Sometimes it seems as if we have been going to occupational therapy forever, certainly more than five years. Together, the boys had 13 hours of different therapies a week up until the time that I had jaw surgery.
At that time we dropped everything except for the two double therapy sessions on a Wednesday afternoon, double occupational therapy and double speech therapy because Wednesdays are a half day at school. Their “father” took them during my period of recouperation. It gave him a far deeper “understanding” and greater “involvement” such that when I had recovered and was ready to take up the reins again, he decided that he’d prefer to keep taking them himself.
These days I take them occasionally when his schedule doesn’t allow him to go, like when he is abroad on business. Hence when Wednesday looms, I am secretly dying to see how their session will pan out with their father away. I’m uncertain what kind of routine they have developed, independent of my input.
In the past it was a great struggle because it was a transition and because therapy was hard work for them. On arrival, they used to enter the waiting room and then I would prompt them to tell their therapists that they’d arrived using the intercom. This meant pressing the button and speaking clearly into the audio box simultaneously. They used to have to use the step to reach the box on the wall, but they are considerably taller now. Each step took a great deal of prompting. On completion I would prompt them to remove their shoes and socks and stack them on the shelf. This also took a great deal of prompting, times two.
These days, they have had many years of practice, many years of prompting. I am keen to see how they will fare.
On arrival at the waiting room, one runs to the window to take a peek into the studio and the other flops onto the sofa. I wait. I observe. There is no further movement from either of them, nor any words. I wait. I observe. I sit on my hands and then put my elbows on my knees with my hands over my mouth. I wait. I observe. It soon occurs to me that I will wait for ever and that there is nothing to see. No action is likely to be forthcoming. I feel suddenly quite saddened for no apparent reason. There are lots of reasons that could cause sadness, but none of them are present, but still, the inertia drags me down. Just like other children they dawdle and are easily distracted. Just like some other children we have the ever present hurdles of inertia, ideation, sequencing and a serious lack of executive function regardless of the label.
I feel a tiny tickle at the back of my brain, deep in the depths from my years of speed reading to track down useful clues and tips. I became a butterfly reader immediately following their diagnoses, hopping from topic to topic, the brief overview and the summaries, gleaning the finer points but missing the big picture in crisis management. There are many tomes just on this one topic:- introduce the new behaviour, positively reinforce the new behaviour and then ever so gradually fade the supportive reward system. It is the fading of both the reward and the prompt that engenders independence. Without that final step they become reliant upon the prompt.
There again, there’s always the possibility that it’s nothing to do with autism, merely tired kids.