...a couple of weeks ago, I went to visit Rachel at school. The intent was to observe her in the pre-K class. She's been attending this class since late-October and has been unable to visit for longer than 15 minutes because of her behavior issues. At this point, she should be attending this class for 2.5 hours, basically spending her whole afternoon there. But, obviously, 15 minutes is a long way from 2.5 hours. They wanted me to observe her and participate in a discussion about where we should be going from here.
As we already knew, Rachel is very routine-driven. She is always looking for the next step. The schedule dominates her attention. This is especially true when she enters the pre-K classroom, probably due to the increase in class size from 6-7 kids to about 18-20 in the amount of time it takes for her to walk down the hall. She seems to become overwhelmed.
Her inability to focus on the task at hand is preventing her from making this process a success. She is unable to interact with the other children (which is one of the reasons she's there) because she keeps focusing on the next step. I observed her in "Writing Workshop Station", where the kids are encouraged to draw a picture for 10 minutes. She was given a piece of paper by another student and her teachers encouraged her to have markers, crayons, etc. The little girl next to her was trying to engage her, but Rachel kept saying "Clean Up song!". This is her least favorite station (put there intentionally so I could observe her there). Despite being ready for "Clean Up Time", she couldn't wait to run back to the carpet. She didn't help with the clean up at all. When she sat down on her letter on the carpet (each child is assigned a letter as a place to sit), she kept announcing that it was time to go back with her teacher.
Her inability to focus is holding her back. After observing this, I called the developmental pediatrician who first informed us that we were dealing with autism to schedule and appointment for her to look at Rachel to determine if our presumed ADHD and OCD is finally taking hold and starting to stand in her way. After all, Kevin and I were saying probably from before the time we learned that we were dealing with autism, she suffered from both of these conditions. They are often co-diagnoses, so perhaps we were right. We'll know if that's what a professional feels in about 6 weeks.
We did briefly talk about her current placement. We talked about whether we need to consider moving her from the CAPP program (where she currently is) to one of the less intensive PEP programs. The impression I received from her teacher and the representative from the Autism Office was they feel her current placement is correct and that we should continue to work with her and the pre-K. But she needs to be able to spend more time in the pre-K classroom. She probably doesn't need 4 hours of intensive ABA. But she does respond to ABA and should continue to receive it. Half-day with CAPP and half-day with pre-K is ideal. And they do feel that, assuming we CAN make that work for the next school year, she very well may be ready for a mainstream kindergarten classroom setting, with some added support including speech therapy and possible OT scheduled periodically throughout the week.
Now we just have to figure out a way to make that work.
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