Anthony's first experience of guilt

If you have read 'Our terribly truthful child' you will know that Anthony is a seven year old boy with autism who has never told a lie, ever. But, that doesn't mean he has never done anything wrong.  And as of last week, it doesn't mean that he's never felt guilty either. 

One of Anthony's special interests, which is nearing an obsession at the moment, is playing a app game called Marvel Champions. Special interests are very common with autism. As Ambitious About Autism say, 'people with autism tend to be more all-or-nothing than most people: something is either absolutely not interesting or absolutely fascinating.' An obsession is a special interest taking over your life or your ability to function due to an inability to stop thinking about or doing your obsession. 

Marvel Champions is just on this border at the moment and it was this game that led to Anthony's first experience of guilt.  Usually Anthony only plays the game when his father is home. This allows some control for us. Sometimes Anthony's father can't be at home because of work or something else and then Anthony is allowed to play the game with certain restrictions. One of these restrictions is that Anthony is not allowed to spend the game tokens without asking his dad. So, if his dad isn't there then Anthony has to wait. 

Last week this proved to difficult and when asked to come down the stairs for dinner Anthony burst into tears. It took me a while to work out that Anthony wasn't crying because he'd accidentally spent his game tokens. He was upset because he was having difficulty reconciling the fact that he had chosen to spend the game tokens despite knowing he shouldn't. 

My son cried for nearly an hour. Then had his swimming lesson and then started crying again. At one point I thought we weren't going to get him to stop crying in order to get into the pool. His whole concern was about how sad and disappointed his dad was going to be. 

It's interesting that Anthony would get so upset by this. He barely blinks when he does some other things that 'disappoint' us like for example hurting his sister, or not trying to do homework. I think it's the first time he's really felt guilty about something. 

I'd tried several strategies and then finally told Anthony a story from when I was a little girl and did something similar and how I felt about the fact that it had upset my parents. Anthony was mesmerised. It culminated in a phone call to my own father to get him to re-tell the story again and explain how my own father had  felt about my 'crime'. 

In many ways I think this shows Anthony maturing. He has always struggled with interpreting his own and others feelings. My heart when out to him. Feeling guilty is awful, but in some way I'm pleased that he's been able to achieve this milestone and that I was allowed to work through it with him. 

Links
Our Blog - Our terribly truthful child
Our Blog - Autism and the misunderstandings of empathy

External links
Ambitious About Autism - Obsessions and Special Interests

Potato handler and crumble creator - autism and interaction in the kitchen

We don't often do roast Sunday dinners in our house. We used to do them a lot but then there was a period of time when it just became too difficult. Not only were the kids not taking part in the dinner but they required constant assistance to stay off of one another, entertained or safe. There was almost a shift system and someone was always away from the table. Recently though whatever combination of child development stages led to this 'no Sunday roast zone' we had entered seemed to pass. And to my absolute delight our autistic five year old was actively interested in the return of our Sunday dinner preparations.

I don't think twice when Jane wants to 'help' me sweep the floor or do the vacuuming. My husband may not believe it but I do these jobs at least once most days. Jane has been 'helping out' for at least a year and she's only two and a half years old. It's because she is interested in interacting with me and her environment. She is not stressed by the noise of the vacuum cleaner or anything else on the house. We've been baking together for at least a year too. But it's not the same for David.

David has been diagnosed with ASD since he was three years old. Sometimes he cannot, and other times he may decide not to, interact with the world around him because he finds it too confusing or because it seems pointless. Let's face it; lots of people prefer to play on their IPads than engage in an actual conversation with someone. As David's verbal skills are very limited, I'm hardly surprised he is sat on the sofa while I'm peeling potatoes on the floor. One after the other the cleaned potatoes from the colander are peeled over a large bowl and then placed into a big pan to on the hob later.

 Jane has already asked what I'm doing a few times and after being satisfied that the game of flying to the moon she is playing is better than my activity, I'm left alone for a few minutes. Then David comes to sit opposite me. His first task is to investigate the potatoes. They are all emptied out of the colander and checked over before going back inside. David then looks at me for a bit before turning over and looking at me through his legs. This is one of the ways David likes to look at the world. Then as I'm finishing peeling a potato I use Makaton to sign 'potato'. He jumps up and hands me another one from the colander. "Thank you" I sign and say. But my grin is far more than a 'thank you' smile.

David returns to play with his IPad but spends the next 15 minutes guarding the colander from any would be thief and almost to the second, jumping up and handing me potatoes until they are all gone. Each time I am thrilled.

After I'd finished making the rest of the Sunday Roast, I started on pudding - rhubarb and pear crumble. David wonders into the kitchen and sees me measure out the ingredients for the crumble. I'm beginning to break up the butter and crumble it into the flour and sugar just like my mum taught me. Then David leaned up onto the counter and stuck his hand in the bowl to feel the texture and see what I was doing. Again I use Makaton to ask David if he wants to 'cook'. He seemed interested, so I immediately brought the bowl down onto the floor and David and I shared the bowl while he copied me pushing the butter through my fingers and into the flour and sugar.

This type of shared attention is so rare. It requires an interest in people, activities and a preparedness to share them with someone else. This is really difficult and new for David as it means seeing things from another person's point of view.

Honestly, if there had been nothing else to do I'd have peeled potatoes and made crumble all day. The crumble proved to be more fun than handing over potatoes and David was a bit disappointed when I finally needed to pour it over the fruit. And despite his valiant efforts, he didn't have roast potatoes or crumble for dinner as neither is yet in his acceptable food repertoire. But I saw a little boy excel himself. And I saw hope for independent living skills in my son. What a great Sunday roast I had this week.

Links
Our blog - Racing Clouds - David's Delight
External Links - Communicating and Interacting

Disastrous at decision making

A report released today by the Kings Fund reports that mental health patients are at risk due to budget cuts. I've been listening to Radio 5 Live about it. It occurs to me that many people may not know that quite a few mental health conditions are comorbid with autism - that is that they are common occurring conditions.

Identifying normal repetitive play

I have been watching Jane repeat the same play sequence whenever she is presented with a tea set.  Jane has two older brothers with autism so she is more likely to be on the autistic spectrum than another little girl who has no autism in the family.  I'm watching to see if this play might indicate that she has a lack of social imagination. 

Difficulty with social imagination is one of the 'triad' of impairments that leads to an autism diagnosis. Our social imagination lets us understand and predict what other people are going to do or how an unfamiliar situation may turn out. Some children with autism find imaginative play very difficult and others can use their imagination but because they find guessing the next step in a social situation difficult, they prefer to act out the same scenes each time.  

However, children also learn through repetition. Practising new words and skills is part of being a toddler and should be typical as Jane is nearly two and a half years old.

Jane has been repeating a game we have shown her about making a cup of tea.  Pouring the tea from a teapot into a cup and bringing it to an adult. She then asks them to drink it, asks if they are finished and then takes the cup away.  Here are some things I've noticed and engaged in that indicates to me this might be normal play.

Jane's routine is usually functional, which means things can be used for what they are.  However, Jane can also use substitution in this routine.  This means if presented with a tea set without a teapot and presented with another object, for example a jug or bowl, Jane is happy to pretend this is the teapot.  If there are no substitutions, Jane can also pretend she is holding a teapot, and this is using her imagination too.  Beyond, this Jane was quite happy to bring me a coffee instead and when I said I was hungry, she offered me a piece of cake. This shows she can cope with, think about and engage in changes to the play sequence. To my delight this was cooked in an imaginary microwave in the bookcase.  And as I'm handed my cake, it's obvious that Jane is having fun. A few minutes later she's left the activity and come to watch the television.

However, I could be concerned if Jane appeared anxious or extremely focused during the tea routine.  I would note if she was upset by changing it or unable to have intervention in the play. I'd also be concerned if Jane was unable to finish her routine without getting upset or persisted in only playing with this set, whether she was enjoying it or not.  I can also look for a specific type of repetitive behaviour called 'stimming' which tends to be a sensory adjustment.

Repetitive behaviours, obsessions and routines can limit a child's participation in other activities, cause stress or anxiety.  However they can also lead to enjoying special interests or help someone stay calm or cope with a situation like David does. I'm likely to continue to monitor Jane's progress with watchful eyes.  For now, it looks like I'll be enjoying imaginary cake.

External links
Ambitious About Autism - Repetitive behaviours and stimming
NAS - About autism