! no!). He was getting an enthusiastic reaction either way, he thought. He liked to get an enthusiastic response with a lot of excitement. We started with this, with ignoring some things, or re-directing with no comment and no facial expression. Alternately, when he was doing well, we would be super-super enthusiastic and have a lot of facial expression. He liked that and didn't understand it was not good to get that by pushing a lamp off the end table. We had to teach him that by how we responded to his actions. That was one thing that really helped, but it is very, very odd to do. Like -- your kid pushes a lamp off the end table (previously a guarantee of a huge reaction from me, iykwim) and you ignore it or quietly re-direct -- how does that seem like an effective response? But this was effective where so many other things were not. Another thing is that if he is stuck, sometimes being stuck can mean he is not able to "hear" and process information. For some kids, while they can't "hear," they can "see." So it is a possibility that visual strategies would be helpful. This is where you have a laminated card you carry around, that you take out as a reminder to look at, when certain things start to happen. It is not something I have really done, but I have heard it is really good, and I have done it in some small informal ways and found it helpful. I think it makes so much sense to start with a reputable program that it sounds like Nurtured Heart Approach is. But I have not tried it. I have got a lot of information for the more autism stuff if you ever are interested, though. For autism -- you would start (probably) by keeping a log of his difficult behavior. What happened, what happened before, and what happened after. Then you look at the list and try to see if you can identify a function of the behavior (which include attention, escape, and access). If one of these functions seems to fit, you try to respond appropriately (attention -- ignore, teach a better way to gain attention; escape, don't allow it, teach better ways to cope and express needs; access, don't give it, teach acceptable ways to ask for things and work up a frustration tolerance). Then there are so many related strategies. There are so many skill gaps or deficits that could be a root problem, and those can be identified, and supported and taught. There are many ways to change the environment to increase success by making things easier on the child, and slowly increase the difficulty level. A schedule and a timer can help kids know how long things will last and what to expect. Etc. Etc. Etc. A good relationship is necessary and underlies all of this, too. It is just ---- there is more to it than that. I have found all the things like "The 5 Love Languages for Parents" to help with that. But it is a foundation. It is not a book about teaching children with autism.

It is great information that you have found that joint compression is helpful. You are not really looking for one thing ------ but every thing you find that is helpful, counts for so much, and can add up over time. It sounds like sensory may be one small or large part of the picture. I feel like I have a pretty good grasp of my son's sensory needs now, but it has taken a while. Overstimulation can look one way, and understimulation can look another way. For him ---- he has a lot of understimulation, and it does not look like understimulation in particular, but then low and behold, that is what understimulation looks like for him. It looks like what I would think of as overstimulation. Sometimes they look the same, but I know what has been going on and whether at that moment he is likely one or the other. It is not that what I do for one or the other is so different, but I have a different mindset and goal, kind-of. I have read some, but I have attended a few seminars by now, that are either about sensory needs and strategies, or about autism, and I go to a parent support group that has had presentations. Also my son is in school OT, and finally we have a good experience with someone who is getting him. This is the program used for his sensory stuff at school, I do not pay for it or have access to the pay-stuff, but it is what the school uses and I have a good impression. It is just the thing I am familiar with. http://www.sensationalbrain.com/ What I like about this is that it addresses a common criticism or concern wrt sensory. Now -- I have heard some very reputable people who are NOT pushing a sensory-only approach, say that this common criticism is not something they see as a problem in their own experience, they think it is a bit of a made-up concern. But it is a concern that I care about addressing. Anyway, here is the criticism: let's say you have a child, who wants to get out of doing math, and has a history of avoidant/escape behavior (exhibiting behaviors in order to escape, avoid, or delay doing an unwanted task). Well, what if your child finds out that if he does a certain thing or says a certain thing, then he gets to have some nice sensory thing, and not do math. Now -- so what, right, if afterward there is a nice transition back to math. But what if instead of a nice transition back to math, you have more of the behavior, and then you are left wondering, is this really a sensory thing, or is this just a way of trying to get out of math. Now -- as I have said, I have heard that this is not something to be too concerned with, that it is viewing kids as more devious than they really are, and more manipulative than they really are, when really, they are just trying to have their needs met in the best way they know how. But anyway -- this (and others I am sure!) way of including schedules, doing sensory activities on a schedule so that they are done ahead of time (before they are really, really needed) so that the child is not put in a situation of needing to "request" them through their behavior (if they are not yet able to recognize that they are starting to need a sensory activity and request it). It also lets you use a "preferred" sensory activity as an incentive to do a less-preferred activity and complete it, so that then it can be time for a more preferred activity. I am not sure that it includes "break cards" or requesting a break, but my son is working on this, too. He is learning how to realize he needs a break and request a break. The way it works for him, is that, in the first place, the "work" he is doing is not supposed to be too long or too hard for him -- it is supposed to be appropriate, as near as we can tell. If he requests a break, he can have a timed break, but he cannot do a "highly preferred" activity (aka he can't play an iPad game) during his break. He can have a break that is just -- not doing the work, just sitting. Or, he can do a little relaxing break but with something that is not highly preferred. He gets the highly preferred thing (whatever it may be) when he has finished his break, gone back to his work, and then completed his work. Then he gets to do something highly preferred, not just when he has asked for a break (by saying "I want a break" or showing his break card, yay, or started to act like he is not doing what he is supposed to and being prompted to "ask for a break or show your break card"). This could all be over the course of 5 minutes or as long as 20 minutes, depending. My son is not someone that medication would help (the opinion at this time, from everybody who works with him or knows him and has a knowledgeable opinion), but he is helped by a behavioral kind of approach. This is part of what a behavioral approach can look like for him. I think of him as primarily needing a behavioral approach, and then we add sensory into it. For other kids, they might do sensory and find that everything else falls into place, and not need further approaches. It just depends on the child, you would just need to find out by experimenting and also by finding out what professionals think. My son is not considered impulsive (even though he can appear impulsive). He is not impulsive like medication would help. He can do things when he is motivated, and he is motivated by preferred activities, highly-preferred activities, and a good relationship. I have seen him, countless times, go from not paying attention, to paying attention, when he is reminded that he needs to finish his work first, and then he can do something preferred. It is a very, very good strategy with him (but not the only strategy, and not a "hammer and a nail" strategy where he will suddenly be able to do something that is not an appropriate expectation for him). In the meantime, though, if he is very understimulated or overstimulated ---- then he is not going to be able to have these other strategies be so effective. It is important. It is not the most important thing, but if he happens to be understimulated (more common with him honestly) then it is the most important thing at that moment, in a lot of ways. People who work with him: I like people who are open to medication (and really, to anything: to special diets, etc.) but who are not trying to push it on everyone. I do not care so much about the opinion of someone who either thinks that no kids at all should take medication, or that all the kids they see should take medication. I have not had this experience, though, I have been fortunate to mostly be around very open-minded people who want kids to have every tool possible in order to succeed. I do not like it when people have only one pet theory and want to apply it to everybody. Even when it is something that is a good thing, I don't think it is a good attitude to have. That is something that used to turn me off about sensory needs, a little, in the past. I met a couple of people who thought it was the only solution for any problem, and were critical of me, and I did not like it. I have had the same experience with special diets. But I have realized that I need to see past that, and not be put off by thinking I have to pick just one thing and belong to "a camp." It is not something I need to worry about.

I have read several of her books. I appreciate her views. I find a lot of reasons to value her perspective. I separate in my mind information about autism in general, and then information about some specific parenting choices. The general information I welcome from any source that seems reputable and helpful. But there are specific parenting choices where I do make a choice that is counter to the direction a lot of people choose to go on, and there are adults who say they wish they had not had this therapy. It is a controversial topic. When it comes to this, I think it can be a very pat, easy answer (one way or the other) for a non-parent who has never had to decided on behalf of a child. I especially value the perspective of a parent then. But I value the views of teens and young adults, too. It is just in a different way. And I look at myself, and I see things differently as a mom than I saw them as a teen and young adult, so I read that into things. I also think that for some things, people who are older will naturally have a more mature view in general, even though that is not true in every case. For example, there is part of me that wonders what the Duggar daughters will think about their molestation when they get to be older. I respect their voices now, I do. I just have this feeling like -- maybe they will change a bit of their opinion as they are older, and think about their own children. It can change things. Sometimes things get brought up through your own kids and then you see things in a little different way. I have a sister with no kids, and I have this experience with her, too. But it is not like I do not value her in general ------ there are just a few specifics where I think I have a different perspective b/c of being a parent. It is not like I will not listen to her on anything, or totally not value her, only because she does not have kids. But this is my thought process. It is the thought process I have, what can I say.

I read some criticisms and feel like they are from the viewpoint of a teenager, not the viewpoint of an adult who is charged with raising a child. I do not discount things for that reason, I just find myself thinking, that I have got to do what I see fit. But I don't look to teenagers or very young adults with no parenting experience to tell me how to raise my kids. However ------ here is something that is available. There are adults who have autism (or strong autism characteristics) and who are now raising children who have autism! This is a win-win in perspective for me in a lot of ways. B/c, they have the first-hand experience as well as the experience of a parent trying to make decisions on behalf of a child. I do not automatically copy them, either, but I have found it to be helpful to see what they say. In practice this is a few blogs I have read (reading through old posts) and then for books I have just read John Elder Robison. But those are for autism. I assume there are similar things for ADHD.

If it was just math, I would be with you. If there were a few activities she had trouble with (like ballet -- I could see her growing into that and being ready for it in a short-ish time), I would be with you. But when you say how she looked sad when you picked her up from day camp and the counselors told how she acted ----- then I am not quite with you. That sounds like it is sad for her, and like she is missing out. I do not care if kids "miss out" on public school K or 1st or if they "miss out" on ballet. Those are so optional. But if she has trouble with day camp ---- then it makes me think she has trouble with a lot of things that should be fun for her, and that should be options and opportunities for her. I think you should keep track of her problems. Are they really minor? Is it really just math? Is the problem only about school work and artificial demands of a school environment? B/c that is one thing. If she is not able to do things that (for me at least) fall into the category of things I really want kids to be able to experience, and not be shut out of, then I think that is a different situation than when it is just a matter of not being able to do school work and math. If you look back and see that this day camp was not a good setting for her, but there ARE good settings for her where she can have good experiences ----- then to me that is "lesson learned," you found out that some structures of activities are not a good fit for her. And if there are plenty of good options, then so what if a bad fit does not work out. There are plenty of good fits. But if you are just withdrawing into the home b/c of so many things she cannot succeed with, then that is not the same situation. I also think that with a lot of choices we are faced with making for our kids, you hear two sides. You hear adults who had it and didn't like it. But then you hear adults who had it and liked it. Then you even hear adults who didn't have it and say they wish they did have it. And you hear adults who didn't have it and are so thankful they didn't have it. Those are really the 4 choices (I think). You have explored 1 out of these 4. But the other 3 are: "didn't have it didn't want it, had it and liked it, and didn't have it but wish they did." Every one of these 4 responses to these 2 choices that parents have ------ they are all valid and legitimate responses. I like to see if there are factors that seemed to cause one of these responses. Then I think "hey, maybe I can prevent that negative outcome, by learning from these people's valuable life experience." It seems you are drawn to 1 of these 4 adult responses, but you need to explore the other 3, too. I am often more personally drawn to "did it and am glad," but I owe it to my child to research the reasons that others have "did it and didn't like it, and didn't do it and are glad they didn't do it." If I only care about the choice I am personally drawn to, then that is not fair to my child. B/c my child could just as easily grow up to wish I hadn't done it as to be happy I did do it. My issues are not medication (as it is not recommended) but my son is part of practices that are controversial, too, and have adults who say "it was bad and this is why." I owe it to my son to listen to their "why." But I will still make what I think is the best decision for him as his parent (together with my husband) and I am not going to listen blindly to one side. But I can certainly look at specifics and take that into account with my own son so that I hope he will not have some of the negatives that other people have experienced. And it is not like it is perfect one way or the other. There are pros and cons to both sides. For many, many choices we must make with our special needs children. It would be great if we could just take it all on our own adult shoulders but that is not always a good option. It can be an option, but it is not like there are no drawbacks, I mean.

Hmmmm...... well, I count tons and tons of things. But they are easy, easy, easy. Since we are working on just engaging together and paying attention to things together...... I feel like little things all day long are counting. I feel like every little outing, interaction, time looking at a book, time spent hanging out together, etc etc etc ------ I feel like it all counts. I do not worry so much about "current goals." Current goals are partly for me, but I do not need to stress over them, b/c that is why my son has outside therapy (we are fortunate that insurance pays for it). But I need to be aware and any time he shows a hint of using a current goal skill ----- then I am all over it (aka -- I am very positive and encouraging). But I am currently about having a nice family life. I cannot make therapy goals count for more than our family life. It would be like that saying about how parents have to put their own relationship ahead of their kids, or there may not be a marriage left to sustain the kids and family. I feel like that about it. But it is more just like life with autism right now. It ends up that right now it just looks like parenting. I have more goals sometimes. Right now my number one goal is to increase his interest in books and his exposure to common childhood book themes. It is a priority. But it looks like story time. And it is story time. It is just really new and exciting for him to find this enjoyable and to be able to pay attention and follow along. But this is just my current season and I am needing to kind-of take a break! In the past -- I have continued on weekends (important -- since I am a public schooler -- so weekends are key). I have built in little, short times that are tied to a room and a time of day. So -- I would have a little card or paper I kept in the kitchen. I would have one by the garage door (for on the way to the mini-van). I have had one in the bathroom for before-bath. I would have these tied to little routine times in the day like snack, going somewhere, brushing teeth, etc, and it was easy to get them in the routine this way, and also to keep them short (which was needed). That would be for more review-y things, not too hard/frustrating. For hard/frustrating things, I would try to do them at the most conducive time in the day. It might be morning. It might be during a snack time. If I got a better-than-usual snack -- that could go a long way for my older son. If it could be special for him b/c it was hard work -- that was something he liked. For the hard/frustrating things -- it would not work to just slip them in. But review (necessary review!!!!) could be slipped in and he liked if I kept to a timer so he knew it would be short. I have a tendency to add things on, and he hates it. If there is a timer he knows I can't add things on. He liked to tell me my time is up, like he is in charge. It helped him a lot to be more cooperative. But right now is a bit of a break time. And fortunately my older son is mostly on grade level right now and so I do not have to stress things for him! There is always more that can be done, but he is at a place where I am very happy with how he is doing, and it is time to let him have some self-motivation and stuff -- that is something we lost a bit when things were more mom-driven. They needed to be mom-driven, though! But there is a need for him to take over some things in some ways, and I think that means for me to step back, so I am stepping back. But I think it is the right decision right now, I am not just throwing up my hands or something. Edit: he has a required reading time right now.... so I do still do that.... and I will be monitoring.... but I am also trying to step back and give him the chance to be responsible for himself. It is a bit of an issue with him, it is just his personality! Edit: from in the past..... do I count an activity as a break, or not as a break? It depends on how hard/difficult/frustrating it is for my child. If it is more of a review, and if it is a preferred activity ---- then yes, it can be a break. A lot of sensory activities can be this way. Not all of them, though. If it is not a preferred activity, then it can't count as a break. It is something where you look and see if your child likes it or not. Does your child feel mastery. Does your child feel like he is doing well at it. If it is like this -- it can be more of a fun/break thing. If it is just plain hard -- it doesn't matter that it is "supposed to be enjoyable" (b/c it is considered enjoyable in general). Then it is not really a break. But you could make your "academic" time the break, if that is reviewing things (or not reviewing, but a strong area) that your child is confident about and enjoys. It just needs to be a mix. But I prefer looking at it as how it really is for the child, not whether is it "schooly" or "not schooly." B/c maybe bouncing a ball is the most frustrating thing the child will do all day, even though it is "supposed to be" something kids like to do. But then hopefully kids improve and those things can start to be enjoyable!

I know two kids personally who take ADHD medication. They are friends of my oldest son. The first one, broke something in my home after many close calls, and I quit letting him in our house after that. I did take them to the park many, many times, where nothing could get broken. I have never had another child over age 3 who I felt like was going to mess up my house like that. He started medication after he and my son moved on from being such good friends, but I still talked to his mom. He did not do well with the first medicine he tried, but he did much better on the second medicine, and he is obviously a calmer kid. I also hear gossip (really more reports from my own son -- I am fortunately not around people who would gossip about children this way, but I have heard some things from people I am not friends with) about who is sometimes needing extra help in school (and this is NOT only a public school thing, in fact I personally think it can be even worse sometimes in non-public-school settings, just depending on the atmosphere) -- and it is not this boy anymore. He used to be notorious in his grade. The second child came to a sleepover, and his medicine was going to wear off while he was at our house. His mom spoke to me about it and said call her to come get him if needed. He stayed the whole time, but he was causing other kids to be frustrated with him, by not taking his turns well enough when they played, and getting bossy, and over-reacting to things. For me -- he did not follow directions as easily, but it was manageable. But I doubt my son would have been friends with him, if he always acted the way he did when the medicine was worn off. He was very possibly not at his best for other reasons besides just the medicine wearing off, but we had the kids lay down at 10:00 and I checked on them and made them quit talking and stuff, so it is not like he was up all night. Medication has never been recommended for either of my sons, so it is not a decision I have ever faced. But I feel like I have seen these two kids benefit. I do not think it is nice for young kids to have a bad reputation, or to be unable to play with friends, and I do not think those things are entirely under a parent's control. My older son (let alone my younger son) had a speech delay when he was younger and it made him have a hard time finding kids to play with who would want to play with him, and it is just a hard situation. It is not just a school thing. It may just be a school thing -- and I think that is different. I just mean, for these 2 kids it was not something where there only consequences were results of a school setting. They both wanted to have friends and be included and invited and things, but these can be the kids where your kids are saying "don't invite him, he doesn't take turns" and that kind of thing, and not every parent is going to be nice about it, even though many are and I hope you have (or can find) some good kids for her to be around either way. I am just mentioning this b/c it is the kind of thing that people who want to be really negative about medication never seem to mention. There are reasons to medicate I think are shallow -- but I don't think it is shallow to want kids to be able to have friends and positive interactions with others. And, I do not know anyone who has medicated shallowly. As much as I seem to hear about imaginary (?) kids who are medicated for the most shallow, avoidable reasons. I am sure it exists, but I have not met those kids. I have only met two kids where I think it has helped them, and I think they are having happier childhoods than they would otherwise.

I totally like him. I have read several of his books. I liked The Explosive Child. I also really like PBIS (positive behavior interventions and supports). We have it in our school system, and my younger son used to have a section of positive behavior supports in his IEP. It worked really well for him. I was surprised when, last year, it was removed from his IEP -- I thought it had been so good for him. But then it turns out it is only for kids who have fairly serious behavior issues that he was not having anymore. I feel like, though, there are times when they can get like "no, we are different from that other very similar program" for reasons that seem very small to me. For example -- like, as you may know here (wink) my son benefited from FBA (functional behavior analysis/assessment). But there are people who like the Green style, and say "oh, and it is so different from FBA, which we don't like." And then they give an example. And the example they give of an FBA is ------ well, it should never have been an FBA, somebody has implemented it in a really wrong way. Like -- someone has used it as a tool to do what they want to do anyway -- which is to keep their punishment mindset -- they are just doing it in an FBA format/structure. But it will be incorrect, it will be violating what I have read are principles for properly/effectively conducting an FBA. So my conclusion is not: FBA is bad. My conclusion is: that was not even FBA because they were not doing right. But honestly I feel like I like all the positive, problem-solving kinds of approaches. I think they would be great to try in a group. Just try to make sure that people agree with them, I think, b/c I think with anything -- people may go through some motions but still keep doing what is familiar to them or what makes sense to them, which may be a punishment-based or shame-based approach. If people are not on board with the new and different mindset ---- then I think that is a problem. I think you would need to have someone like the pastor and/or youth group leader speaking up for it, if it would mean a shift in thinking and attitude from a lot of people who are going to be part of it. If it is something where everyone part of it is naturally likely to be on board, then this is not going to be an issue, I think. Education and information are nice, but there are so many people who are not going to agree with collaborative problem-solving, b/c it is new and different, and it is not their problem, and they will continue to think what they have thought all along. But if some key people addressed it, maybe that would help. My church right now is very inclusive in a lot of ways, but it is not perfect. But I think people have willing hearts for sure. But it is a more open-minded church than others I have attended. My sister's church is very inclusive and I believe it is mainly because of the role model and leadership of the youth minister. I have seen him (when I have visited) really come out and make statements that make it clear how he thinks and what he expects. I have never seen anyone else in a religious show as much leadership in this way as this youth minister. He is very well-liked by the youth, too. Separately ---- do not get hung up on the introduction. Of course that is not where you are heading! Separately -- Green is someone who is mentioned by the author of Zones of Regulation on her information page, too, which I think is cool.

For the way it worked for us -- it would not have sped things up for us. It would have given the people on the diagnosis team more information. But I think there are situations where it would speed it up, b/c they might be able to run fewer tests if some are already run. But for us the wait was for the appointment, and it would not have gotten us a faster appointment. But on the Internet I have never heard of another place where *everyone* is diagnosed at one place, and it is a 4-hour appointment. I know a handful of people whose kids got diagnosed at another place, but I called them, and they try to refer everyone back to the place I ended up taking him, unless they have complex medical needs (aka epilepsy I think). (The tele-medicine option in my town is still through the same place I went, it just saves the time and the hotel stay.)

We went with my younger son two weeks before he turned four. The people were extremely nice and they were good with him. At the time we had to drive into a nearby city. We went the night before and stayed at a hotel to be ready for an 8:30 appointment. Ours was a 4-hour process. We spend about 45 minutes out of 3 hours, going through 3 separate 45-minute sessions. One with a doctor, one with a speech therapist, one where he was with two people who were some kind of specialist with autism. We had a parent interview. Then those people talk to each other, for 45 minutes I guess, then we got the diagnosis. It was pretty intense but I left with a good feeling, that they were competent people and saw an accurate representation of my son. The speech therapist who did the parent interview was very nice, and the doctor was very nice. We watched one part through a glass window and that was for my son to play with 2 women. They had some good toys for him and were able to get his attention and stuff (not so easy to do with him at the time!). Truthfully I was seeking a diagnosis for him by that time (this time was many months after the first visit to the pediatrician when I was asking for a referral -- at that time I still had many doubts and wondered if I should even bring it up). I needed to get help and guidance, and I was ready. I "could have" started the process earlier but I was not ready. There is another option now in my town, so that it does not take so long to get an appointment. They do some things and they film it and the video is watched by people at the same place where I took my son. And/or they do it with Skype. It is not so easy to get a diagnosis here. I am in a small town and it is not something where you can just have your pick of options. That is just the situation for our local area. We are in a fairly rural part of our state. But overall my process was: bring it up to the pediatrician. She agreed and wrote the referral the same day. She had some paperwork to do for the referral b/c the place we went requires background info before they will even schedule an appointment. Then we got an appointment. Then I filled out a bunch of paperwork and I had a phone intake interview. They determine what tests they will run and with who, based on the paperwork and the phone intake interview. This is b/c some kids are at different language levels (etc) and so they cannot go by age. My son had testing that was "out of age level" but was what was needed for him. He had things meant for a younger child. I think that is pretty common though. Other kids will need testing at a higher age level, for certain areas. But overall for me ---- in the gap between the "getting the referral/making the appointment" time, I read more, and I also viewed this thing that is a series of videos that shows behavior of children with autism and without autism. Between those two things, I really already knew before I heard it officially. I do not think that is the case for everyone -- that is just how it was for me personally. My son has many things that are very obvious. He is really not a child where it is more complicated to tease out. It used to seem like that -- but as I found out more about it (and for me, especially watching the videos) it is obvious. Also, there are some general stereotypes that I used to believe (like probably a lot of people!). My son does not fit a lot of stereotypes. Namely: he is physically affectionate and has always been very attached to me and his other family members; he has never flapped his hands or toe walked; I think he pointed and gestured (but I think he pointed and gestured in a way where he was not establishing joint attention ----- I am vaguer on this, b/c I would say he pointed, but I am not sure that it "counts" as pointing the way people want it to when there is joint attention established and checked for). By those things, I did not think he could have autism (b/c don't all kids have those 3 characteristics?). But then I found out those were not automatic characteristics. When I found that out I felt more like "yes, this is what it is." But then -- the end of the story for me is that it is what it is. You could go through this process and have a different conclusion. But I think that is good information, too. I think there is something in thinking "maybe, maybe not" that can leave you (or it left me) feeling like an observer, looking for signs and wondering about them, and then when I got an answer, I felt more like jumping in and doing things, and I did not have the same kind of observations and internal conversations anymore. That was valuable for me. Edit: I mean, I now spend zero time noticing things and thinking "is that autism?" I also no longer have awkward conversations where people wonder if I am seeing things that they are seeing and why I do not notice what they notice. It was agonizing at first, but now I am much more comfortable to be out in the open as an autism parent. My son is (btw) someone where it is obvious to some people in some situations, though not everyone in every situation. It is not a big deal but I can have necessary conversations as they come up (to share information) and/or talk about things if someone is curious. I also no longer have the same worry that maybe I am just a bad parent who cannot handle my own kids. I also feel much more confident and comfortable with being in public and sometimes being noticeable. But do you know what I mean -- wouldn't it be nice to be done with gentle conversations? I really do not like them. It is easier to be on the same page. And then if you get different information -- you can be back on the same page, too. I found them to be unbearable awkward.

http://www.amazon.com/Big-Short-Inside-Doomsday-Machine/dp/0393338827/ref=asap_bc?ie=UTF8 I have just been reading this book and there in a person who finds out he has Aspergers when his 4-year-old son is diagnosed with Aspergers. He says he has some mixed feelings about it. It comes across like his wife is interested in it for their relationship. But here is what jumps out at me. Earlier in the book they are talking about him, and it is just one thing after another that is coming across like he has Aspergers (probably setting up for later in the book, maybe). But at the time, he is in his early 20s, and there is a problem that is recognized, and he looks into getting some help. And the person thinks that he has bipolar disorder! I thought this guy was a very cool guy in the book, he is someone who makes a lot of money in the stock market b/c he does not follow the crowd and does his own research. But it struck me that with something there, and it left open, there was a thought of it being bipolar disorder. I do not have anything against bipolar disorder or mean to put it down, it is just -- if you do not have it, you do not have it, how is that going to be helpful information? But the person in the book, as an adult, I think it comes across like -- he had to figure things out as a child and figure out why he was different, why he did things the way he did. And he came up with an explanation for himself, and he managed. Then as an adult he found out this new information and would have to go through the process again of putting those pieces together. To me I read it and think, it might have been better to have had this information when he was younger. That is just my take on it. But it was interesting to me to come across it, in a book that I did not think was going to have anything to do with autism.

I would do it and start it, if you think the attitude is there. I would not start it if attitude is an issue. I would put everything into encouraging a good attitude with the school teacher. After schools starts ---- these are all things to ask the teacher. I have a personal opinion ---------- the stuff in Barton Level 1 --------- it is not in the category of things where it is going to be messed up or something go in a different order or be confusing. It is basic phonemic awareness. It is not phonics. It is not learning "e makes this sound" in one place and "e makes this other sound" in another place. Ime that is what is confusing. But learning about phonemic awareness through one kind of game or another kind of game, or through one kind of format or another kind of format, it is all learning about phonemic awareness and generic in its way. My son did phonemic awareness games and teaching things at school, and I thought it was helpful for him. It was more phonemic awareness. We were hitting the same thing. It was not a case of "here are some sight words! memorize them!" and it was not a case of "mom says a makes this sound, but teacher says a makes this other sound, so what in the world is going on." That is my take anyway. If money is an issue I think you can feel free to pass over 2 weeks. If you are more comfortable with waiting and speaking to the teacher and planning to support what he/she does (which I think and HOPE would be better than continuing to do Barton separately), I think that is fine, too. If you are like "let's get going" in your mind -- then I think it is fine to go for it, too. But I do NOT think you are going to hurt anything by doing Barton Level 1. I do not necessarily think you should go on in Barton separately from what is happening at school -- very possibly I don't think that. But my son is one who needed so much phonemic awareness, and I do not think anything hurt. Phonemic awareness is not sight words, and it is not phonics. It is just phonemic awareness. Ime it is not something that is confusing or that will be different across curricula b/c of the order things are taught. (One program starts with short vowel sounds, one starts with long vowel sounds, one has no controlled vowels and all vowel sounds are thrown in from the beginning, etc.) But that is based on what things I know my son was fine with (seeing different formats, sometimes doing beginning sounds and sometimes ending sounds after he could do each one separately) and things he was not fine with (sight words, inconsistency in rules, inconsistency in letter sounds) until he was taught them explicitly and got practice and stuff.

My son is sometimes unable to express he is in pain, he has a harder time when the pain is worse. So I am not surprised about a child not expressing his loss in an obvious way. But I think you do just get to know your child, but when something has never happened before, all you can do is see what happens. But something I do know is, if it seems like something would hurt, and he is acting certain ways (that are not expressing pain in a usual way), then he is most likely in pain but not able to express it in the usual ways. We also taught him to say "ow" and "boo boo" and "owie" and "my _____ hurts" in ABA. Before ABA he did not know how to say these things (and we prompted him to say it when we saw him get hurt, for a while, which helped him a lot). Now he does know how, but he does not do it so good when he is in more pain or when it is a diffuse pain instead of "something just happened." He does best when he has just had a bump -- then he can say "ow" and he can say "I hurt my ______." And "my ____ hurts." But he has a harder time anytime it is not that exact situation (like -- he has just fallen or bumped or whatever and just gotten a bump ----- it does not automatically mean he can say his stomach hurts, but he can sometimes, but I do not think he can say it every time). But this is an area where I have a mindset (b/c this is how the ABLLS is and my son does the ABLLS ---- just in general) where you rank something from easiest to hardest and simplest to more complex. So "an obvious bump" is easier and simpler than "his mouth hurts but it just started hurting, nothing so obvious as a bump or fall." I also had my son refusing to take Tylenol b/c (as I figured out after 2 days with the help of his resource teacher at school) he really, really wanted red cherry Tylenol and I had gotten clear (stain-free) grape Tylenol (or possibly generic aspirin). So he wanted Tylenol but for whatever reason he only wanted a certain kind that he knew had made him feel better another time and he was not ready for a brand change. He was saying something that made sense to his teacher even though it didn't make sense to me. But that is how we figure things out!

http://www.amazon.com/Alfie-Birthday-Surprise-Shirley-Hughes/dp/0099208628/ref=sr_1_23?ie=UTF8&qid=1437870284&sr=8-23&keywords=shirley+hughes+alfie This is kind-of a weird book, but my kids like it. They like Alfie anyway when they have been the right ages (so far lol -- my oldest son and my daughter have both liked Alfie at least). The neighbor's cat dies and the dad is really upset about it, but he is just grumpy. That is my summary. But my 2 kids and I liked this book at least. It is way above the level of my ASD son right now, but I think he will like it in a couple of years. He is running 2-3 years behind my daughter right now in his taste in books, so I think he will be there in a little bit. But separately -- my ASD son had a tooth pulled earlier this year and it was supposed to be no big deal (a long story here, involving his gum being split also, ugh ugh ugh) but the x-ray did not show the root being as long as it was when it was pulled. (I asked for it to be pulled b/c the x-ray "showed" it was almost out, and if he wiggled his tooth it would re-split his gum and that would be bad, too). But it was painful to him for about 2 weeks. But now in good news -- and I am actually really thankful for this -- now I know how (or one way how) he acts when he is in pain physically. Before this there have been times when I have really wondered. But now I have got a very clear connection: I know he was hurting, and I know he was acting like this. So -- to some extent, now you know how he acts when he is upset and processing things in some background way (maybe), or now you know how he acts when his parents are (very understandably and part-of-life-ly) upset, or now you know how he acts when his routine is disrupted. Or you know some combination of these things. Maybe you don't know everything ahead of time -- but this is all going to be helpful information going forward. And it is a huge load off my mind, honestly, to know certain things my son did while his poor little mouth was really hurting. Now I know those are things he does when he is hurting. With all the possibilities of vague stomach problems etc. or ear problems etc. it is a huge load off my mind in a lot of ways. Not that he would not change with age, but at least I have a huge number of clues now.

http://www.amazon.com/How-People-Autism-Grieve-Help/dp/1849059543/ref=sr_1_1?ie=UTF8&qid=1437825721&sr=8-1&keywords=autism+grief I read this book from the library. Interesting. I agree, too -- it is a big change, you can take it slow. I also think there have been societies (or are) where there is a longer formal grieving period, and I think there is a reason for that. It does not go away so fast. I am glad we are not required to wear a black arm band for so many days, or wear black for so many days, while we are in mourning, but I think the idea makes sense.