Tuesday, November 25, 2008

Look Away, Look Away

When I get Joy out of the crib in the morning, we have a little routine. I open the crib-tent zipper, open the blinds, greet her with a cheery good-morning. Then depending on how asleep or awake she is, I may pat her, help her untangle from the blankets, eventually help her to her feet.

Then we have a little hug, and I say the word "hug."

Then I repeat the word "up" several times, and give her a chance to request it (something she used to never miss, but it went away one day a couple months ago and hasn't come back yet).

Then I count "Ready, set..." and give her the chance to say either "up" or "go," another prompt she never used to miss.

Then I fill in the "go" for her, and lift her out of the crib with a kiss, and her pyjama-ed little feet go padding out toward the living room and/or breakfast table.

She does not look directly at me during this entire routine.

At least for this eye-contact avoidance thing, I have a frame of reference: John Elder Robison's book Look Me In The Eye, in which he describes how difficult (and perhaps over-rated?) eye-contact can be.

I don't have as good a framework for Joy's other frequent visual avoidance situation, where she declines to look at whatever task she's doing with her hands. I supposed I should say "whatever task she's being asked to do with her hands," because it's most noticeable when it's something an adult wants her to do: link pop-beads, put in a puzzle piece, buckle herself into her booster chair.

The booster chair is a fascinating example. She's very good at climbing into the chair herself, and retrieving the three straps that have to buckle together, and fitting the buckle together and pushing each side in with a pop! but with her fingers out of the way so as not to get pinched. Except she generally does it without looking, other than perhaps peripherally. When she accidentally gets one side of the buckle turned backward, it's well-nigh impossible for her to correct without seeing what's gone wrong.

How to help Joy look at what she's doing, enough to see it, learn it, achieve it?

Physically giving her head a gentle re-direct seems rather ham-handed and invasive, but it does at least get her to see that the buckle is turned backward or whatever, and correct it herself. Calling to her with voice-prompt, making a noise by tapping the item, waving the item in front of her face... none of them very effective.


Maybe she just wishes she were in Dixie -- Look away, look away!


rainbowmummy said...

Stickers? Perhaps, like a sticker that means "look" like an eye.

Eye contact is soooo over rated! And I know Egg doesn't have to look at me to see me, like when he's "in his (apparent) own world" watching You Tube if I stick my hand up, out of his view I get a high five. And I also know he uses his ears and not his eyes to hear!

Ohh you could wrap it up, the buckle I mean, Then when she goes to fasten the buckle she won't but it might be fun to unwrap.

It will happen, everything always works out in the end, so I am believing :0)

Anonymous said...

i have a couple of friends whose little ones have (bear with me, i have NO idea how to spell this) stereotipi (???) .. essentially they tend to prefer to use their peripheral vision more than any other and to visually stim. i wonder if that's at all relevant here?

there are a few developmental optometrists out there who are really knowledgable about that stuff, but they're not always easy to find.

i've been feeling like we're losing some of the eye contact that kenz had acheived for a while. but i too think of john and others who talk about how uncomfortable it can be to feel forced to maintain it and i try to let it go.

Lynda said...

I can understand why a little kiddo would avoid eye contact with another person. That's a pretty intense thing. A lot of stuff is going on in the face that needs to be interpreted! But I'm at a bit of a lose to understand why she would not want to look at an object. A toy, her food, etc.
Sometimes what I do when she's looking off to the side (and I've seen her therapists do it also) is put my hand up like a shield in her line of vision. She'll then look down at her toy long enough to see where pieces, connections, buttons, etc are and then be successful with the item.
This is definitely one of those Elvis sightings. Sometimes she can be very focused on her toy or activity. I guess one thing we can do is try and find a very motivating activity for her that she HAS to look at to do and practice with that. But what would that super motivating activity be??

Mama Mara said...

For Taz, I sometimes think that it is sensory overload at work, as in "you want me to touch something AND look at it too? OVERLOAD!" At school, they're trying a slow, multi-step process. For example, instead of saying, "Taz, get your notebook out of your backpack" and then watching him stick his hand in and fumble it around without looking, they do this: "Taz, put your hand in your backpack." PAUSE. "Keep the hand in there." PAUSE. "Keep the hand in there ... AND ... look down at your hand." PAUSE. "See your notebook?" PAUSE. "Touch your notebook." (He stops looking at his hand at this point, but that's okay.) PAUSE. "Pull out your notebook."

It's helping.

Trish @ Another Piece of the Puzzle said...

Do you think she understands the connection - that looking at something will help her figure out how it works?

Our son used to use his peripheral vision quite a bit. That, along with several other issues, went away after we implemented the GFCF Diet. Even with that improvement, direct eye contact was intermittent until he got a bit older.

I used to trick him into looking in my eyes by asking factual questions, such as "Are my eyes purple?" He loved opposite jokes and would look at me and smile. Now at age 6 he is started to learn that looking at people is part of listening to them.

I wish I had an answer for you. If it were me, I would probably go see a vision therapist/development optometrist (different from a regular eye doctor).

datri said...

We're fortunate that Kayla's ABA teacher is also a vision therapist (multi-talented, she is) and yet even she can't get Kayla to look at the tasks that she is supposed to be working on.

Our ABA teacher recommended seeing a developmental optometrist, in particular Melvin Kaplan, who has written a book about vision therapy and autism. Although his office is only a couple hours away, our insurance doesn't cover optometrists and we just don't have the money for it right now.

Anyway, he talks about prism lenses in relation to autism. You can Google prism lenses autism and you should find some info on it.

Niksmom said...

A couple of additional thoughts to add to the already good ones...

If this is at all a recent development (she used to look and now doesn't), talk to her neuro about it.

If she hasn't already been seen by a developmental optometrist (good info here: http://www.children-special-needs.org/parenting/pediatric_opthalmologist.html), you could consider that.

I know that Nik doesn much of the same sort of things but he will now look at me more and more. He still can do all sorts of tasks w/out looking though. I think some of it really is a sensory processing issue.

Have you talked to her ped about this at all, too? Definitely worth investigating but not worrying about too much right now. If it doesn't seem to hamper her ability much and is more of a frustration for you, I'd give it some time.

Anonymous said...

I have a friend who just got her son glasses (not for vision per se) - they sort of serve as blinders to help him focus and reduce peripheral vision.

As Mama Mara pointed out earlier, I can imagine you patiently saying each word to Joy, always labeling and prompting. Such a good mama, you are.

JoyMama said...

Wow, what a gorgeous rich set of comments. Lots of food for thought here, and it's obvious that Joy and I are not alone!

I should clarify that the "look away" is something that's ongoing rather than new, and hasn't really changed lately. It's just one of those things that you get to thinking about and noticing more when it occasions a couple of comments in close succession (and we've now got ten therapists and a daycare provider to make such comments, can you even believe it?!)

Stimming, avoidance, preferring peripheral vision, overload, maybe even seizure activity... any or all of them might be implicated. Here we are again, trying to suss out cause and effect! A never-ending saga.

Thanks so much, and I'll be happy for any further thoughts too!