When five year old Alex arrives at Children’s Therapy Center for his weekly speech-language and feeding therapy session, he can hardly contain his excitement. Dashing through the front door, he makes a beeline for the cubbies against the wall and stashes his coat, shoes and hat in an empty slot.
“Good job, Alex!” says Erin, his therapist. She turns to his mother, Maria. “He has worked hard to learn that routine and now it’s coming to him naturally.”
Diagnosed with Autism Spectrum Disorder (ASD), Alex received both occupational and speech-language therapy through Early Intervention, a program specifically designed for children age birth to three. However like many children with ASD, his symptoms didn’t simply disappear after his third birthday.
“Our pediatrician recommended that he continue to receive therapy,” says Maria. “He gave us a list of places to call but most were too far away and hard to get to by bus – we don’t have a car. Children’s Therapy Center is in our neighborhood. We can walk here, which is so helpful!”
Alex leads the way to the feeding room, where today Erin will work on helping Alex accept new and different foods into his diet. Like many children with ASD, Alex has very specific likes and dislikes when it comes to food. The list of welcomed food includes yogurt, bananas, Oreo cookies, rice, Mexican pasta, soup, Mexican bread, and Lay’s potato chips. He has recently tried apples and – at least for now – finds them acceptable, although Maria acknowledges that might change with no warning.
Erin arranges several small dishes of snacks on the table including orange slices, carrots, crackers and applesauce. Alex becomes agitated at the sight of the carrots, a food to which he has a strong aversion. However, instead of jumping up from his seat and racing off, Alex reaches for his picture communication book, a red notebook filled with pictures that his mother made for him. He opens the book, rapidly searching for a picture of a carrot. He jabs at the picture, shaking his head.
“No carrots today, Alex?” Erin asks, tilting her head to try to make eye contact with him.
Alex refuses the eye contact but continues shaking his head forcefully. “Can you show me ‘no’ Alex?” Erin asks. “Show me the picture for ‘no.’” Alex scans the page and then flips to another one, where he identifies the picture he’s seeking. “Good, Alex!” Erin says. “You said ‘no carrots’ so we’re not going to have any carrots today!” She gently moves the dish of carrots off to the side and Alex’s anxiety subsides.
“Alex is learning how to communicate vocally as well as through pictures, which can help him manage his emotions,” Erin explains. “Without a reliable, effective way to communicate he can’t explain his needs. When a child can’t do that, it’s incredibly frustrating for them. They end up having to express themselves in other less effective and potentially damaging ways such as running away or hiding.”
Maria says that she and her husband made the decision that she should quit her job in order to stay home with Alex. “I wanted to,” she says. “The more time I spend with him, the more he improves. Unless we practice [what we’re learning in therapy] with him constantly, what’s the point of taking him to therapy? Alex and I are learning together.”
Her son’s achievements delight Maria. “Alex loves coming here,” she says. “It’s fun for him. When you make things fun for a child, they learn more. He thinks therapy is all about play time!” Her biggest goals for Alex are to continue working on communication, potty training and the transition to a full day of school. Alex is currently on the waiting list at CTC to receive occupational therapy in addition to speech-language therapy.
Very little gets past this curious, perceptive little boy. Spying a UPS driver coming through the lobby door to deliver a package at the front desk, Alex calls out, “Hola!” Then he adds sternly, “No diapers!” His mother laughs. “I buy his diapers in bulk and have them delivered by UPS to the house,” she explains. “He is not a fan of diapers. Maybe that will motivate him for potty training!”