Autism Review

Jimmy was especially active and his mom was having a really difficult time keeping him occupied while she filled out his intake paperwork. His mom was a little frazzled as Jimmy darted around the room, jumped onto the chairs, pulled on the curtains (pulling them off the rod!), and banged on the windows. I intervened at the window banging for safety reasons and as I gently redirected Jimmy he lunged for his mom's coffee, and with a spray of cappuchino across the carpeted waiting room he finally paused.

"Oops," he said, as his mom gave him The Stare. Jimmy froze.

Mom froze too, and after surveying the mess she excused herself to the bathroom. I stayed with Jimmy who suddenly realized he was supposed to be sitting quietly.

Mom returned with some paper towels. The unfinished paperwork sat on the chair, and she cried as she dabbed at the rug. Jimmy knew enough to stare straight ahead at the toy on the child sized table and play quietly.

His mom was upset about the rug and worried that it would leave a stain. "I just don't know what to do!" she said between sobs. "I can't even take him somewhere to get help without it being a disaster."

I really didn't care about the rug because it can be cleaned. Also, cappuchino is relatively benign when I think about all the possible things that can get spilled onto a floor. "It's really ok," I said, attempting to reassure Jimmy's mom. She couldn't hear me and asked for some cleanser.

Soap is an emulsifier because it can take a substance like cappuchino and disperse it into another liquid, like water. Soap micelles have long hydrocarbon chains that help isolate oils or grime so they can be 'cleaned' or 'removed.'

I was thinking that maybe the paperwork was more important than the cleanser and that maybe for the short term the water would be enough to provide a diluted mixture to blot up and reabsorb the coffee into the paper towels. That wasn't enough for the mom though. She wanted some cleanser.

I watched the mom scrub and scrub at the floor, and I figured that is what she did with Jimmy too. I imagined her taking Jimmy against a washboard and scrubbing with all of her might. I bet she tried everything she could so that she could remove the behavioral difficulties that interfered with his participation in school.

You can scrub all day sometimes, and it just isn't enough.

Foaming agents are added to detergent products because somewhere along the line of history people started associating soap bubbles with ACTION. The bubbles might help some, but they aren't really required for the emulsification process. That's my very basic understanding of the chemistry of how this stuff works anyway. The mom wanted ACTION. She wanted to see her scrubbing effort make bubbles. Bubbles meant the rug was getting cleaned.

Maybe bubbles would mean that Jimmy's behavior could improve too, if only we were scrubbing hard enough in the right direction and with the right effort.

I found some rug cleaner and dabbed it into the carpet as I knelt next to mom and handed her a scrub brush. I grabbed a second brush and went to work on the carpet.

"I bet we can get that out no problem," I said hopefully as I scrubbed and scrubbed. Jimmy's mom smiled.

We have a lion in my office that was left by a child several years ago. Here is his picture:













I placed him on my cable modem in plain view of everyone who came into the office hoping that someone would claim him. No one ever did, and I felt sad about it because he is a Webkinz and they were rather popular for a while and I am sure that some child was very happy at one time to have this toy. Anyway, I leave him on top of my cable modem just in case his owner ever makes a claim. He is our office mascot, and I have come to enjoy his company every day.

Today I was cleaning and organizing because I couldn't settle myself into documentation. I found a bunch of stray toys. I found the following:

1. a yellow clothespin that goes to a full set
2. an orange sheep that is matched to a full set of parent/baby animals
3. a green peg that goes to a pegboard activity
4. blue and yellow blocks that are part of a construction set
5. a peg from the BOT-2 (a motor test)
6. scissors
7. an ant from Ants in the Pants
8. the letter A from a wooden puzzle
9. a lion that goes with a set of jungle animals
10. an orange pencil gripper
11. the letter P that goes to a bead stringing set
12. a small red lion that goes to Mastermind Jr.
13. a yellow triangle that goes to a parquetry set

Here is the collection:









Undoubtedly, parents are familiar with the phenomenon of stray pieces of toys and games being lost or misplaced. It happens here too and periodically I round everything up and try to return toys to their proper home.

I decided to take a more proactive approach and create a temporary 'home' for all stray pieces and parts. Here is the picture:









I think I want to keep it in a central location, maybe near the lion. It makes sense to me.

In partial fulfillment of my ongoing public service mission, I wanted to bring a job opportunity to everyone's attention. There is an interesting article in The Washington Examiner today that talks about the DC area Department of Youth Rehabilitation Services wanting to find someone who can teach yoga or tai-chi to children in the program.

I am sure that educating at-risk children in stress management and situational coping strategies is probably a good idea. However, this isn't the only issue in the article that got my attention.

According to the article, the Interim Director got some people suggesting other programs including building a race car, involvement in music programs, and instruction in boxing.

As I read this I couldn't help but think that there were some needs in that program that were obviously not being met.

The article states that "Ward 1 Councilman Jim Graham questioned if turning to yoga was the best approach given the problems the youth face." This makes good political theater, because in a time of fiscal constraint and questions about mandated services it is easy to take pot shots at things that are not well explained. The value of engaging children in normalizing occupations and teaching them appropriate leisure time use is precisely what they need to help avoid recidivism when they get back to the pressures and stresses of their neighborhoods.

How well is the DC Department of Youth Rehabilitation Services meeting the need? Well they have had four Directors in the last year and their system seems to be under a great deal of stress given the severity of behavioral problems that exist in their programs.

I called the Department and spoke to their Human Resources Division. They don't employ occupational therapists, at least not in that job title. There is no Occupational Therapy Department. They have a Recreation Therapy Department, but there are no openings.

This seems like a prime opportunity for someone to go and help them understand a little more about occupational therapy and how it can help with their programs. With such close proximity to AOTA and OT educational programs in the area there are a lot of local resources to leverage.

In full disclosure, I want to state that I don't make these recommendations from an armchair. Locally, we have taken a deep dive into similar programs and transformed the OT services there. We still have some way to go and a lot of opportunity for developing the services further, but it is possible to enter these systems and begin to make a difference.

If any audacious therapist wants a road map to what we did, feel free to contact me. It sounds like this DC program needs some help.

The clock was ticking past the 10am appointment time, adding much to the level of stress that Michael's mom was feeling. Michael had more important plans than therapy and did not want to come inside the building for his appointment. Over the weekend several thousand maple seeds fell from the trees, covering the parking lot and creating a rather large distraction for any child who had to make their way from their car to our front door.

I watched Michael as he grabbed handfuls of the seeds, stood on top of a stone in the yard (as if this somehow added significantly to his actual elevation!), and launched the helicopters up so he could see them twirl whimsically to the ground.

It was such a simple childhood occupation but it was so much fun, and it caused me to pause this morning because I was a little surprised at how simple the play was and how apparently meaningful it was. Playing with the helicopters evoked happy feelings for Michael - and for me - but not for his poor mom, who for a moment thought that the appointment time was more important than the play! What person who has ever been exposed to maple seeds doesn't have a happy memory of playing with the helicopters?

Among other things, childhood play creates competency precursors for adult functioning. Even though I believe this to be true, I find myself a little taken aback sometimes at the power of childhood play lessons. I told mom it was ok and to let Michael play for a few minutes. He was creating some memories, and I thought that it was important to let the moment happen.

Vortex forces are created at the leading edge of the maple 'helicopter' wing, and this is what causes the lift that carries the seed such a far distance. What seems like a whimsical twirl actually generates a force that carries the seed to a distant destination.

Childhood play does the same thing, actually. I watched Michael launch the seeds, and then I watched him twirl himself in imitation of the flight. Then I thought that he was still so young, and that there were so many places that he would go to in his life. I watched his mom smile as she watched him play.

I guess that today's lesson is that there is something to be said for putting your face into the wind and twirling.