Caroline–and her mom Ashley–needed help. At 16 months, Caroline had lost the few words she’d gained, was eating only liquids, became upset when people laughed, and couldn’t tolerate crowds, visit the grocery store, or sleep for more than an hour or two at a time. Caroline and her mom were exhausted.

By the time Caroline turned two, they were on a better path. Ashley learned about VIA from one of their doctors, secured a Medicaid waiver with help from VIA’s Admissions and Family Support Services Coordinator, began learning about Applied Behavior Analysis (ABA), and got Caroline set up to receive services from VIA’s outpatient team.

Fast forward six years to today, and Caroline’s progress illustrates the transformative power of the early intervention services that have positioned her to succeed at VIA’s Day School, where she began in June.

Expanding Food Choices

When they first started working with VIA’s outpatient team, one of Ashley’s goals for her daughter was for her to progress from tolerating a liquid-only diet to eating a peanut butter and jelly sandwich. The staff invited Ashley into the clinic so she could see how they handled lunch with Caroline and learn how to follow-up at home. Ashley learned to focus on making eating fun by providing choice, offering praise, and modeling excitement. She shared, “I learned that I needed to give Caroline a reason to want to eat, and I did that in a lot of different ways, including making it fun. I’d touch the food–something Caroline would have thought was icky–and say, ‘Look, it’s on my finger. Yum!'”

With help, Caroline first moved from liquids to pureed food. Ashley and the VIA team were then able to get Caroline to eat peanut butter from a spoon. To increase her tolerance for texture, over several months they gradually added jelly and bits of bread to the mix until Caroline was successfully eating peanut butter and jelly sandwiches. Next, the VIA team provided a visual plate for Caroline, allowed her to select foods to put on it, and saved a place for an adult to also add a selection or two so that they could introduce new foods, textures, and flavors.

Today, Caroline’s diet includes peanut butter and jelly sandwiches, pizza, chicken nuggets dipped in sauce, grapes, and Nutrigrain bars.

Making Requests

Before coming to VIA, Ashley had tried teaching Caroline simple sign language, but that didn’t work well since Caroline wouldn’t look at her enough. At VIA, the outpatient team helped Caroline use pictures of toys and other items to make simple requests. This evolved into her using her Picture Exchange Communication System (PECS) to communicate and visual schedules to stay organized. Today, Caroline can also vocalize requests using simple sentences with some prompting. For example, she may pull on her mom, who then asks, “What do you want?” Caroline can then answer, “I want to go outside.”

Sleeping Through the Night

When Caroline was really little, the gentle motion of her baby swing would encourage sleep. Once she outgrew that swing, she’d only fall asleep with her mother at her side in the living room, and once Ashley moved Caroline to her bed, she’d only sleep for an hour or two at most. The outpatient team suggested a gradual approach that took patience and years to implement successfully. Today, Ashley and Caroline fall asleep in Caroline’s bed. After an hour or so, Ashley can slip out, and Caroline will sleep in her own bed all night. If she wakes up for some reason, she’ll go right back to sleep.

Parent Coaching

Throughout all of this, Ashley worked side-by-side with the outpatient staff, used the same visual aids at home, and learned to follow through with the consistency Caroline needed to succeed. Caroline now participates in grocery shopping for 15-20 minutes at a time, pushing their cart and lending a hand by adding items to it.

Attending School

This June, for the first time Caroline climbed into the yellow school bus that now takes her to VIA’s James C. Hormel School, where she learns and communicates using her PECS in the classroom, and initiates games of chase on the playground.

As for Ashley, she became so inspired by her daughter’s success that she decided to change careers, and she recently joined the staff at VIA after a career in nursing.