Monthly Archives: December 2011

Sleep Loss or Why I’m Now 50% Gray

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When doctors, therapists, experts, and books talk about autism, they talk a lot about communication. They explain unusual play, stimming, repetitive behaviors, developmental delays — in short, everything they can see and maybe help with. That makes sense. During evaluations and therapy, these are the behaviors or lack of behaviors they confront. Most of them kindly will, at some point, also remind you to take care of yourself and to seek out support groups or activities that will strengthen you as a person. They are aware that parenting a child with autism can be highly stressful.

Here is something that isn’t talked about enough. Sleep loss. Not a single individual - including the developmental pediatrician - even once mentioned sleep irregularities in spectrum kids. Not a one. So, for the first couple years of his life, we had no idea how common sleep irregularities are.

And it’s irregular alright. When you bring your newborn home with you, you expect to sleep in bursts. You are aware - not prepared, as nothing can prepare anyone for what sleep loss with a newborn entails. But you figure on going a couple of months getting up every hour or two. Then you somewhat reasonably (depends on how lucky you are really) expect that will taper off to getting up once or twice a night until you are eventually blessed with an all-night sleeper.

Our daughter was pretty easy. She followed this pattern, although she woke up once a night for a lot longer than we expected. But we knew that wasn’t unheard of, so it was no big deal.

And then came Callum. He was the sweetest, smiliest, easiest baby in all the world. But this child woke every 1 to 2 hours every night until he was 2 1/2. And, for the year before that, he often refused to take a nap — happily babbling away and joyfully shouting and jumping in his crib. This, of course, put a serious dent in his big sister’s nap time and night sleeping as well. We’re all affected. If you take a good look at my family of four, you might notice the circles under our eyes at any given time.

And, although he is now known to sleep through the night some nights, we run about a 50/50 chance that Callum will wake up screaming, be inconsolable, and eventually become alert enough — to stay up for, oh say, 4 to 5 hours before getting sleepy again. This means a lot of extraordinarily early mornings. It is quite common for me to go to work at 7:30 a.m., having been up since 1 or 2 o’clock in the morning.

There are all kinds of supplements and alternative therapies people swear by. We’ve tried some of them. It didn’t help. Our lives are made of up of randomly scattered nights of rarely full, mostly interrupted sleep or only a couple of hours of it. The thing is, as any ASD parents whose children have had this sleep irregularity symptom can attest, it’s really really bad for one’s health, career, emotional state, marriage, friendships, and - dare I say? - driving capabilities. Ongoing sleep loss makes you susceptible to all kinds of colds, viruses, and even things you wouldn’t think of such as muscle strain. We find ourselves more accident prone. I certainly have lost a lot of my enthusiasm for going the extra mile at work. (I haven’t volunteered to chaperone a school dance in three years.) I’m too tired to accept invitations that involve being out with friends at night. And marriage? We love each other and have no plans for divorce, but we have had the “No, you’ve had more sleep than me, so you get up” fight many, many a time. Almost all of our disagreements center upon who deserves to take a nap more. Which is not unlike people fighting for the last life raft. There comes a point of sleep loss when civility and compromise are strained and it’s every parent for him/herself.

I have been saying for nearly three years now that the best gift anyone could give to me would be a night in a cold hotel room with light-blocking shades. (With Sean back in school full-time and our family of four living on my teacher’s salary, that’s a luxury we won’t give ourselves.) But, oh my, would it be nice. Curiously, people don’t seem to believe me and are more likely to give tourist t-shirts or spa sets as gifts, but I digress.

It will come as no surprise to you, dear reader, dear fellow parent in the trenches, that I am writing this post at 1 a.m.

Listing to my baby going “ah zhoo ah zhoo ah zhoo”. No, I have no idea what he is saying, but he has always babbled as if he’s talking (which is how we often miss the real words he surprises us with). And I am reminded that, one day, he will likely sleep through the night all the time. That, hopefully, he will thrive and maybe, just maybe, become a daddy sitting up with his own little sleep avoider. That I will miss having my soft, chubby kneed baby boy in my arms That, even in the despair of bleary-eyed exhaustion, there are simple moments of pure contentment in the quiet, dark hours of the night, passing the time with this happy little companion.

And suddenly, I’m smiling face to face with my sweet baby boy. My slightly-sleepy-but-craving-skin-to-skin contact little boy who, when my husband went and got him and brought him into our bed, began to pet my arms and face and snuggle and plaster himself to me, giggling in pure joy of cuddling with his mama. Now that? That’s love. He has never said the words, but we know we are blessed in our assurance of Callum’s abundant love.

Our Autistic Christmas Tree (Brought to You by Callum)

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I know what you’re thinking.

And you have a valid point. Yes, even folks with neurotypical toddlers have experienced Christmases with no ornaments from toddler-reach level on down. We did too with our first child.

But as with everything in life and autism - it’s all in the details. Those of you who have an eye for detail and have/had children with sensory processing disorder or autism may have spotted it. He has systematically removed all the ornaments that didn’t suit his purpose. And then left each and every ornament with long ribbons or string. This is because ornaments with short hooks or loops won’t swing to his repetitive satisfaction.

It took me a while to notice the deliberateness of it. And that was after several swing-worthy ornaments fell - causing Callum to come to me for help in putting them back on the tree. When I attempted to put them down lower or higher? He strenuously objected until I deduced the correct location. His little brain had it all figured out, but it took mine weeks to see it.

I find that’s true with a lot of things about our kids, don’t you?

Dear Shopper Staring at My Child Having a Meltdown in the Grocery Store

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Dear Shopper,

Yes, I know. I’m well aware that my child is screaming. Not just a regular scream, but an ear-piercing, sanity-shattering screech. Even if I wasn’t seeing and hearing it, I would know by the expression on your face.

Clearly, you have raised your children better than me.

That is what you were wanting to say, right? There certainly can’t be any other purpose to you stopping in your tracks to stare or elbow your companion or better yet — give knowing looks to other shoppers passing by.

I have no doubt that you have wonderful, well-behaved children. Grown, tax-paying, law-abiding citizens who would never have dreamed of screaming like this in public when they were children. Judging by your expression and utter exasperation, you’ve never hesitated to let them know who was boss.

And I know that you did your best with your children, that you loved them, and want all children to have a solid upbringing in which to start their lives. You are, in all probability, a good person. You probably don’t mean any harm.

This is what complicates what I want to say to you. Because, despite my anger towards you, I happen to have been raised well too. I don’t want to be ugly, even though right now I feel like it.

Because I know some of that anger is misdirected. It is misdirected because I, too, have stood in judgment of someone like me. I, along with almost everyone, have stood in public and watched a scene like this one play out and thought to myself, “Clearly she has no control over her children. When I have children, mine will never behave like that.” I, like most people, wasn’t quite as obvious about it as you. I didn’t stare or make comments that could be heard. But I was every bit as decided. So, some of my anger is really directed toward Human Nature, who refuses to be put in its place.

The nice thing about human nature, however, is that it can be overridden. And all it takes is but a single experience, a single human interaction, to the contrary of your own strongly held convictions. Then presto whammo — you are a new and hopefully improved person.

Let me introduce you to my child. Like you, I marveled at the miracle of life upon becoming his mother. Like you, I rocked, burped, and inhaled his sweet baby scent and thanked God over and over for the gift of him. Like you, I had certain dreams for my child. There your path and my path diverged somewhat.

My precious child is autistic. Yes, I’ve seen Rain Man, and, no, my son is not likely going to be a great card counter. The truth about autism is that it encompasses a wide spectrum of abilities. And, like you and me, every autistic child who has it is different from the next. Yet they do often share some similar traits - sensory overload and meltdowns are one of them.

Every person on the planet has what I think of as an internal alarm system. Most of us have ours in good working order. But some people with autism have what I like to call a hair-trigger alarm system. Theirs can go off with what seems to average folks like little to no provocation. There IS always provocation. Non-autistic people simply aren’t as sensitive to seeing and hearing the triggers, and that’s when the alarm goes off. And when it does, it’s loud. Everyone in the vicinity wants nothing more than to have it turned off, including the people who love them. When you see me “placating” my child and “giving in” to his tantrum, I’m really just desperately looking around for the alarm key or trying to remember the right code to turn off that blaring alarm. It isn’t his fault. And, no matter how upsetting it is for you, let me assure you it is that much more upsetting for him.

I’m sorry that you haven’t had quite as pleasant of a shopping trip as you had anticipated. It hasn’t been so pleasant for me either. Problem is — I have to feed my family, deposit my paycheck, pick up prescriptions, etc. just like you do. And, unfortunately, no one arrived at my house today to watch my child so that his autistic behavior wouldn’t upset anyone in public. I have to leave the house and so does my child. Because I have to teach him about the world. I have to let him practice controlling his alarm system. So that he, too, can possibly be a productive citizen making come true all those dreams I had for him when he was so small.

With so many advances in early detection and therapy, many of us will be able to see most of those dreams come true for our unique children. And for some of us, our dreams will have to change for our children. We may need to re-define happiness and success. For life is like that. We constantly have to reevaluate our expectations of ourselves, others -and, sometimes, even the grocery store.

I’m hoping that your single human interaction with me has given you an opportunity to be a better person. For, with 1 in 91 children being diagnosed with autism now, you are going to have a lot more opportunities to make a positive impact in the life of someone like me. All it would take would be a smile, a pat on the back, or a “Bless your heart, honey, hang in there” to refill a stressed out parent’s reserve of patience and calm. You could be the bright spot in our day. And, then, if you want, you are welcome to ask all the questions you want. Your curiosity doesn’t offend me in the least. Most of us aren’t the least bit upset to talk about our kids - any more than you are. If anything, it is an opportunity to educate and dispel myths.

And, maybe, just maybe, you will be standing there when the alarm gets turned off. Maybe you will get to see what every mother wants the world to see - the wonderful personality of her child, in our case hidden behind a mask of fear, anger and frustration.

Who knows? Maybe I’ll get to see the one hidden behind yours.

If you liked this post, you might also enjoy:

“We Don’t Talk No Baby Talk Round Here!”

Reply to a Disgruntled Reader

Dear Friend Whom I Haven’t Seen Much of Lately

Letter to My NT (Neurotypical) Child

Or you might like “Excess Baggage” from Random Pearls of Wisdom.

14 Things I’ve Learned in My Very Short Special Needs Blogging Career

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Since beginning this blog just short of a month ago, I’ve had a few people email me to ask me questions like, “Is it hard to set up a blog like this?”, “How did you learn how to do this?”, etc. While it is awfully nice that they would ask me these questions, I am a newbie. But it got me thinking about my experiences with blogging over the past few weeks, and I find that I have learned a few things. So, if you are thinking about starting your own ASD/special needs parent blog, here’s what I have gleaned so recently:

1. You can’t just start a blog and wait for them to come to you. It doesn’t work that way. You must use social networking to find your potential audience. Twitter, Facebook, Pinterest, and the like serve a purpose — they connect you in very different ways to people who share your reality. And, by doing that, you will find amazing blogs whose audience you wish to join. Most importantly, interacting with the special-needs community will teach you quickly that you are not alone.

2. Self-promotion can be a tricky thing and feel unnatural for those of us who’ve never worked in sales. You have to do it, or no one will find your blog. But you also don’t want to do it in tacky ways, so finding the right words when promoting your blog can be hard. If you are like me, it will be a test of your courage to step out on that stage for the first time.

3. As soon as you begin reading blogs of other parents, you may feel not worthy. Suddenly, the challenges you are facing with one toddler who is likely on the milder end of the ASD spectrum pale in comparison to the mom who is raising six kids with severe ASD, is in foreclosure, and battling cancer. You might feel like you have nothing to say or offer. You have to remember that everything in life is relative. No matter what our children’s challenges are, we all love and worry about them exactly the same. It is important to neither discount yourself nor discount others.

4. If you put a picture or a name out there into the blogosphere, you will be discovered by those in your real life, particularly if it is a special needs blog. There are a lot more people who connect to the special needs community than you might imagine (teachers, therapists, doctors, nurses, social workers, etc.). It’s a smaller world than you perceive it to be.
5. There is such a thing as blogger’s regret. If you think that you felt stupid over a verbal flub made in front of your co-workers, imagine how stupid you will feel when 25,000 people read it. The printed word can say everything and yet it often doesn’t reveal the subtleties of intonation, irony, and humor. You will re-read a post and realize that it might possibly come across in a very different - and likely unfortunate - way than you intended. This can make you feel a little like you’re doing the walk of shame from your college days.

6. You will receive hate mail. You might get 100 positive and supportive comments, and only one negative one. Depending on your constitution, this might be the one your self-esteem fixates upon.

7. People are not always what they seem like online. There are sharks out there offering iPads, and special needs resources if you’ll just take a moment to give them all your private information. These people will try to befriend you and hitch their wagon to you before revealing their true nature. You have a moral responsibility to rid your blog and social networking from the appearance that you support these folks and not allow them to lurk around.

8. Having a post go viral or get Freshly Pressed (or some other such net attention) is exciting for a day, maybe two. Then reality sets in, your stats drop, and you wake up with blogger’s block. Most blogs that go viral, including yours, really will be a one hit wonder. Perhaps if your blogging intention is merely to make money, this might bum you out. If you are blessed to be blogging about something that is important to you and others, then obscurity isn’t all that significant. When it comes to blog recognition, we can’t all be Dooce, and most of us will probably have to keep our day jobs.

9. Those wonderful folks you are connecting to online are real people who matter. But the real people who live in your house and actually know your phone number and home address matter more. Of course I knew this before I started blogging, but I didn’t know how easy it is to get caught up online.

10. There are a lot of really stupid fake awards, badges, “contests”, etc. that you can clutter up your blog with and distract you from your real purpose - writing useful content. If all you have to do is register and copy/paste some code into a text widget, you really haven’t won anything. If your content stinks, visitors won’t be impressed with all those badges either.

11. There are a bunch of ethical considerations when blogging. Should you use your real name? Is it okay to tell the world about your child? Is it okay to make money blogging about something as serious as ASD/special needs? How do you balance honesty and advertising? Bloggers make different decisions about these for different reasons. It’s important not to judge others’ decisions and to find the answers to these questions that will suit both your blog and your conscience.

12. You might regret letting those in your real life know about your blog. Especially if you live in a small town. It really can stunt your writing. Suddenly you worry what your flesh and blood friends and family will think of what’s really going on inside your head. Once you start worrying about what other people think, you then aren’t as free to write what you really need to say.

13. There’s a world of people out there who know exactly how you feel. They are rich and poor, blue-collar and white-collar, religious and atheist, left-wing and right-wing, American and international, and every sort of dramatic variation there can be. But they know your heart and mind. They too have held a child tightly in their arms and wished it was possible to take away the challenges they will face or heal them with nothing more than a parent’s love.

14. Think twice before blogging about your mother-in-law. It just might get a little more traffic than you anticipated. And then you will constantly be looking around, waiting for the inevitable. Theoretically speaking, of course. ;)

I really do have a LOT more to learn. I am planning to move to wordpress.org — as soon as I get up my nerve. And I have a lot of technical things to figure out about optimizing my site, blogging support forums, something about a sitemap, etc. etc. Everything you need to know can be found online, of course. It just takes a little time to learn what you need to learn. But, overall, it has been a profound and cathartic experience. I urge those of you thinking about it to give it a whirl.

So, Fellow Bloggers, what have you learned from your blogging experiences?

Cool Quotes: Paul Collins Part 2

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“Think of it: a disability is usually defined in terms of what is missing. … But autism … is as much about what is abundant as what is missing, an over-expression of the very traits that make our species unique.”
— Paul Collins (Not Even Wrong: Adventures in Autism)

3 Broken Ornaments, 2 Injured Parents, and a Little Boy on a Trampoline

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Christmas came and went.

Bronwyn, our 4 year-old NT daughter, was a little hellion. We’re not sure, but we think she might be generalizing that some of her brother’s behaviors, such as meltdowns, are okay for her as well. (They’re just 20 months apart in age.) So, she wore us out and put us on edge. We got a little break when she went to go and see the children’s Christmas performance at church with her grandmother. Sean, Callum, and I decided to be cowardly and skip this one as I still haven’t emotionally recovered from the last children’s church performance when Callum went running up and brought down the entire backdrop of the show.

My husband, who was just recovering from an awful stomach flu last week, gave himself a hernia from throwing up so much. My lower back then decided to go out. So both of us were hobbling around in pain, trying to do Christmas Eve assemblage on either pain meds or muscle relaxers.

After presents, my husband took the kids over to my m-i-l’s house to open more gifts there. They live across the river and out aways and had already come to our house in the morning to see our children at our house. Apparently, it is necessary for us, on a limited budget and with gas prices being what they are, to drive across town just to open presents from the grandparents at their house. They could have simply brought them over, mind you. But, of course, that would be the sensible and easy thing to do, and no one would have the joy of upsetting Callum by dragging him back and forth across town on an already chaotic day for no reason whatsoever. Yes, he was miserable, and, yes, Sean had to bring them back home early. Go ahead. Ask me how I feel about this…

And then came Christmas dinner. Let me say that I have a wonderful sister-in-law who also happens to be an occupational therapist who worked with ASD kids for years. She gets it and knows all about repetitive behaviors. So, she wasn’t even upset when Callum inevitably grabbed hold of a Christmas ornament when no one was looking and shattered it. And she didn’t sweat it when he tested the scientific properties of liquid by pouring out a guest’s beverage onto the floor. We’re working on it, but he throws everything to see if it bounces.

While the entire family was in the dining room eating, I stayed in the living room eating mine off a paper plate and hanging out with Destructo-boy. Which isn’t a hardship at all, as he is an awfully sweet and cute dinner companion. His other attribute is that he isn’t my m-i-l, so there is that. But it was kind of lonely. And I could have eaten off a paper plate in the living room at home.

One thing is for certain. The day will come when I will have an opportunity to give a special-needs parent (or any over-stressed parent of small children really) a free moment to sit down at a nice dinner and eat. I will take the paper plate and plastic fork and hang out with the cute little troublemaker and allow that parent a moment of peace and adult conversation. This is my solemn vow.

But here is where I get to the good part about Christmas. Santa brought Callum an indoor trampoline. Callum, who isn’t even aware of Christmas yet and wasn’t expecting a thing, walked out of his bedroom on Christmas morning and saw- something he knew how to play with. Without even glancing at a room covered in toys and presents, he walked right up to it, climbed on, and went to town jumping with a big, joyous smile. Santa finally got one right — which put a big, joyous smile on Mama’s face as well.

Which is all I really wanted for Christmas to begin with. :)

Cool Quotes: Temple Grandin Part 2

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“In an ideal world the scientist should find a method to prevent the most severe forms of autism but allow the milder forms to survive. After all, the really social people did not invent the first stone spear. It was probably invented by an Aspie who chipped away at rocks while the other people socialized around the campfire. Without autism traits we might still be living in caves.”
— Temple Grandin (Thinking in Pictures, Expanded Edition: My Life with Autism)

Patience Is Not One of My Virtues

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“Patience: A minor form of despair disguised as a virtue.” ~Ambrose Bierce

I’m a fairly patient person. I’m not one to speed. I can frequently be heard telling my husband, who has severe ADHD, to remain calm and that we will find whatever lost thing he is looking for. I don’t get all that upset waiting in line. And you’ll never hear me getting angry with a server because our food is taking too long. I’m capable of being cool as a cucumber and have had more than one person proclaim me the best person to teach others how to drive a standard transmission.

So, I would have thought that I would be a good candidate for tolerating the wait-and-see of my son’s developmental delays. For some things, I have been. My husband gets all bent out of shape worrying about Callum’s self-limited diet of chicken nuggets and, well, basically anything dry and crunchy. He was terribly worried about our son’s slight delay in walking. And he asks on almost a daily basis, “When should we start potty training him?” I know that it annoys him how calm I remain about these topics. I was convinced that he would walk — and he did at 16 months. I keep telling him that eventually Callum will eat other things and that we need to worry about more important things. ( I don’t really know this to be true, but it seems to pacify him — so I keep saying it. ) And potty training? With autism already in my family, I am well aware that we could be in for the long haul. At the very least, Callum will probably be behind everyone else with regard to toilet training. So, I choose not to sweat those things and keep up my annoyingly calm facade.

And it is a facade. Because underneath all of my protestations that all will be okay, I am terrified about one thing. When is he going to talk? I know I am supposed to adopt an attitude of keeping-up-therapy-and-hoping-for-the-best, but I confess I suck at it. I know that talking is not the measure of success for autistic people. I’ve read stories and blogs about lots of ASD folks who use assistive communication and writing. But I’m selfish. I want him to talk.

Since I was a little girl, I have always been a lover of language. I was a bookworm who read my first pictureless novel in the first grade and was reading almost a book a day by middle school. When I came across a word I didn’t know, I ran to a dictionary and practiced using the word until I knew it. Idioms have always fascinated me, and I have always sought out their origins. When my mother was going through her antique shopping phase, I would find myself in the back of the store, looking through the old books, scrapbooks, and antique diaries. Finding just the right word when writing, for me, is akin to a painter finding just the right color or brush stroke. I happen to think Wikipedia is one of the great wonders of the modern world. And I happen to believe that being illiterate is just about the worst thing that could happen to a person. I’m the aunt who gives books to children for holidays, and I am the moderator of not one, but two online reading groups. In my teaching career, I have been both an English teacher and a school librarian. Suffice it to say, language defines me as a person.

But language might not be part of Callum’s life. I don’t need my son to be captain of the football team, popular, or a genius. But, oh, how desperately I want him to be able to communicate more than just his immediate needs. I want him to have the power to seek information and to learn about his interests. I want him to be able to seek out minds like his and make connections to the world. I don’t want him to be trapped inside his own mind.

On one hand, I am trying very hard to accept that he may never talk. After all, there are a whole lotta folks who have been in my shoes who prayed just as hard and didn’t get this very same thing. And they have a lot of wisdom to share about changing one’s dreams and expectations. I have no doubt that all of that is true. The problem is that I’m just not there yet. I’m still in that bargaining with God phase. And I worry I’m never going to get past it.

I have said before that autism is a fascinating thing. And it is. But it is also a cruel tease — giving us small glimpses of the minds contained within before slamming the door shut again behind a series of elaborate and confounding locks. It isn’t that I want him to leave the room altogether. It’s just that I would like a really good window out of which we can see each other.

Right now, Callum is giving us a lot of good signs. He has a few words that he uses when he feels like it. Clearly, he has some receptive language. Ask him if he is ready to take a nap, and he will dart to the other end of the house in an escape attempt. He will sit at the table when asked and put his sippy cup down rather than throw it when we insist. Say “bath”, and he enthusiastically makes a run for the tub. He takes our hand and leads us to what he wants. He’ll open the refrigerator and reach for or hand us the milk, saying “Pees?”. And he’ll occasionally say, “Joo” when asked if wants milk or juice. He gestures for help to get on the bed to jump. If you tickle him and roughhouse, he will pull your hand back to do it again and say or sign “more”. And he babbles with inflection all day long. He has pretty good eye contact, is curious to see what we are doing, and “checks in” with us repeatedly when running around the house doing his thing. There is no doubt he has the “communicative intent” all of the resources I have obsessively researched on the web have said are good predictors of speech development. And he is still three months shy of being three.

Yet, I drive myself crazy because I know that, when it comes to autism, there are no certain predictors of anything. And the broken record in my head starts again. I often feel stuck in a state of worry, and I can’t seem to get unstuck.

I’m trying to cut myself some slack here. I know that I am new to this. And I know that, at some point, I will move beyond the bargaining with God phase and into acceptance of whatever may be. But I find it’s not happening fast enough to suit me - which brings me full circle back to the subject of patience once again.

How do so many of you reach that place of patience, peace and acceptance? And how long will it take me to get there?

Book Review: Motivate to Communicate!

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Motivate to Communicate: 300 Games and Activities for Your Child With Autism is a great resource for parents, teachers, therapists, and other caregivers to help motivate children with autism and other communication disorders. Written by Simone Griffin, a speech therapist, and Dianne Sandler, a special education teacher, this book aims to help us use everyday objects to entice children to communicate.

It begins with a chapter explaining how motivation plays a powerful part in encouraging children on the autism spectrum to interact and communicate. The authors caution parents to consider their child’s strengths and interests before embarking on any one of the activities. They also include a list of useful websites to find toys and resources for special-needs children.

Following the introductory chapter, the book is broken into the following chapters:

1. Motivate Me with Food

2. Motivate Me with Party Toys

3. Motivate Me with Social Games

4. Motivate Me with Outside Games

5. Motivate Me at Home and School

Each of the chapters explain dozens of play activities utilizing everyday objects such as utencils, sand, balls, puzzles, mirrors, balloons, etc. There are very few activities for which one might need to purchase materials. Most of the needed items are already in your home or available at a Dollar Tree.

Following the activity chapters are lists of useful links.

I really like this book and the simplicity of the authors’ approach to at home therapy. The explanations for each activity are clear and easy to implement.

My only complaint about this book would be a lack of a skills index for targeting specific needs. Other books of this nature have such an index. I hope they think to include one if updating in the future. Overall though, this is a great addition to an ASD library for parents of young children on the spectrum.