About this blog.

My son was diagnosed with PDD-NOS at 24 months. I created this blog to bring meaning to the often-confusing label. Sometimes I have answers. Other times, just more questions.

Wednesday, January 6, 2010

What to Expect (Almost) Age 4, PDD Edition: Engagement

In the coming weeks, I will be blogging about Brad's progress, but this week, I'm blogging about that which has been constant: his engagement.

Engagement is a difficult thing to describe.

I believe that Brad is easy to engage. In fact, several of his examiners (including his developmental pediatrician, his teachers and his speech language pathologist) have commended him on his ability to attend.

But the quality of engagement. It's different. It's not sharp, focused and sustained, like a typical child. You can see it in the videos.

This is the way it's been since he was a baby. I would never say "he's in his own world." But he's not always in my world either. He's somewhere in between, absorbing some pieces of his environs but disregarding others. I think this is part of what's vexing about A Little Bit Autistic. It's in between, neither here nor there.


Queenbuv3 said...

My son acted like he was deaf when he was diagnosed at 18 months. The EI therapists would chase him around trying to get his attention and engage him more than being able to really do anything with him. He was very hard to engage until he was about 6 and we finally got him in an out of district school. They had been doing ABA with him all day everyday when they were only supposed to be doing it about 1 hour a day four days a week. they were forcing him to engage, attend and make eye contact. They had the nerve to video tape the work they did with him in school. I still can't watch them. Anywhoo! Once we found out what they were doing and saw how his behavoir was horrible as a result and that they had violated his IEP we got him into a TEACCH program. This is when he really started to WANT to engage with other people. It has taken years but I that's ok because it has happened naturally.

Now he wants to pay attention to other people and see what they are doing and saying and looks for instruction. His eye contact is great when you are having an interaction with him, in fact he will just keep looking into your eyes at times.

We never forced him to pay attention or make eye contact. I really think this has resulted from time and maturation. He is much less sensitive to stimulation (except at school when other kids make their noises or scream) than when he was little and I think that makes a huge difference in being able to attend. He also has a sensory diet and sensory things in his room to help him regulate himself.

Of course, I think some of his inability to attend and engage at times is because something just isn't interesting to him. I think we all do this. Why would I or anyone else pay attention to something that doesn't either bring us pleasure or that we don't think we need to learn something. A 4 year old isn't able to see why it's important to engage at times. This is where I think his natural progress and maturation has come into play. He sees now that if he doesn't engage with people for certain things that he will miss out on an opportunity to grow, become more independant, do something fun, learn how to get his needs met, etc.

Is all this off topic or is this the kind of thing you were talking about? I know my son has a different diagnosis form your son but hope that at least some if it relevent : )

Kris said...

This idea of "engagement" is interesting to me because it is the primary reason 2 out of our 3 evaluators gave Alec an ADHD dx instead of ASD. He is "too engaged" they said. "Sociable and engaging" and "quite social in nature" said one. The other described him as a "friendly boy" who "engaged the examiner in pretend play." They both specifically told us at our conference that he was "too warm" and "too engaged" for an ASD dx. Hence, the ADHD and SPD dx.

Alec can at times be engaged and at others (when he is sensory seeking or in a large group) be pretty UNengaged.

I look forward to hearing how Brad is doing!!

Laura said...

queenbuv, thanks for the note. And yes, all of our children are so different. But I appreciate your perspective, and I love your values. I do think that some of the engagement issue has to do with interest.

Kris, thanks for the note. I do notice a difference between that one on one evaluation setting versus a group setting.

Anonymous said...

Yes. Your description fits what we have seen with our daughter. She was interactive enough as a baby and at one to one and a half that we originally dismissed an autism spectrum diagnosis. It looked more like an auditory processing disorder. She is also at a place 'in between'. Without the sharpness and focus you describe in typical engagement. But still quite "engagable" and interactive on her terms. "A little bit autistic" is fitting. She's seven.

Shirin's Art said...

i feel the exact same way about my son...

Nyx said...

Yes. It's usually pretty easy to engage T, although this varies with the circumstances. When he's short on sleep and/or when he's sick it gets much harder. What's kind of interesting is that now that he's verbal, I can kind of tell better what's actually going on ... and I think that often he really is just sort of re-living a variety of things ... I have been extremely stingy with video entertainment, so he doesn't "script" in the same way other kids do, but it's obvious to me that he would if he'd seen a lot of videos. When the twins got sick a few days ago I let them watch Caillou (spell?) and T talks about it constantly, often repeating the same thing over and over. But he also makes connections, it's not totally mindless. When I pulled out grape juice, he said "Caillou made sour juice." I had to ask him several times, but eventually he answered to tell me that he had made the juice out of lemons. Etc. But he often won't reply the first time. He's apparently having much too much fun reliving whatever it is. Before he was verbal he just seemed spacey a lot. But mostly happy. Not what I would have considered anxious-seeming. And yet, I do now think that there is something going on kind of like a phenomenon I experience sometimes in the form of racing thoughts. It's like I can't shut them off. For me, this is usually anxiety produced. But I've been thinking lately ... it's like he's flooded with all these thoughts/memories and he can't shut them off. If I want to be heard, I have to squeeze myself in there in between them. It is also a LOT like he's just sort of daydreaming all the time, you know? A daydreaming infant. It sounds crazy, but I think maybe he REALLY was. And he liked to stay up late and sleep in late. Wanted to sleep all day sometimes. It's almost like he was a teenager before his time, LOL.

K said...

This is very true of R as well
In addition his engagement is very specific- for example to show affection -
However very little joint attention - R will never show me something ( except for a functional reason - like show me the remote because its not working)