Our weekly regimen

Today I thought I would write about the services that Singularity receives, how we fit them into our lives, and the effect it all has on our family life. But first, a Singularity-ism:

The old rubber bands on the violin bridge trick. This is the violin I learned to play on as a child. When I was nine years old, we found it in my great aunt's attic and fixed it up. It is not a fine instrument, so it didn't particularly worry me that Singularity was "using" it. If you've read some of my other blog posts, you may have noticed another "theme and variations" thing going on with the rubber bands. They are endlessly interesting. And always showing up in places where I least expect them.

Anyway, back to the services that Singularity receives....

At school

These services are all provided under Singularity's IEP:

• One hour of speech therapy, broken into two separate group sessions. Speech at school is focused on pragmatic use of language and narrative language. 
• One hour of occupational therapy, broken into two separate group sessions. OT at school is focused on the self-regulation skills needed to maintain focus and attention. 
• One hour daily of one-to-one instruction in language arts with the special education teacher. This is new this year. Singularity needed this service to help to compensate for what seemed like social-cognitive deficits that were making it difficult to understand human motives in stories. 
• In the past, Singularity also participated in adapted physical education (APE). He graduated from APE about a year and a half ago when he had mastered everything that they teach there. He is now in regular PE (which he always was anyway), and his level of engagement and participation is increasing steadily.

When you enter the special education process, you will not be presented with menu of services offered by the school. This is, I suppose, the way they keep costs down. If parents don't know what is possible, then they won't ask for it, right? We were lucky to be working with an OT who had worked in the public schools in the past, and she suggested that we ask for APE. I am putting this out there, in case you think that adapted PE would help your child. There is a lot of power in finding out what services are being provided to other children with similar issues in a different school district. 

The other thing I want to say about special education is that if there is something you think that your child needs, you should bring it up. Does your child need an aide just for recess? Help with handwriting? Accommodations in the classroom? This is what the "I" in IEP is all about. Call an IEP meeting if you have to. You always have the right to call an IEP meeting. If your school or school district does not offer the service that you think is educationally necessary for your child, they are still responsible for providing it. Perhaps another school nearby offers the service. If not, they may need to pay for you to receive the service elsewhere. Really. 

I didn't really mean to go off on this tangent about special education. It just comes up. I'm sure that I will delve into it more in a future posting.

Outside of school

• Monday: occupational therapy in a clinical setting. When I say clinical setting, I mean a clinic with several incredible gyms filled with all sorts of swings, obstacle courses, spinner boards, therapy balls, etc. Singularity has worked with the same OT for over four years. They are now working a lot on self-regulation and sequencing issues, although in the past they worked a lot on vestibular issues. 
• Tuesday: 3 hours of applied behavior analysis (ABA) therapy at home. Our ABA provider is Easter Seals. This service is now covered by our medical insurance at Kaiser Permanente, thanks to California Autism Insurance Mandate (SB 946). This mandate defines ABA services as "medically necessary" for people on the autism spectrum and makes it much easier for families to get access to the service. In the past, we funded ABA ourselves. 
• Wednesday: 3 hours of ABA at home. 
• Thursday: 3 hours of ABA at home. Cub Scouts once a month.
• Friday: Nothing!
• Saturday morning: Speech therapy, which we also receive from Easter Seals/Kaiser.
• Sunday: Nothing! 

I also didn't mean to go into such detail about medical insurance and autism, but, again, it just comes up. 

What does all of this mean for our daily life?

This is a lot of therapy. I don't think that Singularity remembers a time when he didn't have all of this going on. Perhaps for that reason, he is a really good sport about it. 

It can be a challenge to fit everything in. Some days we fail to squeeze in a 30-minute session of therapeutic listening. Some days the bath gets postponed until tomorrow. Fortunately, working independently is one of Singularity's ABA goals, so each ABA session has a designated time for working on homework. Two birds with one stone! And some days homework doesn't get done, and it's just not the end of the world. 

Nine hours of ABA in our home ever week, during which either Klailklop or I must be present, does sometimes feel intrusive. Singularity's treatment plan is mostly directed toward Singularity's behavior, but it also contains some "family goals" designed to change the way Klailklop and I interact with Singularity. When things are not going well, it can be really irritating to have some young whippersnapper evaluating our parenting. (We are usually about twenty years older than our behavioral interventionists.) But with only one or two exceptions, we have become very fond of our team members. 

In varying degrees over time, a lot of Singularity's social life occurs during ABA sessions. Several of his ABA goals pertain to peer interactions, so we import Singularity's friends into the sessions. This is a lot of work to coordinate, and honestly I am not doing a very good job of it this fall. 

We have been seeing our occupational therapist since Singularity was in kindergarten. There is a lot of history and trust in that relationship. She has become very dear to me. Since OT is in a clinical setting, it seems like less of an intrusion, but it does involve schlepping Singularity around during rush hour. Speech therapy is also in a clinical setting. More schlepping. But it all becomes part of a routine, which can be kind of comforting.

Another thing that all of these services and professionals means for our daily life is a lot of meetings to discuss goals and progress and a lot of communication between home and professionals. I am pretty sure that the parents of typically-developing children don't spend so much time communicating about their children. 

It's a pretty full schedule that doesn't leave a lot of unstructured time. I can't say for sure how Singularity feels about it, but I certainly relish those Friday afternoons and weekends.

Did I ever mention that Singularity is an only child? I can only imagine how much more difficult it would be to manage all of this in a family with other children whose needs must also be considered.