The BRIAAC (Behavior Rating Instrument for Autistic and Other Atypical Children) assessment may be helpful to figure out the strengths and weaknesses of a child with autism.
This case study describes one boy with autism (toddler twin) and his mother from the first therapy request through the therapy sessions. The author performed the BRIACC assessment to test abilities of the boy with his mother in the room. The test results for this boy allowed the therapist to focus on specific skills during therapy. During psychotherapy, the author observed behaviors that showed the boy was developing his sense of self. The boy improved, and the narrative ends when the mother decided to stop therapy sessions.
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Teacher's pet
Sep 12, 2008 by dankohnHere I sit, at my computer, without anybody to interrupt or deter me from my cathartic writing! That’s right; both Thomas and Hayley are at school and I have approximately one hour before I have to fetch Thomas and then Hayley. Hey, it’s better than a poke in the eye with a sharp stick, as my father-in-law used to say.
The waterpark last weekend was a success! The kids (and we, the parents) had a great time riding the slides and splashing around. Thomas liked the wavepool the best. He really enjoyed diving under the waves and letting them wash him ashore. The only problem with that was that he liked to float, face-down in the surf like a drowned person. He got more than a few concerned looks from lifeguards, but I waved their concern away and they saw Thomas stand up a few seconds later. Thomas got really upset at one point, actually. I was with him in the wavepool and Jonathan wanted to float down the Lazy River with Hayley in an inner tube. They needed help being shoved into the current and I told Thomas that I was going to help them. He didn’t hear me very well because he kept going underwater and was really upset when he couldn’t see me when he came up for air. He started crying, even! It’s such a comfort to know that he does worry when he can’t see Jonathan or me. It cuts down on our anxiety about him just wandering off.
Another issue we discovered while at the waterpark was that Thomas is not especially assertive with other children. There were kiddie slides that were being “monitored” by a lifeguard. Thomas stands in line okay with Jonathan or me, but when he’s in line by himself, he tends to dance around a bit. He was waiting in line for a turn to go down the snake slide and other kids were just going right in front of him. Jonathan was up at the top of the slide helping the kids go down, and he came down after a few turns and said, “Go up there and see! It’s Thunderdome! No rules! ‘Two man enter, one man leave!’” The lifeguard wasn’t especially strict with the whole turn-taking idea, so we explained to Thomas that when it’s his turn, he should go down and if another kid attempted to “cut” in line, he should say something. The fallout of this was that on the playground on Wednesday, after we picked Hayley up from preschool, he was pretty snippy with a little girl who wanted a turn on the teeter-totter. He said, “Hey! No, it’s my turn next!” She wasn’t really attempting to cut in line, but Thomas perceived her presence as such and was a little pushy about it. So we have to work on that. But the waterpark trip was a success and the kids enjoyed spending the night in a hotel. It was very romantic for me and Jonathan as well. I slept in one bed with Hayley and Jonathan slept in the other with Thomas. As usual, no making-out.
School is going great for both kids. I will be volunteering in Thomas’ classroom on Tuesdays now. I helped out this past Tuesday and I was concerned that Thomas might behave differently in class if I was there. Hayley came with, of course, and now has a little boyfriend. They kept holding hands and putting their arms around each other’s shoulders. We’re going to have to watch her, apparently from now until her wedding day, which she is already planning.
I did some filing for the teacher and cleaned up the coffee she spilled in the hallway on our way to the library. The teacher and library staff were so nice to Hayley, letting her participate and even check out a book although she’s not technically a student. The librarian thought that Thomas and Hayley were twins. I’ve been getting that a lot lately.
I was really worried that Thomas wouldn’t react well to my being in class. Jonathan and I explained to him that he would have to act like I wasn’t even there; just do what the teacher told him and that she is the boss when he’s at school, even if I’m there. To tell you the truth, I had a harder time ignoring Thomas! Every time he didn’t immediately follow the teacher’s instructions, I wanted to say, “Do what your teacher said! Go put your folder in the tray!” I had to stifle my own words on more than one occasion. Hopefully, I’ll get better at it. I know that his teacher appreciated my help and she said that I’ll be helping the kids with reading eventually, and learning computer programs. She told me that she feels like she’s known me forever, and I kind of feel the same way. We have a very easy manner between us. We discovered that she is exactly one week older than Jonathan and we were all at NIU together. Far out!
Oh yeah, the Focalin. We had to take Thomas off the Focalin because he developed a facial tic. He kept opening his mouth as if to yawn before speaking. It was becoming disturbing to us, so I called the doctor (who is out of the office this week) and the nurse called back to say “Stop the Focalin!” Remember how I said that the Focalin wasn’t doing anything for him? Well, it seems that it was. I’ve noticed an increase in rambunctious behavior and general nervous energy since stopping the meds. I was concerned about that. I thought the Focalin wasn’t helping because he was being better, but I didn’t notice until we stopped it. I’m supposed to call the doctor later today and tell them how he’s doing. I’m not sure what we can do now; all of those Ritalin-type medications carry the risk of developing a tic, and it appears as though Thomas is susceptible to that. We’ll see what they say, but he is still doing okay in school, I guess. I’m not going to ask the teacher until next week if she’s noticed a change in Thomas. If I tell her that he’s stopped the Focalin, she might be looking too hard for a behavior change and I’d rather wait until I see her again on Tuesday to mention it.
This weekend will be quiet. We’re doing nothing tomorrow and Sunday we’re going to what will most likely turn out to be an indoor BBQ if Hurricane Ike makes its way up to Chicago.
Angelic weekend
Mar 11, 2007 by AnonymousWhat an eventful weekend! It started Friday morning when Hayley and I went to Thomas’ school for the Art Show. The whole way there, Hayley sat in the back seat saying, “Going to an art show! Going to an art show!” She was excited. I was wary. Last year, whenever I showed up at school, Thomas would flip out a little bit. I understood why; I wasn’t supposed to be there. I was not part of his school schedule. Friday, I told him that Hayley and I would be at school today to see the art show, and he seemed excited. When we walked into his classroom, he smiled kind of shyly. Hayley went over to him right away and said, “Oh, hi Thomas! What a good boy!” and she gave him a hug. Thomas’ teachers thought that was really cute. So did I. Unfortunately, Thomas thought that we were going to go home right away; that I was just picking him up. I did get him to stay for about forty-five minutes, however.
I loved the art show. It was really cool; they had the kids “copy” masterpieces like Van Gogh’s “Starry Night” and Piet Mondrian’s color-block pieces. The teachers took pictures of the kids and then turned some of them to negative to look like Andy Warhol’s works and arranged them in groups of four. There was a section for each artist that showed the original painting or composition and then the kids’ pictures were displayed around it. They had snack stations (Thomas and Hayley’s favorites) and art stations with ink stampers, paint brushes and crayons. We had a lot of fun. Thomas and Hayley were really well-behaved – so good, in fact, that a photographer from the local paper took our picture while we were observing some of Thomas’ artwork. The photographer was watching us, waiting for a good photo opportunity, but both Thomas and Hayley stared at her and plastered goofy smiles on their faces. They definitely know the camera-drill. She asked them to pretend she wasn’t there, so I engaged Thomas and asked him to find his name. (All of the kids’ names were on their particular pieces of art.) He said, “It’s right there,” and nodded to his picture. The photographer stood and waited so I asked Thomas to point to his name, which he did. Click, click, click – she got what she needed. I don’t know if our picture made it in, but I’m sure someone will let me know if my children, at their very young ages, have already gotten their fifteen minutes of fame.
Yesterday, we had to take Thomas and Hayley to the doctor with us. Both Jonathan and I had check-ups, and since our internist doesn’t handle pediatrics, his receptionist really enjoyed our visit. So did the doctor, until Thomas and Hayley dismantled the protective paper roll that was hung on the back of the exam table. He said he didn’t mind, but I was surprised he saw us both together with the kids in the room. Next time, he might ask that we come in one at a time so that the kids won’t have to come in. Actually, we did schedule separate appointments, but SOMEONE (not me) forgot his appointment on Friday night so we both squeezed in together Saturday morning. Other than the paper thing, the kids were really, really good. Actually, lately it’s been Hayley that we have a problem with. She’s not loud or destructive, she just doesn’t listen to us.
We went out to dinner last night with my side of the family because my sister’s company is moving her to California and we’re probably not going to be seeing her very often. A whole slew of us were there, and my sister decided that she wanted one last real Chicago meal, so we went out for deep-dish pizza. The meal was a little later than Thomas and Hayley are used to eating, and the pizza took FOR-EVER to be served, but despite all that, they were very good. It got a little hairy at the end, but it was already way past their bedtime and everyone was, as always, very understanding.
We stopped at my sister’s place before going home and the kids had fun on the stairs. She gave them a stuffed shark named Bruce from “Finding Nemo” and a little toy car one of her roommates got in a Happy Meal not long ago. Thomas didn’t want to leave, but Jonathan and I were getting tired.
Today, we decided we had to replace the kid’s beds. Thomas has been sleeping on a toddler bed for the last two years, and it has seen better days, to say the least. Prolonged jumping and general wear and tear has lately rendered it broken-down and possibly unsafe. We also decided it was time to move Hayley to a toddler bed. By the time Thomas was her age, he had been in a toddler bed for over a year. So I first let my fingers do the walking. We had kicked around the idea of buying him a car bed, but once I found out the price (not including the mattress) we decided to get him just a regular twin-size bed and put Cars sheets on it. We presented the idea to Thomas this morning again, as we have been talking to him about it for a few weeks now. His response was, “I don’t want a new bed. Just a new car.” We took the kids to Toys ‘R’ Us (my keyboard won’t do a backwards “r”) first to get Hayley’s bed and bedding, and that was a bit short-sighted. We had discussed a plan of attack prior to setting out. We thought that maybe I could just run in for the bed and sheets but then we decided that we wanted to see what else they had, possibly for Thomas. Well, Thomas can smell a toy-car section like a bloodhound and it wasn’t long before we were wandering through the aisles of cars while Thomas hollered about which way he wanted the cart to go. He had his heart set on a large, orange and radio-controlled Range Rover that cost far more than we were willing to pay for a “just-stop-screaming-and-let’s-get-out-of-here” toy.
We bought it. What suckers we are! Jonathan rationalized it by saying that he would play with it, too. It was amazing how Thomas’ mood immediately improved by a hundred percent as soon as we left the thing in the cart and it appeared that we intended to purchase it. Thomas chattered happily to the cashier who asked rather skeptically if we wanted her to put the car in a bag.
Then, it was our intention to go out to lunch. We found a Chili’s, which the kids are used to, and pulled in the parking lot and parked. Next began the daunting task of convincing Thomas that he could not bring the car into the restaurant. My excuse was that they didn’t allow toy cars that big in Chili’s. To my amazement, Thomas actually accepted that and willingly left his new toy in the car while we went in and had a very pleasant lunch.
Also to my amazement, Jonathan and I don’t dread taking the kids to restaurants anymore! It’s finally happened! They can sit down, amuse themselves with crayons and kid’s menus, and not scream or cry or otherwise be obnoxious until the food comes! That is a big relief. We’ll just have to see if we can conquer Hooters again. It’s one of my and Jonathan’s favorite restaurants and the last time we were there, Thomas was atrocious. We had to leave before we finished eating. It was about one year ago, actually, before Thomas was diagnosed. We’ll see. We have to take baby steps right now.
After lunch, we convinced Thomas to just go and look at the beds to see what he thought. He seemed agreeable, so we went to our nearest bedding emporium and chose a mattress for him. The salesman was a little confused since Jonathan and I kept explaining to Thomas over and over again that this would be his new bed. We would take the little-boy bed out of his room and replace it with this big-boy bed. We would buy new Lightning McQueen sheets and this would be his new bed and he would sleep in it from now on. I finally told the salesman that Thomas is autistic and we have to be very sure that he understands what’s going to happen and agrees to it before we purchase a new bed, take it home, dismantle the old one and set up the new one only to find out that he will not, under any circumstances, sleep in it. In another complete turn-around, Thomas was surprisingly on-board with the whole thing, answering “yeah” to all of our questions. He was excited! We were cautiously optimistic.
We came home, spent a couple hours dismantling and assembling, and Thomas is now in his room, but not yet asleep. We’ll see what happens. I think the time change has something to do with this late night, but he is being quiet and hasn’t complained. I was actually more concerned about Hayley, since she has never had the power to get out of her crib by herself before. I thought for sure that she would make one or two surprise appearances this evening before getting the picture that even though she is able to get out of bed doesn’t mean that she is allowed to when it’s bedtime. Happily, she went right to sleep and hasn’t made a sound.
We have reasonably well-behaved children. I am very pleased and content this evening, save for the fact that Thomas is inexplicably requesting water. Of course! He has a new mattress that isn’t covered in vinyl, so this is the perfect time to wet the bed. I did purchase a waterproof mattress pad, but still! We’ve also just started putting Thomas in underpants overnight instead of a pull-up, so we’re doubly-concerned. I’ll just be happy if he goes to sleep eventually.
(Update: I just checked on Thomas and he is asleep in his new bed, with the sheet and comforter all crumpled up around his upper body. It’s amazing how angelic children look when they’re sleeping…but they did have a pretty angelic weekend.)
Bedtime troubles and back-to-school
Jan 2, 2007 by AnonymousIt was a very low-key New Year’s Eve for us. Jonathan was at the Bears game with his brother and got home at around 11:30 p.m. By then, Thomas had already been to bed, slept and awoken to crawl into our bed (which Jonathan and I were not in). Instead, he slept on the couch as I put a hem in a new pair of pants. We went to bed around 1 a.m. after I had finished the pants, and that was it. New Year’s has certainly changed a lot since we had Thomas four years ago. I remember that New Year’s Eve pretty well. Jonathan, Thomas and I all fell asleep on the couch around 11 p.m. and woke up at 12:30 a.m. when Thomas cried to be fed.
We have had such a hard time getting Thomas to go to sleep lately. I assume that it’s because of the disruption in his schedule; all of the holidays, no school and Jonathan’s days off have taken their toll on his world. He was very hyper tonight (and still is; probably because of the vanilla ice cream – whose fault is that?) but he’s at least staying in his room for now. The last few nights have been really hard with lots of crying for Thomas and frustration for Jonathan and me. I hope that when he goes back to school (tomorrow! We made it!) and gets back into the normal routine, the bedtime troubles will subside. Last night Jonathan drew more pictures for Thomas about his bedtime routine and that helped initially, but he kept coming out of his room to tell us to go to bed, probably so that he could join us.
Thomas gets into bed with us every single night, usually after he has been sleeping in his room for a couple hours. Sometimes it’s before Jonathan and I have gone to sleep and other times it’s after so we don’t know when he came in. I’m starting to worry about that habit. So many people have told us that he’ll grow out of it and not to be concerned but I’m imagining him being sixteen and crawling into our bed. We’re thinking of graduating him to a twin-size bed (he’s in a toddler bed now which is getting so broken-down from jumping that we probably won’t even pass it on to Hayley). I remember when we transferred him into the toddler bed in the third bedroom when Hayley was about three months old and ready for a crib. Thomas was about 21 months old then and we didn’t know about the autism yet. It was the smoothest transition in the world, though! He knew right away what the bed was for and was very excited to sleep in it. Maybe the newness of a bigger bed would motivate him to stay in it all night. Of course, Jonathan and I haven’t really done anything to convince him to stay in his room. (Right now, we’re happy if he just falls asleep in there.) It might be time to draw more pictures about staying in his bed all night. He usually sleepwalks into our bedroom anyway, so I don’t know if talking about it would sink in for him.
His bedtime has gotten more and more difficult since last year, now that I think about it. He used to go to sleep in his darkened bedroom with no problem. Now he insists that we keep the lights on and we usually turn on an episode of The Backyardigans for him to watch in his room. I don’t think that the desire to have the lights on is that strange; most kids are afraid of the dark at some point. I don’t really like the TV being on, however. Very soon, we’re going to have to get him on track with bedtime. A few nightlights and maybe some quiet music instead of the TV would be a good start.
Other than the bedtime problems, Thomas has been doing well. I’ve tried discussing with him the fact that he’s going back to school tomorrow, but he isn’t enthusiastic about it. Usually, he complains and then says, “Let’s just not talk about going to school right now. Hayley can go to school tomorrow – she’s not too little!” Poor Hayley. If she only knew all the stuff she’d have to do if Thomas got his wishes!
So back to school tomorrow and back to our normal routine. I’m not counting on Thomas having a great day tomorrow but I’m sure that his teachers are not expecting great things from the kids right off the bat either.
Happy 2007 to everyone!
We'll talk about it later.
Dec 6, 2006 by AnonymousWith Christmas fast approaching and not a single gift purchased, my husband and I are going to hit the mall this weekend while the kids spend time with my mother-in-law. If she’s planning anything other than going to Chuck E. Cheese’s, I will be very concerned for her. Thomas already knows that he’s going to see Grandma this weekend, and he’s already decided that he wants to go see the rat. Maybe he’ll be okay, as long as she doesn’t drive by Chuck E. Cheese’s. No matter what she decides to do with the kids, we’ve discovered an effective way of getting Thomas off a subject he seems to be stressed out about. We say, “Let’s not talk about this right now. Let’s talk about it later.” And Thomas usually calms down right away and says, “Okay. Mommy? Let’s just not talk about this right now.” This technique seems to soothe him and change the subject effectively.
Lately, Thomas has not wanted to go to school at all. I think it has everything to do with all of the days off lately; the four-day weekend for Thanksgiving and the three-day snow-day weekend last. All of the time off and disruption from his schedule has given him the impression that school is not mandatory; Mom and Dad decide whether there’s school or not! We were very careful to explain about the snow-day; that there was no school because of too much snow and the busses couldn’t drive in it. I’m not sure how much of the explanation sunk in with Thomas. All he seemed to hear was that there was “no school today,” which is a phrase he has mentioned to me two of the last three school mornings. When he gets home and we’re walking into the house, he says again, “No school today.” To that, I respond that there’s no more school today.
I made the grave mistake of buying candy canes at the store yesterday to hang on the tree. I mistakenly thought that Thomas would simply think the candy canes were decorations on the tree. He came in the door from school, pulled a cane off the tree (I think Thomas can smell sugar), unwrapped it and began sticking it to everything he could. There are sticky pink handprints on the wall of the front foyer here. There are bits of candy cane stuck to the carpet in Thomas’ room. In fact, the whole house seems to smell minty.
Thomas had an “okay” day at school on Monday, a “good” day yesterday, and I have no idea what kind of a day today was because no sheet was sent home. Thomas said he had a good day, but there’s no way of knowing for sure without the sheet. By Christmas, Thomas is going to have ten kids in his class and his teachers are no doubt feeling the pinch. There have been no personalized notes sent home with his sheet this week, so I don’t know why his day was just “okay” on Monday. I think I’ll start e-mailing his teacher for any other information I need.
We’re all eagerly awaiting the birth of my brother-in-law’s first child. His wife Christine is due on Sunday, so every time the phone rings, I run for it. Her twin sister had a baby girl in September after a short, easy labor. We’re all hoping for the same thing for Christine, but genetics seem to be against her. Thomas weighed 9 pounds, 4 ounces when he was born and the doctors have all been telling Christine that she’s going to have a big baby. I had to have a c-section for Thomas after thirty-six hours of labor and only getting dilated to three centimeters. Hayley was a planned c-section (which was wonderful) so I’ll never know if she could have come out the way Mother Nature intended, but even she weighed 8 pounds, 3 ounces. Big babies seem to be the rule in this family, so I’m really hoping that if Christine needs a c-section, they won’t let her labor as long as I did.
Hopefully by the time I blog again, we’ll have a new family member, Thomas will be re-adjusted to a normal school schedule (just in time for winter break), and our Christmas shopping will be close to finished. Whatever happens, we’ll just talk about it later.