Expert: Valerie Herskowitz - 7/21/2009

Question
Hello, and thank you in advance for giving my question attention.

My son was was discovered to have, and "diagnosed" with PDD-NOS a year ago after he turned 3. This summer he is 4 and is answering yes/no questions, either or/ etc... and he is also beginning to be potty trained. He has received some speech therapy and it is helping (mostly training my husband and I!) to talk with and understand our son. My question is: How much unstructured time is okay for a 4 year old with PDD-NOS? I have difficult time arranging our day. I'm a teacher during the school year and a full time mom over the summer and also have a 7month old baby. My son takes a long time to do everything (eat/potty/get dressed)and most of the time I feel like I'm hovering over him telling him what to do and he gets weary of it. But he would not very often go potty of his own initiation (although he's proved me wrong twice-yes!) nor would he ask to have any thing to eat/nor would he get dressed on his own. In any case... I'm confused as to my role. Sometimes I structure up every minute of his time and he thrives with this... sometimes I let him play for long stretches on his own and he is fine with this as well--
he has even learned to play the piano on his own accored-
however I am not comfortable with him being alone so long.
He does not even usually come out of his room in the morning. (in the fall he will have head start and special ed school... but until then how do I prepared him?)

You will probably tell me "a combination" or "what ever feels right"... however... I would love any tips you may have... thank you!

Answer
Dear Barbara,

Well the one answer you will not hear coming out of my mouth is "do whatever feels right." LOL I definitely chuckled when I read that. My husband would love for me to say that sentence a little more often, but truth be told, I am a very structured person. Aside from being a speech pathologist and autism consultant, I am a professional organizer.

I adhere to the principle that a child with PDD or autism needs to be in a structured and stimulated environment most of the day. You would think that it would be important that all kids should have unstructured time, but not for our kids. You son sounds like he has a lot of potential and is right in the window of opportunity for a lot of growth. I am not saying that he can't have any unstructured time, but even that time needs to be organized.

There are some guidelines that are recognized. Here they are:
1. It is recommended that your son receive a minimum of 25 direct instructional hours per week.
2. These hours can be accomplished through therapy, school (only the time that he is being stimulated), behavior, or when you or your husband sit with him and work with him.

It sounds to me that what you are having the most difficulty with at this point is figuring out how to get everything you need accomplished. It is not easy under normal circumstances to raise 2 children and work. But add a special needs child to it-and it is impossible.

I have taught workshops on how to balance your life while raising a child with special needs and am writing a book on that subject right now.

The other thing that you need help with is structuring your son's life. Right now, I feel that the most important thing you need to do is start training him to use a visual schedule. Once he learns to use this tool, he will be much more independent and you won't have to be hovering all the time.

So to sum it up, I would like to help you develop 3 tools:
1. A daily schedule for your son
2. A schedule for you
3. A visual schedule to help him become more independent

I can also help you to develop a good home program. I use many tools for this but specialize in computer based training in the home program. What's nice about computer-based training is that it has the lessons already built in and you can do them with him.

I teach a free class each week on computer based training if you want to find out more about it. It's on the website.

Feel free to write me back.