Adaptive living skills has been funded for a six month period consisting of twenty six hours each month for my nonverbal son Matthew. The specific skills to be addressed during these sessions is toileting and washing his hair. During the initial assessment I mentioned that Matthew had some recent elopement issues so they added in community safety.
The agency providing the services also has a separate division for Behavior services. Even though the Regional Center specified on the funding document for Adaptive living skills and behavior management evaluation they had to be done individually and funded for separately. This assessment phase took months to complete with California Pediatric & Family Services. Funding was approved in April with services finally commencing in October. This slow process is frustrating to the families waiting on needed services.
I decided I want to focus solely with the adaptive living skills as behavior was previously addressed with the now defunct Wellspring. I did have an interesting conversation with the male director of their behavior management program on masturbation. He informed me that we could provide magazines for Matthew and a video that would help guide him in achieving orgasm and ejaculation. This is a topic we will be exploring in the near future.
The terminology utilized and data collected is very different with this new agency. We are working with an instructor as opposed to a therapist. I do not know the training background and have yet to meet or speak with a supervisor.
Due to the gap between services addressing the toilet training we are back to square one. The difference this time is that school is also working on toileting at the same time. We had several meetings in August and September to get this tackled in the school setting.
I mentioned that Matthew has a difficult time with the water on his face when I am washing his hair as he sits in the bathtub. This somehow got translated into teaching Matthew to wash his own hair and then take a shower. I have emphasized that he needs to be comfortable in the environment before he can learn these skills.
Besides having a female instructor instead of a male the services are taking place on Saturdays and Sundays due to the availability of the instructor. After a few weeks of this schedule it works out well instead of the added stress and pressure of Matthew to do all these things after coming home from school where he is being taken to the restroom every fifteen minutes and sitting on the toilet for five minutes.
We have three hours every Saturday and Sunday morning to take the bath and work on the skills that he needs to eventually learn. Taking a bath in the morning is also a new experience for him due to this being a nightly routine previously and still on weeknights.
He is falling asleep in the tub before all the steps have been completed. He is very uncomfortable sitting in the tub and does not sit in a normal position. Instead his feet are behind him and his butt is not even on the surface of the bathtub.
I have made many suggestions that need to be implemented before we can just jump into him taking a shower and attacking me in the process. I feel we need a bath mat for his comfort and safety for when he eventually learns to take a shower. Another idea I had was for a bath mitt to help him learn to clean himself. One more product needed to help Matthew adjust to the change from bath to shower is to obtain a hand held shower device so he can get used to the feeling of water on his body from a spray nozzle. I also think we need a visor for his head so he can learn to wash his hair before we address the water and shampoo in his eyes.
It gets confusing when the instructor wants Matthew to wash his body and his hair when we can see he is clearly uncomfortable in the way he is sitting in the tub. I feel we need to master each step before we move on to the next. He needs to have his feet in a relaxed state before we start him on washing himself and then learning to wash his hair and then becoming familiar with the shower head.
The Shower poster has 40 steps on the process of taking a shower. It does seem a bit overwhelming when breaking down the steps on the tasks that needs to be taught for living skills, but bypassing one or going too fast could ruin the whole process.
When Matthew got out of the tub the instructor wanted me to have Matthew do all the tasks of getting dressed, brushing hair, cleaning ears, lotion on feet before socks, deodorant before shirt and clip fingernails. Matthew needs advance notice that he will be doing these tasks instead of informing him as he gets out of a tub on a cold morning in a house with no heat.
Another skill being taught is to tie his own shoes. We go over this before we go out on either a walk or an errand. I did not want the instructor to teach Matthew how to open the front door or how to put on his seat belt or open the vehicle door. These are all safety issues for me that could have disastrous results. This is similar to teaching him how to use the stove. We are not ready or at that stage in life for Matthew to know or comprehend these things. I again said let us focus on toilet training. Swimming lessons and after school track will become a reality once he has mastered a toileting routine and no longer wearing disposable underwear.
Sexuality Workshop PDF
Indiana University, The M Word
Sexuality and Autism Danish Report
Autism and Orgasm, The Thinking Person's Guide to Autism