Sam and Dan

MEETING TWINS

Twins were so different . They had nothing in common-nothing. Everything was different about them-inside as well as outside
Sam is skinny agile two years with lovely smiling face. He skillfully freed himself from carriage, while friendly scrutinizing me. He was opened for contact and willingly gave me “big five”. Then something different  attracted his attention and he went on traveling, exploring a new place-a coffee shop we were in.
Plump chubby Dan remained in carriage and didn’t show any interest in anybody or anything and didn't respond to my Hi

We ordered drinks and introduced ourselves. Father was a mathematics professor in university. It was good for me-must respect logic. Logic is my main tool.
Somebody should start conversation and I asked probably a wrong question
-So, what is the problem?
Father immediately responded as shoot
-No problem. Everything is fine
Mom however was not agreeing with that. It became obviously that parents have tension about the issue.  That  happens pretty often in families

So I quickly stepped back from problem, changing topics. I was called by a woman whose husband was pediatrician and suspected autism in Dan. That was the whole information I knew before meeting the family. Little Sam helped with destrаction. He began to explore the caf;, moving playfully around. Charming little one. Probably he felt that and behaved pretty confidently, playfully looking at people. He obviously enjoyed being a center of attention. We discussed Sam a little bit. Parent slowly started to talk about Dan and some alarming signs became clear. There were reasons for worry.

Father was surprised and obviously disappointed by my non-professional status. He mentioned that there were no good specialists in the area and probably he had different hope on our meeting.
Mom showed worries clearly, but father seemed was in denial looking for some different interpretations for son's problems. For example that his nation overall didn’t have high mental ability. I objected by the fact that he was a college professor and finished hid study in Italy. Anyway it was some tension. Besides, it came out that father was believer to official medicine. He had a nice experience there. My experience with official System was quite the opposite. Overall father seemed was kind of conformist on everything And of course I couldn’t hide my non-conformism, criticizing the System We didn’t mention the word “autism” at all in our conversation.

Recently it happened that I came to somebody with technical issue and I revealed my intention to work with autistic population. The person mentioned that he has an autistic child and of course I asked him some questions about his son way of life. He seemed wanted to share details, but then it felt as he had some struggle with himself and ended up saying without confidence “He is ok….Yes, he is fine” as convincing himself

Dan father seemed didn’t want or was afraid to hear what problem his son had, mentioning some facts, that Dan is afraid of strangers and even close relatives and prefers only parents’ company. He chewed his clothes. Don’t play with toys. No speech. There is huge difference in twins development. We talked about official approach and what I didn’t like there and how I handled those issues different ways

Dan felt asleep in the carriage. When he woke up I was the one the saw at the first moments as I was sitting near him. Awful fear was in his eyes and he started desperately crying, clinging to father who took and hug him

We agreed that I need to see him for myself in his natural environment-at home. Father was a little bit surprised and probably was not happy with idea.
Before leaving I asked mom to relax as kids feel mom’s worry and fear. Mom said it was not easy. She almost didn’t participate in meeting, running after Sam or maybe by some cultural reasons

AFTER MEETING

I was thinking to share some pretty tough things, but was not sure if I would be able to do it successfully. Parents needed help and it’s not my skill at all
I would explain them that
- autism is not the end of the world
- accepting that they have autistic child-would make them relax about the issue, which is very important as a child feels parents tension
- starting  to do things as earlier as possible is very helpful. All those things are helpful in any case and no harm would do to any child. If they don’t want to accept-no problem. It’d be as preventing  measures and they would just provide extra development of the child

But I felt they would cancelled the meeting

In a day of meeting father rescheduled it on different day by family troubles. I didn’t believe in it. I came at the rescheduled day and nobody was there. I phoned. Father said he’d come, making me to wait pretty long. He seemed forget or… something else was going on. Maybe he hoped I'd not come at all. I asked about if family trouble was resolved and he was surprised with my question

AT HOME

Twins were together on bedroom bed moving around. Then everybody came to living room. Sam started to build something, Dan was not interested in anything –just was walking around, asking for food. Mom told me very important thing, which father didn’t mention when we met the first time. They told me that he chewed clothes, but said nothing about the food issue.
 Dan doesn’t want to touch food, he feels disgusting!!!!. He eats from parents hands as a doggy. WOW! Never saw such a thing. I think it was the most important issue. But in caf; we mostly communicated with the father as mom was running after Sam and father was tense and not open. At home we communicated mostly with mom

Although father said Dan is terrible afraid of everybody, but parents, it happened that the boy let me play with him, cuddling and moving him around. He let me say bye-bye with hands. No problem with contact

That supports my idea about FEAR of the world is the real reason for autistic children to choose their own world over the big world around them. And their world should be respected!!!! And their world make sense if to pay careful attention to everything there
It made sense to wake up and see some unknown woman in front (horror!!)and getting terribly scared and seeing the same woman in his home, talking to mom-dad. Why not to play with her. It’s safe

After meeting I wrote my ideas to parents. I wrote the very minimum consider father attitude. At home I communicated mostly with mom and mom was opened and interested in everything

ADVICES For PARENTS

It'd be good to start doing things as if the child has that issue. (without discussing it with anybody) All those interventions are helpful to any child in any case and do no harm. It’d be as preventive  measures and they would provide development of the child no matter what

-Avoiding situations which gives Dan frustration, so he’d not accumulate or learn anger or aggressiveness

-Training themselves to insist patiently on something parent need from a child without giving up to a child’s tantrum (cry)-quiet confident voice, repeating the same words without any emotions, while explaining a child a reason for that "sorry, but we cannot do (or have ) it now-maybe another day" (giving some hope)

-Making kids life more structured would be helpful

-Creating activities involving both boys together

-Teaching kids responsibility ("Sam , please give that to Dan. You are my helper! Thanks a lot!... "Dan, help father to pick up toys"
Using  'Hand over hand" technique picking up a couple toys "Thank you Dan for helping father"...next time withdraw hand a little... and things like that

- Learning Dan character-what motivates him

(he likes to be helpful -  "It’s so hard for me alone to make it. Could you help me, Dan?" or "Could you help Sam? He needs your help" If a child likes to be praised- " Dan is a good boy. He helps his mom",
What motivates him to do things, when asked? And learning all things possible about his way around. Using things he likes to motivate to do something not so pleasant
“After you clean the room we go for a walk. Let do it quickly Dan”

CRYING     (learning to define cry goal)
1) Manipulating crying to manage mom to give up....let him cry
(Mom learning to stay calm  repeating the right message until HE gives up)
-Sorry Dan you cannot have this, but could have that instead
-You should stop crying Dan and show me what you want

or

2) crying from frustration and anger-don't let him cry
Trying to find out  what made him cry, helping him to calm down –physically cuddling and talking
"I do understand its upsetting, but nothing could be done, lets relax, mom gives you massage or water, juice .. or whatever relaxes him

1) IMMITATION ISSUE-VERY IMPORTANT prevents autistic kids from learning things on their own as regular kids usually learn things-naturally imitating environment. Need help-intervention
Mirror neurons system (some theory behind that)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006185/3

-Telling  everything to the child what is going on with a child and around him
"we need to open the door to go outside" “Dan is drinking juice “  It also helps with vocabulary

- Teaching Dan imitation

Activity “ Pushing the ball!”
Sit on the floor-Mama with Sam, Father with Dan
Pushing the ball (better smaller ball, not to get distracted with the size)
-Talking –"Daniel is pushing the ball to Simon"-"Daniel is getting a ball FROM Simon"
First helping Dan with pushing -"hand over hand", then gradually withdraw the  help so he'd push independently
After ball its good pushing a car, it’s good to have a car which could “deliver” small things-"We send Simon red buttons, Sam sent Dan blue ones" (learning colors)

-Imitation of different movements-hands up, move fingers, make a fist

SAM as a Big Brother idea

Would be good for imitation, would be good to teach relationship. Sam helps Dan, because he is a Big Brother. Sam helps Dan because he is a Big Brother (not because Dan has issues)

Going HIS way
-could be different than  stubbornness

-It could be because of autism.
-It could be because of spoiling (when parents give up their way and kids use it for themselves)

EXPERIMENT

Since Dan likes food its a good motivation to teach him things
 (goal- disciplining- Parents are bosses over meals-Food is good for that purpose. Learning many other things along the way-colors, numbers, big-small utensils) (If you need I can come and help)

Start new things with their favorite stuff in order to attract attention naturally

1 During the day kids should eat by their own small table.

Table better to divide in 2 parts-(red and blue-learning colors)-one for each child.(Could put photos and names later) They should know their color. Dan chose first which colors he likes (teaching “Making Choices”)
Maybe use plates of those red/blue  colors

-For Dan food could be on sticks, so he could get sticks by hand and eat from stick. Before using it for real meal need to see how it works, so he’d not be frustrated. Never asks kid to do things without being sure that child knows how to do them

Language

-If a child is not verbal, he still getting language
(there is expressive language and the opposite “acquiring ”) So he needs to increase acquiring anyway.
- There is evidence that a child has normal real speech inside, but it doesn’t go properly outside, (I saw evidence to that)

-Some sounds could be turn in meaningful word-“pa-park”
“ba-baba”-maybe child would pick it up. Using any opportunity to talk to him

 Chewing things

- First need to exclude teeth issue
- making a “necklace’ from material he likes to chew and put it over the neck. Every time he chews a pillow or clothes refer (point) to that necklace. Need to know if that behavioral(as nail-biting) or physical need


LITERATURA to HELP

Dr Miller Method method
http://www.millermethod.org/
The book I have (I also have different materials from him)
From Ritual to Repertoire (  $200...!!!)

-Please write down everything new or interesting-just have a paper available in any rooms-a couple of words would be enough.  That is IMPORTANT

-When have time-please write me results of experiments so we could modify-adjust things. NO forcing for Dan on anything!

- Notice what makes Dan frustrated and see how he handles frustration. What makes him happy and please write it down
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Father didn’t respond at all.
 I asked if he got my email and he thanked me politely

VICIOUS CIRCLE

I continued to think about little Dan and his parents. He depends now on them and their decision. Their decision is based on their own beliefs and mostly on father beliefs in professional knowledge

Consider that official version about autism does not exist yet.
Consider what a mess is happening with coronavirus.
Consider that now scientists only started to learn the brain and some scientists already come to conclusion that mental illnesses is not the consequences of chemical imbalance, but result of psychological trauma and chemical imbalance is just consequences of that. 
Consider that pharmaceutical industry is openly against that “trauma idea” which could cure mental illnesses by psychological way, and would not allow destroying their very profitable  business

It is sad to think that possibly little Dan will go the official way of ABA training, special schools or inclusion-those things which official System offer to autism issue

DIFFERENT WAY

Leaning a child’s way to function is a helpful thing. And only parents could do that  not to looking at their child through disease as professionals must do
If a child feels that adults UNDERSTANDs him or her it makes a child happy to be with that adult and cooperate with that adult on everything (that is from my practice)

Unfortunately, most parents do not even try to, relying completely on professionals to tell them how to be with their child. They deprive themselves and their children great time together and important tings as trust and attachment. Parents become dependent on the System together with their children creating a vicious circle
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Father wrote again asking how much kids of 2yo are allowed to watch TV
He also reported an achievements

DANIEL's  ACHIVEMENT

BTW , Daniel has some  achievements. I manages to pick the fork and use it to put the food in his mouth.
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Would be great to understand a сause of that behavior (probably father expected only congratulations and not much of recommendations, but I couldn't help myself)

My guesses

1 Something made him scared-he could see something scary in a form of vegetable or whatever...
2 Could be sensual issue-he touched some wrong stuff and now doesn't want to touch anything

So, its good to do careful experimenting to find out a reason and not to scary him m anymore

Experimenting with his favorite food and without bringing attention to the process. As doing it by the way. If he ate from the fork NOT to bring attention to it  as " Good job Daniel! You ate from the fork".. Just distract him from the the issue kind of " Wow! strawberry is delicious! Why not to try another one It looks so nice!!"
 ....attention only on food!!!
He will get it eventually

BOOK  READING

What about book-reading activity. We did not discuss it, but that one has many great  helpful opportunities

Book should be with hard pages (carton)  so boys could turn pages. Boys should participate-actively involved . Pictures should be real-photos so it would be easy recognized
Probably Daniel would not be interested, but books for him should be about FOOD

Could be also a real food involved which would end up in his mouth from the fork or stick
(you prepare before some food which match pictures in the book. If a child recognize it-he gets the real one in his mouth! or could be any other game, which he would like)Only positive emotions about food, but with Learning elements

Boys could learn to take turns in turning pages-good skill to have
And maybe match pictures with real thing as apple which could end up in the mouse
Matching is very needed skills

Books on shapes
Opposites as "big  vs small"-small piece of bread and a big one
Unlike TV with books they can hear, see, touch and taste and even  smell at the same time. Watch which sense kid react better. Autistic kids are usually visual
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Ask Daniel little natural meaningful tasks  as "Give me" " take it to mama"-
or
" give me that (remote control) and we start TV watching
"take it to mama so she could open the door and we'll go for a walk"
"open the door as my hands are occupied"

Need to get Dan  involved in real things so they would be a part of his life
Use VT viewing as motivation to do things YOU want them to do

"We watch TV only sitting on those chairs, because its good for your back...or whatever...Please bring them and we start"
Build connections in his mind
Everything natural and meaningful(and you can create a lot of those little tasks-for routine or for discipline or for skills)

Good Luck with everything
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Father did not respond!
Recently I sent email how is everything is going with the boys
No response!