Special Needs

Intro and question

Hi!  I'm Cleo.  I have a 2.5 year old boy who is smart, sweet, funny, adorable and receiving services for global developmental delays through our state's EI program.  He receives speech, physical and occupational therapy and also qualifies for a special education teacher.  He is being followed by a dev pedi who is unwilling to diagnose him with anything beyond global developmental delays at this point, except to say that he does not think DS has autism, as he is socially on track.  I'm not sure I fully agree with him, but don't think that DS would get any extra benefit from having an ASD diagnosis right now, so am willing to let that be.  DS has been receiving services for about 8 months now and has made tremendous progress.  I'm not sure how much of that is due to the therapies he receives, how much of it is due to him just being ready to show his skills and how much of it is due to us really stepping up the interaction he gets with other kids his age, but it doesn't really matter to me, as long as he is making progress.  

DS attends a neighborhood play based preschool.  His special education teacher visited him there for the first time today.  She is not his original special ed teacher, but had seen him twice before, although both of those times were over two months ago.  His preschool teachers expressed some concerns that DS was very unwilling to interact with her and that she was a bit forceful in her interactions with him.  They have always taken a bit more of a coaxing, try-it-if-you-like approach with him, where as his special ed teacher is definitely a bit more of the we're-going-to-do-it-my-way type.

I intend to speak with her about taking a softer approach with DS, but wanted to get some outside opinions before I do.  I have not been very impressed with this clinic as a whole...we've had some serious communication issues with our coordinator and a physical therapist who no longer works with DS.  I want to make sure I'm not approaching this from the angle that this clinic can do nothing right.  So, my question is, is there some benefit to a teacher forcing a 2.5 year old to do it her way?  DS will typically do what is asked of him, if he can have some time to explore the idea.

I'm not sure I'm making myself clear, so as an example, the teacher brought train tracks and trains on one of her visits to our house.  DS looked at the trains, tried to spin one on its top and roll it around on the floor.  The teacher kept taking the trains to put on the track.  DS got pretty frustrated with this, eventually completely shutting down and refusing to cooperate with the teacher at all.  

My mom has similar tracks at her house (left over from when I was a kid), and when I told her the teacher had brought trains over, she got them out for his next visit.  DS looked at the trains, tried to spin on it's top, and push it around on the floor.  My mom took different trains, put them on the track, and pushed them around on the track.  Eventually, DS put his trains on the track and pushed them around there, too.

Now, one of his goals is to play with toys the way they are supposed to be played with, not just spinning them, so I understand the teacher wanting to encourage him to play with them correctly.  But is there any benefit to not letting him have some time to get comfortable with the idea?  I'm really struggling to think of any, and just want to make sure that I'm not seeing the situation through mom goggles before talking to the teacher.

Re: Intro and question

  • Welcome!  I have 2 boys who are globally delayed (4,2) but do not have ASD (theirs is genetic).

    We have the same situation going on with our teacher.  DS2 has a PT, OT, and SLP whom he adores and is happy to interact with.  But the teacher, she's abrasive, in his face, and on top of him.  He's 2 and she has some unreal expectations of him and wants him to fit her mold.

    Which I understand is part of having him "catch up" but in the same sense, he is still an individual.  She claims he won't sit and attend a task for 20 minutes, she's never gotten more than 2 minutes out of him.  But 2 seconds later she said he sat and paid attention to an entire alphabet book with her.  I think it's more of a personality issue and they just don't mesh well.  

    I would call the teacher and ask her how the session went.  Mention that the daycare teachers noticed he struggled to connect and you were calling to touch base.  Let her tell you about the session, what she noticed, etc.  Our therapists often ask for advice on how to connect with DS2, his likes or dislikes, prior to engaging him.  Especially if she doesn't see him often, she has no rapport with him.  Offer your suggestions as helpful tips for next time so that she can have more success with him.  is there a food or a toy he's very motivated for, things he likes dislikes, what will cause him to disengage.  

    Personally, I try not to dictate therapy sessions.  My kids are always going to need services.  There are going to be times that therapists change often, or they have to work with someone they dont' love, or they have to do something they don't want to do.  And sometimes, they just have to deal with it.  It's why I haven't kicked our teacher out.  It's only till June, and he'll learn to tolerate someone with that type of personality in the future.  She's not mean, she's not harmful to him, she just doesn't mesh with what he's used to.  And he's going to have people like that in the future and he'll tolerate it better then.
    To my boys:  I will love you for you Not for what you have done or what you will become I will love you for you I will give you the love The love that you never knew
  • Thanks for your replies! She did send me an email saying that he wasn't very cooperative with her (she put it much more delicately). She is supposed to be going out weekly now, so hopefully as she becomes part of the routine he will work better with her.

    I do agree that it's important for him to learn to work with people he doesn't like, and I appreciate you reminding me of that. I do worry that he won't get anything out of his sessions with her if their personalities clash too much...but maybe I should just wait and see what the next few weeks brings.

    Thanks again!
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  • How much time does she spend at the daycare? Maybe she feels pressed for time.
  • How much time does she spend at the daycare? Maybe she feels pressed for time.
    She spends 30 minutes there.  That is a really good point.
  • -auntie- said:
    Hi!  I'm Cleo.  I have a 2.5 year old boy who is smart, sweet, funny, adorable and receiving services for global developmental delays through our state's EI program.  He receives speech, physical and occupational therapy and also qualifies for a special education teacher.

    That's a lot of services. Strong work on your part. Are they all pushed into preschool or are some at home or in a clinical setting?

    Only special ed is at the preschool.  He only goes to the preschool twice a week for 4 hours and I didn't want him to be receiving services practically the whole time he's there.  The others are all at home.


    He is being followed by a dev pedi who is unwilling to diagnose him with anything beyond global developmental delays at this point, except to say that he does not think DS has autism, as he is socially on track.

    Socially "on track" at 2 1/2 is a pretty low bar. At this age, associative play is emerging and cooperative  play won't be mastered for a while. While I can appreciate not being hasty in this regard, I kind of side eye a dev pedi who sees a child who needs the level of services you are getting who would say that at his age. Perhaps time will bring clarity. 

    I agree that social skills is a pretty low bar for him right now, which is why I'm not sure I fully agree with him.  DS makes great eye contact and is willing to interact with others in an appropriate manner.  He's interested in his peers, and tries to interact with and/or imitate them.  He's extremely affectionate.  He's not particularly sensory avoiding or sensory seeking.

    But.  He's obsessed with spinning things, even things that you wouldn't think could spin.  He's come a long way with this, and now typically only does it when he's feeling anxious or frustrated, or when he comes across something new, he has to see if it will spin before he can play with it in a functional manner.  He tends to (I think) hyper focus on things that interest him.  He seems to get lost in it, and not notice what's going on around him.  He thrives on structure and routine, and occasionally will lose his mind if you do something outside of certain routines, or if you don't react to him the way he wants you to (he's come a long way with this too...improving his speech helped tremendously).

    I will not be surprised if an ASD diagnosis is in his future.  Maybe I'm just still in denial right now and hoping that time will turn things around.  

      I'm not sure I fully agree with him, but don't think that DS would get any extra benefit from having an ASD diagnosis right now, so am willing to let that be. 

    He might. For instance, you aren't going to access ABA without an ASD dx. Of course, not all communities offer ABA via EI or the local school district.

    I'm guessing we can find an ABA program if needed, although not through EI...I guess I don't know much about the ASD diagnosis process, or for that matter, ABA.  I'm kind of reluctant to spend a lot of time on the diagnosis process right now if he wouldn't get an ASD diagnosis, only to have to go back in a few years when potential social issues would be much more apparent.  What we're doing right now seems to be working.  I don't know enough about ABA to know what it would bring to the table.

     DS has been receiving services for about 8 months now and has made tremendous progress.  I'm not sure how much of that is due to the therapies he receives, how much of it is due to him just being ready to show his skills and how much of it is due to us really stepping up the interaction he gets with other kids his age, but it doesn't really matter to me, as long as he is making progress.  

    It's great that he's making progress. That's awesome. 

    It would matter to me. Most children getting special education services improve as a function of those interventions and maturity. It would be very unusual for a child to make the kind of leaps and bounds sort of progress you're seeing from mere exposure to peers. Especially around motor skills. It would be the sort of thing seen in a child removed from an institutional orphanage or extremely negligent parents. I doubt that would apply here.

    But if he was picking up skills primarily from peers, ASD would be a less likely dx down the line. 

    I really think it's a combination of all three.  In the course of doing these interventions, it seems that a lot of his delays stem from anxiety, or extreme cautiousness, or maybe just plain old stubbornness.  For example, with his gross motor skills, he can climb...it's just scary.  I think the therapies gave him some of the skills he needed, and watching other kids do it gives him the confidence he needs.  He definitely is much more willing to try new things when other kids are doing it, and we saw a lot of progress from him when the clinic was on summer break, but he was still doing community toddler classes.

    DS attends a neighborhood play based preschool.  His special education teacher visited him there for the first time today.  She is not his original special ed teacher, but had seen him twice before, although both of those times were over two months ago.  His preschool teachers expressed some concerns that DS was very unwilling to interact with her and that she was a bit forceful in her interactions with him.  They have always taken a bit more of a coaxing, try-it-if-you-like approach with him, where as his special ed teacher is definitely a bit more of the we're-going-to-do-it-my-way type.

    It's really hard to weigh in on this. The two teachers come from very different teaching philosophies with different areas of expertise. The nursery school teacher probably isn't as qualified as the one associated with EI. The EI teacher would be certified in teaching students who have special needs. What is an appropriate manner of working with a well developing child can be vastly different for one who has global delays and may be at risk for ASD. 

    Exacerbating that situation, the EI teacher's time is a lot more valuable. She gets a very limited amount of time to work with your DS and has specific goals for them to meet. She doesn't have the luxury of allowing your son to figure things out through exploration as would be the case for a well developing child in a traditional play-based nursery school. 

    Very good point. 

    This isn't a dig on traditional preschools; it's what I chose pre-dx for DS and he thrived there. 

    I intend to speak with her about taking a softer approach with DS, but wanted to get some outside opinions before I do. 

    Be really careful of this. It trends awfully close to telling someone how to do their job.If you feel you must say something, couch it in a way like "I find DS repsonds best if I allow him 5 minutes to transition to a new activity".

    Very true, and I don't want to tell her how to do her job.  I have calmed down a bit about this and am more inclined to wait and see how he does with her when they have more of a chance to get to know each other.

     I would also be mindful of the fact that many "non-profit" community preschools have a love/hate relationship with EI. They need to fill seats, but they resent having outside resources interupt their programing. Plus there tends to be a little professional jealousy in the mix; the ECSE teacher probably has a masters and the nursery teachers may be working with a 2 year degree. The difference in salaries would likely be striking. I have a friend who did the books for our coop nursery school- the entire staff mornings/afternoons made less money combined than my mother did as a public school teacher.

    I don't think this is the case with our school, but will keep that in mind.

     I have not been very impressed with this clinic as a whole...we've had some serious communication issues with our coordinator and a physical therapist who no longer works with DS.  I want to make sure I'm not approaching this from the angle that this clinic can do nothing right. 

    Do you have other options vis a vis clinics? In education, fish stinks from the head down. If the person running this place isn't very good, s/he'll have trouble attracting and keeping talented people on staff. That said, you only have about 6 months before they transition you to the local school district.  

    I do have other options, but as you say, only have about 6 months before we go to the school district.  When our issues with the clinic came to a head, we had a lot of other changes going on, and I was reluctant to bring more to DS's life right then.  I also really liked his SLP and OT, and was pretty reluctant to try to start over with those therapies.  His OT just left, but his SLP is still with him, and his new PT is doing great with him.  I'm not sure I want to mix up therapists with him again 6 months before moving to the district.

     So, my question is, is there some benefit to a teacher forcing a 2.5 year old to do it her way?  DS will typically do what is asked of him, if he can have some time to explore the idea.

    Benefit? Absolutely. IME, growth comes from being pushed outside what is comfortable. What you are describing is the very foundation of ABA which is the gold standard for many with ASD and developmental delays. 

    Giving him time might not be practical in the context of a bi-weekly visit to the school. If he was a child who was a strong self directed learner, he probably wouldn't have qualified for the Developmental Teacher in the first place.

    Fair point.  I seem to be having a lot of trouble reminding myself that what's best for him might not be comfortable.  

    I'm not sure I'm making myself clear, so as an example, the teacher brought train tracks and trains on one of her visits to our house.  DS looked at the trains, tried to spin one on its top and roll it around on the floor. 

    You realize the developmental teacher would see this as a classic autistic behavior? I can see why she was all over it to prevent it becoming entrenched and harder to redirect.

    Yup, I know this is a classic autistic behavior.  It's part of the reason I don't fully agree with the dev pedi. 

    The teacher kept taking the trains to put on the track.  DS got pretty frustrated with this, eventually completely shutting down and refusing to cooperate with the teacher at all.  

    I would hazard a piece of this was also data collection. She needed to see how far she could push him as a baseline before she'd lose him entirely. It's critical when working with delayed kids who have ASD traits to tread a narrow range between pushing them out of what's familiar and comfortable and letting them stagnate in dysfunctional skills for their age. I know this can feel pretty harsh, but it may be what is needed to help him develop into his own best self.

    Data collection is a good point.  Hadn't thought of that.

    My mom has similar tracks at her house (left over from when I was a kid), and when I told her the teacher had brought trains over, she got them out for his next visit.  DS looked at the trains, tried to spin on it's top, and push it around on the floor.  My mom took different trains, put them on the track, and pushed them around on the track.  Eventually, DS put his trains on the track and pushed them around there, too.

    That's great. Perhaps what the teacher did at school played into this success in appropriate play. 

    Now, one of his goals is to play with toys the way they are supposed to be played with, not just spinning them, so I understand the teacher wanting to encourage him to play with them correctly. 

    She's a teacher, not an encourager. This isn't a playdate with grandma. She's there to help him learn skills to play with toys in the appropriate manner which will benefit him as he learns to play cooperatively with peers in the next couple years. If he doesn't learn this, he will not be a desirable playmate and peers will avoid him. This will impact his ability to master the zero order social skills required to be fully included in Pre-K. The social piece is about to become a whole lot more complex; he may be "on par" with the expectations of a 30 month old, but that doesn't mean he won't fall off the chart as expectations ramp up.

    But is there any benefit to not letting him have some time to get comfortable with the idea?

    See above.

      I'm really struggling to think of any, and just want to make sure that I'm not seeing the situation through mom goggles before talking to the teacher.

    I can imagine it's very hard to have your son's preschool experience be so different than what a typical child would have. Responsibility for that disappointment sometimes gets ascribed to the team put in place to help. It's sort of a shoot the messenger situation.

    Maybe a better thing to do would be to talk with the ECSE teacher and ask her about her philosophy and why she uses the approach she does with your child. Since you are served under his IFSP, ask her for startegies you could use at home around building skills.

    Yes, I might do this.  Thanks for your thoughts.  I really appreciate it.


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