Tuesday, February 14, 2006

Growing pains... can be good!

Happy Valentines Day to all! B passed-out his valentines to his teachers today, first thing, happily explaining what asagao are (see previous post) to all who would listen :). He was then waylaid by Ryan, the teacher of the other 3rd-4th grade class, & came away from the encounter giggling madly, hiding something in his hands. It turned out to be a whoopie cushion, so I do believe that there is more than Valentines madness on tap for today. May the Force preserve them all... ! I made a whilrwind visit to Paula's classroom, then ran out to get to my 9 o'clock therapist appointment. The waiting room was absolutely quiet, in marked contrast to my last stop, & I took the opportunity to just sit a bit & enjoy the quiet before taking my knitting out to wait...

Lately I have been finding my therapy sessions to be focused on processing things that I need to get a handle on in my life- an opportunity to talk about various issues & get to the core of them so that I can get on with the living part. Today I really crystallised some concerns/thoughts about Brendan's current development. This was very much on my mind because not only has he seemed to have very different needs since his recent meds crisis, but the traditional strategies for everyday life with B have not been working as well. The differences have been apparent at both home & school, & some people had been wondering if the changes were due to the medication change, so we had arranged to meet with B's teachers tomorrow (C is only working in the morning, so he can be there) to discuss new strategies & share our perceptions of what's going on with B. C & I feel strongly that B's current behavioural changes are developmentally driven. C was looking at some of the Eriksonian developmental stage info our pediatrician hands out at the yearly check-up, & it seemd to him that B was behaving appropriately for his developmental stage- with the unique B spin on it, of course. B's been very interested in spirituality & death lately, which is spot-on for his age of nearly 10. He has been thinking about impermanence vs eternal, & the stories he makes up & tells us (about his various bionicle or pokeman creatures) are complete with what happens when they die... his new lego game does not allow for characters dying because he doesn't think it's appropriate for a kids' game (!). Many of B's tic/OCD thought triggers have been changing, too. He's much more disturbed by noises & unpredictability (particularly during class time) than he has been for a while, but still seems to enjoy unstructured time with his school friends. At home, B's needed almost constant companionship/distraction, & really wants to discuss things or tell us his stories or just talk. On the other hand, he's been remarkably mature about some things... I mentioned yesterday that I was concerned about my aversion to playing board games colliding with his need to play the game we designed, but he had come to the conclusion on his own that it was okay for me to play only occasionally if I wanted to, & he was apprecitative of my help in designing the game. After school yesterday we watched "Spirited Away" together in japanese (with english subtitles) & we were not only amazed by how many japanese words we understood, but had some really satisfying discussions afterward about the spiritual/moral issues raised in the film. B pointed out to me that C & I would never behave the way the parents in the film did (they, in essence, are tempted by the food of the gods, eat it without invitation, & are turned into pigs for their greediness) & I agreed wholeheartedly that Dad & I are too uncomfortable about overstepping social boundaries to eat food uninvited. This seemed to comfort him & to free him up to really enjoy & think about the rest of the film.

So- back to the meeting with B's teachers... I was bemused to discover yesterday that the meeting has become a summit- both B's OT & speech teacher stopped me in the hall to say they'd be there, too, although neither of them ususally comes to B's school on Wednesdays... When I told C about this development, we decided that this was a sign that everybody was noticingstruggling with the differences in B's behaviour & looking for some help. I had heard from B's OT that he had started resisting being pulled-out for OT & that she was going to try to adapt what she is doing with him to work in his class setting at least part of the time. She said that in most kids who begin resisting like B is, it's a sign that they no longer need OT, but with B's motor-planning & sensory integration difficulties, this isn't the case for him. Sooo, I really can see why she would like to be in on the discussion tomorrow. I have been feeling somewhat intimidated, though, by the change from "get together with teachers" to "full team" feel we're getting now... I told C that it made me feel like we need to bring concrete ideas & strategies for these folks, rather than just brainstorm/chat. C thought it was enough that we even called the meeting (many parents don't get even that involved) & was feeling fine about going-in with general thoughts & ideas. While talking today to my therapist about B's recent challenges & changes, I was able to put what I've been noticing right out in front of me & look at them...

What I see is a boy who is growing. Over the years of dealing with Aspergers, OCD, & more recently with Tourettes, B has developed strategies for coping based on where he was emotionally & cognitively. As B grows & changes, his strategies have had to change, but it's been very gradual. In the past, most of the coping strategies have been "outside-in"- developed by his care-givers with input from his psychologist & psychiatrist & the other skilled people in his life, & then implemented by his care-givers to assist him. Over the past few months B has been taking more responsibility for the coping, but it's still been based on an "outside-in" system (to my mind, at least). I think that B is experiencing not only a change in what his needs are, based on changing developmental stages, but also a change in how the coping strategies need to be implemented. When I look at it all this way, it seems very natural. But also pretty big! We may have to shift some of his school goals to accomodate them. For example, a lot of the focus has been to "plant" B in the classroom (since he usually prefers to do his work alone), so that he can learn to interact with other kids, learn pragmatic language, & appropriate socialisation. But if the noise & unpredictability are affecting his ability to overcome the internal "noise" from the OCD, then he may just need to have quiet times & places for part of the school day. He clearly enjoys playing with the kids outside after lunch, & other unstructured times in the day, plus the school play rehearsals have begun & he's having a blast working on that (his teacher told me wistfully that she wishes his whole day could be spent on the play- he's not only enjoying it that much but functioning at his best & brightest...). Perhaps that will do for social time, rather than trying to keep him integrated into the classroom all the time. I think that sharing the "toolkit" approach with everyone will be a good thing, too. We can share not only the current complement of tools that B has, but our strategies for helping B develop new ones as the need arises. We'll also have a common language/terminology we can all use with him, which is a great help.

I am so glad that I've had the chance to really think about & process my perceptions before going into tomorrow's "summit" :) I strongly suspect that the shared experiences of these folks will give an even more complete picture of where B is at, & I do believe that we'll be able to find strategies to help both B & all of us cope with his emerging capabilities, as well as changing needs. Yet again, I feel deeply grateful for the village that has assembled itself around him & us as a family. Their skill, creativity, & respect have made school a safe place for B to be, are what allow C & I to have the breathing room we need as human beings, & give us essential alternative persepectives on our kid.

2 Comments:

At 12:30 PM, Blogger not my blg said...

Lisa,

My son Alexander sounds so much like "B". Did you do a post about the early years? His diagnosis is "autism" but he seems more on the asperger's side. He has been sick lately with conjunctivitis and his first serious ear infection. Because of his illness, we have seen more frustration and meltdowns which come from nowhere. We haven't seen these type of meltdowns for almost a year, which makes me think that he was sick much more often than we imagined. Fortunately, he can now tell us if something hurts, but only when we ask. I'm very grateful for this new skill because it helps us to help him. His language is only slightly delayed. He loves to play with other children in unstructured settings. But as soon as circle time comes, forget about it. In addition, he seems to want to imitate everything, and I mean everything he sees from television. I'm very concerned with Alexander becoming more aggressive as he gets older and whether his frustrations will grow. I wonder if we had waited to get an evaluation he would be diagnosed with Asperger's. He doesn't have the typical need to stim as most kids on the spectrum do. He does stim, but even trained eyes have a hard time figuring out what he is stimming on. My wife and I know but most of the time it isn't obvious. I'm also concerned with his "mischevious" behavior. Many times he will do something just to watch our reaction.

 
At 4:39 PM, Blogger Lisa/Jedi said...

Hi alexander's daddy! Yes, I have written some history posts, found in the January archive, that cover B from birth to kindergarten (just after he was diagnosed). I do plan to continue to fill-in the middle, pre-OCD years, to present as well. Sometimes I do wonder what the diagnosis would have been if he'd gotten one pre-school-age... but his neurologist-diagnosed ASD diagnosis certainly does seem to fit the bill for him. Like all kids on the spectrum, B doesn't have all possible "symptoms" (thank goodness!), but his own unique mix of the possibilities :) He never was much of self-stim kid, but perseverative behaviours have been a constant- some (like whacking himself in the stomach) requiring intervention & some not so much. When it comes to modifying misbehaviour, we were fortunate to have the book "1,2,3 Magic" recommended to us when B was still pretty small (http://www.amazon.com/gp/product/1889140163/qid=1139951863/sr=2-1/ref=pd_bbs_b_2_1/102-0952473-7176907?s=books&v=glance&n=283155). It worked miracles for us! When he was pre-K & kindergarten age, B used to tantrum so severely that we couldn't send him to his room for time-outs. He'd just trash the room & hurt himself in the process. This book gave us really workable solutions that helped us sanity-wise, as well as positively modifying his behaviour in a way we felt was respectful to him & his needs. It sounds like Alexander is a smart kid who enjoys the fuss his behaviour can cause- I remember this stage very well. I found that the less I reacted while a) cleaning up the mess, b) putting him back where he was supposed to be, c) -your least favourite behaviour here-, the less he acted out. I just wasn't fun to watch any more :)

I can also relate to your concerns about having a sick kid that doesn't tell you he's sick. That's B to a "T". He had chronic tonsillitis when he was 5 & we never knew it! After having his tonsils & adenoids removed & tubes placed in his ears at 5 1/2 years old, B has bounced back as a remarkable healthy kid. We anticipate his extraordinarily high pain threshold to finally be an asset when he begins orthodontia soon... !

I hope this been helpful! I may not be a psychologist (or any -ologist, for that matter) but I resonate to your concerns & am still here to tell the tale...

 

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