Tuesday 16 August 2016

PLAY AGAIN: It surprises all the Time

Harshit (name changed), a 6 year old kid, joined Potentials in the month of April, 2016.
He has been consistently taking Occupational Therapy for Sensory Integration and ABA therapy outside Potentials. At potentials, he began with Play-Social Communication- Language Therapy in April, and Speech Therapy in June.

 His first session with me was on 1st April, 2016.  As we begun, Harshit only wanted to jump. So therapists joined him. When I insisted on him to sit, he again got up. It was as if we had springs. It was a super jumper session, with 3 of us jumping all over the room.

 I was told that Harshit is here till September, 2016. I can deliver as much as I want in these few months. In the beginning, I was a little scared, as understanding the kid, and the autism specific to him will also take some time. Initially his sessions, and thinking of goals and activities was becoming cumbersome, because all my thoughts were revolving around the deadline “September”. Hence, his sessions were boring. In retrospect I would analyse the session to be boring. I didn’t enjoy at all. Something was missing. Then after a lot of introspection and analyzing, I realized that Play with him was becoming a task. My focus shifted from the deadline to co-creating joy and having fun with him.

This one thought made all the difference. The sessions were transformed. Since he loved to jump, we kept different things to jump on. So once we kept pasta. Raw pasta from the market was the play material. We first explored it and found that it makes a sound when it breaks. I threw some on the ground and started to stomp my feet on it. Harshit joined in, and he wanted more. So with one activity that was fun, we could target his joining in the game, body orientation towards the play partner, asking for more pasta when it was all crumbled. Now when he was tired, we sat and broke the pasta with our hands and heard the sound, and felt the texture. I broke a pasta piece close to his ear. So we could also target proximity, and tolerance of another person close to him. Gradually we introduced bubble paper and thermacol balls. Playing with all these things was total fun.

I started looking forward to Harshit’s session. Earlier he had a blank face or a frown at times, but now the facial expressions where easing down. We started seeing an Ok face, and gradually we saw Harshit smile more. The expression of joy changed into sharing of joy with the therapists. With consistent Occupational therapy, his sensory needs were also getting fulfilled, and he was learning new skills. Harshit was sitting willingly now, so we did some structured sitting tasks.  Narrations before an activity were helpful. The narrations helped Harshit know about the activity, what is expected out of him and what might be difficult for him. This strategy eased his anxiety of the newness of the task. A clear start and stop was also defined for structured activities. For unstructured activates we told him the activity that followed. The confusions in his mind were getting clear, the uncertainty of the moment, that time or class was becoming easier to understand, and his verbalization was increasing too.

One fine day, I happened to talk to Harshit’s mother about his progress and present skills. The mother was elated to share that Harshit has started playing, though for shorter intervals, with his cousins. The best part for the mother was that he has started tolerating children around him. I took this as an opportunity to ask mama to write the progress that she sees in Harshit. I gave her a sheet of paper to write. I am so glad to share with all of you. The mother wrote: Small improvement in joint attention and eye contact.

1.            Has started tolerating other people around and also let them play with him for short duration. Was playing with his cousin with ball.
2.            Lately we are also observing playing appropriately with toys and showing interest in them.
3.             Listening and following commands.

I was so happy to read the progress that the mother shared. I was glad to see, how the mother could observe the small changes in Harshit that will make a big difference to their life. Harshit’s family has preponed his trip, and they are leaving in August itself.

From a therapist’s point of view some changes that I saw in Harshit over a period of 4 months:
  1.             He has calmed down, and jumps in excitement.
  2.                     He is willing to sit and do a task.
  3.            He makes an attempt to play, or do the work given, even though he finds it difficult. This is a wonderful thing about Harshit, because until someone tries, how will they know how much fun can the task be, and what to improve upon.
  4.          He will also reach out to the play partner or therapist for help if he finds the task difficult with therapist facilitation.
  5.         He joins into take out pre-speech sounds with us. He attempts to produce a sound, and we can see that with his mouth shaping.
  6.          Harshit has been able to internalize the point that- when he speaks, uses his words, people understand him better. He picks up words from his exposed language and says something when he wants a reaction, or asking for something (need based communication) or asking for more play. This is a beautiful skill that he has picked up. He learned to say chapak chapak (Hindi words for splash splash), when it was time for water play.
  7.          He has started doing reciprocal coordinated play. Like ball catch and throw with 2 play partners, sliding a ball over a slant surface taking turns. He waits for his turn, and observes the play partner with therapist facilitation.

In 35 sessions across a period of 4 months, with 2 sessions in a week, Harshit could learn some basic foundation skills that will help him in his growing up years. Harshit left to his home town, leaving a beautiful experience of play with me.