Thursday, September 3, 2009

DIY - Lesson One

Self-sufficiency is an issue that is common to all adolescents, not just those with a learning disability.

As parents, we try to foster independence in our children from an early age -- expanding the boundaries and raising the bar of expectations as they mature and there is evidence that they are ready for the next level. One of my son's first forays in this direction involved two pairs of sneakers that we had bought for him when he was about three years old. The sneakers were the same style, in different colors. One morning I asked him which shoes he wanted to wear, and he replied without hesitation, "One of each!" Fine by me -- he had made his own choice!

Sometimes lessons on independence come from unforeseen (not to mention occasionally unwanted) circumstances. One evening in early December when he was in eighth grade, my son suddenly became very dizzy and nauseous. After spending the night in the Emergency Room, he was admitted and later diagnosed with meningo-encephalitis -- both meningitis and encephalitis. (I need to add from which he fully recovered.) He spent nearly three weeks in acute care before being transferred to a rehab hospital for four more weeks. The therapists that he worked with there were exceptional, and they really understood my son. Much of what they worked on -- physical therapy, agility -- was related to his recent illness. But the therapists recognized that there was a need to bolster some more fundamental skills, beyond any damage to his speech and coordination that resulted from the virus.

One thing they worked on during that time was taking a shower. Again, this is not something most parents would think of teaching their children. But to a child with a learning disability that affects organizational skills, the "how" part of taking a shower is far less obvious. My son's occupational therapist created a list of steps, laminated the list in plastic so it could hang in the shower, and verbally went over the steps with him at each shower: from turning on the water and adjusting the temperature before stepping in, to a logical order for washing. The therapist suggested top-down, basically starting with shampooing the hair, and this worked well for our son. We brought the card home and put it in the bathroom, where it stayed for several more weeks until he was confidently following the same routine each day. The sequence of steps was not the critical factor in helping our son master this skill of daily living. What mattered for him was the list, the verbal instructions and the routine order.

For neuro-typical children and adults, taking a shower is almost an instinctive skill. But for those challenged by Nonverbal Learning or a similar social communications disorder, instinct plays a very minor role in grasping either the importance or the fundamentals of some basic life skills.

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