Our First Meeting
I met Nathan a 4.8 year old boy, last year in September through his parents. He needed an Occupational Therapy assessment at the request of his lovely family. My first interaction with him wasn’t so rosy; he cried, kicked and screamed. Nathan came across as a really strong and healthy boy in those few minutes. There was a lot of carrying, pulling, tagging, running, kicking and some more screaming. It took a while for Nathan to get into the room for the assessment, but finally he did. When he got in, there was little or no eye contact with me, he did not even respond to his name being called and neither did he actively participate or follow instructions.
As he explored his environment, I interacted with his parents and it was evident that he came from a loving and stable home. Nathan, the second born of three children, liked moving around and made good use of every opportunity. We all have likes and dislikes and Nathan did not like sitting down at the table or do any activity that involved sitting. Don’t even mention writing, getting Nathan to hold a pencil to write was a toll order. When he finally did get to hold the pencil, we were very far from the table, we were on the floor. He doodled a bit and tried to copy a circle but just like that, he closed this pencil chapter.
I noted that he was a sensory seeker and he sought for proprioceptive and tactile sensory stimuli. For more information about sensory processing and Autism Spectrum Disorder, you can read our article; Sensory Processing Disorder in Autism Spectrum Disorder, Lessons from a Burger
Nathan’s First Occupational Therapy Session
From the initial assessment, I was able to identity what would be the goals of the therapy sessions. Immediately after the assessment report meeting, I was ready to start the therapy sessions.
Here we are, session one, me all armed with a visual schedule of all the activities to be done. The activities comprised of a few sensory, movement and table activities. Then comes Nathan, not interested at all, coming into the room, not interested in the visual schedule and not interested in me either. Change of routine was really hard for him; coming to a therapy session was not in his previous routine hence he wanted nothing to do with it.
A good chunk of the first therapy session was spent walking outside, collecting a few sticks and Nathan sliding on the slide. Then he went on to jump on the trampoline then came in and did a few of the movement activities.
Several Occupational Therapy Sessions Later
After a number of sessions, still maintaining the same routine, I started getting a few brief glances from Nathan and I felt like I had climbed Mt. Kenya, a rapport had just been created. We progressed well during the subsequent sessions and there were fewer moments of crying or running. We finally reached a point in the sessions where Nathan was able to sit at the table for five minutes and do a variety of activities. To add on to this, he was able to follow one step instruction, do a bit of painting, doodling and even tried to work with the pencil occasionally.
Parents On Board
Nathan’s parents were on board from day one, they made an effort to attend 90% of the therapy sessions and when either of the parents could not attend, they did follow up with the home program. His parents ensured they shared with the school what Nathan was doing during the therapy sessions and also shared with me what Nathan did at school. This ensured that all who worked with Nathan were on the same page. His parents were quick to notice every improvement, big or small and they truly celebrated it. My most memorable achievements shared by the parents were;
- The family attended a family gathering and his parents had brief moments to sit and chit chat. Nathan was able to follow a few instructions and this freed them to mingle with family members.
- Nathan had to have a doctor’s visit and he was able to follow all the instructions from the nurses and doctors.
- Nathan was able to participate well in the school sports day and even got a medal.
- Nathan finished his homework at home with very little prompts.
- At school, Nathan was able to be more attentive and learn better.
Nathan in this entire process was not the only student; his parents, siblings, teachers, extended family and I were part of this awesome class. In this class we all learnt from each other constantly with no breaks.
What I have Learned from Nathan
A rapport is important while working with an autistic child. It doesn’t have to be based on a child’s verbal language; all you have to do is show genuine interest in them and what they like.
When a parent/caregiver is involved, it makes a big difference!!! Once the parent/caregiver is aware about their child’s condition, then they get access to right information about what they need to do and they actually do it, it does have an impact on their child. Parents/caregivers have much more hours to work with a child than the therapists. In addition, they have access to special moments during the day to day life of a child, where they can teach a skill.
Consistency is King
Consistency in therapy, in the home program and routines is very important. Visual schedules and routines create a safety net for a child with autism. The visual schedules and routine applies to all ages and the earlier the child starts the better. When this is applied in all their environments, it makes their life and the life of all working around them easy.
As I wrote about Nathan, I couldn’t help but think of all the other autistic children in the world. I couldn’t help but ask myself some questions.
- Are we taking time to learn from special needs children?
- Are we taking time to create awareness on the needs of the special needs children?
- Are we taking time to educate their caregivers?
- Are we taking time as caregivers to implement what is taught?
- Are we taking time to work together as service providers?
- Are we taking time as healthcare providers to learn more about autism?
- Are we taking time to create policies that will make life better for the Autistic individual and their family?
- Are we taking time as learning institutions to make the Autistic child included in education?
- As religious institutions have we included the autistic individual and their family in our activities?
- Are we taking the time as research centres to research more about Autism?
Are we taking the time?
As we celebrate the World Autism day 2020 #letstakethetime.
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