Syllogism-ism: Part I

As I blogged last week, lately I have been concerned about Brad's ability to make those higher order connections. Recall Brad's speech evaluation over the summer. I was a bit - shall we say - prickly in the immediate wake of the debrief with the speech language pathologist. As I blogged, she told me that Brad was rigid and lacked imagination.

So I was reactionary. That's my M.O. when some one tells me something I don't want to hear. But to give me credit, over time, I was able to be objective about the evaluation and appreciate what she was trying to tell me; my reactionary phase was short-lived. Herein lies what separates a denialist from a realist.

She also told me something I hadn't previously considered: he's impaired in verbal reasoning.

"What???" I asked. No, Brad has a communication impairment but his ability to reason is perfectly in tact, I thought. Reasoning and language are totally separate areas of the brain. I read that somewhere. He has a language impairment. And a sensory issue. And a social issue. And poor working memory. But reasoning is intact. It's that simple, I reassured myself.

I hate it when I'm wrong.

After originally dismissing the SLP, I have come to believe that she is correct: Brad does have an impairment in verbal reasoning. What that means (disorder versus delay) and how it will play out, I'm not sure. But that he has an impairment is pretty obvious now that it's been brought to my attention.

Syllogism-ism: Part II

Cue the syllogisms.

To "treat" his impairment in verbal reasoning, Brad's private speech language pathologist engages Brad using printouts like the one pictured above.

It starts with W questions, who, where and what.



Then it moves to "what happened".



And then what I call the syllogism prompt: "what will we do?"

Every week, they work on a new "story" that follows this basic interactive format. The column on the left (the W questions and the syllogism prompt) does not change. The SLP leaves me a printout so I can reinforce and practice in between sessions.

Goals, by their nature, should be something to strive for, not something already mastered, and that's why I really like this intervention. Currently, Brad doesn't really get it. He can't deduce, or problem solve yet. That last "what will we do?" question consistently trips him up. But he even though he can't formulate deductive reasoning, I think he is starting to comprehend these little syllogisms, perhaps in a passive way. But comprehension isn't for nothing. Little by little, I like to think that this type of intervention does exercise those tenuous "higher order" synapses, perhaps keeping them from dying off or causing them to flourish.

I will close with a proof point: I set the table the other day and forgot to set cups with the kids' drinks. Brad: "Mommy, you made a mistake!" (Ha! And it won't be the first, Brad.) Now that's deductive reasoning.

Added: The printouts pictured above were created with BoardMaker.

"Pruning"

When it comes to interventions, much is written about "rewiring" the brain - the theory (and, for some, hope) that intensive interventions can cause an atypical child to be more neurologically typical. Is rewiring possible? I don't think anyone knows for certain.

But it is well settled that you can work with the wires you already have. During childhood, the brain undergoes a pruning process, during which underused neurons and synapses simply die off. This is perhaps the best argument for early diagnosis and early intervention. With early intervention, perhaps we can prevent some of those tenuous synapses from dying off, and the sooner we start, the better the chance for a positive outcome.

With that in mind, in the coming weeks, I will blog about interventions that we have tried. In the upper right, I indicate that we use "moderate interventions." I'm going to try to give that vague statement a little more shape, speaking of course from a parenting/anecdotal POV.

First, a prefatory note about goals. Because, of course, as any special needs mom or dad with an IEP knows, you need to start with goals. About one year and nine months ago, if you had asked me about my goals for Brad, I might have replied that there is only one and that it is that he acquire speech. Flash forward about six months later, I started thinking more about social pragmatics and empathy. I added warmth and humor to the list of goals for Brad. Today, on a high level, my goals for Brad have shifted to intellectual capacity, i.e. making those higher order connections and doing whatever we can today to avoid intellectual disability down the road. Not that communication and warmth and humor aren't goals for Brad - they most certainly are. But I no longer fear that Brad won't acquire speech or develop empathy.

Happy Halloweenie!

We vax.

As flu season approaches, I feel compelled to write: we vax.

As in, we fully vaccinate our children, including Brad who is mildly autistic and Jeremy who is allergic to egg.

On the Brad front, there is no doubt in my mind that vaccines don't cause autism. I fear the fallout of widespread vaccine rejection.

On the Jeremy front, he can have egg-based vaccines administered at an allergy clinic. They keep him for observation afterward, and can administer anti-histimine, steroids or epi-pen if needed. For the record, Jeremy is five, has received several egg-based vaccines and has never had an anaphalactic reaction to a vaccine. (He did have an anaphalactic reaction when eating eggs, scrambled eggs, undiluted, at age one.)

Be safe, everyone.

Added: An Epidemic of Fear [via Wired]