I was wondering if someone can help me with something. I have a down syndrome patient who I began seeing about a month ago. His first few sessions were good, no crying, he played with toys and laughed, he even began attempts at verbalizations. All of a sudden, he would begin crying as soon as he walked in and would not stop crying for the entire session. This has been going on for about two weeks now. I've tried everything, songs on the iPad, toys with lights and sounds. I've taken him to the gym (the clinic where I work also offers PT and OT) and put him in the ball pit, on the swing. I've used a weighted vest and joint compressions, but nothing seems to work. Last session I allowed him to cry and I wouldn't pay attention to him. He would come up to me arms stretched out wide, and I would ignore him, after 45 minutes of crying, he finally stopped. He didn't do anything in the remaining 15 minutes, he just sat there and rocked himself but did nothing towards his goals. Today, mom brought a family friend's son with her (patient likes him and plays with him) to see if it would work, nothing changed, I had to ask the boy to wait outside with mom because he kept picking him up and cradling him in an attempt to get him to stop crying. I spoke to mom, she says he is not like this in school, that at home he plays independently, and she doesn't smother him. She says its only here when he begins to cry. I began taking it personally until he was seen by two other clinicians and he did the same to them. I believe its pure manipulation, that al he wants is to go outside and be with mom because the second he is allowed to go out he stops crying and is happy and he plays in the waiting room. I'm considering letting him cry himself out but I always hate doing that just because I feel its so unproductive. Mom suggested she come in at the beginning of the session to see if it would help calm him, but I know it won't really work, but I'm going to do it just so that mom isn't left with that doubt. But after that I am fresh out of ideas. I don't know what else to do aside from letting him cry and let him get used to the therapy, but I was hoping there could be other ways to target this. If anyone has any ideas whatsoever, I would really appreciate them. I'm at my rope's end.