Sunday, April 27, 2014

"Knockin' on Heaven's Door"

An old saying goes, “A steady knock wears the rock.” Over the years, I’ve discovered that raising a child with autism often needs that steady knock, requiring immense patience, attention to detail, and confidence that eventually the task will be rewarded as the old makes way for the new. For some time, dealing with certain behaviors of Alex’s has been consistent knocking, yet feeling as though we’re not making much progress. Lately, however, we’ve had that satisfaction of where we make sudden headway and truly see the end results in sight. These moments give us encouragement to keep plugging away and make us thankful that our efforts are worthwhile as we are moving forward.

In December, we increased Alex’s behavioral therapy sessions from once a week to twice a week with the hopes that the additional sessions would help improve his social skills. In working with his behavioral therapist, who is wonderful with Alex, we decided to dub these additional sessions “Fun Fridays,” where she, Alex, and I would go places and do things he enjoys. Our outings would be the equivalent of recreational therapy, which is designed to use skills in the community that have been learned in therapy, such as social skills and coping skills. In essence, these sessions require him to apply in the real world what he has learned in therapy. Before we leave for these outings, his therapist gives Alex a briefing, preparing him for things he may encounter and reviewing social and coping skills. She has made small cards with visual cues for me to carry in my purse in case Alex needs them that say things such as, “I can use my calming skills” and “Take deep breaths” and “Count to ten.” She also reminds him of common courtesies to use while we are out, such as saying, “Please,” “Thank you,” and “Excuse me.”

Overall, these Fun Fridays have gone remarkably well, and all three of us have enjoyed our outings to the library, the bookstore, and restaurants, as well as going shopping. As the weather gets warmer, we are looking forward to going to various parks to enjoy the outdoors. Several weeks ago, Alex decided that he really wanted to go to a local restaurant that is a retro-style diner, and his therapist and I decided that we would use that as a reward he could earn with good behavior over a month’s time. Actually, we had some concerns about how he might react to being in a restaurant that is typically quite crowded at lunchtime, and she wanted him to be able to order his own food, which required repeated practice over several sessions. However, he held up his end of the bargain and fulfilled his obligation to behave himself for the month, earning his trip to the diner for lunch. The day we took him for his reward lunch, the diner was completely full except for one table near the back. Although I had some trepidation about how he would cope with all the people and noise as well as having to wait, he handled the situation beautifully, even ordering his own food to his specifications: two Polish sausage without the bun and with grilled onions, cole slaw, and a medium Sprite. His therapist and I were pleased with how well the lunch went, and Alex really seemed proud of the reward he had earned.

Even with the progress Alex has made, thanks to therapy, medication for his anxiety, and healing that has clearly taken place, we still work on social skills that prove more difficult for him than most people. Like a small child, we constantly remind him to use social graces, such as thanking others for doing things for him. Despite modeling these behaviors for him and verbally cuing him many times daily, Alex, like many people with autism, doesn’t naturally think to use these polite phrases on his own. Last week, his therapist suggested that we try visual cues instead. Even though Alex will comply when we prompt him verbally, he hasn’t reached the point where he will say what he should on his own, and asking a twenty-two year old, “What do you say?” is becoming tedious. At first she suggested sign language, but Alex has always been resistant to learning signs in the past. However, I thought he might respond to numbers, and we tried holding up one finger for “Please” and two for “Thank you.” Immediately, Alex caught on to the system, which has worked like a charm. When I shared this new routine with Ed, he tried it with Alex, who correctly responded with the appropriate phrase for each visual cue. When Ed held up three fingers and teasingly asked Alex what that meant, without hesitation, Alex came up with his own clever idea, saying, “You’re welcome.” This simple and effective solution after years of trying to get Alex to use his manners has been the reward for us of that steady knock. While we wish we had thought of this idea years ago, we’re just thankful that he’s taken to the number system quickly and consistently and are hoping we can eventually phase out the visual cues so that he does what he should automatically.

As a reward for his good behavior and for faithfully responding to our one/two cues, we took Alex out to dinner last night at the diner he likes so much. Sitting in his favorite booth, where an album of Bob Dylan hangs on the wall (hence why we have dubbed this “the Bob Dylan booth”), Alex used his manners nicely and enjoyed his Polish sausage and cole slaw. He also liked listening to the oldies music playing in the background, correctly identifying the songs’ artists, including the Beatles and the Rolling Stones, thanks to Ed, who has taught him about classic rock as they have listened to music they both like together. At one point, Alex began swaying to the opening chords of a song he recognized, and he and Ed both smiled, knowing it was Bob Dylan, whom they love and I don’t. Suddenly Alex began to sing—perhaps applying the skills he has learned in music therapy—the words of the song, even more clearly and more in tune than old Bob himself: “Knock, knock, knockin’ on heaven’s door.” He continued to sing, unabashed and undeterred if he forgot a word, just singing every note and every word joyfully. To most parents, this would be no big deal, but for us, this showed us how far Alex has come. As Alex sang the entire song, I’m sure Ed felt pride as Alex sang the song of his musical hero, and I was moved to tears that our son who has struggled with speech and has lacked confidence in his ability to communicate could sing to his heart’s content. As I looked up on the wall, even Bob seemed to smile in bemusement; we just keep knock, knock, knockin’ and getting closer to heaven every day.

“And I say unto you, ask, and it shall be give you; seek, and ye shall find; knock, and it shall be opened unto you.” Luke 11:9

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