Wednesday, October 28, 2009

I'm going to my room (post script)

I realized, after corresponding with a few of you about my last post, that I'd left out an important bit of nuance.

We aren't "sending Ben to his room" in the traditional time-out sense. In fact, it's been really important that we don't treat this as a punishment.

Again, thanks to Jordan at Communication Therapy for framing it this way.

We suggest to Ben that he go to his room the way a helpful but deadpan maitre'd at a fancy restaurant would offer a very important, stinky cigar-smoking patron a booth far from other customers.

"Sir, I believe you would be much more comfortable in our private booth."

Prompting Ben to go somewhere else to cool off doesn't focus (overtly) on stopping the behavior, it's just about moving it to another location. So it's a relatively unthreatening proposal.

The result is that the behavior does stop - but this happens because Ben self-regulates rather than responding to threats of punishment (which can just pour gasoline on the fire).

And, more importantly, I think that Ben is starting to grasp the real consequences of his actions: "You hurt people's feelings when you express anger this way."

The focus isn't on the anger, but on the expression of it. (Wow, I feel like I'm channeling Jordan right now.)

That's not to say that we aren't trying to teach better ways of coping to begin with, but once we've passed the point of no return in the rage cycle there's not a lot of learning going on.

Reflecting on this made me recall a recent Slate article on how lowering the emotional intensity with which we respond to our kids' behavior is often the best tactic for changing it.

Sunday, October 25, 2009

Discrete Trials of Frustration (or: Thank you, Wii)

We have a Wii at our house. Wii is this Nintendo video game where you move around like you're really doing stuff and these characters in the game really do what you're doing and, well...

(So, okay. If you are Amish, or have been backpacking for the better part of two years, or are able to be blissfully unaware of popular consumer culture and you don't know what I'm talking about, it's a little hard to explain. You can go here to find out what Wii is.)

Anyway, we have one and Ben really enjoys it.

He likes the standard Wii games that come with the whole console-controller-thingy: like bowling, baseball, golf, and boxing. But he really loves the newer Wii Sports Resort, in which the Wii avatars visit Wu Hu Island, a sort of Wii Club Med. There, you can pick from archery, fencing, wake boarding, ping pong and frisbee, among other activities.

I credit the hours Ben has spent so far with Wii to introducing him - conceptually - to many sports that never would have come across his radar. Familiarity with different sports and games - even if you're never going to actually play them - is a useful sort of social currency.

After all, knowing things like what a pick-up game is in basketball and what it means to be on the fairway versus the bunker in golf gives you just a few more ways to join a conversation.

It's also helping to build real honest-to-goodness hand-eye coordination and gross motor skills.

Ben's ability to hit a softball in the real world increased dramatically after he mastered it in Wii. He went from not even knowing how to stand or hold a bat to actually being able to connect with the ball in the span of about a week.

(I'm sure some occupational therapist post doc is writing a doctoral thesis on Wii at this very moment.)

But there's another benefit to Wii that I did not anticipate, and it's probably the most powerful and most valuable one. It's also the most painful one for Ben.

Wii teaches you how to lose.

Ben has inherited a double dose of the perfection gene and this is amplified by his spectrum traits. One of the chief triggers for him coming unglued is failure: not being successful at something that he really wants to do.

This is a little different than being competitive. He doesn't need beat someone else to be happy, he just wants to be perfect.

But Wii doesn't care if you're a kid. And Wii doesn't care if you're really cute. And Wii doesn't know that you're on the autism spectrum and after all, successive approximations are really what's important, right?

No. If you miss the shot in ping pong, you lose the match. Your avatar hangs his head and the words YOU LOSE flash on screen.

There are plenty of activities - real and virtual - that provide this brutal, inevitable lesson for Ben, but the thing about Wii is it doles out lots of success along with the failure.

Unlike in the real world, Ben can get a strike in bowling and make par on a the golf course, so he's motivated to keep trying.

Wii ends up being a little like discrete trials in applied behavior analysis, a common therapy used with children with autism. You present the person with frequent, repeated opportunities to perform a skill that's just on the edge of their competence. The frequency means that there's lots of positive reinforcement with success, and failures don't have high stakes, because opportunities to try again just keep coming.

At the beginning of the summer, losing Wii games was one of the triggers for the explosive verbal and physical rages that Chris and I wrote about.

I began to think that I wanted to place a moratorium on Wii for awhile, that he just wasn't ready for it, he wasn't equipped with the coping skills he needed and that the frustration was outweighing the fun.

On the other hand, these frequent outbursts gave us frequent opportunities to try a new strategy for dealing with rage: just letting him be mad, but making him to go to his room and cool down by himself.

The regular frustration that Wii served up like a disappointment batting cage gave Ben lots of opportunities to practice his coping skills, too.

Jordan over at Communication Therapy gave me great coaching on setting this up with something like this: "You can say those words when you're mad, but they hurt our feelings, so if you're going to say them, you have to go in your room where you can't hurt anyone."

At first, retreating to his room was something he did towards the end of the rage cycle, with our (usually physical) prompting.

Then, little by little, Ben would go to his room by himself even earlier in the cycle. Next, it became a regular part of the ritual. Often accompanied by a dramatic door slam and in one case the declaration, "I'm going in my room to (screaming) CALM DOWN!"

Lately when he's upset, Ben often goes to his room and slams the door, with no prompting from us, rather than exploding in a verbal rage or physically acting out.

Usually after five minutes, we hear him happily telling a story with his trains or we peek in to see him engrossed in a book. Sometimes, he even comes out calmly and apologizes.

I think many of you know how amazing this is, what a huge corner I feel we've turned, what a don't-write-about-it-or you'll-jinx-it moment we're in.

Ben's emotional outbursts are still happening and he still has a long way to go to learn the skills that that will let him say, "Oh well - whatever." more often. The period before he goes to his room is not pretty, but it's getting a lot shorter.

And he is learning that he CAN let go of those feelings and not stay hooked. Maybe he is starting to understand that he is the only one who can get himself back to a state of equilibrium.

And I think I have, at least in part, a video game to thank for that.

Tuesday, October 6, 2009

Dispatches from Kindergarten (and a blatant fundraising appeal)

A few weeks ago, Ben started Kindergarten in a big public school. It's the kind of school where there are bells for each period, and students line up on the blacktop before school starts, and everyone has an assigned desk with his or her name on it, and the hallways have shiny linoleum floors.

At Ben's new school, the students call the teachers "Ms." or "Mr." rather than by their first names, and the principal comes to work in a neatly tailored suit every day, even when the temperatures climb into the 80s. Families are encouraged - but not required - to send their children to school in a uniform.

And there's homework.

Toto, I don't think we're in preschool anymore.

I was nervous about the transition into a much more formal, traditional school environment where expectations would be higher and routines would be more rigid.

But Ben is doing great, possibly because of that high degree of structure and predictability.

His teacher and the whole team of professionals that support full inclusion and his IEP goals - with things like a social skills group and extra help with fine motor skills - are excellent.

And like most schools, a parent organization works to raise extra money to pay for things that public funding no longer can: a library and a librarian, a computer lab, and enrichment activities from local arts organizations.

So here's where you come in. You knew this was coming, didn't you?

Ben's first fundraising activity is a walk-a-thon on October 24th. Students will walk laps around the school campus (ten laps for Kindergartners) and donations will go to the school PTA to support a variety of programs and services for the students.

So if you like the blog, if you support public education, and if you're not also shaking down your friends and family to support your kids' school, click on that Donate button over in the right margin and put a couple bucks in our PayPal account that we can pass along to the PTA on behalf of Ben.