Winds of Change.

If there is anything we wish to change in the child,

we should first examine it and see

whether it is not something that could be better changed in ourselves.   

Carl Jung

From what I have learned, traveling around the blogosphere, there are different approaches to behavioral therapy.  There is ABA, or Applied Behavioral Analysis, Floor Time, and TEACCH.  The one that we participate in is ABA.  And for that?  There are variations as well.

My son has a total of about 30 hours per week of ABA time, divided about half into a one-on-one kindergarten school aide and half on regular therapy and the ABA group call themselves a team.  There are two tutors and a third, senior tutor who work “programs” with him.  The programs are a couple minutes each and teach a language, school, comprehension, or daily life skill (like brushing teeth, washing hands).  Once he completes the task, he receives “reinforcement” in the form of play time with the tutor in a desirable activity like piggy-back rides, playing with cars or other toys, or making a fort.

My son has seen tremendous progress over the last year. The ABA team consists of the behavioral therapist who is the Ph.D., and his assistant therapists who help choose and develop programs based on skills my son “masters”.  Then there is a “case manager” who shows up for a weekly meeting, and does a once weekly “shift” to supervise the tutors’ implementation of the programs and to determine my son’s level of progress.  And finally, the three hands-on tutors who work with my son on a daily basis in therapy and school.

Throughout the year, there have been lots of tutor changes.  Tutors come and go.  I have accepted all the changes, although have been sad to see a couple of the tutors go.  My son, also, has accepted these changes with very little increase in his behaviors.

All have come and gone, up til now, but one.  Our steadfast senior tutor.

She is one that has been a constant in my son’s life, from the time we first started. She has been our miracle worker.  She is the one who took my son from a constant screaming ball of meltdown goo, when he saw an escalator, to the kid you barely glanced at, as he alights and steps off from the same mechanical staircase, a year later.

She’s a person who has extinguished so many behaviors, in the year she’s been part of our lives, that I’ve become a bit spoiled by the whole thing.  Behavior?  Beginning of a meltdown?  Take him to Trista.  She helps me figure out the why and extinguishes the behaviors.  Problem solved.  She teaches me, and like a magic spell, it works.

Now, she’s being removed from his team.

Why?  Well, I can understand that generally, change is good.  And I can understand that meeting new people, and taking instruction from different people, are also good.  Where I am perplexed is the manner in which this change is occurring.

Change can be rocky or it can be smooth.  This is going to be rocky.  First, the details of the change have been vague.  I know a name for the new tutor.  It’s Jessica.  If you read here regularly, you know we already have a Jessica.  A second Jessica will be a little confusing.

I have not been introduced.  Apparently, she is going to meet my son at school for the first time.  She will have a max of four days of training, and our senior tutor, Trista, that he’s known for a year will be gone.  Erased.  And with her, all her encyclopedic knowledge of the triggers for my son’s meltdowns, the tricks that she uses to extinguish his behaviors, like water on a fire, and the special reinforcers, that she knows he loves.

He will still have his other tutor who has been on his team for about two months.  He is wonderful and mellow but he does not know the triggers or recognize all the behaviors.  Just last week, his lack of knowledge combined with a mystery meltdown, to put gas on my son’s fire, when he asked my son to “count” to work through the meltdown.  The meltdown continued full on for 30 minutes.  An afternoon shift was cut off that day due to repeated meltdown, something that hasn’t happened in a long time.

The other tutor?  She’s brand new.  Still being trained and has worked with my son a total of maybe four times for a total of maybe, six hours.  I’m asking this “change” be effected less cold turkey and more easing off.

I’m just wondering.  Since I put it out there on Twitter and got three responses so far, what is your experience with a change in tutors or other people who work with your children?  Is it a cold turkey thing or is there a transition period?  And how do they react?

Meanwhile, with this change I’m already getting a resurrection of some oldie but goodie behaviors, ones that I’d thought were previously extinguished.  So, while, I wait it out, I thought I’d put together, my rendition of my son’s greatest hits…  I’d change the lyrics but Brian over at Both Sides of the Coin does such a better job than I could ever hope to, that I will just put out my own mix, dedicated to my son’s meltdowns….

“Tootles’ Greatest Hits” album is, hopefully, available for a limited time only…

Side One

Bad to the Bone  George Thorogood

Bye-Bye-Bye ‘N Sync

Cry me a River  Justin Timberlake

Saturday Night’s Alright for Fighting  Elton John

Winds of Change  Jefferson Starship

Side Two

Fall Out  Bitchslap

Same Old Song and Dance  Aerosmith

Sweet Emotion  Aerosmith

Rebel Yell Billy Idol

No More Tears Ozzy Osbourne

I’ll probably listen with earphones.  My nerves will be less frayed that way.

Bye bye bye, Trista.  We love you!


About solodialogue

I'm a lawyer and the mom of a 6 year old boy with autism. I work part time and spend the rest driving here and there and everywhere for my son's various therapies. Instead of trying cases, I now play Pac-man and watch SpongeBob. I wear old sweaters and jeans and always, always flat shoes to run after my son. Yeah, it's different but I wouldn't change it for anything. The love of my child is the most powerful, beautiful and rewarding aspect of my life.
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22 Responses to Winds of Change.

  1. Kelly Hafer says:

    Hey Karen – I wonder why they are making the change? Yes, change is necessary for growth and you want Tootles to be able to generalize his skills, but this seems a little stinky, IMHO. I am sorry you guys are going to have to go through this very unexpected (and unnecessary to me) change.

    Ted and AJ have, in the past, done okay with therapist changes. However, even months later, we still here old names and wonder where old therapists have gone. They just don’t quite grasp the finality of the changes.

    Is it possible for you to intervene and request that Trista and Jessica work together for a week and s-l-o-w-l-y phase Trista out? That way it isn’t so abrupt? I totally sympathise with the loss of a long-term therapist. We had Yoda in RI for the 14 months we were there. Fortuanately, and for reasons unrealted to us, she and her husband chose to relocate to VA. Now we have the same ABA therapist that we have had for more than a year. The info that these long-term players have on our kids, the history, the “tricks” and everything that they know abou our kiddos are priceless.

    I wish you very good luck. Can you call and kind of fight this? ((Hugs))

    • solodialogue says:

      That is so lucky-weird that Yoda came to where you guys relocated! Someone is looking out for all of you! This morning we had a meeting and the transition will be slower. Trista will work with the team and give them her encyclopedic knowledge as much as possible. Then, she will become a reward for T’s good behavior! (Thanks for the hugs! Always appreciated and returned.) 🙂

  2. Wow. This does sound a little “stinky.” Why would they initiate this switch without your express permission? It seems like a waste to remove all the knowledge and experience from your treatment team with barely any transition period. I think I’d have to complain!

    I wish I had some advice for you, but Little Miss has always been good with therapist transitions (possibly because her memory isn’t the greatest). I’ll keep you and T in my thoughts!

    • solodialogue says:

      Thanks Karla. Really, we want T to be able to handle changes but I don’t know many people (much less an ASD child) that can handle cold turkey! We have negotiated a compromise of a longer transition period and using Trista as a reinforcer for completing tasks ( if you do A, then you can have lunch with Trista or playtime with Trista). Keep your fingers crossed!

  3. Tootleslady says:

    Riot in the streets!!! TRISTA STAYS OR WE GO!! or just a longer transition period!!

  4. Lizbeth says:

    We’ve had issues with transition. Some from when we moved and others from when therapists have moved on or we switched services. Either way, Alex remembers them ALL. He seemed to at first accept the new person but we’d have an increase in behaviors at home. Only later would we get it in words that he was upset that so-and-so is not working with him. He takes transitions hard. He has a bond with these people and I sometimes think they don’t realize how attached he gets. And when they go he reacts. I anticipate an increase in unexplained behaviors or meltdowns and just give him a wide berth knowing why its happening. Alex still talks of things he did with Miss K.—she was his first Speech Therapist from when he was three. He remembers her like it was yesterday.

    • solodialogue says:

      It’s so weird how much Alex and Tootles are alike – eerie! T will do the same thing. He shows acceptance and then increases behaviors at home. This weekend was like a horrific tornado. I wonder if it has something to do with how they remember people and things. Very intense. I wish I understood it better.

  5. tristd says:

    i love you guys too! Tay has been such a huge part of my life for over a year and its hard to let go and let someone else take over, but I will be praying for a smooth transition period 🙂 I will miss you guys too, words can express how much! Love you all, Trista

  6. Jim W. says:

    Transitions suck, to be plain. Our wrap services for preschool age children will end at Lily’s sixth birthday, so the folks currently handling her services will ALL be gone, including our version of your Tristan, or the woman I like to call our “Annie Sullivan”.

    We have had three years of services from them. They re-evaluate scheduling every transition from summer to school to summer, and we have dealt with many many changes. The thing that most pisses me off, is when they bring in NEW people to work with her. Often we find ourselves providing her the training her BSC has failed to provide.

    It’s icky. But on the plus side, it was one of these transitions from school to summer about a year or so ago that brought us our Annie Sullivan. Sooooooo, in a way I guess there can be a silver lining. When her hours have been limited, we’ve fought it, and fought for MORE. I can’t always say we’ve been successful, but unless Tristan is leaving because she’s found greener pastures, it can’t hurt to make a bit of a stink. After our last stink we ended up with “Annie” for 20 of the 30 hours that Lily currently receives for wrap.

    Worth a shot.

    • solodialogue says:

      That cannot be! Losing them all at once? I cannot imagine how she will get through that! Are they planning to “social story” their “completion”? Yeah, as parents, we tend to have to supply some training to the new people. I don’t mind giving information here and there but the stored and filed knowledge – that’s a lot of info. Trista is not leaving for greener pastures. She is being removed from the team. I do understand that my son’s behaviors can escalate when he’s good and comfortable that he’s got a tutor under his spell and that the change can be good in that regard but the cold turkey approach is just wrong! Trust me, a meeting was had today and there will be no cold turkey now! Trista is being turned into a reward for my son’s completion of his programs… that’s a solution that – hopefully- will work!

  7. Jim W. says:

    crap. . . meant to get notifications of follow-ups via email and found out I can’t do it after the fact. So. . . this comment is a throw away to get the follow-up.

  8. Kara says:

    Slipping back into old behaviors makes me want to suck my thumb and snuggle my woobie. In my head, I know that it’s a glitch we’ll work through. But my heart and soul relive the times when those behaviors weren’t just glitches but our way of life. Sometimes my heart and soul don’t listen to logic and can be real ass pains. On occasion, they act up more in anticipation of what might lie ahead than Ellie’s reaction to the actual transition.

    You got a really good Jessica. Maybe it’s something in the name and you’ll get a double force of awesomeness.

    • solodialogue says:

      Why must you be so logical? I really don’t like the escalation – but I hope you are right and it’s a “glitch”. We shall see…. Double force of awesomeness – love it! 🙂

  9. Brian says:

    Okay, okay. If you request Karen, I”ll do a Song in the Key of Brian to one of those up there. You can pick which one of ?Bye Bye Bye, the Ozzy Song, or Cry me a River. Note: I may just do Bye Bye Bye cuz that song is just awesome.

  10. Oh no!! That sounds awful! Poor you and poor Tootles. I wish I had something helpful to say, but we’ve been following an ABA program for all of three months! I hope she managed to somehow pass her knowledge on before she leaves though…

  11. ElizOF says:

    Why all the changes Karen? Have you asked them to justify them; especially Trista’s? I can understand budget cuts but they at least owe you an explanation… I don’t understand why there are so many tutors in and out… Trista sounds like a stabilizing presence … Shame she’s leaving too. Urg! 😦

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