I was quite pleased with the consultant recommended to us from Emerging Minds.
We talked a lot about Nathan and what I've been observing. She gave me a lot of resources to look into but she had some immediate practical suggestions.
A social story book about the people who take care of Nathan. Some of his anxiety seems to be concern over the competency of those taking over when I'm not there. I can put together a book of his usual caretakers and talk about how they are able to take care of him. I can also see about including something uniquely positive in their interactions with him, something I can't replicate. That might help him to see them as positive additions to his life again, rather than as worrisome substitutes.
A detailed visual schedule for troublesome activities and transitions. First A, then B, then C, then D, where D is something he really likes and would look forward to. I can also put together specific goals for activities like karate or Beavers.
A shadowing situation where I bring him and the caretaker with me when I have to go out (assuming its possible) so that he's not losing me during this transition period as he learns to trust the caretakers again.
I'm adding a few things to the roster.
Rewards for polite behaviour. I've told Nathan that he doesn't have to like everyone but he does need to be polite, which means not screaming or hitting people. He doesn't have to interact, but he needs to say hello when they come in. If he's not polite, he loses his television and iPad priviledges. If he is polite, he can have an extra story. I'm hoping we can avoid the drama and thus keep the situation from devolving right from the beginning.
Regular phone calls. If I do have to go out without Nathan, I'll let him call me on my cell phone every half hour or so. Or I'll call him (we'll see what works better logistically). That way he can connect with me and I can reassure him on any concerns.
I think I may need to be more firm with his school and push for certain features.
I need to know what the circumstances are for him using their autism room. I also need to know what their plans are with him. Hopefully I can get that information without too much trouble.
He needs to have an updated visual schedule which accurately reflects the day. He needs to have regular encouragement and praise for doing well. He needs to understand that the rules apply to him as well as the other children.
It won't be easy. But hopefully we can turn it around.