The New Approach: Evelio's Re-Evaluation

At our family therapy session on June 8th, Evelio's therapist told us that he had finally gotten in to see the head ABA therapist (after being at the school for a month and a half!) and that she (Dr. Chandler) had totally changed his care plan.

Keila showed us the behavioral notes for Evelio for the past 2 weeks and he was having 12+ aggressions on day shift and evenings and around 1-3 on overnights. :(. . . .

As I said, Dr. Chandler re-evaluated Evelio. She sat through all his class time and observed him at leisure activities also. She concluded that his aggressive outbursts were mainly due to him not understanding what is going on. She said that they were trying teach him things well beyond his level of comprehension and it was stressing him out which led to frustration and violent outbursts. She estimated his functioning level at only 9 months. When I heard that my eyes filled with tears. When he was evaluated in June 2010, when he was 2 and a half years old, the Child Study Center at OKC children's hospital estimated his functioning age at between 8 months and 13 months in various areas. 8 months was the estimation for expressive and receptive language. And now, a full 2 years later, with therapy and school implemented during that time, he has regressed in most areas to 9 months! So, Dr. Chandler decided to changed their approach.

- Stop Potty-Training
At first I didn't like that. I want him to use the toilet. However, keeping in mind that his mental age is only 9 months, we have to think of him as being a 9 month old baby instead of looking at the monster almost 5 year old boy that he is. Now it is impractical to teach a 9 month old baby how to use the toilet, correct? Now I see why they want to stop. Evelio is seriously delayed in more important areas that we should be worrying about right now. Looking at it that way, potty-training in my opinion can be put on the back-burner. Now, Evelio has NO problem peeing in the toilet. He does not know when he has to pee, but he knows when he is in front of the toilet, that he should try to pee. He has memorized the routine of pulling his pants down and standing to pee, flushing the toilet, and pulling his pants up. Even when he doesn't need to pee, he still pushes and tries to pee. If you try to sit him on the toilet, he freaks out. So they are still going to take him to the toilet every hour so that he doesn't forget the routine. But that is what we need to bear in mind. He is not actually potty-trained in #1 because he doesn't know when he has to go, he has only memorized the routine of what is supposed to be done when he sees a toilet. There is a big difference.

- Work on Cooperation and Compliance
In order to teach Evelio anything, they need him to cooperate and comply with tasks. Evelio can barely sit through 1-2 minutes of anything before becoming frustrated and restless. Therefore, they are going to stop trying to teach him any new academic skills at the moment. They are going to set him very short assignments (lasting a maximum of 5 minutes). He will have his assignment and a short playtime immediately after and then back to another assignment. This will teach him the concept of "if I do this, after I can do what I want". Ultimately, this will serve as his motivator for completing tasks. Also, they plan on rewarding him for EVERY good thing that he does. Meaning, when they tell him "Pick that block up" and he does that, BAM he gets a Skittle. Then they say, "Put the block in this bucket," and he does it, he gets another Skittle. This will make him more inclined to follow directions. Once he grasps that, they will only give him a Skittle for every 3 things he does right, and so on and so forth.

Now, after he starts cooperating and complying, they will start increasing the time of assignments and decreasing the playtime following, until his assignments go from one to another with no playtime. Then, after he is cooperating with that, they will start increasing the level of difficulty on the assignments very gradually.

This is going to take a LONG time. They told me to take the small achievements as huge ones. That's something they don't need to tell me. I have been doing that for 2 years already. I take nothing for granted when it comes to what Evelio can do and what he knows. I have mixed feelings on this session. I feel very happy that they finally know how they are going to approach him and help him. I am happy that they do believe he can be helped and taught. But, also I feel very crushed at the fact that he's only at a 9 month level. Him regressing even after 2 years of therapy and school makes me think that maybe nothing will help. I try to steer myself away from those thoughts. This is definitely not the life I wanted for my son. I can only hope that through the school staff and therapists and my efforts and with time, he can make progress. . . and not regress. . .

That's all I have. . . :(