Friday, May 28, 2010

Red Flags vs Green Flags

Photo Credit to NakedPastor (really?)
It is IEP season in Special Needs Land. Families across the nation with kids with greater than average needs are putting on their big girl and big boy panties, their hip-wader boots, and diving into the swamp. Some are coming out winners, some are coming out losers, but most dread the hunt.

Attention School District People: When you focus on deficits, that is what you will see.

Attention Special Needs Parents: When the school focuses on deficits, that is how they will view your child.

Recently, I read a lovely piece written by Dr Jim McDonald called Red Flags vs Green Flags. He addresses the issue of autistic "red flags" and how they end up guiding professionals to make autism diagnoses when those diagnoses might be premature or inappropriate. What I found most compelling about his article is his urging of looking at what the child can do... green flags.... and how development works and that the addressing of those green flags is so very important. I was struck by this overarching concept: Look at what the child CAN DO. Build from the positive. Support that, and allow it to become a building place to address deficits.

Anyway, I thought it might be worthwhile to share his article with you.


Red Flags-Green Flags: Which do you follow?
By Dr Jim McDonald

Parents frequently tell me about the ‘red flags’ that professionals claim to see in their child.

‘Red flags’ are signs of autistic-like or delayed behavior---such as severe language delay, lining up cars, flicking his hands, isolating himself, not talking to others, repeating actions or communications and many more ‘suspicious’ behaviors.

Seldom do people stop and ask: Does the child show as many positive social behaviors as the ‘red flags’ that appear? The diagnosis of autism, PDD or Asperger’s is often based on these ‘red flags’ without accounting for two critical things; ‘green flags ‘ developmentally correct behavior that is not autistic-like, and recent changes showing productive social and communicative behavior. These ‘green flags” and recent changes show that for some children, autistic behavior is a developmental matter more than a long-term disorder. Some professionals seek out negative signs, focus on the obvious differences and ignore positive ones that I call “green flags.” This results in unreliable and invalid assessment and treatment.

A green flag is a behavior that shows the child is developing in skills that show he is not autistic or delayed all the time. It also suggests that he is even developing out of autistic habits. Common green flags include playing with others, initiating or responding to others’ contacts, playing functionally and not repeatedly, communicating to others more than to himself, showing more interest in people, using language socially, occasionally having reciprocal conversations, cooperating, showing empathy and many other skills that can be built into the effective social life that defines success in autism.

A global ‘green flag’ occurs when the child is showing fewer ‘red flags’ over time or when they are less autistic-like in certain environments. It is now clear that autistic behavior is not everywhere and with everyone. Autistic behavior varies as the child’s environments vary.


When a child is seen as a list of Red flags, people often attend more to negative behaviors and less to positive ones that a can be built socially. Attending to red flags can result in increasing them.

Focusing on red flags often frightens parents into a state where all they see is negative things. Red flags depress parents and a depressed parent often gives up or gives up opportunities to help the child themselves. They give professionals many tasks that only they as parents can do at home in their daily interactions. Red flags can get parents into a habit of getting rid of behaviors rather than building positive behaviors (Green flags)

Focusing on “green flags” gives parents hope and motivation based on clear evidence. “Green flags” show how the child is developing and where support is immediately needed. They give the parents a place to start to have successes. We find that when parents and professionals respond to the ‘green flags’ they get more of them. Often the most effective beginning goal for a child is to have him do more of their green flags and do them in interactions with people who are matching, balancing and responding to them. Parents will even find that there are ‘red flag” and ‘green flag” people, that is ones who their child does poorly or well with.

Discuss the “green flags’ with your family and others so everyone is supporting your child’s progress rather than focusing on his problems. Use the red flag-green flag approach in your IEP plans with the school. Specify the value of including green flags in the goals so the child has some success to encourage him through the difficult goals.

Monday, May 24, 2010

The Sweetest Moments

This video will either break or warm your heart. Possibly both. I cried and loved it at the same time.

Q&A from StoryCorps on Vimeo.

I hope you loved it. I hope you share it with others.

Tuesday, May 18, 2010

On Why I Drink Alone

What no one ever tells you about raising a kiddo with more than average needs could fill the entire book... or two. But one thing I noticed that snuck up on me... surprised me a little bit more than normal... was how I lost friends.

They didn't go missing. They just seemed to fade away.

Not all of my friends, to be sure. Indeed, I can honestly say a few of my friendships got stronger, more real. But suddenly I look around and notice we are not asked on playdates. I don't get called for happy hour, or movie night, or lunch. Co-workers and friends are always "happy to see me", and love to chat it up when they do, but the phone is silent.

In many respects this happens to every new parent. Those without children go along in their childless world, not needing to worry about 2am feedings and temper tantrums and babysitters. And you slowly gravitate to other parents with same age children. You are in the same space as them... the diapers and the strollers and the potty training. You are reading the same books, learning the same things, going to the same places. Those friendships now work for you.

But somewhere in J-man's second year, between assessments and therapy and work and home and coping, the phone stopped ringing. The invites dried up. People pulled away. Or, maybe I pulled away. Coping with the onslaught of issues and dealing with the craziness of that life was enough for me. I probably stopped accepting invitations. I probably sent out signals that we're not open for business. Seeing other kids developing on-schedule hurt. Hearing stories about what their kids were doing and how normal their lives were hurt. Even today, I imagine I would still be hard pressed to bring the J-man just anywhere. He is like a 16 month old in a 3 year old body..... doesn't follow directions... does what he likes, when he likes. There is no casual "hey let's hang out and the kids can play on their own". He doesn't operate like that. And most people don't get that....

And of course I wonder... are we rejected? Do they not call, not ask, because we are not wanted? Don't get me wrong. I get it. I mean, people's lives are complicated and full. On those days and times when you are getting together with friends, you want it nice. Fun. Friendly. You don't need issues. You don't want problems. You want it easy, seamless. And lets face it: We are neither easy nor seamless. So I get it.

Still, it can be hard to swallow... this new normal.

Wednesday, May 12, 2010

Ice Cream Monster

Your love is better than ice cream
Better than anything else that I’ve tried
And your love is better than ice cream
Everyone here knows how to fight
-Sarah McLachlan

I have created an Ice Cream Monster.

It started out so simply. Find something motivating and encourage language through that. Reward communication attempts by giving him what he asks for. Keep it simple, keep it natural, keep it real. So when J-man showed his love of ice cream cones, and his willingness to try to talk for said cones, I thought "hey, how could this be bad?"

Can I blame a severe speech delay for my son's future obesity? And possible rickets?

It's ice cream in the morning.

It's ice cream in the evening.

It's ice cream all night long.

For example, last night's journey from the living room to the kitchen. After bath, J-man got excited: Ice cream awaits! He drug me off to the kitchen, pulled my hand to the light switch and said 'liii". On goes the light, and off we go to the fridge. Hand placed on fridge and the request came, unbidden: "Iiiieee Eeem".

"Ice cream cone? " I asked.

A scream of joy erupts from his little body.

And the little tiny cone is made (Note: we have these teeny-tiny cones, which results in a little scoop of ice cream. We are trying to avoid massive amounts of ice cream. Trying...)

And we go through this crazy play over and over again.

By Cone #4, I decide enough is enough. No more "Iiiieee Eeemm", I say. J-man shakes his head, yells, takes my hand over and over and places in on the fridge.

"No," I shake my head sadly, "All done Ice Cream".

J-man yells louder, grabs my hand and makes my fingers curl into a fist. He then takes my hand and shoves it into my face, moving it back and forth.

He is making me do the sign for ice cream.

Clever bugger.

Yeah, he got another one. No doubt massive tooth decay and Husky jeans are in our future.


Monday, May 10, 2010

IEP Alert Level: Low

We had another IEP meeting last week.

What is it about these meetings that freak me out so much? 

Allow me to catch you up to speed on where we are in the whole world of IEP.  J-man is getting his speech and special-ed teacher time at his wonderful child care center, J&J.  His J&J teacher also works with him within the classroom and has been involved with implementing his IEP.  We go two days a week, and so far he is doing well.  Come summer, he will get three observational sessions with the District representative (a teacher?  a speech therapist?  who knows.... apparently they don't know either... *sigh*).  The purpose will be to check in on how he is doing and what recommendations those staff can make to deal with issues or concerns that may come up over the summer months.

And that was what the meeting was about:  Summer plans. 

The transition from our Birth to Three staff to our current staff has been a bit of a struggle...for both J-man and myself.  Of course, Kristin was outstanding.  But it is also that the new folks just don't know him... and me... very well.  And I worry that they look at him with a "glass is half empty" kind of look... read him in the worst possible way, the worst possible light.  I am not saying they do, just that I worry they do.  So the other purpose of this meeting was to do a little "now that you have worked with him a little, thoughts?" kind of meeting. 

So, we started out the meeting with one missing:  The Special Ed teacher.  Doesn't bode well, does it?  But we go on with our Speech therapist, the J&J staff, and us.  We went through the goals and where he current stands (informally).  It was good... our speech therapist had just had a really good session with the J-man (he has been slow to warm up with her) and was able to get some good information from our J&J teacher about other things she has been working on.  I think she was surprised at how much he is doing.... because he rarely does it for her.  I chalk that up to the time of day and her being new.... he just isn't a morning person, and doesn't give it up easy.  He makes you work for it....

It was also wonderful to hear what he is doing in the classroom, and how much his J&J teacher appears to love him.  She glowed when she related stories, and I never got the sense that she was overwhelmed or lost when it came to working with him. The J&J staff also related their summer plans... they are changing the configuration of their room to accommodate a lower teacher-student ratio.  J-man keeps his favorite teacher, but now it will be only 1 to 7 versus 1 to 10.  Color me THRILLED!!!

We discussed goals for summer, and then move to the fall.  And then she dropped the bomb...  she had placed J-man on the list for the school district preschool for the fall.  Even though she knew... and admitted she knew... that we planned to continue at J&J.  Lucky for her, Daddy had already left the room with J-man.... he might have come unglued.  She (hastily) made her case:  if he got into one of the classes with a specific teacher she knows and thinks very highly of, it would be wonderful and we should go for it.. she said "Kristin-like" wonderful.

So GEMM stayed in check and I listened. 

She said he didn't know what class he would get into, because that is based on busing....

"Hold up,' I said, "No Bus."

"Oh, well you could drive him, but he would probably love the bus." She stated.

"No bus. Period" I said.

Are they on crack???

So basically I am in a bit of a holding pattern.  We are thinking about it.

Now, before you start screaming at your screen "What about J&J?!?!?!".   We won't leave them....  this would be an add on.  He loves J&J and I love J&J and that is that. 

Good meeting.  Confusing meeting.  Not sure what to do next meeting. 

Lucky for me I have some time to decide.

Ooooooh Mommy!

Last year, J-man couldn't say "mom".

This year, he can.

So it was a good Mother's Day.

Thursday, May 6, 2010

Pride (In the Name of Love)

Pride.  Get it??
We had a big event at our house tonight.


J-man pooped on the potty chair.  Now, I need to explain:  he was fully clothed, with a diaper on, when this momentous event occurred.  Also, I have no idea if he really knew what he was doing.... I mean, did he know that he was pooping while on the potty?  Or was it an 'accidental poop'?  No idea.

But here is the kicker...and for me.....the REAL BIG EVENT for the night. You see, I missed this big event, but walked in the house about 30 seconds later to Daddy and J-man at the door, big giggly smiles on their faces and the aroma of the event in the air.  Daddy revealed the excitement, and J-man was giggly, shyly looking at me.  Of course, I was super excited and lavished all kinds of praise.

And J-man looked PROUD.

I have seen J-man look proud and self-satisfied, like when he finishes a puzzle or some kind of hard task.  But I have often felt that he could care less about pleasing me.  I mean, he doesn't like it when I am unhappy, but never seemed to work for my approval.  And tonight, for the first time I can really remember, J-man seemed happy and proud that I was pleased with him.



Monday, May 3, 2010

Defiance, thy name is J-man

Markers + J-man = The Joker

"They" talk about the Terrible Two's.

What the heck do "they" know?

A little story.

J-man has decided, for reasons known only to him, that he doesn't want to get dressed.  Or undressed.  It doesn't seem to be a clothing choice, or some sort of sensory thing. It feels more like a mental 'middle finger' at me....  Mom, I don't want to do what you want me to do...  if you get my meaning. 

So the other day I decided that it was no longer gonna be a wrestling match to get him dressed in the morning.  He was going to participate, by golly!  After a fairly routine chase around the living room, dining room, kitchen and office, I had him cornered. 

"Pants on", I said directly.

"Whiiiiinnnnneee", J-man responds.

"Pants on! Foot in!", I insist.

"Nonononononono", insists J-man

And round and round and round we went for the next 20 minutes or so.  And finally, exhausted and completely willing to admit I suck at being a parent, I wrestle the pants on him.  J-man proceeds to throw a fit on the floor while I leave the room and do some deep breathing in the kitchen. 

About three minutes later, J-man comes into the kitchen.  He looks directly at me, yells, and takes his pants off.  Defiantly!  I sit on the floor, exasperated, and say/sign to him "Mommy is MAD".  I give him my most angry mom look at turn my face away.  He leans his head on my shoulder and pats it gently. He tries to pull my face back into his view. His eyes gaze up at me with this look of "let's make up, mom".  He tries to wriggle into my arms so he can give me a hug and a snuggle.  And of course, because I have a noodle-spine, I allow it!

And he is still pants-less.

Oh lord, give me strength to deal with this boy.  I clearly have no idea what I am doing.


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