Therapy homework and 8-year-olds

[macchiatto]

Leo had an unintentional therapy break since fall of 1st grade (graduated from PT and OT but was waitlisted for the others). Now he's restarted speech and PT and soon will be starting OT and CBT as well. He hasn't had multiple therapies at once since he was younger and I'm wondering; at this point, is it best to make him responsible for doing his therapy homework? Any suggestions on a system to help him keep track of it? 

[freezorburn]

What does the therapy homework entail? Is it something that could be customized to a token board?

[mrsbuttinski]

Given that you now know you are up against an ASD-mindset? Oh. Hell. No.

At least, not at first for a whole raft of reasons.

1. Your child tends to be low energy even by spectrum standards. You are inserting a lot of therapy, all at once. The list exhausts me just reading it; I predict cooperation will be dependent on his level of physical and emotional fatigue.

2. Recognize that you are up against the black & white thinking unique to ASD minds. He's bright and aware that he is being asked to work on things about himself that are not up to an expected standard which can sometimes translate to feeling badly about themselves or denial that there's an issue. Or there may be anger at the injustice that he has to work on something that others don't.

3. Understand that therapy will likely look different than the warm and fuzzy kumbaya approach you may have experienced in EI. It's not going to look so much like play anymore because PT will be working on physical strengthening and if that were his thing, he'd already be choosing such activities. OT is going to be handwriting and shoe-tying which he probably already loathes. Speech for social skills will be a reminder of his differences as it will likely happen with kids who are noticeably impaired and generally annoying. And CBT is hard work as it requires admitting to "shortcomings" and confronting them.

YMMV, but we found a matter of fact approach with recognition of the hard work and unfairness the best practice. It helped to reference previous growth and success when hitting a wall around some new skill.

4. To that end, where you can, try to make the practice of skills part of your lifestyle. Look for real world and relevant places to practice skills. Instead of stringing beads, see about model building. Practice social skills at scouts, Sunday school, the park. Go for a family hike at a local park. Where you can, find a fun approach, there are typing programs that play almost like a video game for instance.

IME, by the time he's mature enough to take full ownership of applying himself to therapy he needs to be his best self, he will have outgrown the need for most therapies.

[mamaturtle]

There is no way I would be able to tell DS to take care of his therapy homework because it will never get done. And I would be the one correcting DS or reminding DS to do fix whatever behavior is negative for his well being I have seen done in action at therapy sessions.

For OT and PT, I do have to remind DS to put his heels down when he walks with "heel, toe" and I have to remind DS not to "w" sit when I catch him doing that. I do need to add some exercise activity somehow and hope daycare summer care will keep him active till I pick DS up for therapy.

For ST and ABA, I put into practice asking for things with manners and trying to implement talking on the phone with relatives. I don't know if text messaging relatives is any helpful but DS does text DH. I am also correcting DS for fake crying like a baby to not do that.

Any other skills that need work I don't have time for because I work full time and just want to get through evening routine like everybody else.

[macchiatto]

Thanks for the input! The insights were very helpful, especially since he hasn't really had any ASD-specific therapy so far.
He's super diligent about school so I wasn't sure if this would carry over.

A token board might work. (You mean like a reward chart?) Specific things so far are for example, his SLP wants him to make a list throughout the week of three problems that they can talk about during his session (since they're working on size of the problem and he can never seem to think of any on the spot). He's also supposed to remember things while eating (very messy eater for his age) like wiping his face after every 3 bites.

He just started PT but so far she asked him to practice his wall sit and superman position. She suggested he try reading a page or two in those positions.

[macchiatto]

mrsbuttinski that is a great point about all the therapies as well. He had 4-7 appts/week when he was younger, but that was in preschool so he wasn't also juggling full-day school (and some of them were only 30 mins).

The one good thing about it taking a while to line up all his therapies is it's helped with a more gradual start. Speech started in Feb, PT started a week ago, OT starts early June (the week after school gets out) and CBT will probably start about 2 weeks after that. And you are spot on that his level of cooperation has been very dependent on his level of fatigue!

[freezorburn]

I guess it's like a reward chart?

Here's a pic on one that DS was using during his therapy sessions, and later on I adapted it for his bedtime routine.



The tokens were blank when he used this board with his therapist. I drew on them later to work on our bedtime routine steps. He's not reading yet so the headers don't really matter.