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April 18, 2014 / 18 Nisan, 5774
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Life Lessons From Raising An Autistic Child (Part III) – Therapy


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The father’s story:

What’s your parenting philosophy? How do you feel about discipline? What educational approach do you find most compatible with the sum of yours and your child’s personalities?

As parents, we’re called upon to make countless decisions regarding the chinuch of our children. Some will happen via research and thought-out discussion, but most tend to be made by the seat of our pants. Now, though all of us would admit that it’s wiser to think out our approach before we’re in the heat of the moment, usually we get away with it. However, when raising a severely autistic child, the stakes are different. The only hope for getting through to him is by keeping your instructional and disciplinary methods consistent and predictable. Therefore, the choice of educational approach takes on added significance.

There are two popular schools of thought regarding therapy for autistic children. We only wish we’d known as much about them at the beginning of our journey with Menachem as we do now…

The DIR Therapy Session:

Menachem is sitting and staring at the wall. Though it does not look like a particularly exciting activity, he is, for the moment, blessedly silent. I contemplate attempting a quick phone call. No. It’s our daily twenty minutes of DIR therapy time, and that means that I’m supposed to enter his world. The focus of DIR, an acronym for the major therapy components of Developmental, Individual-difference and Relationship-based, is to join him where he’s at, in the throes of his activity, in the hope that we will, through that, form a connection.

Arnold-053113-HandsSo I sit in front of him, directly in his line of vision, so that he’s looking at me instead of the wall. He blinks his eyes. I blink mine. He scratches his nose. I scratch mine. Hello Menachem, I say to him, wordlessly. I’m here, I’m your father, and I care about sharing your world.

Menachem gets up and climbs onto the bed. He begins to jump. I take a breath, climb on and jump along. He jumps off, and runs out of the room. I follow him. He tears through the house, his usual whirlwind. So now I’m chasing him around the house, which is not much different from what I do at any other time, but, hey! I’m doing DIR!

No cynicism, I admonish myself. Now Menachem heads for the stairs. He starts to run up and down. No big surprise; this is one of his favorite activities. Here goes. I’m running up and down the stairs myself. We pass each other on the way. Up and down. Up and down. This is called therapy? I try to silence that inner cynic but it’s hard, oh so hard, when my son cannot dress himself, cannot go to the bathroom, cannot put two syllables together…and I’m getting goals from therapists that are about making eye contact and imbuing communication attempts with significance. All nice and high-sounding…but completely immeasurable. How in the world do I know if I’m giving my son the desire to communicate or merely chasing him around the house?

But the evaluating doctor was so confidant and definitive when he told us to enroll Menachem in a DIR-based preschool – and even offered to pull strings to make sure he got a spot. Overwhelmed and grateful, we didn’t think to question his advice, or to investigate whether there are other approaches out there, better for our son. They started with him on the first stage, which is regulation. After all, nothing can be accomplished if the child isn’t calm and receptive, so the first step in DIR therapy is to help Menachem calm himself down when he is in a hyperactive state.

My wife and I eagerly await the secret of how to do this. But there is no secret. Menachem tantrums, and we are instructed to sit down next to him, massage him, speak softly, do whatever it takes to soothe him, to make him feel that his feelings are understood. After all, if he’s crying, there must be a reason. Enter into his world.

Problem is, we have no clue why he’s crying, and if Menachem knows, he’s not telling. My son is particularly hyper, and over time we try everything we can think of to calm him down, including changing his diet, putting him on medications, but nothing works.

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