Crying

Crying… Crying is a behavior that often gets desired results…when a child cries he gets the toy he wants…he gets to stay with mom rather than being left at class…he doesn’t have to do the non-preferred task…he gets to leave early… But by catering to the crying we teach him that it works – cry and you will get what you want. Crying is one behavior that we cannot control (legally at least). We cannot stop a child from crying if he doesn’t want to stop. We can stop a child from throwing toys, stop them from head banging, make them perform a desired task (hand-over-hand), etc. But if a child is crying, there is no way to stop it. But there is not necessarily anything wrong with crying – while it can be quite wearing on those listening to it, it isn’t actually hurting the child. He’s exercising his lungs, he’s learning to use his voice… So as long as the child can stay somewhat on task while crying, and accomplish his goals, the crying can be ignored. If the crying is catered to, it simply encourages it. And in the case of Luke (see below), the crying is actually lessening some now that it is not being rewarded.

How to settle him down

Luke is about 4 or 5. The first few times I worked with him, he was fine. He has a very short attention span, but I would get him to play with something for a couple minutes at a time, and he always loves to play ball. He doesn't speak at all, except for saying, "Ba! Ba!" when he wants the ball, and, "Ma! Ma!" when he wants his mom. When I started actually pushing him and forcing him to sit through looking at a 4-page book with me, or finishing a 4-piece puzzle we had started, he would sometimes get kind of aggressive. Once he threw a book that hit me in the head and left a bump on my forehead for several days. Another day he got mad and started hitting, kicking, and throwing things at me, and somehow I ended up with a cut on my forehead (which I didn't notice till afterwards when someone pointed it out to me). I guess the aggression thing was nothing new though, he's been really aggressive with other staff people a lot. About 6 weeks ago, he started crying. Screaming and crying for his mom the whole evening long. "Ma! Ma!" Interspersed with plenty of tears can be heard throughout the halls. I can sometimes get him to calm down. One night I held him in my arms and rocked him for about 15 minutes, saying, "Shh, it's okay," over and over. And then his was fine for the rest of the time. Of course this used up half of my half hour with him. Another time I just got him really busy doing stuff and he was more or less okay. Blowing bubbles works for a little while. But of course the same thing often doesn't work twice. And even if I get him calmed down, he usually goes back to crying again as soon as I pass him off to the next person. I'll be working with him again tonight. What will work this time?

Annabelle

Annabelle...I first met her during my second week working at the autism center. Petite, light brown hair cut to her shoulders and tousled about, a cute little slightly turned up nose, I guessed her age to be about 4, but she might be 5 and just be small for her age. Annabelle doesn’t talk at all. But she cries often, in frustration, in anger, in I don’t know what else. That first day she came to me crying so hard, so I took her in my lap, and holding her close I began helping her place plastic close pins back into a plastic Tupperware container. Sustained attention. This worked for awhile, and her sobs began to subside, but then she got tired of the close pin activity and began throwing them on the floor. Hand over hand I helped her pick them up, since she refused/couldn’t do it on her own, and we moved onto another activity. Little Annabelle has since learned to pick things up off the floor on her own…I watched in awe a couple weeks ago when she got down out of her chair and picked up the puzzle pieces she had thrown on the ground when I told her to. I often wonder what goes on inside her head, what she’s thinking, how she really sees the world. She likes to lick things...lick puzzle pieces, shapes, books, etc. This is a sensory activity for her, but what does she get out of it? I wonder this so often with our kids. How do they experience things? What’s it really like for them???

Training

Tonight at work I was assigned to train one of our new staff members, which was interesting since I haven't done that before and she probably has more outside experience than I do. But it went well, and obviously our head supervisor feels I do well enough to train, which was somewhat of a compliment. We started out with Macy, an adorable little black girl of about 5. Macy can be as sweet as can be, but also has a quick temper and can certainly throw a fit. She talks some, and we usually work on saying 3-4 work sentences. When I first started working with her I was hard-pressed to get her to sit in a chair with me for more than a couple minutes, but now she'll sit for a long time in my lap looking at books and directing, "Point to the ____," mimicking what I've instructed her to do in the past. I've barely started showing our new staff member what I usually do with Macy when we're given another child, Benjamin, a brown-haired, freckle-faced boy of about 6 or 7, with a light blue cast 2/3 of the way up his left arm. I've never really worked with him before, so I settle staff member with Macy and sit down with Benjamin. He is sweet, compliant, and smart. He is completely verbal and very polite, so we start by going over some letters. When I realize this is way to easy for him, I pull out a very simple crossword puzzle and then a word search. He tells me he can't read, but he can recognize simple three- and four-letter words. He easily does both the crossword and the word search. At this point Macy is no longer cooperating, so I try to corral her while at the same time showing staff member how to chart. Time to rotate. We take Macy and Benjamin to the next room and start over with a new set of child/ren for the next half-hour. This is how it continues for the next four half-hours, working with a new child or set of children each 30 minutes, me trying to orient staff member to each of the children as well as the room, and teach her charting at the same time. About halfway through the evening, during which I've been having her work with kids most of the time, she makes some comment like, "I thought I was just going to be observing tonight." But she's doing great and interacting with the kids is the best way to learn. It can be overwhelming at first, mostly just because you don't know the kids, but it gets much easier quickly.

Candyland

Candyland is easy, right? Any three-year-old should be able to play it, shouldn't they? I always thought so. But trying to do something as simple as play Candyland with autistic children often just doesn't work. I've tried it with at least four of our kids. One just didn't want to. "No, not that. No, we not do that." At least he's verbal. Another just didn't get he. Okay, so we drove Thomas the Tank Engine around the colored pathway while I tried to get him to verbalize, "The train drives." A simple enough sentence, but not for a child who doesn't really speak in sentences. Another child was frustrated and didn't want to do anything, so I felt Candyland was as good as anything. The concept of the game was completely lost on him. He kept screaming as I tried to get him to say "The red man jumps." We finally settled for "No more games." My final attempt was somewhat more successful. With this little girl, at least we chose colors (she chose blue man, I was red man). We then established the concept of "Your turn" "My turn". But moving her man vs. mine was confusing, especially if she drew a red card (since my man is red). And moving sequencially along the path was completely hopeless. We were lucky just to be moving to the right color. Of course it quickly became very apparent to me that she doesn't know her colors by name (everything was called green), so okay, that's something we'll definitely need to work on, but she could match the card to a space of that color (but of course not the next space of that color, just some random space of that color somewhere on the board). Which of course made the game pointless, but she didn't understand the point of the game in the first place. Oh well, it was good for practicing turn taking and matching. I never realized Candyland could be such a complex game.

I am not autistic, and I do not have autistic children, but I began working with autistic children approximately two months ago and it has been the most rewarding journey. First, before I share that journey, a little about me. I am 23 years old, the second oldest of four children. I’m a medical student, currently working in a research lab for the summer. I have two adorable 12 month old kittens, I enjoy power yoga, and I love spending the afternoon or evening at a coffee shop reading, writing a letter, or journaling. I have worked with children a lot, babysitting throughout my teenage years, working in a pediatrician’s office, working as a nanny last summer. I currently work in the nursery at my church every week. Children have always been my passion, second maybe only to medicine.
In this journal, all names have been changed. Locations and identifying details will not be used. Come join me on this journey of helping children learn to interact with a world that often just doesn’t make sense to them, and share your stories with me along the way if you'd like.