Posted by Lee Fuoco

In-Home Services for Children with AutismWhen 11-year-old Jessie* was diagnosed with autism spectrum disorder (ASD), her grandparents – who have had custody of her since birth – were crestfallen. On the one hand, at least there was finally a name for it all – the seemingly endless obstinateness, the rigidity with transitions, the struggles to interact with peers, and all those birthday parties where the other kids looked like they were having a ball while Jessie seemed about as comfortable and in her element as a goldfish at the beach. On the other hand, here was the long and utterly unknowable road of supporting this child towards… what? Inclusion? Education? College? Maybe simply more fun at birthday parties? Jessie lacked so many of the milestones of a typically functioning child, that her grandparents were truly fumbling in the dark.

ASD is such a varying and mysterious diagnosis. There is no one way to present, function, or struggle as a child on the autism spectrum and there is no one way to help a child with ASD interact with and thrive in their world – so instead there are in-home behavioral clinicians like Jennifer Pottle of JF&CS.

Jennifer is the walking embodiment of what she practices: she is calm, consistent, patient, and deeply empathic. When a parent or guardian feels exhausted and past their limit by a child who is refusing to comply with a request, Jennifer continues to sit calmly at the table, confident that the next unruffled, measured request for cooperation will be the one that elicits the success she knows the child is capable of. She meets kids where they're at and follows what motivates them, creating (with the ongoing collaboration of dedicated bachelors-level behavior monitors) interactive, child-specific visual tools aimed at optimizing clients' already-existing strengths. She coaches discouraged, exhausted parents and guardians to set and hold firm, simple limits and to rebuild their behavior management approaches from reactively reinforcing the negative to proactively searching for the positive.

Over the course of a year, Jennifer worked with Jessie and her grandparents to address goals of reducing aggressive incidents and noncompliance and enhancing independence around activities of daily living, including tooth brushing and hand washing. During that year Jessie struggled with abusive language, hurling objects, screaming, and the silent treatment. Her grandparents were sometimes filled with despair. But after a year of working closely together, Jennifer was able to tell Jessie that she had met her goals and would be graduating from our program. Jessie exclaimed, "Freedom at last!" before expressing genuine concern about Jennifer not coming back. Jennifer met this as she had met all the other dichotomies, inconsistencies, and challenges in a year of working with a child with autism: with the simple, persistent belief that Jessie not only could succeed but that she would.

*Name changed to protect privacy.

Lee Fuoco, MSW, LICSW is the Clinical Director of JF&CS In-Home Services, which provides home-based clinical services to kids and families under the Children's Behavioral Health Initiative (CBHI). Lee graduated from Salem State University's MSW program in 2010 with a Child and Family concentration. She is a family therapist who has worked exclusively with systemically-involved, high-risk kids and families utilizing systems-focused and social justice perspectives. She also has a specialty in clinical work with LGBTQI clients. Lee also teaches as adjunct faculty at Salem State University's MSW program and sits on the planning committee of the Youth at Risk Conference.