advice for reaching an almost 4yo possibly HFA space cadet?

[mingmama]

Hi to everyone here! I've been perusing your archives and am just amazed at all the wisdom and insight you all possess! I wonder if I could bend your ear about my oldest son.

 

He is almost 4, and has been receiving speech and OT through the school district for a year now. He was *finally* evaluated by the school psychologist this month, and she thinks he has high functioning autism. We've been on the waiting list for the local childrens' hospital for about a year for an autism evaluation, so hopefully soon we should get a second opinion.

 

Although he has made lots of progress in speech therapy, he really seems to find talking almost painful. He speaks in 3-4 word sentences now, but often pauses between words, and really seems to have to work hard to access vocabulary. His pronunciation is also fairly clear for individual words and short phrases, but often gets slurred for longer sentences. Often he'll try to tell us something, get part way into telling us "The kitty...is..." and then just give up and ask us to come look at what he is talking about instead.

 

Also, he spends about half the day in total space cadet mode when it comes to imaginative play. He has an incredible variety of scripts that he runs through (mostly from books and movies) which he acts out and narrates constantly. Oddly enough, he can repeat long phrases from movies and books pretty clearly.

 

My problem is retrieving him from his imaginary world to the here and now to work with him on his speech and OT "homework" - I have to basically turn his head physically to look at me to get his attention, and then if I try to get him to talk (or to balance on one foot, or skip, etc.) in a way that he finds too novel or stressful, he retreats back to la la land. He is really open and talkative as long as we are just playing a new game...but the instant he figures out that I'm trying to get him to talk, he becomes very resistant!

 

He is actually a really sweet guy, gets along great with neuro-typical children, and is really empathic and emotionally connected to those he knows well. His visual skills are strong (excellent memory, and, per the psychologist, he is years ahead of his age when it comes to pattern recognition, puzzle solving type stuff). Until he was three or so, the differences between him and his peers were not terribly clear - but now most kids can carry on a conversation about "when, why, and how?" questions, while he is still stuck on "who, what, where." There is obviously a bright young man in there, but I'm having trouble interfacing with his fantasy world to teach him about ours! Any tips??

[rafiki]

.

[Jennifer-72]

Also, he spends about half the day in total space cadet mode when it comes to imaginative play. He has an incredible variety of scripts that he runs through (mostly from books and movies) which he acts out and narrates constantly. Oddly enough, he can repeat long phrases from movies and books pretty clearly.

 

My problem is retrieving him from his imaginary world to the here and now to work with him on his speech and OT "homework" - I have to basically turn his head physically to look at me to get his attention, and then if I try to get him to talk (or to balance on one foot, or skip, etc.) in a way that he finds too novel or stressful, he retreats back to la la land. He is really open and talkative as long as we are just playing a new game...but the instant he figures out that I'm trying to get him to talk, he becomes very resistant!

 

 

What happens if you try to engage in his play? Ds would often act out a book we had read to him or would do some other repetitive type imaginary play that he would get stuck in. The best things we did were largely learned from the program mentioned above. We would match his play and insert ourselves in that play. Sometimes as one of the characters already in the play or a new character. Then once that was okay with him we would have our character do something unexpected to try to move the play forward or in a new direction. For example, we would have our figurine fall and get hurt. We would make it rather dramatic to make him notice and then we waited to see what he would do. At first, he would do nothing, but he would watch my antics so I would take it a step further and add another toy to help my guy out with a doctor kit or I would say to ds, why isn't your guy helping my guy out. Over time he started responding to my interruptions and it really moved his play forward. If you want to move language forward you need imaginary play. Don't feel like you are not working on language when you are playing with your son. You are doing a great service in moving his communication and his cognitive flexibility forward just by playing.

[heart'sjoy]

We've been using RDI with a consultant for 1.5 years now. The program's foundation level is totally about re/gaining the relating between your child and you. It's broken down into such tiny steps it seems surreal.

 

I now have a child who can actually utilize me as a guide.

Feel free to pm me.

:grouphug:Melody

[SweetMissMagnolia]

can relate to some of that-my 8 1/2 yr old ds (asperger's adhd) has a pretty strong imagination too ---his latest is LITTLE BIG PLANET video games and he will pretend he's characters from those games and sometimes it just drives me batty lol.....

[Critterfixer]

My younger twin son is hFA, but not very imaginative, I'm afraid. Reading about your son reminds me so much of myself when I was young. I lived mostly in my imagination until well into high-school age. I would invent my stories, script the dialogue for my characters (many were inanimate objects, or animals) and play by myself for hours. Typically, if someone else wished to join in, I had to call all the action and vocals, telling them what to do or say. Not exactly conducive to having playmates! Anything that was out of character or departed from the script playing in my mind would disturb me to the point that I would not play. I didn't have television growing up so I couldn't repeat lines from movies, as your son does, but I can understand why a world he fully understands and controls is so appealing to him.

 

I have no idea whether this would be helpful or not, but if he has a favorite character from his play world who seems to be the hero, the person who always figures in the action, I'd try to utilize him or it to bridge the gap between his fantasy world and reality. If he struggles to tell you what he thinks, have him tell you what his main character would say or do in this situation. It helps if you really get to know his own stories. Play along not by trying to craft the narrative, but by letting him tell you what you are supposed to say or do. You may find that he is more willing to try your game if you are willing to play his game by his rules.

[Barbara H]

If you haven't already done so I would suggest reading some about Stanley Greenspan's method of Floortime. I think it might be a good fit in helping to gently connect to him and expand your interactions. There is quite a lot of information about it available online.

[gingersmom]

If at all possible I would take him for a private speech/ot evaluation/services.

[mingmama]

Thanks for the recommendations of the More Than Words guide - that looks perfect! We'll be ordering that! And we'll also be looking at the Floortime and RDI methods as well. Are either of those methods possible to implement at home, with minimal guidance from an outside therapist?

 

regarding outside testing: he has been on the waiting list at the local children's hospital for almost a year for autism screening. Also, I'm taking my son for a private speech evaluation this week. Still no IEP meeting date set, but it seems likely that the school district will want to put him in a special ed preschool setting, with a class size of 8. I'm really, really doubtful that this is would be a good move for him - his speech therapy is currently in a class of 2-4 kids, and he is pretty distracted in that environment.

 

Also, it sounds like the focus of the special ed preschool will be on classroom readiness (planning to homeschool him through a public charter program, so not applicable), and social skills (which is not a particularly deficient area with him - he is totally fine socializing with same age kids). Ugh. Really, he finds the whole school setting pretty distracting, and sometimes upsetting (lots of bright fluorescent lights, crowded halls, noisy kids, who wouldn't?!). The more distracted and over-stimulated he gets, the more likely he is to retreat to a zoned out state.

 

On the other hand, although we could afford to pay for one on one speech therapy (thanks to a local low cost university program), that would be absolutely it. We would not be able to afford any other kinds of therapies on top of that, and I just don't know what he needs, exactly, to help him connect a bit more and motivate him to talk.

[mingmama]

What happens if you try to engage in his play? Ds would often act out a book we had read to him or would do some other repetitive type imaginary play that he would get stuck in. The best things we did were largely learned from the program mentioned above. We would match his play and insert ourselves in that play. Sometimes as one of the characters already in the play or a new character. Then once that was okay with him we would have our character do something unexpected to try to move the play forward or in a new direction. For example, we would have our figurine fall and get hurt. We would make it rather dramatic to make him notice and then we waited to see what he would do. At first, he would do nothing, but he would watch my antics so I would take it a step further and add another toy to help my guy out with a doctor kit or I would say to ds, why isn't your guy helping my guy out. Over time he started responding to my interruptions and it really moved his play forward. If you want to move language forward you need imaginary play. Don't feel like you are not working on language when you are playing with your son. You are doing a great service in moving his communication and his cognitive flexibility forward just by playing.

 

 

Thanks for the insight! I think that's what we need to start doing...playing his game, rather than trying to start new ones of our own.

 

ETA: When we try to engage in his play, he seems kind of baffled - not really hostile to having us play along with his script, but also not really sure how to respond. He usually humors us for a bit then goes back to whatever he was doing before. I haven't been terribly persistent, though, so we'll see how it goes if I am!

Edited October 3, 2011 by mingmama

[rafiki]

.

[mingmama]

My younger twin son is hFA, but not very imaginative, I'm afraid. Reading about your son reminds me so much of myself when I was young. I lived mostly in my imagination until well into high-school age. I would invent my stories, script the dialogue for my characters (many were inanimate objects, or animals) and play by myself for hours. Typically, if someone else wished to join in, I had to call all the action and vocals, telling them what to do or say. Not exactly conducive to having playmates! Anything that was out of character or departed from the script playing in my mind would disturb me to the point that I would not play. I didn't have television growing up so I couldn't repeat lines from movies, as your son does, but I can understand why a world he fully understands and controls is so appealing to him.

 

I have no idea whether this would be helpful or not, but if he has a favorite character from his play world who seems to be the hero, the person who always figures in the action, I'd try to utilize him or it to bridge the gap between his fantasy world and reality. If he struggles to tell you what he thinks, have him tell you what his main character would say or do in this situation. It helps if you really get to know his own stories. Play along not by trying to craft the narrative, but by letting him tell you what you are supposed to say or do. You may find that he is more willing to try your game if you are willing to play his game by his rules.

 

This is great, thanks! One problem is that although he uses some phrases during his imaginative play, much of it involves him physically acting out the role of the main character in, for example, an episode of Curious George (or the entirety of the book "Harry the Dirty Dog," or what have you). Maybe I can just try adopting the persona of the Man in the Yellow Hat, and see if I can get involved in the story line, hmmm...

[Jennifer-72]

Thanks for the insight! I think that's what we need to start doing...playing his game, rather than trying to start new ones of our own.

 

ETA: When we try to engage in his play, he seems kind of baffled - not really hostile to having us play along with his script, but also not really sure how to respond. He usually humors us for a bit then goes back to whatever he was doing before. I haven't been terribly persistent, though, so we'll see how it goes if I am!

 

If he is noticing you that is a great start! Just keep it playful and keep at it. It takes a lot of work (often times, more than you think you can provide), but you can do it. Just when you think you are not getting anywhere, it will click for him.