Why "Running with Bunions"?

Saturday, September 30, 2017

What does In-Home Therapy Look Like?

early therapy sessions often took place
 on the trampoline
Wonder Boy takes his dinner plate to the counter. He skips to Mister J, pats the therapist's legs, tugs his arm.
 
Mister J waits for Wonder Boy to make eye contact. "What do you want?" he prompts.
 
Pause. "I want 'go outside,'" says Wonder Boy.
 
Mister J looks into Wonder Boy's eyes. Waits.
 
"And bounce!" Wonder Boy exclaims, referring to a favored outdoor trampoline activity.
 
"Do you want to go outside and bounce?" Mister J confirms.
 
"Yes, I do." Wonder Boy smiles.
 
Sessions begin with hello.
 
"How're you?" Wonder Boy waves at that day's facilitator, who makes eye contact and returns the greeting.
 
After a few minutes to review the previous session's notes, therapy starts in the primary work area. A sturdy table, mirror, indoor trampoline, bubble wrap, hats and trains in a dedicated space. "Ready hands," says Mister J.
 
break time
Flash cards with familiar faces are spread across the table. "Find Oma?" says Miz M. "Pop? Papaw? Mommy? Daddy?" Wonder Boy recites nursery rhymes, learns paired words like "shoes and socks," identifies nouns and verbs, needs and wants.
 
In the beginning, Wonder Boy received 2 hrs of private therapy/month. Following his diagnosis Wonder Boy received more than 50 hours/week of in-home Applied Behavior Analysis (ABA) Therapy. When he entered Kindergarten and was no longer available during school hours, that number dropped to a still significant 18 hours/week. For three hours, every day except Sunday, therapists help Wonder Boy learn to learn.
 
Applied Behavior Analysis
"...design, implementation, and evaluation of environmental modifications to produce socially significant improvement in human behavior…"
 
Families provide a clean, safe environment to meet and assure therapist's supplies are available wherever sessions occur. An approved individual over 18 must be present.
 
At Super Daddy's house, facilitators enter without knocking. There is laundry, dust, peeling wallpaper. There are no secrets, locked cabinets or closed doors. Life happens. Everyone participates, helps, learns.
 
In the entryway, Miz K challenges Wonder Boy to "go to the sink and turn on the water." Then, "go to the couch and sit down" and "go to the bathroom and wash hands." For each correctly performed task Wonder Boy receives a gelatin fruit snack.
 
Outside, Wonder Boy asks to be pushed on a swing, bounced on a trampoline, chased, picked up, put down, carried, tickled. He learns to take turns. He learns "don't tickle me."
 
Wonder Boy bursts into the kitchen, a plastic potato in his hand. Mister J instructs, "Give the potato to Nonnie."

Wonder Boy places the toy into my hand. "Great job!" says the therapist. Mister J and Wonder Boy high-five, low-five, bump fists. When Wonder Boy isn't looking, Mister J retrieves the potato. So Wonder Boy might attempt the task again.

therapy happens
everywhere
Sessions end with "goodbye." But therapy continues.

"I want trains," says Wonder Boy.
 
Super Daddy points to a truck. "Do you want this train?"
 
Wonder Boy frowns. "No, I don't."
 
Super Daddy reaches for the box of trains. "Do you want these trains?"
 
"Yes." Wonder Boy smiles. "I do."

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