Every so often Katie manages to surprise the hell out of me. The past few weeks were one such time.

Two weeks ago, I discussed how Katie’s in-home therapy team and I had decided to break up some areas of rigidity that were taking place at home. Maia, our case manager, created the plan. Juan, Katie’s awesome behaviorist, and I were tasked with implementation. We both dragged our feet, and Juan assured me that while things would get worse at first, it was necessary and eventually things would get better. “I know,” I said. Like him, I wasn’t looking forward to several weeks of tantrums and aggressive behavior. Juan repeated himself with a pained expression marring his normally cheerful grin, and I said, “It’s okay, Juan. I know.”

Maia’s behavior modification plan started with the seemingly simple task of Katie sitting in the family room for one minute while I faked using the bathroom with the door closed. Both Juan and I were certain this would trigger a lengthy tantrum. In fact, since I couldn’t leave the bathroom while a tantrum was in progress, Juan told me I should bring my smartphone, reading material, and anything else I might need to entertain myself for a prolonged stay. Then we both sighed.

I couldn’t shake the feeling that, at least in the case of this particular area of rigidity (i.e., refusing to let me use the bathroom alone), Katie’s behavior was tied to her recent bout of separation anxiety. (Read about that here.) If this were true, then it felt like we were punishing her for having (and expressing in the only way available to her) feelings. As an adult who sometimes struggles to identify what I am feeling, I hated this thought. So after discussing it with Maia, she modified the behavior plan so we started with a less tantrum-inducing request: Katie would sit in the family room and count to five while I stood in the bathroom doorway.

Juan had me buy special treats to serve as reinforcers for our task. One of the rewards Katie selected was Izze sparkling juice. I purchased a flat of eight-ounce cans at CostCo and they sat in the back of the minivan, waiting.

On the first day, I announced that I was using the bathroom and Katie predictably sprinted ahead of me. When I didn’t follow, she sat for a moment on her stool, confused, and then returned to the family room. We repeated this a few times. Finally I made it into the bathroom first, but she tried to join me. I calmly said no, and we returned to the family room to start over. At last we got her to stay in the family room and I stood in the doorway for five seconds. When I came back to the family room to reward her, Katie kicked at me. “Nope,” Juan said, “No soda.”

Katie pitched a fit over the lost soda. She lost the soda again and pitched another fit. But this was on the scale of normal kid behavior, not an autistic tantrum. Juan and I were pleased.

The second day, as soon as Juan arrived, Katie requested “that bathroom thing.” This made both Juan and I laugh because that’s what I’d called it the previous afternoon. We reminded her that she was working for an Izze. “An orange one,” Katie specified. “I want orange soda.”

“Okay,” I said. “You wait in the family room with nice hands and feet and count to five and you can have the orange Izze.”

Katie nodded grimly, clearly determined to do whatever it took to get the soda.

“You can do this, Katie.” I demonstrated counting to five using my fingers. “This will be easy.”

She gave me a dubious look that broke my heart, then planted herself in the green plaid club chair and began to count. It took me five seconds to make it to the bathroom doorway, so she had to count a second time. When I returned, she slapped me five and said, “Orange soda, please.”

She guzzled the juice and said, “Bathroom thing again. I want blackberry soda.”

Yes, I let her earn a second tiny can. And all those tantrums Juan and I were sure would happen? They never occurred—even when I closed the bathroom door. Like I said, Katie still manages to surprise me.

Until next time,
Cynthia Patton