Sunday, May 15, 2011

Special Needs Kids: Behavioral Difficulties

This paper was first printed in 'Community Living' and is a great example of Gill Levy's 'down to earth' writing. Gill is respected as one of the leading authorities and has many years experience of working with visual loss and multiple disability. Thank you to Gill for this paper.

David and the glasses
We all had a soft spot for David's rather scatty mother. 'I do me best, you know', she would say, 'but I was never the brightest at school. Couldn't concentrate for long. But I've all the time in the world for my son'. Everyone agreed that he was 'a handful', but 'could be so loving and affectionate at times'.

She would never allow him to sleep away from home. 'If I can't cope with him, you lot won't, with all them other disabled ones around', she would say. He would occasionally 'trash the environment', tearing soft furnishings and curtains, and kick tables and chairs over. And he would slap his face if one to one support was not available. As he got older, taller and stronger - with a growing spurt after he left school - he 'presented services with even more of a challenge'.

Seeing David's bruised face and bitten hands, the new centre announced 'Something must be done'. She approached the Community Team for help - and along to the Centre came 'this nice young rookie psychologist', Judy, who asked lots of questions and sat watching David for a morning. 'I want an up to date sight and hearing test', Judy said. The staff were disappointed - they had hoped for a 'behaviour programme'.

Testing David's eyes took 'three goes' for the gentle-mannered lady optometrist visiting the Centre - David had to become familiar with a new person coming close to him and shining a light into his eyes. 'Well, she said with her hands on her hips to emphasise her words, 'this young man literally can't see beyond the end of his nose. Life must be hell for him - he's so shortsighted. He must have glasses'. There was a chorus from the assembled staff, 'he'll won't wear them'.

The optometrist smiled knowingly. 'Don't assume! Most people can be helped to accept glasses. You need to find something to motivate him'. Two weeks later, she returned with a pair of 'half strength glasses', explaining that it might be months or even years before she could prescribe ones which would 'give him the best possibly sight'. 'Spectacles will totally change his world', said the optometrist. 'Think what it must be like to suddenly see things you never knew were there! You have to introduce him slowly to this strange new world so avoid frightening him'.

The frames were light, and David sat stock still when they were placed on his face. We held our breath, expecting him to 'explode' or throw them away, but a tea tray arrived for the optometrist. David examined it carefully and then watched his favourite staff member, Kathryn, leave the room. He was unusually calm. 'I'd suggest you take the specs off him now', said the optometrist 'but try putting them back on when he has his tea, and then take them off after a few minutes and build up wearing time during activities he enjoys'.

David and Kathryn went into 'break'. She approached him, calling his name and timidly announcing she was going to put his glasses back on. She placed a cool cup of tea in front of him, and we stood in silent amazement as David looked at the cup and then at his right hand, which was resting on the table. He watched his hand (as if it did not belong to him) slowly moving towards the cup, using his now-seeing eyes to direct his hand. He did not spill a drop.

Saying 'biscuits, David?' I offered him a plate, anticipating 'the usual performance' - him clumsily grabbing at the plate, sending biscuits flying. But instead he reached slowly and deliberately towards the plate, helping himself cautiously. He grinned. We were transfixed. It felt like 'a miracle' watching him have a second biscuit. He had already realised that with his glasses on, he could tell the round chocolate digestive biscuits from the oblong Bourbon creams. His glasses had given him choice.

Within a few weeks he had learned to use his hands for quite 'delicate' things when he wore his glasses. We were all so delighted by the way he so easily acquired new skills, that we barely noticed the improvements in his behaviour. Then his Mum dropped into the Centre one day and asked: 'Who do I hug? I don't know what you've done to my son, but he's a different person. It's wonderful'.

I questioned her closely. David would not be parted from his glasses at home. 'Build up wearing time?' she said. 'I have a fight to get them off him these days'. He no longer needed to be lead around. 'The end of Mum abuse' she said, because he would grip tightly and dig his fingernails into her arms. He had become continent, finding his way to the toilet by himself. He could now watch TV from his favourite chair, and not stand with his nose on the screen. He no longer needed 'half as much attention - and he was happy to watch other people doing things'.

By his next six-monthly review most of his 'behaviour had gone'. 'Of course', said his Mum, 'now he can do more and more for himself, he doesn't get cross waiting for attention'. He very occasionally slapped his face if he was really frustrated (usually with good reason), and we worried he might damage his glasses - but we no longer thought of him as 'one of the difficult ones'. A year or so later and we could not believe the difference and we told the optometrist just how much we thought the glasses had changed his life. She smiled.

David had been wearing glasses for several years when his Mum rushed up to me in the street. 'Here, Gill. I don't want you telling no one but… It wasn't just David that needed glasses. I did too. I'm learning to read now - and they thought I was stupid! On second thoughts, ducks, you can tell the whole bloody world'.

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