Matt's commitment to therapy was unwavering, even when his attempt was more mechanical than consciously driven, and our days were long and exhausting. Six days a week, he spent 20–30 minutes completing Constant Therapy homework, which involved interactive exercises targeting core communication and mental competencies. Once his session was set up, the technology enabled Matt to work autonomously, unlike so much of his life, which depended on others. Every month, his speech therapist, Jessica, adjusted the difficulty to keep pushing him. Since the program relies on structured repetition to build new connections, Matt often had to circle back to revisit complex abilities, as in his persistent struggle to repeat the name "octopus" back in December.

Over time, a single monthly program update to increase the difficulty and broaden the content couldn’t keep pace with Matt’s potential. Jessica was juggling so many fundamental needs, and I didn’t want to divert her focus from areas that depended on her unique training. I therefore offered to manage the Constant Therapy app myself to ensure Matt’s long-term trajectory and gains were sustained. While many caregivers might not feel comfortable taking on this responsibility, the App’s technical staff trained me to modify and add new drills to Matt's daily homework. I was delighted with this independence.

This sustained, multi-year endeavor showed remarkable returns. In a summary posted on July 30, 2021, I reported: "The first year, Matt was stuck at Level 1 skills; it was such a struggle. Over the next two years, the difficulty level increased, currently ranging from 3 to 8, and his language proficiency improved, with accuracy rising from 80% to 100%. Most notably, his latency decreased from 45–137 seconds/task to 2–9 seconds. Perseverance paid off." This exponential decrease in processing time underscores the success of the program's underlying premise and format.

Constant Therapy is just one of many “brain drains” Matt faces during our busy days. People take so much for granted, especially the fact that the mind rarely gets a break. For example, it is strenuous for Matt to recall recent memories, and he sometimes avoids our questions to dodge having to think further. However, he occasionally pulls a rabbit out of his hat and surprises us with his recollections. For example, our family excitedly anticipates seeing the creative characters in Sunnyside Farms’ annual Halloween harvest display. When asked about one character, Matt couldn't recall the name "Mr. Incredible," but he immediately named the character's alter ego, Bob Parr. A day later, he managed to list three additional characters he had seen: Wonder Woman, Spiderman, and the Hulk. This showed that, although retrieving specific details remained unpredictable, some memories were being stored.

These cognitive gains quickly translated into real-world observations. Matt recently acknowledged a driver with a friendly wave after the driver stopped to let us cross. Later, to my surprise, when I indicated we were ready to go to therapy once I finished closing the windows, he walked over to the patio door, closed and locked it. However, he then got into the car without remembering to open the automatic garage door. And finally, after witnessing three car accidents on the highway in one day, Matt identified the pattern as unusual, gathered his thoughts, and clearly communicated his observation to Mike. It’s all about the baby steps.

An encouraging transition occurred as Matt developed a deeper understanding of his own limitations, recognizing that what he said or did didn’t always align with his intentions. This, in turn, enabled him to begin correcting his own errors—on a very limited basis, mind you. Leveraging this progress, we shifted our approach to encourage Matt to self-evaluate, independently identify mistakes, and generate his own ideas for assignments—rather than relying on others to determine which game to play or movie to watch. It was a noble, though somewhat premature, plan.

© 2026, Sarah Watkins