I get asked a lot lately, “so how is Tony doing?”
Well, it’s been a very busy couple of months. We went right from the transition out of services with his former ABA providers (and he was really heartbroken about that) into the holidays where pretty much everybody who works with us wanted to take time off for Thanksgiving, Christmas, and New Years. Which of course, I understand and support- but he doesn’t, as we all know. He got a nasty respiratory infection, an infected sore in his ear, one of his baby teeth fell out and another is hanging on for dear life while the other one grows in on top of it. Not comfortable for him sometimes, and he has let me know that on his speech device. I eliminated one of his two daily walks to start transitioning him to what will be doable for that once he’s in school. We’ve now moved his Tuesday and Thursday therapy appointments this past week to other slots to accommodate the anticipated ABA schedule. And on Tuesday, he got his first dose of the COVID vaccine.
Anybody who knows Tony knows that’s a whole lot for him. But we’ve still been pushing forward and he’s been making a lot of really great progress on some of his goals. The only thing we’ve really put any pause on is functional sitting for extended times while eating in public skills- we’re waiting until the RSV/Flu/COVID wave passes to reduce his likelihood of catching something as this is something we do with him unmasked.
The above pictures are from October, when we started working on functional public eating skills and staying seated after he was done in public locations.
His music therapy team told me a couple of weeks ago that he has been extra flexible the last couple months, and there can be no greater indicator of how far he has come to be given that bit of feedback after everything I described in the paragraphs above. There was a time that even one or two of those things happening would have caused a period of significant rigidity and stalled progress for a few weeks.
But right now, he’s moving along at a good pace on everything that doesn’t involve motor planning. For many of the things we are doing involving communication, he needs a preferred edible reinforcer. He’s given that for correct responses or appropriate behaviors only. We are working on fading use of kindle and TV and replacing them with functional play for reinforcers during in-home sessions and he can tolerate doing that for more than an hour and a half at this point. He’s cooperating with seated trials of non-preferred tasks of 6 minutes (he was at 2 min at the beginning of November). He’s showing increases in crowd tolerance. We’re at him tolerating his clothes during functional tasks for 1 hour 35 minutes during home therapy sessions, and he’ll tolerate a bandaid for as long as an hour (we were at under a minute for this early in the fall). He can keep his jacket on now for the entire hour or longer walk (when we started out at the onset of cooler temps this past fall, he was at 20 seconds). We’re starting to fade his use of the kindle as a reinforcer in preferred public locations also by replacing it with cart pushing, which he can currently do for around half an hour before he gets tired.
This was from today in Ulta, and many times in preferred locations he will come back when asked if he starts to walk off, and is improving a lot in his ability to stay in the area. Here he was walking back towards me after I called out to him because he started to wander away a bit.
Even some of his motor planning goals have seen movement. Just this past week, he’s succeeded on getting his own jacket on three times all by himself. And we’re working on generalizing different jackets to him, sometimes he and I will swap coats or he’ll borrow his dad’s. He got both of those jackets below on by himself!
Ok, yeah, I know. My kid is 10, and many of these things would happen at a much younger age for another child. But they’re still happening, and so we’re going to celebrate it because the happening part is what matters.
We do see, of course, some moments where either his memory or his difficulty in generalizing doesn’t help. A “no” he might tolerate in home will not be tolerated at the zoo or a crowded mall, nor will he have the same level of directional flexibility in those places, so in these kind of situations we have to work on location by location, increasing tolerance and using edible reinforcers that we currently don’t need in the community walks for directional flexibility or denial tolerance. And he doesn’t generalize current behaviors to all locations. Meaning, skills we’ve worked on and he’s doing amazing at in locations we’ve done a lot of work in the past two years- he’s not transferring those to locations he hasn’t been in since the start of the pandemic. He’s wanting to pull that memory file and run it as his current behaviors for those locations, so that is something we are working on location by location also.
Today, Litchfield Park Public Library, where he wanted to run all over the place, pull up the window shades, and generally do what he would have done 3 years ago. Was able to transition him to functional seated tasks, but it took skittles to persuade him.
That can work for people too. His first walk with Miss Emily when she started back up doing some of his habilitation hours a couple of weekends ago, he wanted to revert initially to how community safety walks happened when she was last working with him (and at that time we were at only three direction changes at 20 seconds, which he would then ask to retrace back so he could walk his preferred route). We didn’t see any pushing, but he got upset and leaned into me a couple of times when she started giving him the directional instructions. He verbally fussed and stomped a bit, and we talked about it. Because he wanted everything to be exactly how it used to be when he last worked with her a year ago. And then it just clicked. He walked all over our community with her in ways he’s never done before and it was a beautiful thing.
He did (and a very happy thing it was indeed for me to see) generalize all of his public store locations skills with her.
So, yeah, there’s been a lot going on…but he’s doing great. Thanks to all of you who cared enough to ask <3
