09 June 2011
ACT would like to introduce our readers to another very cool kid, Johnny. Johnny is a sweet, funny, and bright nine-year-old boy who loves sports and has been diagnosed with Asperger’s Syndrome. When Johnny was younger, his mother says that his challenges revolved around anxiety and phobias. She says that he was extremely sensitive to any type of sensory stimuli. Certain noises and the sight of a “jumpy-jump” bothered him; he would tantrum when he encountered them. The feeling of his feet being off of the ground was so scary for him that he never played on a swing. Certain textures bothered him so it was difficult to find clothes and shoes that he would tolerate wearing. Johnny also had significant difficulty with peer interactions. His mother recalls that during many of his birthday parties he would run into another room and hide.
Johnny began occupational therapy, during which he was gradually exposed to all types of sensory stimuli. As time went by, he became increasingly able to tolerate more movement, textures and sounds. He also began to do gymnastics at a gym that used behavioral techniques during lessons. Johnny’s mother was pleasantly surprised when he began to swing, jump on a trampoline and do other gymnastic activities. She credits the combination of the occupational therapy and his gymnastics classes for helping him overcome many of his sensitivities to sensory stimuli.
As Johnny got older he faced different challenges. He had difficulty understanding other people’s perspectives, using pragmatic language, navigating social situations, trying new activities, and complying with rules and instructions. He also engaged in frequent attention-seeking behaviors, was extremely competitive, and was occasionally aggressive toward his brother. When Johnny was almost six years old ACT therapists began to work with him and his family. His mother recalls that she knew she was doing the best thing for him by starting behavior therapy; however, beginning therapy was difficult for her. She explained that following rules and limits was very challenging for Johnny during the first few weeks of therapy, and she occasionally felt guilty for not yet having the tools to set those limits herself.
During his three years of treatment, ACT therapists worked to improve Johnny’s social and auditory processing skills, use of pragmatic language, problem solving ability, ability to manage anger and anxiety, and compliance with verbal requests. They worked to decrease his anxiety, aggressive behaviors, and attention-seeking behaviors. They also facilitated play dates. Currently, Johnny is much more able to navigate social situations successfully, can have good conversations with peers, is more compliant, less aggressive towards his brother, demonstrates fewer attention-seeking behaviors, is willing to try new activities, and is able to manage some of his anxiety.
Johnny’s parents and brother were often included in sessions so that his new skills would generalize to them. ACT therapists often went on outings with his family to help generalize the skills that he was learning in sessions. Johnny’s family took part in parent education so that they could successfully implement behavior management strategies at home. Currently, they are successfully using a conditioned reinforcement system to increase Johnny’s compliant behaviors and decrease his non-complaint, oppositional behaviors. They also take Johnny to a Cognitive Behavior Therapist to decrease his anxiety and help him better understand the connection between his emotions and behaviors.
ACT therapists have been accompanying Johnny at school since he was in first grade, and now, in third grade, he is much more independent at school. He regularly participates in class, plays very well with his classmates, tries to resolve conflicts calmly, and is doing extremely well academically. Therapists assist Johnny only when he needs help to manage his anxiety, resolve a conflict with a peer, or try a new activity. They give him subtle cues to help him decrease his self-stimulatory behaviors, competitive speech, and non-compliant behaviors, and they provide his teacher with education about which strategies work best for him.
Looking back on his treatment, Johnny’s mother says that he has come a long way and made very significant progress. During the past three years, she recalls that there were times when he would plateau for awhile, but would always “pull through” and continue to make improvements. Johnny is currently taking a break from home therapy and continues to have ACT therapists support him at school. His mother states that his most significant improvements are his compliance at home with his parents and his ability to navigate complex social situations. Johnny’s mother also says that ACT therapists gave her and her husband the tools and education necessary to manage Johnny’s behaviors at home, and she feels confident that she can handle any behaviors that may arise in the future.