978-1572305441

144 A MIND APART
The therapist would move with him and intrude on the activities again,
subtly at first, then more forcefully. Once Trevor could tolerate the therapist’s
presence during play time, she set up games involving turn taking
using puzzles, the Lego pieces, peek-a-boo, or songs involving
actions.
After much persistence, Alice and the therapist realized that there
were times Trevor had to take the lead and structure, even control, his
mother’s turn-taking play with him, to allow him to enter into the play
activity. Sometimes Alice had to be a passive participant in the to and fro
of social interaction. If she showed any inclination to change the pattern
of play, if they did the puzzles in a different order, if they used different
figurines to line up, then Trevor would get upset and go away
mad. Once Alice followed her son’s lead, she learned that Trevor would
pay more attention to her and be more aware of her. This was an enormously
important discovery for Alice and allowed her to play for longer
and longer periods with her son. We could now cut back on the time for
the therapist to interact with Trevor one on one. Alice gave Trevor treats
like time on the computer or watching TV for playing together, for completing
a puzzle with her, and for allowing her to take turns in playing
with the figurines (candy is not a terrific reward since it sets up all
kinds of other problems in eating and nutrition). Once she let Trevor
take the lead and be more comfortable with her, it was easier to introduce
modifications from within the play activity itself. An important dynamic
emerged between entering Trevor’s world, letting him control the
agenda, and then challenging him to develop more appropriate skills.
She was combining her knowledge of Trevor’s inner world with some
fairly standard techniques for encouraging positive behavior and learning
that are used with typical children as well as children with ASD.
Trevor was easily getting twenty-five hours of therapy per week
once we combined the time in day care and the sessions at home. It was
nice to see that he made significant gains in the day care setting as well.
Trevor started to pay more attention to his teacher. He would regularly
come to her for help, would show her the newest Lego creation, his latest
craft creation (which was often new pieces for his mobile). The day
care introduced a picture exchange communication system (PECS),
which basically allowed him to use pictures to communicate his needs.
Once he developed a facility with that, his language and words appeared.
He started to request food or favorite toys, then he started to
label objects. His language skills made rapid progress after he learned to
point to pictures or other objects of interest.