how should a therapist handle this?

[Ktllc]

we have a therapist come to the house to work on sharing, flexibility, following someone else s idea, etc.
Tonight, V had a meltdown over several "details" (wanted to play with green coins, not yellow, wanted to play hulk and not the game that was . offered, and more). Therapist kept on telling him his choice, explaining that the color were randomly selected and basically answering all of V's arguments all the while v is crying and very agitated with body movements. It lasted fir a good 20 minutes and every time h would calm down, something else would trigger him. THERapist made V play the game with Partner but V was still in his meltdown. Despite warning V that there would be no extra time to play Hulk if he did not stop arguing instead of playing the game, Therapist decided to still play Hulk by extending the session well after it was suppose to end. THERapist declared it was a good session!!!
I asked him how I am suppose to bring V back to a calm state when he gets stuck.Therapist said that V did end up calming down and it was good. I pointed out that the only reason headlined down was that he got to play Hulk, the one thing he always wants to do. therapeutics : oh... yes, you're right.
I asked . my question again. what should be done to stop the meltdown be cause when it starts it does not stop. I explain that the evening would be tough and therapist seemed surprised "you think so?" to which I replied " I know so". and yes the evening sucked! therapist offered to bring some books and videos for me to read/watch... really??? that's his answer???
I want to work on deep issues. I don´t try to put a band aid on stuff. He tells me "I know you don't have time to talk to him like I did". I replied that do that all the time, I take the time, I have no choice.
gosh, I need someone helpful,competent in v's issues.
AND keep in mind that V is doing good right now, that is nothing compare to a V who can be anxious and just not doing well at times.
I'm tired of struggling alone. the center that tested him offers private session to work on goals that th parents choose. But like fir testing, there is . waiting list. Who knows when we will be seen...
(I'm typing on my kindle...the typos have to be worse than ever )

 

[InsaneCdn]

All I can offer is hugs.
We never got anywhere with therapists and difficult child...
I wanted somebody who knew more than I did. We got ONE of those, who was able to help "us" find some resources, push back at school, etc.... but even that therapist couldn't reach difficult child.
The rest? I was so many miles ahead of them that they were either threatened, or clueless.

 

[InsaneCdn]

By the way... sometimes the secret lies in not being so obvious.
My difficult child was hung up on colors... one color for a while, then he'd switch.
So, I became an expert on hues and shades.
Green?
Forest green, grass green, Irish green, pale green, cat-eye green... which "green" do you want?
Force a choice between subtle differences... it's less of a fight.

 

[TeDo]

Ktllc, that therapist is not knowledgeable OR competent when it comes to spectrum behaviors from the sounds of your post. Personally, I would have told him not to bother coming back and work on the skills myself. YOU know your kids and YOU know what needs working on and YOU are in a position to prioritize them ..... without intentionally putting V through all that. It reminds me of horror stories I've heard about where therapists "make" their clients get over their fears by immersing them in them for an extended period of time with no way out, no lifeline. That's basically what that therapist did to V. Poor kid.

I realize he has issues. So do both of my kids. I have prioritized their lacking skills to work on (no more than 1 or 2 at a time) and my kids are 14! I teach in the moment a LOT and have only been "negotiating" with difficult child 1 for a year now. It's not perfect but we are getting better. There is a lot of time to work with V on skills he will need.

Getting off my soapbox now. Supportive (((HUGS))) coming your way with a few extra (((HUGS))) for V.

 

[BusynMember]

Has this therapist had any contact with spectrum kids? She sounds very clueless, like she is trying to discipline a neurotypical child into not being defiant. Your son isn't being defiant...he is being Pervasive Developmental Disorder (PDD). You can't force him to be flexible. With the right interventions and time it often happens, but not by force. I would go with somebody who is specifically treating Autism Spectrum Disorders (ASD) children because she doesn't get it. You can not teach or force V to get over his autism any more than one can teach a gay person to be straight. But a good therapist can help you work with V's differently wired mind and to give V appropriate interventions.

 

[susiestar]

therapist is either extremely young/new in her job or a total idiot. I don't see how she helped V in any way. She DID teach him one thing: that she doesn't mean it when she says things. She said there would not be time to play Hulk but then she stayed late to play it anyway? Sorry, that just sabotaged many of the thngs she is supposed to be teaching him. It irritates me beyone belief when a therapist or teacher or even another parent does this. Say what you mean, and if it comes out of your mouth, stick to it, make it happen.

Would a different therapist be possible? One with either more training, more experience, more common sense or all 3? The LAST thing V needs is inconsistency.

Would working with an Occupational Therapist (OT) on sensory issues help get V to a point where he could get more out of therapy wtih a therapist? Or maybe play therapy would be better? I don't know what this therapist's goals for V are, but I can't see how she is doing much to achieve them.

 

[buddy]

I think as usual your gut is telling you what's wrong here. We teach choices and flexibility slowly and positively by laying out the choices on a choice board, putting them either in a short sequence or using a first_________ then________ board. What goes in "first" is highly do-able and not one of the known struggles when we start to teach this...... (What goes in "then" is what he loves or wants....like the hulk). I still use first....then......verbally sometimes with q.
Just my two cents.


by the way, this is all based on kids who dont do well with abstract and need high structure, concrete procedures. So, for the choice board start with only two things then build up. Keep super high interest things off or they'll pick that. Have a separate board for the then choices (things you knoe theyll love) when starting this....

it eventually can be used by you......putting for example, first bath then story or first math then cookie. if a.child gets stuck in whatever task they do you can add a visual timer (which are sold as apps now) so they have to either stop when it ends or for soyme kids they use that toy or do that activity at least for the time you set. (start low then if it's a choice they don't like to do long)


LOL I keep editing this......
If a child keeps picking the same things you can use a bag to pick choices or a spinner board with pics all around in a circle.

 

[Ktllc]

I have called the therapist today and left him a voivemail. All I said is that it is not a good match for our family and that he could call me back as I really don't like saying that through a voicemail. I don't know if he will call back, I'm just trying to be considerate.
I called the Autism Spectrum Disorders (ASD) center today in order to get some tips on what I try to do and our case manager gave me a lot of ideas that match Buddy's suggestions!
husband and I set some time today to talk about frustrations and what strategies that V can use. We all acted what upset looks like and came up with: go to your room for some quiet time, go in the swing or squeeze hands into fists several times. The problems: V was really not sure what we tried to explain! He claims to never recalls his tantrums. He just kept on saying I don't know to everything and almost being upset by the conversation. I believe it was a bit too abstract for him... I'm currently making some picto cards to give him a visual.
Like always, it's all about getting the rights words, the right time and the right pictures... It will definitely take several trials.

 

[TeDo]

Ktllc, first HE needs to recognize when he's getting upset. You can talk about it ahead of time so he has a clue what you're talking about but until you catch him in the moment and talk about how his body feels and what he's thinking at that EXACT moment (before it gets too bad), it is going to be too abstract for him. You're doing fine. Recognizing the body signs is the first thing you have to try to teach him. You can do some pre-work like talking about how YOU know when you're getting upset and explaining that to him so he knows it's not just him. That's where we started and we put labels to the feeling that go along with a particular set of "symptoms" that difficult child 1 feels. He needed to learn to recognize the physical/mental signs that go with his different feelings before we could work on what to do when he felt/thought those things. Do I even make any sense?

 

[Ktllc]

Yes TeDo, you make sense. V recognizes 3 feelings now: happy, sad and mad. A year ago he could not recognize any feeling! So we are progressing, just very slow. Instead of using my own words (upset, frustrated, etc..) I probably should start with HIS words. Really never thought of it in those terms. So yes, thanks for your input.
It is exactly what I love about this forum: brainstorming together.
We have tried to start with the feelings first, but went nowhere. Starting with the visual signs is probably best for V. It is sometimes hard to remember how concrete he is.

 

[buddy]

Lol! that's what happens when you're so old and do this a long time. Q used to have a little feelings book with actual pictures of him....I have to say this is an area he has learned alot about and uses it, but truly has been ongoing direct teaching and cues.

For the building up to rage times, maybe even during it, you might be able to have a single sign/word. Sometimes it worked for us to do a T for time out. we practiced when not in a rage. said stop, think, and then he had to choose where to go to calm. we also did "candle" blowing like holding up fingers and blowing each one out.....(deep breathing).

look up"tolerance for delay" procedures .....school had great success with q with this, me not as much but I didn't do as many tasks with him.

 

[TeDo]

Ktllc, those are the EXACT 3 feelings difficult child 1 could "identify" just a year ago and he applied those labels to situations that were not those, like saying he was mad when he was really only frustrated. Now he has included frustrated and nervous. You might want to try figuring out what YOU notice when he appears in a certain "mood" he doesn't know. Then you can say something like "I see you're breathing faster, do you feel that?" or "I see your face muscles are getting tighter, do you feel that?" and tell them what those signs tell YOU. That way he can either correct you or start feeling it himself. If he notices, then use those signs and put a label on them. Eventually he'll learn to do that himself. My difficult child 1 is 14 and he can only identify 5 feelings. For us, that's progress. I'm tickled V can identify 3 at his age.

 

[Ktllc]

Tedo, V can name those 3 feelings but does not always apply them approprietly and certainly cannot say how HE feels. He is able to say "I feel good or I feel bad". But a year ago he could not even name those 3 feelings. So yes, it is progress. Looking at books, he is able to label all 3 the right way. I actually think it is one of the reason he is diagnosis with Pervasive Developmental Disorder (PDD)-not otherwise specified and not High Function Autism. He has a basic understanding of feelings or why people act the way they do. Applying theory to reality is harder.
Yesterday, we had a mini meltdown about what movie to watch. We all agreed on pirates and V wanted dinosaur. It was done without preperation but both husband and I jumped on the "first...then..." technique. We promissed that the next day (today) he would watch the dinosaur movie. He had a hard time understand why he could not watch it right now, the notion of democratie is not easy! . But long story short, V was able to calme down within minutes and enjoy the movie he had not chosen.
Most of the time, it's not so much about coping techniques but a need to understand why he can't have his way all the time, why his choices/wishes have to come second or third sometimes.

 

[TeDo]

Good for you and husband and good for V. Yes, that is the hard part and we are still working on it here too. He's making progress, although slowly. Keep up the good work. By the time he gets to be the age I'm dealing with, he'll be WAY ahead of the game. KUDOS

 

[TerryJ2]

I agree with-Susiestar, that the therapist sabatoged the whole thing by giving in. If you say no, it's supposed to be no. It's supposed to teach difficult child how to cope, how to handle the change in routine and thought patterns. All she did was make him wait.
I like the idea of getting him to understand the "why" of things, like the movie, and giving him delayed gratification, so he can watch the movie of his choice the next day. I've noticed with-my difficult child, he would eventually become interested in whatever was on the TV, even if he didn't choose it, because he is just drawn to the TV and videos. Unless he was in full-blown meltdown, we could work around it and distract him.
You're doing a great job.
I had to chuckle at Insane's idea to implement shades of green. I'd try it and see what happens.
It is huge progress when your difficult child can name feelings and use the words. I cannot tell you what a change there has been in this household because of it!

 

[DammitJanet]

K...those are the first 3 emotions I could identify when I started therapy in 06! So your little V is in a really good spot considering how old I am. I literally could only identify 3 emotions inside myself. I worked very hard up until the end of 2010 when I lost my therapist to overcome my problems but I gotta tell you that in the past two years I have backslid quite a bit. I do have high hopes that the kids who get all this during their formative years will have a much better outcome than someone like me who came to the game so late in life.