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Detren
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02 Apr 2008, 9:26 am

I am highly considering a time line/list to help us get ready in the morning. Mornings are frustrating for me and my 8 year old. I know lists can be a great thing for many people, but I am a little concerned that it may backfire on me. (sectioned plates backfired on me! oh my goodness.) My child has OCD tendencies, and I am concerned that he will become overly dependent on a list/ time line.

Why I think this may backfire on us: Let me share our experience with sectioned plates. My child does not like his food to touch, and would not allow more than one thing on his plate at a time. So he would eat it all, then I would give him something else. I decided to try sectioned plates with him. He LOVES his sectioned plate, BUT it has backfired on us. If we go back to a single plate he wants a new plate for each item or for me to wash it between items (I have refused to do this, and he just says "ok, I think I am finished eating then.") He still only wants one thing on the sectioned plate at a time, but now insists on a separate eating utensil for each section on the plate.

We are now taking steps to counter this from getting worse. I have talked to him and we have compromised to an extent. I understand about not wanting food to touch, it makes me shudder inside when something wet leaks over to something else on my plate that it would not normally go with. The compromise is that he may keep his sectioned plate, but must use the same utensil for each section. He is allowed to lick it completely clean and use his napkin to dry it off after he is finished with one item, but is NOT allowed a new utensil. He must also allow me to put, and I agreed to be VERY careful not to drop things into another section, everything he plans to eat in the meal on his plate at one time into their respective sections.

The neurologist believes that we should just get rid of the sectioned plate completely.

I guess I would like suggestions as to what to put on our list, and what to leave out. my idea is:

7:45-8:00 get up and start breakfast (child's name: Medicine)
8:10: We should be getting washed up and brush our teeth
8:20: Find our clothes and put them on:
*Take off dirty clothes
*put on clean underwear
*put on clean pants
*put on clean shirt
*put on clean socks
*pick up all your dirty clothes and put them in to the dirty clothes basket
*check hair in the bathroom mirror
8:30: Shoes, coat, (and hat if we need it today)
8:32: Bookbag and head out to wait for the bus
HAVE A GREAT DAY!


anyone have suggestions for my list? (and yes, I feel that I have to specify put on CLEAN x, because I can't tell you how many times he has stripped down and put the same clothes back on, and we have to restart the whole thing.


------------
Yes, this is a repost, I initially posted it in the general section, but it faded into obscurity with no response. If a moderator is reading this, please delete my other thread.



katrine
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02 Apr 2008, 11:11 am

We use a system called TEACCH. We use a schedule: laminated signs that stick with velcro to a board. The smart thing about this is that it is the list itself - not the contents - that create security. Velcro means that you can change the order of activities. The child reads the list, knows what is going to happen, and feels secure.
It is a common misconception that schedules create rigidity. If they are used correctly, they actually make the child more flexible.
I have had a tendency to do things exactly the same with my son - the same routines, the same walks, ect. While I don't mess with the morning routine, I was actually advised to change the routes we walk - to keep him flexible!
I find that as long as I make a list/schedule, he manages fine. This makes it possible to do lots of stuff without him becoming overloaded and anxious.



Last edited by katrine on 02 Apr 2008, 2:14 pm, edited 1 time in total.

Jennyfoo
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02 Apr 2008, 12:45 pm

A few suggestions for you that have worked really well with both my AS 9 y/o and 5 y/o ret*d son.

-have him pick out clothes the night before and set them all out, ready to put on in the morning.
-have him get dressed before breakfast. Then breakfast is a motivator for getting dressed.
-use more concrete language. Instead of "we should be getting washed and...." say "Wash hands, wash face, brush teeth." "Should" leaves room open for interpretation.

I agree that he may become dependent on a list, but it he has the same routine/ritual behavior every morning, things will go more smoothly as it is comfortable and familiar. He may become just as dependent on a routine without a list.



ster
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02 Apr 2008, 1:53 pm

the great thing about a velcro board is that you can let your child have some control over the order of things.....for instance, if he wants to put his socks on before he puts his pants on-so what? at least he's doing it...............i agree that this form of listing items to be done is the most flexible method & is the easiest to change. when you start the system, make certain he knows that he is to do the items in the order that they are put on the velcro strip. you could put pictures of him gettting ready, but this might lead to problems if he gets stuck on , for instance, having to put on the same exact shirt that's in the photo-if this is the case, generic pictures or clip art would be better

Re: the divided plate.....We all still eat off divided plates. The bottom line for us is that we are eating. prior to the divided plates, there were issues with foods touching etc...........I personally don't see anything wrong with using divided plates. They use them in school cafeterias too, btw.



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02 Apr 2008, 3:45 pm

If your son is on medication, make sure it's not something that increases obsessive tendencies. Read all of the possible side effects.

I use lists with my son and that has greatly decreased his aggression and tantrums. He doesn't obsess over the lists. I was somewhat concerned that he would obsess over lists or reject them. I actually initiated the list making by posting my own "To Do" list for myself, somewhere he could see it. He was so fascinated by my list and the fact that I was checking items off as I completed them, that he wanted a list of his own.



Detren
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02 Apr 2008, 4:38 pm

I've been looking at the TEACCH thing on google, I just can't find an image. I might be able to do something like this from a craft store, with either velcro or magnets. Or possibly a dry erase board, but the smell of those makes me feel ill. If you could find an image of one, please let me take a gander.

Yes, I will take out the shoulds, good idea there. Getting dressed before eating won't work with him, he is a very messy eater and by the time he got finished he would look like he slept in the clothes and have food stuck to them.

He is on Metadate in the mornings and Ritalin in the evenings, we are still adjusting the Ritalin dosage, we just went back to half a pill on that.

I sometimes make todo lists for myself also, I use the "notepad" program on my computer and put a - in front of finished things and a (note) note after things I need to note about it.
*-pay electric: (6billion dollars, check 4567)Ref# please don't turn off my power!)
I would rather not keep him looking at the computer all day, though. I was thinking something a little larger, like a poster on the wall actually.

The order I wrote my things in are in the order he gets dressed already every day.



ster
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02 Apr 2008, 6:49 pm

here's some info . it has pictures of the velcro boards, & directions & suggested sources for images. hope this helps

http://www.polyxo.com/visualsupport/makingpecs.html



mom2bax
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02 Apr 2008, 9:38 pm

if you want to do a magnet board, get some stick magnetic strip stuff, available at most craft stores and you can, put it on a metal baking sheet that you hang on the wall
or get a coark board and just pin up the routine
or go really low budget and masking tape it to the wall in order.



katrine
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03 Apr 2008, 2:25 am

Why is he on ritalin in the evening? Can he sleep :)
I know ritalin makes some kids get tics like Tourettes, but I don't know how it effects OCD tendencies.
My son is on ritalin/Strattera, and when the ADHD is medicated, the autism is much more visable.
Is it possible that this autistic trait is what you are mistaking for OCD, or is he outright OCD?

One last critical question :)
Do you have a child psychiatrist, or only a neurologist? I'm asking, because my son's neurologist knows zit about autism - and medicating autistic kids.
Autism is such a niche, that you really need an expert for advice on how to deal with behaviour issues. We use the psych. for medication problems, and teacher/psychologists who are in the autism field for schedules/structure/visualisation ect.



annie2
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03 Apr 2008, 2:38 am

The timetable sounds good, but I probably wouldn't put so many times on it. My 7yr old has a timetable with when he has to be up by, then a list of all the things that have to be done in between (that he ticks off), and then a time to leave for school. If I put a lot of times for everything, I would find that he'd waste time standing in front of the clock, waiting for it to be the EXACT time before he does the job! All the best. :D



Detren
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03 Apr 2008, 8:47 am

With the metadate he has developed an eye tic, but he does not seem bothered by it. His words "it's just something I do now." (and shrugs)

So far he only has the neurologist working with him, we have had only one appointment thus far. The metadate wears off in about 8 hours and it's about gone/ or gone before he gets home from school. The neurologist has us trying ritalin just to see if it will be a big enough difference. Without the metadate he sits all day at school and just twidles his pencil and hums ALL day. Does no work. He pays attention, but does no work. First day on the metadate he did all of his school work the entire day. We would work all night on 2 pages of homework, and might not even finish. Some days, however, it was wearing off before we could get to our homework and it was still taking all night. The difference, however, was vast. (even with just the metadate, I think that the "I had a good day at school" thing helps greatly and makes homework less stressful.)

We are trying the ritalin to help him keep focused for homework, and are still adjusting the dosage. I think it was too high. I don't know that I really want to keep him on it though. I have an appointment to evaluate the benefits of it next week. Benefits: less breakdowns (crying over nothing, stomache aches), quicker homework times, more play time Cons: yells more, pushes (seems to have replaced the crying), sense of taste is way off (everything is yucky and he already has problems getting enough nutrients), appetite down, more spinny (twirls).

We have a referral to a "feeding clinic" from what it looks like, it's a nutritionist with experience with children with OCD tendencies. (I am 2/3 through the paper work to get his appointment and plan to finish them by tomorrow. They gave me BOOKS to fill in.) I have told him about this, and oddly enough, he has been trying to eat new things to "practice getting ready" for this. He put a large piece of brocolli in his mouth and said, "Mommy, I think you forgot to take the hair off of this brocolli. Could I please spit it out?" So after explaining that it wasn't really hair :D we decided to just try a piece that was more or less just stemmy. Wonder of wonder, he was game, but it still felt bad and tasted bad, even though it was no longer hairy. He has agreed that he will try other vegetables just to stay healthy, and I promised to buy different ones until we found one that was actually yummy. (no hairy veggies though:D)

I'm going to sit him down and talk about it with him, to an extent I think he should be able to have a say in all of this, especially since the ritalin is really in his "down" time. The benefits of the metadate are huge though, and I think until he is a little older it stays.

annie2: Yes, I can see him waiting for the EXACT time. I already get in trouble when I say, c'mon guys, we need to move a little faster, it's already 8:20. (and it's only 8:19). He is a slow mover, and I might try the times first anyway, even WITH him watching for the exact times. I am a little more concerned that he might take too long on one thing, and then freak because he is running late. If he just has a list with no times I can see him getting easily overwhelmed with so many "items" on it. He will sit and hold his socks and forget that he has them in his hands sometimes until I prompt him back to them. (normally only because he is talking about something, or worrying about something.) At least 15 times each morning I have to say something like: "Honey, that really is interesting, but I do need you to finish putting your socks on. Put your socks on, then finish telling me, I'll wait."

My grandma has this blue cloth thing with clear plastic pockets for children's memory versus at church, I might be able to find something like that and use index cards to put in the pockets, that might be easier than velcro. (just have to hang it high enough that the 2 year old doesn't run off with half our list.)

Wow, I seem to have rambled a little off topic! haha. oh well, guess I can't really hijack my own thread.



katrine
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03 Apr 2008, 10:23 am

hairy broccoli :lol: :lol:


So just to get things straight: your son has AS, ADHD and OCD tendencies. Is he diagnosed ADHD/OCD? Could it be Tourette's? (don't in any way mean to suggest he isn't these things, but it would help help you if I knew :) )

I ask because a lot of the symptoms you describe as OCD could "just" be AS - but if they ARE OCD, maybe medicating OCD would help him much more than medicating ADHD. Also, I think the ritalin could make OCD symptoms worse. The pushing and yelling on ritalin really worries me, as it sounds like a lack of impulse control, which is exactly the kind of thing ritalin is supposed to "fix". So either the dose is too LOW, or the drug is wrong for him.

If the symptoms are AS + ADHD:
Have you thought about Strattera? We're trying it with my son, I'm not sure what I think of it yet, but it sounds good: it works 24/7 and doesn't effect appetite. You see, my son was having the same problems yours is with ritalin: bad afternoons and evenings, and no appetite. (He thinks everything is pretty yucky when he's on ritalin!)

If he has AS, ADHD, and OCD it don't know what to suggest :) He would need medication for both ADHD and OCD, and I would think you would have to find a really great doctor (childrens psychiastrist) with HEAPS of experience with kids with autism and comorbid conditions. It wouldn't be a job for just any doctor or even neurologist.

Appetite and food: heaps of AS kids have sensory problems with food, just like you descibe. This is pretty nornal for AS. It seems to get worse with ritalin, because they just aren't hungry.

It sounds like a good idea with your mothers blue book for cards :) I used clipart for a long time - now use boardmaker.

Hope some of this is usefull. Otherwise correct any wrong assumption I made along the way.... :)



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03 Apr 2008, 10:35 am

I'm still intrigued by the need for separate utensils for each section on his sectioned plate. My son insists on a different utensil for each type of food if they are different flavors, like he has to have two spoons if we are having peas and pudding (not together! gross!).
I don't see the big deal with it, so I let him do it. What's the problem with washing two spoons instead of one? My husband can't understand it, but he doesn't do the dishes so he can't complain....besides, he has his own quirks. :wink:

I like the idea of the velcro board for helping your son to get dressed in the morning. I agree that it doesn't so much matter the order in which he dresses, as long as he gets out of the house with all the necessities for the day. And if he is able to mix it up a bit, then there isn't a danger of your list backfiring.

Can I just say how much I love this forum? :)



katrine
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03 Apr 2008, 11:12 am

OOPS I just read your post on another thread, so some of what I said is not relevant. Sorry.



Detren
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03 Apr 2008, 1:26 pm

Runt wrote:
I'm still intrigued by the need for separate utensils for each section on his sectioned plate. My son insists on a different utensil for each type of food if they are different flavors, like he has to have two spoons if we are having peas and pudding (not together! gross!).
I don't see the big deal with it, so I let him do it. What's the problem with washing two spoons instead of one? My husband can't understand it, but he doesn't do the dishes so he can't complain....besides, he has his own quirks. :wink:


It's not the problem with wanting separate utensils, it's the fact that it seems to be expanding. It went from only needing to finish one thing at a time, to having to wash things between tastes, to that PLUS separate utensils, we have to draw a line somewhere because it was steadily escalating. (dishes aren't my favorite thing either, and I don't have a dish washer.) I already let him get a new glass every time he wants a drink, but that's mostly because if you walk away from your beverage here the baby steals swigs of it.) We also have a rule that we all sit at the same table and we stay in our chairs until everyone is finished. Lines have to be drawn somewhere and that is where we chose to draw them.

The issue with washing 2 spoons instead of one, is that tomorrow he might want 2 plates instead of one, and the next day it might be 2 spoons, 2 plates, and he must stand while he eats, and the next day, all that and he has to wear his train hat. Where does it stop?

And sure, you can say how much you love this forum. haha

We are still figuring out half this stuff, we just got our diagnosis and go back this coming week. My mother is trying to bribe him into going to the beach, but I don't think he's going to go. I would have to cancel his next appointment (only a check up with the nurse but still...) but it's a once a year vacation, so I am leaving that up to him.



Runt
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03 Apr 2008, 2:55 pm

Detren wrote:
Runt wrote:
I'm still intrigued by the need for separate utensils for each section on his sectioned plate. My son insists on a different utensil for each type of food if they are different flavors, like he has to have two spoons if we are having peas and pudding (not together! gross!).
I don't see the big deal with it, so I let him do it. What's the problem with washing two spoons instead of one? My husband can't understand it, but he doesn't do the dishes so he can't complain....besides, he has his own quirks. :wink:


It's not the problem with wanting separate utensils, it's the fact that it seems to be expanding. It went from only needing to finish one thing at a time, to having to wash things between tastes, to that PLUS separate utensils, we have to draw a line somewhere because it was steadily escalating. (dishes aren't my favorite thing either, and I don't have a dish washer.)

Right there with you--I have a family of 6 at home with no dishwasher. Sucks, doesn't it? But I do get your point about having to draw the line somewhere and I totally respect that. Plus, it gives me something to think about with my lil one in the not too distant future.
Detren wrote:
I already let him get a new glass every time he wants a drink, but that's mostly because if you walk away from your beverage here the baby steals swigs of it.) We also have a rule that we all sit at the same table and we stay in our chairs until everyone is finished. Lines have to be drawn somewhere and that is where we chose to draw them.
Yeah, we do the new cup for each drink he gets, but they are the tiny Dixie cups that I don't have to wash, thank you Dixie! However, he won't throw them out but stacks them on the sink. He doesn't care if I throw them out, but he refuses to do it himself. Again, I completely understand having to draw a line somewhere, and what is appropriate for one child may not be right for another.

Detren wrote:
The issue with washing 2 spoons instead of one, is that tomorrow he might want 2 plates instead of one, and the next day it might be 2 spoons, 2 plates, and he must stand while he eats, and the next day, all that and he has to wear his train hat. Where does it stop?
Gotcha.

Detren wrote:
And sure, you can say how much you love this forum. haha
Well, I thought I was loving it, but now I am not so sure. Honestly, there really is not a place on the Internet for me. :?

Detren wrote:
We are still figuring out half this stuff, we just got our diagnosis and go back this coming week. My mother is trying to bribe him into going to the beach, but I don't think he's going to go. I would have to cancel his next appointment (only a check up with the nurse but still...) but it's a once a year vacation, so I am leaving that up to him.

I wish you the best of luck.