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This Greenspan article is so good it deserves its own thread: a review of progress of 200 autistic children

(29 Posts)
lingle Mon 27-Jul-09 08:55:13

Here is a review of the progress of 200 children diagnosed with ASD.

http://www.playworks.cc/articles/200casechartreview.pdf

The section on why the "wait and see" (page 3) approach is wrong is so convincing that it has made me change my mind about that topic (a first?blush). (though I still stick to my own "brand" of therapy). Basically, he points out that there are pessimistic and incorrect assumptions about the potential of children with ASD underlying the "wait and see" approach. Grrr - wish I'd read this 18 months ago....

As an incorrigible optimist with a mildly affected child, I was also especially taken by the data on page 19. Eighteen of the children (the top performers) developed social skills that were significantly superior to those expected of their age.

This article is an appendix to "The Child with Special Needs" by the way.

fanjoforthemammaries7850 Mon 27-Jul-09 09:18:38

That seems very encouraging, except for the part where the children with low tone did worse, sadly we are not receiving any intervention YET but doing my best alone.

lingle Mon 27-Jul-09 09:27:06

Do you need a OT then Fanjo?

fanjoforthemammaries7850 Mon 27-Jul-09 09:30:33

Well, not sure, we have just really begun the process diagnosis, and she is progressing well naturally. Still unsure whether she is just delayed, it's a very unclear picture. Am aware that clock is ticking, but can't afford to pay for an OT myself.

It's a lot to think about.

nikos Mon 27-Jul-09 09:44:43

And it's why I'm such a pusher for diagnosis. My ds has asd very mild but because we found out before he was three we have been able to really work with him (no specific therapy just family type intervention) and he has inproved so much.
And it's really interesting about the superior social skills. Ds is nearly 5 and while I wouldn't describe his social skills as at all superior at this stage, he will speak to people at parks etc in a way my other two children didn't at this age. It is very appropriate converstion and he will try to engage unknown children in a way my other two wouldn't.

fanjoforthemammaries7850 Mon 27-Jul-09 09:50:46

That is positive to hear, I admit I have been DREADING diagnosis and almost can't bear to think of it but it would help to think of it in that positive light.

Your DS sounds great, it must be so pleasing for you that he does that.

sadminster Mon 27-Jul-09 09:57:14

Lingle I love your optimism!

I started reading The Child with Special Needs last night. Cried through the beyond the label chapter (obviously I cry at everything). I have no idea how severely affected (apart from the obvious language issue) ds is ... but it was pretty encouraging.

Fanjo, what issues does your dd have with low tone? BIBIC have an OT who'll do an assessment & put a therapy programme together ... I don't know how close you are to it, but they have full funding now so the whole thing only costs £50 + travel.

fanjoforthemammaries7850 Mon 27-Jul-09 10:01:07

sadminster..that does sound interesting. I am in Edinburgh though. Possibly there is one in Scotland?

My DD has quite bad low tone, didnt walk until 2, is still quite floppy and falls over a lot, can't manage stairs without a LOT of support. However she has improved a lot, she still had head lag at over 1 when pulled to sit.

fanjoforthemammaries7850 Mon 27-Jul-09 10:01:57

Actually, part of her lack of pointing is she finds it physically quite difficult to do.

cyberseraphim Mon 27-Jul-09 10:53:09

Fanjo - The NHS in Glasgow provide OT to autistic children/all children with ASD type issues so assume Edinburgh may be the same ? We had a fantastic OT assessment 2 weeks ago and we have lots of new ideas to work with.

fanjoforthemammaries7850 Mon 27-Jul-09 10:58:48

Hopefully they will, she did have physio for her hypotonia. She is still at the early stages of diagnosis, due to have people come to the house soon and things, and also waiting for an appointment with the communication team so maybe OT will follow.

The emphasis is on getting her support when she starts nursery in January though, at the moment.

fanjoforthemammaries7850 Mon 27-Jul-09 11:07:35

(their emphasis, not mine)

cyberseraphim Mon 27-Jul-09 11:11:37

It's a great article. I definitely agree that each child needs an individual approach. The authors highlight early use of at least some pretend play or some use of functional langugae in the early years as being indicative of a 'better' outcome (even if the child appears severe in other respects). I think most research has shown this, particularly if the onset of the skill is spontaneous or needs only a little coaxing.

fanjoforthemammaries7850 Mon 27-Jul-09 11:14:14

My DD uses a quite lot of pretend play and functional language, so I also found that part encouraging. smile

cyberseraphim Mon 27-Jul-09 11:25:41

The hospital therapy (Floortimeish in some ways) we did put a lot of emphasis on turn taking and sharing so now DS1 has abnormally good turn taking skills. He will let DS2 have a turn in a way that DS2 (NT) would never dream of doing.

fanjoforthemammaries7850 Mon 27-Jul-09 11:35:29

that sounds really promising, you must be pleased!

cyberseraphim Mon 27-Jul-09 11:45:01

Yes, we found the therapy overall to be very useful and definitely aided his development. "Wait and See' is terrible advice. It is usually well meant but usually given by someone who has no idea how a child is supposed to develop. I hate the 'Einstein was a late talker' myth. 'Ooh and is it linked to his son's schizophrenia?' is not the required response when someone mentions this !

nikos Mon 27-Jul-09 11:46:06

I think there is so much that can be done for children with ASD and if I could sum it all up it would be to continually drag them into your world. And the earlier this starts then the better for the child. those of you who haven't try and get on a Hanen More than Words course. Believe it changed the course of my sons condition.
a year ago he would have spent a lot of time on his own. Yesterday he didn't leave the company of his siblings the whole day long (by his choice) and literally sat and chatted to his older brother as he watched him assemble his new lego project. They learn that people can be fun and therefore choose to join our world.

fanjoforthemammaries7850 Mon 27-Jul-09 11:51:38

I read somewhere that it becomes easy to leave these children in their own world and so it becomes a vicious circle with them withdrawing more, and so you must continually drag them into your world and make a big effort. This appears to be so true.

DD just informed me that her lunch is "very tasty",.she wouldn't have done that a month ago!

lingle Mon 27-Jul-09 13:09:45

Oh good Sadminster I am glad you are reading Greenspan.

My views on dx for DS2 are unchanged (I won't be seeking one).

sadminster Mon 27-Jul-09 19:18:35

Lingle I just can't read any more doom & gloom statistics writing my not-yet-three-year-old child off ... I think it will kill me.

I've been Hanen-ing him like crazy - he's not really any more verbal (he's more vocal, has a couple of new words & a few signs) but the SALT & HV have both commented that his attention & eye contact are better, he is so much more aware of sound & has even been responding to his name. He's pointing & has been playing/hugging/sharing/turn taking with the other children at the child minder. We have such a long, long way to go the only way I am going to cope with this is by looking for good news (& my trusty anti-depressants) hmm I'm assuming that despite all the positives his language deficit will put him at the low functioning end & I am dreading hearing that tbh

lingle Mon 27-Jul-09 19:39:27

Good for you for getting treatment for the depression.

Have SALT and HV felt that there has been a regression or is the dust still settling?

To increase his awareness of sounds so quickly is very impressive. DS2 often still thought his name was just part of a game at 3.2/3.3 or so.........

RaggedRobin Mon 27-Jul-09 23:09:34

thanks so much for this. wish i'd been armed with it eight months ago when a gp refused to refer ds to a paediatrician because his speech therapist (not a specialist in this field) had suggested we "wait and see". thankfully, the gp we saw recently referred us without hesitation.

RaggedRobin Tue 28-Jul-09 01:04:35

stayed up way too late to read it, but am glad that i did - i found the description of emerging logical dialogue very uplifting:

"the islands became continents"

so we're now aiming for pangaea!

sadminster Tue 28-Jul-09 07:16:04

Ah tbh I'm not sure if he's responding to his name or to my tone of voice - but a month ago he wasn't responding to either. He is definitely better with sound - even at my most pessimistic I can see that (e.g. he looks for aeroplanes when the fly over, he looked at the baby when she cried). Now if I could get him to come when I called or give me things ...

HV is suggesting that most recent crisis was more to do with the arrival of a new sibling that anything else hmm I'm not so sure. He's much more with us now though.

What do you think he means by functional language?

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