Expert: Dr. Sharon A. Mitchell - 10/18/2008

Question
I am the mother of 3 children, my son is the youngest and is on the Autism spectrum.  My son is 4 years old and was diagnosed at age 2.  Since then he has attended a preschool program for children with autism.  My oldest daughter is 11 and my younger girl (who has ADD) is 8.  My husband works often long hours and has a long commute to and from work, meaning he has little time at home.

I have wanted to create some sort of schedule to organize  our time at home together so that I can help my son more with social and language skills.  I just seem to be really stuck coming up with ideas that are practical and will work around our hectic schedule.  Between my girls' activities, their friends visiting, helping with homework, and the constant housework and cooking that needs doing I just can't figure out how to create a consistent schedule.  I feel very guilty that I am not doing as much at home as I think I should be but I am concerned that I will not be able to follow through with a schedule because of the many disruptions to our routine.

Unfortunately we have no means to hire any type of help and have no family that would be able to lend their time as frequently as we need it.  I would love any suggestions so that I can do more to help my son reach his full potential.  

Thank you,
Angelina

Answer
From the tone of your email, you don't sound harried despite your very busy life. The fact that you're not at the end of your tether must mean that your son is doing not too badly. And if that's the case, then you're obviously doing many things right.

Organization and schedules are wonderful things. But life often gets in the way of our plans. Since you have more than one child, your entire lives can't be organized around the needs of just one. (I'm not sure that would be healthy for him anyway.)

He has older siblings to watch and play with and to learn from. That's a real boost. And he has contact with other children when his sisters' friends are around.

If your little boy has been in a preschool program for the past two years he's also gaining socialization and language experiences there, so lots is happening for this little guy.

It's not easy for a parent to carve out an hour a day for just one child, with no interruptions. But I'm not sure you need to do that.

There are things you can do to encourage your son's language development. Most of them you are likely doing instinctively but you may get some more ideas from The American Speech Language Hearing Association http://www.asha.org/public/speech/development/Parent-Stim-Activities.htm

Do you ever have the opportunity to observe at your son's preschool? What techniques to they use? How do they include the kids at circle time? What songs do they sing? Which actions go with which songs?

Ask for a copy of the songs, then sing them at home with your son while you're folding laundry, doing dishes or giving him a bath. If they do a craft activity your son likes, can you later do the same activity at home? The added practice will only help him as will the bridge you're building between skills at school and skills at home.

I like therapies that both fit into the lifestyle of a family and are play-based. One such one you could consider is PRT (Pivotal Response Therapy). What's nice about it is that it's a way for you to play with your child. You don't need to slot in an hour a day at a consistent time but can just play with him whenever you get a few moments. It's something you can get started with after doing just a bit of reading.

Another nice thing about PRT is the low cost to get started. Most of the training manuals are about $7 each http://kady.education.ucsb.edu/autism/behaviormanuals.html

Here's some information on PRT http://www.brookespublishing.com/autism/prt/interview.htm  PRT was featured on one of the Super Nanny episodes http://specialchildren.about.com/b/2005/11/04/more-on-tonights-supernanny.htm The main PRT manual is available here: http://tiny.cc/AeTcB

Here's are three short video clips of a young boy prior to PRT then during subsequent PRT sessions: http://www.brookespublishing.com/autism/prt/video.htm

If you don't want to or nor have to time to do some reading on PRT or similar play-based approaches, you could focus just on enhancing your son's language while you play. Sites like this one give good but practical tips any mom can incorporate into the child's day: http://www.tr.wou.edu/perc/documents/INDIRECTLANGUAGESTIMULATION.pdf

I don't think you should beat yourself up over not having regular, formal therapy sessions at home with your son. Your daughters learned many skills by just growing up in your home; your son will too. Consider that since he's so young and has been in a structured preschool setting already for two years, perhaps he needs unstructured time to just be a little boy at home, time to play and hang out the other little boys his age do. You have lots to offer your son and are likely helping him in ways that you never realize.

As long as you see your little guy progressing you can relax. You're his mom, not his teacher. He needs you to love and care for and play with him, rather than be his therapist. And it sounds like you're doing just that.

Sharon A. Mitchell, B.A., B.Ed., M.A.
www.autismsite.ca