by KC Kelly, Ph.D.

Autism: A Case Example of Hope

Alex’s (name has been changed to protect anonymity) mother sat across from me and cried into her hands. “I just don’t know what to do anymore,” she began. “From the moment he gets home from school, he races through the door and right to the couch in the living room where he throws all the pillows onto the floor and begins to run back and forth jumping all over both of the couches. I’ve tried everything to stop him, but he doesn’t even seem to realize that I’m there. He’s in his own world. He climbs on the wall unit, breaking things and one day it almost fell over on him! He will also throw tantrums by screaming and crying at the top of his lungs for hours and I don’t know what he wants!” She stopped talking and continued to cry.

Alex has autism. He is five (5) years old and falls into the lower end of what we call the Autism Spectrum. He does not talk, does not communicate, and exhibits aggressive behaviors such as hitting, biting, pulling hair and scratching when he does not get what he wants.

What is Autism?
The experts define autism, also called autism spectrum disorders (ASD) or autism spectrum conditions (ASC), as a spectrum of psychological brain developmental disorders characterized by widespread abnormalities of social interactions and communication, and often patterns of highly repetitive behavior(s). Just like with any child, or any person with a disorder, symptoms and behaviors can vary greatly amongst those with autism.

The Bad News:
There is no known cure for autism.

The Good News:
No matter how low functioning the child, autism IS treatable and a child with autism CAN grow, learn and change.

The Scenario:
Alex goes to school in an autistic class and follows a schedule throughout his day with his peers. He works with professionals in the field of autism, so his behaviors ARE controlled to some degree. This is a definite indicator that Alex CAN learn at home.

My Challenge:
To help Mom become an expert, not necessarily on autism, but on her son.

How We Started:
Firstly, Mom and I did a home make-over into a child-proof safety zone. Next, we talked for a while about what needed to be done to help change Alex’s behaviors at home. I explained to Mom what Alex needed: Routine, Consistency, and Repetition as I witnessed a complete absence of all three of these imperative factors for change in the home. Sound simple to do? Well, the idea is simple. The execution of the idea? Not so much.

1. Routine: An autistic child needs a steady, consistent and solid daily routine. They also need to know what the routine is in a very visible, clear and easy to understand way. If an autistic child does not have a daily routine, this could be the reasoning behind exacerbated acting out behavior(s). I made Alex a picture schedule including his entire day of activities from the moment he woke up in the morning until bedtime. Introducing the schedule to Alex was not easy, but with repetition he stopped testing us and it became routine. Now the test would be to see if Mom could enforce this consistently everyday.

Note: Schedules can be made using either use words or pictures depending on the academic level of the child. The schedule is usually made from small laminated cut outs containing the words or pictures, and with the use of velcro, are put upon a rectangular shaped piece of colored cardboard. (This is how I do it.) The activities of the day are all present and flipped over to show completion. A child should never start an activity without checking their schedule, and similarly, he/she should never end an activity with flipping the piece over and seeing what is next on the schedule.

2. Consistency: Never break the routine. I understand that “life happens” and we must leave room for flexibility; however, for the most part, the way a child is going to learn best is through consistency. The best way for an autistic child to learn is when they know what to expect. This also helps to reduce anxiety and increase reliability and a comfort level conducive to learning.

3. Repetition: An autistic child needs repetition. In order to learn, things must be done over and over and over again. It is important to have patience and if your child is not “getting it” right away, try not to get upset. Instead, take a deep breath and DO IT AGAIN. Repeat, repeat, repeat. And then praise.

Important: When introducing something new to an autistic child, you want to do so in a soft and gentle, yet firm manner. It may be very frustrating at times; however, use you must use repetition without losing patience. I promise you will be rewarded when manipulation ceases and learning begins. I also showed Mom how Alex learned that FIRST he will do a task and THEN he will get rewarded. I usually like rewarding with verbal praise or a small healthy snack. It all depends on to what the child responds best.

The Terrible Tantrums:
“Alex will SCREAM and cry for HOURS,” said Mom with exasperation. It was indeed a piercing scream that I witnessed myself on many occasions, and when I think of that noise today, my ears start to ring. I made pictures of basic needs, such as bathroom, hungry, thirsty, pain and demonstrated to Mom how to use these with Alex. If none of those things were bothering Alex, we knew he was attempting to manipulate Mom for attention or because he was upset that he didn’t get something that he wanted. Mom needed to stay consistent in not giving in to Alex’s tantrums no matter how heart breaking they were to watch. She needed to allow him to “cry it out” until he was willing to either communicate with us using his pictures or give up his manipulating tactic.

Remember: We need to never get upset at a child who has difficulty communicating, but help them the best we can to let us know what they want/need.

After working for approximately 6 weeks, 2x/week with Mom and Alex, Alex changed his behavior at home dramatically. It was a long road. It was a frustrating road. But it paid off. Now that I’m not there anymore in the home to help, I can only hope that Mom (and I DO understand how difficult it is) will remain consistent with Alex’s home routine and use repetition, patience, and love when teaching him new things.

If you are looking to get some specific questions answered about autism or to help you with an autistic child, whether the child is your own or a student of yours, please feel free to write to me at: www.DOCintheBiz.com. I would love to hear from you.

All my best,
KC Kelly, Ph.D.

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