Tuesday, June 19, 2007

A little help

Scooter is on the wait-list, and so now we just wait. We'll be doing a couple things in the meantime--hearing test (to rule that out), lead test (mostly because of the Thomas stuff, though developmental issues might come into play here too).

As Trillian and I have calmed down and been able to talk about things without roiling emotions, we've also found the humor in the reason why we finally got the referral process moving.

The provincial occupational therapist was not too concerned at the outset of Scooter's appointment, but by the end said that she would contact his current therapists to get a sense of their perspective. This happened because Scooter did not utter a single word the whole time he and Trillian were there. He would come over to Trillian and hold something out as if to ask, "Can I play with this?" But not a single word.

The speech therapist initially dismissed the provincial OT's concerns. But then she mentioned to a colleague the fact that Scooter was increasingly chewing on his clothing and had been grinding his teeth while talking. The colleague does both speech and occupational therapy and works extensively with autistic children. She made some suggestions about the chewing, but also indicated that this raised a red flag. And so we got the MCHAT.

During the colleague's evaluation of Scooter, she noted that he made limited eye contact, didn't follow gestures or make many himself, and was very limited in his pretend play. When they pretended to have a tea party and she mentioned needing a spoon, he insisted on finding a toy one, even when she showed him that she could pretend to have one--thus, demonstrating a more concrete approach to play than he should have at this age.

Now none of these behaviors are entirely unusual or unexpected for Scooter, yet in both situations his actions were exaggerated from his normal behavior. He can be quite chatty, even if his language lags a bit. Sometimes he purposely doesn't speak and uses sounds and gestures to try to make his point, but this is almost a game. And while he does gravitate to the same sort of toys and pretend play, he is quite capable of coming up with novel scenarios. The other day he picked up a balloon on a stick and turned it first into a violin and then a hockey stick.

I suspect that during both evaluations, Scooter found himself in unfamiliar situations and so was more restricted in his activities. I was surprised to hear he didn't speak at all during the one--is that my chatty boy? But, as Trillian and I have observed, this may have been the difference between being told to give him some time (yet again!) and moving forward in the process. I doubt Scooter has any concept of this, but he couldn't have picked a better time to be more idiosyncratic than usual.


bubandpie said...

That's a big part of the evaluation process, I think - the fact that children on the spectrum WILL behave a lot differently during evaluations than they do at home. All the diagnostic tools have to correct for it, I think, either by focusing primarily on a parent interview or by considering the child's behaviour more in terms of their response to strangers than their actual abilities.

A big obstacle to evaluating Bub is that he doesn't want to do things on command, just to impress you or please you. But that itself is a kind of symptom.

Rodrigo said...
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Lisa b said...

Good I am glad you are moving forward. It is such a chore to figure out the system.