Help with lower functioning autistic child

[amo_mea_filiis.]

I have a friend who has been paying me to watch her son, and it's becoming a frequent thing, so I need help. He is, without a doubt, the most difficult kid I've ever had. I've babysat about 15 kids in the last 5 years. All different ages, and different abilities. One of the most easy going kids was a child with autism and was non-verbal. All have been at least a sleepover, some were more than a week at a time. 

 

He's 9 years old. Autism, iq of about 70, and his language skills are less functional than it seems. He requires an insane amount of supervision, which means I can't get daily things done while he's here. If-then, when-then statements are useless. Visual schedules do nothing. He grabs, throws, runs, constantly repeats nonsense things (goo goo gaa gaa boo boo toot toot) while giggling. He can't sit for a movie, and will not play his computer while here. He does not chillax and play with toys. A time out can't be done because he doesn't stay. If he has to earn activities, they don't happen. If I take activities away, he just tantrums until his parents come. 

 

The worst behavior is during bedtime. He just will not stay in the bed. He does the same at home. He gets up, runs around, is very loud, and eventually his parents yell at him. His bedtime anxiety is through the roof. Because of this, I no longer allow the flashlight or nightlight (it really does make it worse! He made it easy to take those items because he threw them at me). When he's here I block him from leaving room and will sit in the bed with him and *gently* push him down when he tries to sit up. I absolutely watch for signs of distress, and he's been ok. He eventually stops trying to sit up, and will kick me out of the bed saying he's ready to sleep.

 

A huge portion of his behaviors are attention seeking, but I can't completely ignore because of the attempts to run and grab at everything (he will try to hit my son's drums with anything he can get his hands on. I've been locking him out of that room).

 

He will wash a few dishes. He likes to "make the silverware happy." Lol. But he requires supervision. He will also vacuum a little. When he takes a bath, he scrubs the tub for play. If chores and cleaning are preferred activities, I'm perfectly fine with that!  

 

I'm planning pizza, cereal, sandwiches, and other easy foods because I don't have time to get the dishes done for the next meal, or even time to cook.

 

A huge part of the problem is that my house can't be kid-proofed for him. I'm baby and toddler safe. I'm tantrum safe for my son.

 

He's not capable of most board games, and when he is, he gets mad or swipes the game to the floor. So this doesn't motivate my kids to play any games with him. He used to enjoy playing war with my son (empty airsoft guns) but now he just throws the guns. When he's played with legos, he breaks pieces. He will not play with baby/toddler toys because they're for babies. 

 

At home he literally only whines and cries until he can have video games, and he does chores for money. Those are his 2 activities. We don't have video games. He will play in the pool for a bit, but the pool is not open the times I have him this weekend. He will play at the park for a short time, but he usually just wants to know when he can go play his games.

 

He WANTS to come here! He's so desperate to play with my son, but can't. My son really tries, but he's also spectrum. There's only so much he can handle. 

 

His behavior analyst and direct therapist will be here today (my son's people as well) and I'll be getting ideas from them, but I was hoping to get some practical ideas from you guys.

 

Anyone want to sleep over on Saturday and give me an extra pair of hands? lol 

[OneStepAtATime]

No helpful suggestions but lots of hugs.  That sounds exhausting.  Best wishes to all of you.

[PeterPan]

Well if they trained you to be an RBT for him and then *paid* you to do that, that would be good for both of you.  He clearly needs more intervention and the pay might be better.

[Lecka]

I am afraid I am a little pessimistic about him having a lot of improvement if his home situation stays the same.

 

I think if you can show progress and then the parents are inspired with hope to follow through at home, that could be great, though.

 

I hope you get good advice from the therapists.

[amo_mea_filiis.]

Well if they trained you to be an RBT for him and then *paid* you to do that, that would be good for both of you.  He clearly needs more intervention and the pay might be better.

 

They pay me well to work for them, but not to watch the kiddo. Maybe I could talk to them about paying for my RBT training. 

[amo_mea_filiis.]

I am afraid I am a little pessimistic about him having a lot of improvement if his home situation stays the same.

 

I think if you can show progress and then the parents are inspired with hope to follow through at home, that could be great, though.

 

I hope you get good advice from the therapists.

 

On the bolded, I'm with you 100%. They're not "bad parents," which is a great thing around here. They acknowledge his disability, but do nothing to work with him at home. He's got some great skills; he'll vacuum their stairs for a quarter, do the dishes to make the dishes happy, loves using visual schedules at home, and has insane control during a tantrum. 

 

I tried telling mom how he went to bed with no lights and no fixations on fire or monsters, and she wasn't interested. She said they just end up yelling at him and she doesn't have the patience.

 

The BCBAs say the giggling is probably a mix of attention and a vocal stim. Thinking of it as a vocal stim could help me ignore it a bit. He tends to start the giggling when he's thinking of doing something that he shouldn't. I have not tested his follow through though. With my son, if tell him not to do something and then ignore the tantrum, he will usually not do the thing. I'll have to see if this kid still tries to do the thing, or just keeps vocally attention seeking, and see if it morphs back to the stim. 

 

His RBT may be staying with us. This guy has no experience, and is not capable of teaching the boy new skills. With my son, they (son and RBT) act like brothers. Inappropriate jokes abound, initiated by my son, but work is getting done, and tantrums are nil while the RBT is here. Of course behaviors resurface the moment he leaves, but at least the school and basic chores are done. 

 

Our BCBA thinks that maybe my son will get bored with the inappropriate stuff and it could slow down.  

[kbutton]

Does anyone know if the IQ of 70 is likely correct? My son was diagnosed with ASD at 9, and I can see some similarities in preferred activities (he LOVED heavy, meaningful work) and in stims (my son stims vocally too, which can be difficult if you need quiet), but he is 2e. I have a friend whose kids have IQs in the 70-ish range (one for sure, one with big highs and lows that "averages" to 70), and it takes them a long time to learn new stuff, but they do learn it. I didn't know them when they were 9, but I guess it took more time, more patience, and more work at 9. Lots of time, patience, and consistency even now that they are older--I am wondering if that is being factored into the equation. Sometimes therapy tends to focus on skills or a specific thing, and other stuff gets less attention, like support for how long it might take to acquire a skill. I realize that kids can really get"stuck" regardless of IQ, which complicates things. If the IQ is accurate, and the parents are not on board with what that means (in denial), they may be avoiding the hard work for that reason. 

 

Do the parents realize his RBT is not helpful? Would they advocate to get a more effective person to help out? I am just thinking that if expectations are managed, maybe the parents could move forward and be more consistent. I know that getting a bead on what is typical socially, emotionally, etc. for our child based on both IQ and the ASD diagnosis was helpful--we would never have understood that ASD puts him socially behind by about 3 years, regardless of IQ, for instance. That's a huge adjustment in thinking, and we've chosen to focus on the positives of that (permission to not feel a lot of pressure for him to act his age, while also working to help him behave appropriately).  Anyway, I am rambling. I hope someone can get through to the parents. He sounds like he is a motivated kid.

When my son was younger, it was worth every minute I had to work on teaching him chores and things. It kept him busy, and he learned a lot from that even though it was inconvenient. On the vocal stims, ADHD meds helped. :-) Listening to music or other appropriately noisy things also helped him not need to make as much noise himself sometimes. If he just can't help it, he has to go to his room or outside where his stims won't totally drive everyone else nuts, and he's learned to be okay with that. 

 

Oh, my son LOVED to listen to books on tape and sort things. If you have sorting tasks, that might be something that will help him chillax, as you put it. :-) He sorts by his own methods and standards, so beware. He also liked to take things apart and rearrange the parts (and put them back together). I do remember very well the days of not being able to leave him alone at all, ever. It's hard.

[amo_mea_filiis.]

Kbutton- the low 70's seems like a good representation of him. It takes an incredible amount of time for him to learn new skills. 

 

After today, I'm not likely going to be watching him much anymore. There's nothing he's willing to do here without negative behaviors. 

 

I really hope I'm able to just say no next time I get a call. He just pushes my patience too much and it takes time to recover. My own son is spectrum, borderline IQ, and just can't handle him anymore. The expectations for my son to behave are exceptionally high, and the boy is pushing buttons, touching everything (he even tried to grab a cactus plant in a high window sill!), and breaks things. 

[Lecka]

I think if you say no, it may help his parents to look for a better option that will work better for everybody. I hope so!

 

You could be available for an emergency, though, maybe.

[kbutton]

That's really hard. I hope they do what they need to do to have his needs met!