Sunday, September 16, 2012

Where we've been and where we're going

I've talked about researching different therapies, but I haven't mentioned what we've tried. When I first began my quest to find the "perfect" therapy, one that stood out to me was DIR/Floortime. You can read a detailed description of what DIR/Floortime is here. Essentially it is a child-led form of therapy that encourages the adult to get on the child's level and try to share in his or her interests. The goal is to engage the child and create "circles of communication" between the child and therapist/parent/teacher/etc. Here is another great explanation of the method. I was created by Dr. Stanley Greenspan, and I learned a lot about it from reading his book Engaging Autism. What interested me the most was the focus on going with the child's interest and joining in with their play. I decided that I wanted to give Floortime a try and found an EI agency in the area that specialized in the therapy. I called up our service coordinator and requested a change in service providers. Soon we had a new teacher and a new SLP, both of whom were trained in Floortime. As usually, J did a great job of adapting to the change and welcomed them with open arms. Or at least with his little hand, guiding them into our living room and getting ready to play with them.  The sessions looked quite different from the one's he had with his previous therapists. His new SLP didn't bring the bag of toys he had grown accustomed to. Her goal was to build upon his interests in his natural environment. If he wanted to walk around the house, we followed him. If he wanted to play with a toy we did our best to join in. We were tying to "woo" him into engaging with us. If he busy with something and not paying us any attention we would try to playfully get in his way to encourage him to interact with us. I found that much of,  what I was already doing with J on a day to day basis mirrored Floortime pretty well. His teachers repeatedly encouraged our interactions, and commented that we have a strong bond. That was great to hear.
   Over the course of the summer we requested yet another increase in services and went from 3 days of 45min sessions to 5 one hour sessions each of ST and special instruction. I also requested an OT eval and J was approved for 2 one hour sessions a week. Suddenly we were very busy, with therapists coming to our house for 12 hours a week. Giving up your home to "strangers" for that amount of time definitely takes some getting used to, but his teachers quickly came a part of our routine and daily lives.
   As time moved on I continued to research and read up on different therapies.  I was reading books, blogs, articles, etc. I kept reading about  Applied Behavior Analysis (ABA) and the success that many have had with it. I was beginning to think that J needed a bit more structure  to continue to improve. Our Floortime sessions were starting to all look similar. J enjoyed going up to our second floor and exploring/running away from us.  Many of our sessions were spent following him around from room to room. He also got into the habit of leading one of his therapists to the computer to watch one of his favorite videos, and too much time was being spent watching Moose A Moose. I decided that I wanted to add in some  ABA to the therapy mix. Floortime and ABA are very different styles of therapy, and many don't agree with mixing the two. I have read of many cases where the two styles working side by side successfully though, and I want to give it a try.
    There is a great school in our area that specializes in ABA. I found that there was a waitlist, but that a spot would open up in September. I asked that our service coordinator put a request for the therapy. I was nervous that it wouldn't be approved, as we had recently been granted an increase in services. We were already receiving 12hrs of therapy per week. The ABA would be 15hrs on it's own. It would take over his current 5 hours with his SEIT,  but he would continue to receive his 5hrs of ST and 2hrs of OT per week. So all together he would be receiving 22 hrs a week of therapy. Once again our awesome service coordinator came through and everything was approved. He was also able to add in a social group one evening a week, which is geared towards kids with communication delays. A busy schedule to say the least. But everything I read talks about early and intensive inetrvention as being key to seeing growth, and I want to make sure J is able to take advantage of every opportunity available to him.
So here is our current schedule:
ABA - M-F from 9-noon
ST - M-F 3:30-4:30
OT - W&F 8-9
Social group M - 6:15-7:15pm
Yes, my not-yet 2 year old needs his own day planner - or at least I do to  keep track of it all. In the next few weeks we will also be adding preschool into the mix. I will write more about that in an upcoming post. We are only 2 shortened weeks into ABA so far, so how effective it wil be with j remains to be seen.

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