Ha!  You thought this was going to be some artsy post about some painter!  Boy were you wrong!!

 Monet is a 5 year old girl who had some sort of brain injury early in her life.  Well, she’s only five, so obviously “early”, eh?  I think it was a hemorrhage, a bleed, which can wreak havoc on any brain, developing or geriatric.  Monet does not speak.  In grad school we were taught to use “people first” language, and to describe people’s disabilities as “different abilities”.  People are people first, not disability first.  There’s more to him than his diagnosis.  So the “autistic kid” in the corner flapping his hand is actually “a kid with autism”.  The “albino” is actually “a girl with albinism”.  And my husband is a man with asthma, not “an asthmatic”.  In theory, this is great.  It sets up expectations of fair language, and has largely done away with the acceptability of calling someone “a retard”.  I still think that “person with mental retardation” calls the R-word to mind, and, let’s face it, 5th graders will use anything as an insult.  If “bleeker” became the word for people with disabilities, they’d use that, too.  This P.C.ness can get carried too far, as you might expect.  Children ought not be referred to as “non-verbal” and never “a mute”.  In many circles children with autism, “do not speak yet”.  And we were given a little bookmark-sized handout in grad school with alternative phrasing which told us that a good way to talk about  a person who is nonverbal is to say she “communicates with her eyes”.  This calls to mind a book I read in high school called, “I Raise My Eyes to Say Yes”, as well as “The Diving Bell and the Butterfly”.  While there are those who use eye blinks and movement to communicate, this is not the case for Monet.  Monet shows her interests by tearing around the room, vocalizing grunts and shrieks, and reaching to people.  She knows several manual signs (eat, jump, more), but hasn’t really caught on that they are for communicating. 

Today my work calendar called for Monet’s therapy to occur during her lunchtime.  Lunchtime is, shall we say, challenging, for the others in her room, as a direct result of her actions.  In addition, lunchtime is an excellent time to work on communication skills because food is, for many children, highly motivating.  And when you’re working on actions that are learned in a highly behavioral way (think Skinner), food is your go-to tool.  We’ve been working on perfecting the Monet feeding session since the summer, when she started at the center.  It has not gone well.  Monet pockets food in her mouth, spits it out, dumps milk in her mouth and dribbles it down her shirt, reaches, grabs, and intones for the food on the table, and jumps up every 45 seconds for no apparent reason.  She hasn’t caught onto the sitting-down-at-meals expectation.  She’s not a completely safe eater, and the person supporting her always ends up looking like they’ve just introduced mashed peas to an 8 month old. 

I went in fully armed today.  I grabbed the weighted vest (designed for proprioceptive input, and to slow her down), the non-slip scoop bowl (to keep food in it, and to keep it on the table), the adapted fork handle (big chunk of foam with a channel for a regular fork), the adapted spoon (similar), and the adapted chair (with arm rests, to make some feeble attempt at containing Monet).  I also used a bike helmet. 

What science is this?  Is this because of her brain damage?  Is this some crazy sensory integration therapy?  Ah, no.  She just likes the bike helmet (from the dress-up area) and wore it yesterday afternoon and was able to attend to a table-top toy for 30 minutes.  Maybe it helps her “feel” her head like the weighted vest helps her “feel” her body.  Maybe it just feels snug and cozy.  Whatever it was, it seemed to help yesterday.  So I thought I’d try it. 

She used picture icons to request apples, milk, rice, and chicken from me, more than 10 times total.  Initially, I held out my hand, and she just tapped the picture.  I prompted, “Ask me”, and made a grabbing motion with my hand.  She figured it out.  Eventually I took my hand away, and just showed her the picture, saying, “I have apples!”  She not only came to the table, but when I motioned for her to sit down as a requirement for eating, she did so.  She handed me those silly pieces of paper to communicate.  She understood I was the keeper of the food, and that handing me the picture of the chicken unlocked a morsel.  She was communicating. 

Monet still terrorized the room when she’d finished eating, sending children shrieking as she stole their toys and bounded about the room.  But as I left I glanced over to the house corner.  Bike helmet still securely planted on head, Monet motioned to a peer with her teacup as she grunted, and the other girl poured them both some tea. 

Whatever skills and desires are locked away in Monet’s head we’ll never know.  Whether she understands and chooses not to listen to her teachers and classmates as they tell her to stop, or sit down; or whether meaningful comprehension of spoken language evades her, is not something I’ll figure out in 15 minutes of therapy a week (though lunch took upwards of 40…hmm).  The sight of that child with her teacup in hand, helmet on head, made me smile.  In that moment, she was any child, dressing up for a tea party with a friend.

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