Rid of Risperdal

After a year on the drug, Lawrence was finally weaned off of Risperdal while in the feeding clinic. He now takes Zoloft for his OCD, but this is his only medication.

For Josh, Risperdal was a miracle drug. He calmed down, stopped biting, paid attention, and made social connections. It was a perfect fit for his needs.

For Lawrence, this was not the case. I hadn’t known Larry before he started, but I’ve certainly seen a difference since he stopped. He’s hyper, but not excessively hyper. He dances and sings and runs just like a typical six-year old. He gets excited to go for a ride or get in the wagon. He’s upgraded his physical shows of affection, and is learning words at a much faster pace.

There have been a few drawbacks to taking him off the Risperdal. Changing his diaper used to be a 12-second procedure, now he always runs away before I can even clean him. The process has become a four-minute battle, and that doesn’t even count trying to get his pants back on. He’s also developed a, in Aaron’s words, “love for his peep”. Regardless of how many times he try to redirect him, as soon as we turn around his hands are back in his pants. Anyone have any advice on this? We don’t want to give him a complex, but at the same time he can’t spend his time with his “peep” hanging out of his diaper.

Overall, however, I think removing the Risperdal was a good decision for Lawrence. He’s becoming more engaged and growing and learning faster than ever before. I hope this works out for him.

Autism and Attachment

Taking an autism seminar course, I’ve heard a great deal of myths surrounding autism in the past several weeks. One which is constantly recurring is “Autistic individuals cannot form attachments to people” or “autistics connect to objects not to people.” Is this true? I’ll present some anecdotal evidence and let you decide for yourself.

After working with the triplets and Charger all summer, I had to take a break to get my school affairs in order, and the boys needed time to settle into kindergarten. So over the past two weekends, I’ve been able to see all 3 boys for the first time in 4-5 weeks. Here were their responses upon seeing me.

Charger: “Cale! Cale’s back! He came back for me! He came back to play with me. Charger is happy. Charger is surprised. Cale has come back!”

Josh: I get into the car and turn around to smile at Josh. His eyes light up, and he reaches for my arm. I put my hand in the backseat and he plays with it the whole ride home.

Lawrence (after six weeks!): I walk into the bedroom where he’s laying on his parents bed, hidden under some pillows. Larry’s dad says, “Lawrence, look who’s back. It’s your buddy Cale!” Larry lifts his head slowly like he’s not sure what to expect. Then his face breaks out into a giant grin and he reaches for me. We collapse onto the mattress together and roll around kissing and laughing until we fall onto the floor where he pushes his fists into my cheeks (his signature expression of happiness/affection). For the rest of the evening, he’ll look over to where I’m standing, smile, and run over to offer another hug.

With this evidence at hand, is there any question about the ability of autistics to form attachments?

Ask An Aspie: More thoughts on Scripting

Since the previous post, I have been thinking a great deal about scripting and the role it plays in my own life. I obviously have the capability for spontaneous speech, but often I find myself resorting to scripts. Why use scripted lines when I can generate my own speech? For the most part, my scripts come to the surface when I’m encountering an emotional issue. Use of scripts can be brought on by three key occurences:

1) A situation where I don’t know how to respond. Say I’m talking to a friend and they bring up something I’m totally unprepared for, like that they’ve been molested or are abusing heavy drugs. My first thoughts are typically a list of movies and songs which include this sort of dialogue. I can pull a line from one of those and use it to stall for time while I try to think of something relevant to say. Or I can use it to deflect/diffuse the situation entirely. Say for example, we both watched a film where a similar event happened to a character. If I pull out an immediately recognizable line from the film, the other participant usually laughs, which then takes the attention away from the difficult subject matter. Mama Mara mentioned that her boys use the phrase “V-E-R-N” from Rainman when there is an issue, and this tends to bring the anxiety level down.

2.  When I’m emotionally overloaded. In times of emotional overload, it seems the whole brain-to-mouth connection is disrupted. I can’t find any words to express what’s bothering me, so I typically resort to a scene which evokes the same emotions even if it does not relate to the triggering event. I’m reminded of a time when Charger, the intern, her boyfriend, and I were playing a game of Sorry, and the boyfriend had to take a phone call and left the table. Charger became visibly anxious, and started exclaiming loudly, “Something is missing! Is it here? Is it here? Is it here?” We could all see the guy, so there was no direct connection to the situation. But what he was broadcasting about his emotions was very clear: The order of our game has been disturbed and I need it resolved.

3. When one lifted phrase can capture a whole scenario. I often say that I think in paragraphs but need to speak in sentences. Everything floats around as fully developed ideas, but I obviously can’t release the whole flood simultaneously. I need to chop it into single sentences presented in a sequence others can understand. I call it the “Brain English to Social English translation process.” But there are times when a line from a movie or book can capture the entire thought floating around in Brain English. For example, a gentleman on campus and I have begun the courtship process, and there is a flurry of thoughts in my mind about the meaning and role of secrecy and the way it is affecting the relationship and how we can work through that. Whenever I’m thinking about the topic, the line that immediately comes to mind is the opener (and closer) of the Outiders: “As I stepped out into the bright sunlight from the darkness of the movie house, I had two things on my mind, Paul Newman and a ride home”. We see it all here, the emergence from secrecy, the idealization of how things could be/who we could be, and the knowledge that practical concerns are preventing us from reaching that goal.

The notion that there are people who don’t process their thoughts in this manner is actually a bit strange to think about. With all the media we take in in our lives, have they seen no one who can capture the thoughts of the moment better than they?

I’m not sure if my explanations are making sense. As the title implies, this post is a work in progress. I have the brain English for it, but I need to translate it into social English and the process is slow going. I will likely be refining these thoughts further as time goes on.

Ask An Aspie: Scripting

This question was submitted by @cleopitty, who asked:

“Why do you believe scripting serves a purpose?”

Consider yourself at the age when you were just beginning to talk. Where did your words come from? Most likely Mom and Dad and other individuals having conversations with and around you. You spent several months studying their every move, and then one day you were ready to start releasing some of your own. The neurotypical world is immersed in the social, so the language that spoke deepest to you was that of conversation.

But consider this time for the autistic infant. People and their conversations are not their biggest prioirty; there’s so many physical facts to take in. So the things he pays attention to are those facts about an interest, whether it be insects, trains, or doorknobs. Most of this information (“content-based”) comes from books, movies, and other sources which provide their material on a one-way basis.

So unlike the neurotypical infant who grows in a world immersed in conversation, the autistic infant lives in a world full of facts, mostly provided by television and books. From this point of view, doesn’t it make sense that while NT kids would learn conversational speech first while ASD kids would learn scripts first?

Over time, as the child spends more and more time focusing on the sources of his facts, he will come to generalize to appreciation to television and books as a whole. So he starts parroting more scripts, ones from all assortments of books and movies. He now has a language, developed from the focus of his infancy.

This language, these scripts, become a basis for trust; things connected to the scripts are things to pay attention to and learn, and are awarded the same belief supplied to what has been directly scripted. This makes the language expandable, slowly at first, until the trust has been generalized to the word-instructor (parent, TSS, or therapist), at which point the language can truly explode.

This process can then burst ouwards as the generalization of trust continues. Soon the child has multiple sources of scripts expansions, and eventually the scripts fade to insignificance. They may still appear from time to time, particularly in times of stress, but there are so many other phrases and ideas available that they no longer prevent a more spontaneous conversation.

I would hold scripting-expansions responsible for over 75% of Charger’s language gains this summer, and highly recommend it to anyone teaching/hoping to teach their child conversational English. The most important aspect is to start very slowly, sticking very closely to the script but only changing or adding a word or two, and then over time (periods of weeks) increasing the amount and variety of changes until you reach a pace for comfortable development.

Some Resources for the Elementary level

I’m taking a “Teaching English Language Learners” class this semester, knowing that a great deal of the things learned here will generalize to working with autistic children. So I should have a great deal of resources to present in the coming weeks.

The first I’d like to mention is the “Oxford English Dictionary for Kids“ .  My instructor uses it when working with children first learning ESL, but I was struck by how similar it was in design to some of the tools we were introducing to Josh this summer.

In the classic version, a large picture sits on one side, and on the opposite side, each item in the overall shot is blown up and labelled. This would be more successful with Lawrence who already has the words but hasn’t yet made the connection with the meaning.

The “Word and Pictures Cards” edition has words on one side and the image on the other. They cover topics ranging from emotions to food to toys and games- basically topics kids like to talk about. They can be carried around separately as flashcards or kept in the original binding for organization. For a family pondering trying the PECS program but wanting to try a simpler form first, this item could be an ideal first step. A content version is also available which could be used in a classroom setting for academic topics.

The third item I liked from the same seller was the Picture Dictionary for Content Areas. From dinosaurs to the civil war, this book has pictures and labels for every subject covered in a typical elementary school curriculum. You can easily make a game out of the pages, covering the side with the labels and asking the child to find a particular picture in the larger setting. This would increase both language competency and tracking skills. This would be great for Charger who has a rather complete basic vocabulary and is now ready to move on to science and history.

In all three books, the pictures are clear, the words are relevant, and the book is visually appealing. As it would be less than $100 for the three book set, I am going to suggest to the outreach center that they order the collection for their resource shelves.