July 27, 2010

Maybe the soup isn’t cold enough

soup My dad likes to tell this story. He’s a dad, so he tells it a lot. My uncle, his identical twin, has also told me this story. Genes are powerful things.

The story is about a boy. He seems like any other boy, except he doesn’t talk. He’s two years old, then three. But he’s happy and lovable, so his parents don’t worry about it too much. By the time he was five years old, he still hadn’t said a word. Not one. Then one day at dinner, he looks up to his mom and says “The soup is cold.”

His parents are beside themselves. They can’t believe it! Their boy can talk! And so clearly! When they finally recover from the shock, they ask their son why he hasn’t said anything before. He replies “Up until now, everything was fine.”

I often question whether or not I’m making the soup cold enough for Moe. In other words, do I make things too easy for him so that he doesn’t have to communicate? About half way through his ABA program last year, we started pushing him pretty hard. The idea was to increase his frustration level so that he would need to communicate with us. This seemed to work for a while, but then he shut down. He isn’t motivated by too many toys, so we used food as a motivator. But meals became incredibly frustrating and tear- and tantrum-inducing. So we backed off, and then that seemed to work. He would tell me “more” or “all done” with signs or sometimes words. But once again, we seem to be back to more tears and less communication. I think it may be time to start requiring more from him again.

This kind of up and down and constant experimentation always makes me question if we’re doing the right things with Moe. We know that we need to keep working hard. The research shows that early intervention does make a difference. But in the back of my head I’m always wondering how much it matters – if he’s just developing on his own terms and will talk when he has something to say. When he does, I hope it’s not to complain about my cooking.

5 comments:

  1. I have also heard other versions of the "soup is cold story" a child wakes up one day and starts doing everything or starts talking etc.
    We have also not been able to strike the right balance between pushing N enough to keep her going but letting her be before she shuts off due to pressure.
    Her previous ABA provider would push her a lot and we were left with a very cranky N who was crying throughout the session and was shutting us all out of her world.
    The new vendor is playbased and N is more smiley and all but they just dont push her enough and she is not meeting her potential.

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  2. Ann, it's so hard to find the right balance isn't it? And because our kids are growing and changing on their own I never know if it is the therapy that is or isn't working or just Moe's own development.

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  3. My advice: if the ABA approach isn't working, try something else. My recommendation: Floortime/DIR. We did 'traditional' speech therapy with Hallie until we were going blue in the face (about a year and a half, maybe) with zero tangible results. Switched to Hanen method---almost immediate success. (We never did ABA in a formal way so I can't use that as an example). Hanen is the speech analog of Floortime (very child-directed, based on developmental model and not behavioral one, etc etc...see my blog because I talk about Floortime a bunch on it). Anyway: it might not work, either, but it's definitely worth a try.

    For what it's worth, I really hate that story. Making Moe's soup colder most likely will yield a little boy who can't talk who is even more frustrated than he is now, not a little boy who will open his mouth and utter fully-formed sentences. We heard variations of the same story with Hal (and of course, the story implicitly blames the parents, yet again; we moms are either refrigerators or too indulgent and our kids' autism is ultimately our own fault, you know). Amazingly, we can report after numerous experiments that tormenting Hallie by withholding her favorite stuff made her crabbier, not chattier.

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  4. @Abby, I really hate the story too. I've finally let go of "he'll talk when he's ready" or "when he starts, he's not going to stop!" Our ABA provider used a combination of techniques, including play-based Floortime-type models. I find that no one technique works for Moe all of the time. We have to change it up periodically to keep it interesting and motivating, adjusting the pressure as required. But you're so right - when he's miserable no progress is ever made.

    Don't know much about Hanen - will definitely research! The school Moe will attend in the fall uses the Competent Learner Model.

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  5. I agree on the 'no one model' thing completely. We mostly use Floortime, but ABA (or ABA light) is useful to help us with some of Hallie's challenging behaviors (eating-wise, it's been the only thing that kindof, maybe, sort of works, and I think it's also been helpful for some pottying issues we're having).

    Hanen is child-directed, like Floortime is, but more invested in getting kids talking (by focusing on their interests) than in 'closing circles of communication' even if they are non-verbal (which is more what Floortime is into). The books that we found helpful are *It Takes Two to Talk* and "TalkAbilities*. Neither is rocket science but both contain some helpful ideas. The other thing that really, really worked for Hallie in terms of getting her speaking was OT focused on her sensory issues. Jumping, swinging, and other forms of proprioceptive and vestibular input helped steady her enough to get her to produce meaningful words (and approximations thereof). I am not entirely sure how all this works, but it really did help.

    Moe is adorable and bright and he's going to get there with your help; I just wish I knew what the answer was for all of our kids (and it doesn't really help matters at all that they each need their own individualized answers, does it?)

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