One of the things I promised when I started this blog was that it would be gritty, and contain the real life drama of being a teacher in a severe and profound classroom (in more ways than one) as well as being a parent. I’ve been very light on the parent bit. Too light.
So time for some gritty heaviness.
Yesterday, I introduced you to the idea of PANDAS and some of Thomas’ difficulties. For once, Jane is actually just as skeptical as me about this business. None of these conditions (PANDAS, autism, PDD-NOS, ADHD) have any sort of test a body can give. Every one is identified by some sort of shopping list of symptoms and behavioral characteristics. We are infinitely frustrated by this. It’s not like spina bifida or Down syndrome, where there is this definite physical marker or genetic thing. Autism and everything about it is like some sort of phantom whose outline you can just barely make out in the mist. You know its there. Or do you? We don’t know where it comes from, where it is or where it will be in the future. Something is there…or is it? What is it? Is it just bad behavior? Is my son just being a stubborn and obstinate shit that needs to be disciplined into submission?
His teacher called yesterday. Thomas is in regular 1st grade with support from a para. His teacher is actually pretty competent if not extremely empathetic. Her son, who is in 3rd grade, is identical in a lot of ways to Thomas, with the autism/PDD-NOS diagnosis. Her husband teacher MoID kids down the hall from me, so I there is a bit more of a connection than simply casual. Thomas is exhibiting a lot of wildness, immaturity, and generally disruptive behavior. Like at home, he requires constant, diligent supervision at all times. He’ll wander out of the room, get in the faces of other kids, hug the littlest ones around the neck, yell loudly, exhibit defiance…pretty much a uniform constellation of behavior problems.
Jane was the one who talked to the teacher, so she laid it all on me when I got home. And then she asked, “What should we do? Any suggestions?” I’m a behaviorist. This is supposed to be my thing. My area of expertise. However, before I can think like a behaviorist, I have to process as a father. And that is an energy and time consuming thing. We’re constantly having to adjust to new behaviors and new demands. I think any parent has to do this to some extent. There’s always some new thing on the horizon, some new developmental/emotional/behavioral issue. But it usually isn’t quite so bizarre and different. Like now Thomas want to smash and smush things. glue sticks, toothpaste, chapstick, crayons, bar soap…all smashed and crumbled. His impulsive behaviors are becoming more compulsive and not doing them can lead to tantrums and meltdowns.
It is a lot to take in and deal with.
One of the difficulties I’m having is wrapping my mind around the concept of compulsions. I get what a compulsive behavior is, but how to handle it as a behaviorist becomes tricky. From a cognitive perspective, compulsions are driven by a false or irrational belief that something bad may happen if a person does not engage in a certain behavior or set of behaviors. But this is unsatisfactory from a behavioral perspective. I can’t just assume anything regarding motivation. I’m going to have to noodle this out some more in order to determine function although it is looking a lot like automatic reinforcement. Thomas has a lot of marbles but he is very concrete in his thinking, so a cognitive approach will be challenging.
An instance of this is when his teacher was talking to another student. “I know you can do this! All you need to do is push yourself harder, and you can do a lot better!”
Thomas overheard this, and promptly went up behind the poor boy and gave him a hard push.
He was just trying to help!
At least I’m not contending with a lot of head banging and self-injurious behaviors. At least we have had an opportunity to mainstream, which I’m not sure is going to be able to be maintained. Right now he is fully included, with OT and speech therapy. We’re trying to hold on to as much of a regular environment as possible for him, but as he gets older and bigger (he already weighs over 70 pounds!) it will be more difficult especially if we see more aggression.