What’s Laundry Got To Do With It

StockSnap_4876CF9B9C.jpgExpecting More in ABA and Why This Should Matter to Parents

It is frustrating  when vocational programs for learners with autism that focus a majority of their goals and time on  laundry and cooking.  I’m just guessing, but there are a more than a handful of people in this world who do not know how to cook or do laundry, but they lead successful and independent lives.  The skill these successful neurotypicals possess is to see a need and make a call to friends or a service to get the job done.  Problem solving at it’s best.  So why is it completely necessary for learners with autism to learn to sort, wash, and fold?

Adolescent programs for learners with autism are necessary.  Except that when enrollment begins at age 8 for an adolescent program, it leads to many questions.  The major one centering around expectations.  If treatment is a pipeline for adult dependence and more laundry, then let’s stop the Autism Waivers, ABA funding; save your money.

With programming focusing on a daily skill of laundry, cooking, and showering…it leads me to wonder what the pipeline to therapy really is.  Shouldn’t therapy and intensive treatment be a change agent?  Yes there is a path for everyone and college, vocational-trade, and job coach support.  However, shouldn’t the underlying precept of a therapy program be to engineer and teach the learner to communicate, problem solve, reason, and think.

I’d rather leave the actual focus of vocational goals up to the families.  Culturally speaking, not all families focus on laundry, cooking, and the like.  Some of them are busy shuttling kids to Kumon, Swim, and Violin.  Not all neurotypical children have an interest in cooking and laundry and they voice their opinions of such.  So, why don’t learners with autism get a choice?  Why should they become master laundry sorters, folders, measurers of detergent, and quesadilla makers regardless of their ability?  Are these vocational goals and adolescent programs starting at the age of eight more reflective of low expectations of the therapist and the center?

Parent’s let’s talk…

Let’s level the playing field here:

  • If  your neurotypical child’s kindergarten teacher brought laundry from home and had all the student’s sort it, measure the detergent, wash the clothes. Would this work for you?
  • If your neurotypical 8 year old child were placed in P.E, recess, and lunch with 16 year olds? You would find that odd and question why they were put in the same peer group, right?

If it’s not good for the gander, it’s not good for the goose.

Daily Living Skills are necessary.  The focus should step into the modern era and open our eyes to what neurotypicals bring from a skill set level to social relationships, employment, and college.  This is what our focus should be in the Daily Living Category.  More than this, parents must be consumers who have not lost their expectations for what the therapy they pay for should produce nor their expectations for their child’s achievement.  Let’s move from being in awe about Dr. Temple Grandin and her accomplishments, but ask the deeper question “How Do We Get There?  How Do We Accomplish This?”

I’d rather my child learn how to:

  1. Be sensitive to his or her own body odor and act accordingly
  2. Know when he needs a haircut and call to schedule himself
  3. Know how to navigate from point A to point B using google maps
  4. Ask for directions when lost
  5. Know how to use ATM, Debit cards, and monitor if money is lost or stolen and what to do when that happens
  6. Know how to use a locker at the gym
  7. Balance healthy food choices and snacks
  8. Call to order or use the web to purchase food, groceries
  9. Know how to create a schedule, use a schedule
  10. Know how to text message  (written or voice command) and listen to a text.
  11. Know how to “google” something to find out the answer
  12. Know when to understand when his/her clothes fit and coordinate himself/herself based upon the occasion.
  13. How to call Uber or a cab.
  14. How to tell if someone looks safe (tricky topic)
  15. Know how to pick a partner and ask someone on a date.

The list goes on.  And I’ve yet to mention doing laundry.  The point?  Laundry can be taught at home.  Give the parents the task analysis if you must…but they don’t need that. Focus on real life in therapy so that our kids have a fighting chance to make it in the college dorms, apartments, and to use their money, and make safe choices.  All of these things are not taught in the treatment room or in the make shift adolescent room in the therapy center, this is real life and needs the real world experience.

And if you are thinking about insurance and what they will/won’t cover..the list above is either in the category of Problem Solving, Communication, Reasoning, Daily Living-Hygiene, Daily Living-Spatial Reasoning and Transportation, Cognition (number matching- calling on the phone)…so yes this can be done.

Time to Stretch….and Thrive.  The world is waiting, let’s prepare our learners with autism better.

~Landria Seals Green, MA., CCC-SLP, BCBA

The SLP GURU

NEVER BEEN TO A BASEBALL GAME

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Processed with VSCOcam with c1 preset

How Exposure, Opportunity, and Experience make a Difference in Teaching Concepts

I’m using this Saturday morning, taking a brief break from studying, and watching the movie “Hardball” with Keanu Reeves.  It’s a story of redemption for Keanu as he is tasked to coach an inner city youth baseball team.  True to life, he eventually learns that investment has a cost and the teaching-learning is reciprocal.  In a memorable statement, he asks the team if they’ve ever been to a baseball game.  The children reply “No”.  Keanu states “Until you see a baseball team, you’ll never learn to be one”.

Wow…

Isnt’ this what we know as therapist’s.  ABA, Speech, Occupational Therapist.  Especially those of us that work with children with autism.  Being is Seeing.

When we want our client’s to BE…we essentially want them to learn the concept and the proof of learning is in the data.  You know those pesky numbers that require us to show that what we are doing has social relevance, is working, and has generality.

But our client’s need to “see a baseball team”.  How do we deeply want our clients to identify fruits, vegetables, foods when the the opportunity to go to the grocery store doesn’t happen, the experience of eating a select food item happens often, and the exposure to only what he will eat continues to exist.  How then and what connection do our clients have with our learning tools and teaching stimuli? I was amazed in doing language therapy with a group of children last year that in discussing animals, none had ever visited a zoo; asking them about where to find books, few had visited the library.  How do we as therapist’s get up this mountain of language lack and get to acquisition, fluency, and generalization of new concepts?

  1. WE MUST WANT TO.

First things first.  The desire to get to know what our clients know has to be there. We must have the motivation to build our treatment around them, allowing the learning material and objects to be motivators.  The connection to the learning tools is because of interest and the need to know more.  Connect the small interest and expand on that.  After all, project based learning such as Reggio Emilia does this with typical brain developers. How awesome is this to take this concept of interest and expansion into the world of discrete trial teaching and ABA therapy.  For instance, if your client loves all things “red’.  Why not start with red things, apples, candy, veggies, chips, crayons and use them to teach categories and smaller categories (i.e. fruit, snacks, shapes, colors, crayons, clothing, etc.).

2. DON’T ASSUME. GET TO KNOW YOUR CLIENT.

Here is where it’s not tricky at all, but this is where therapist’s get in their own way.  This is the part we miss.  I recently read a post on FB from an SLP who gave reasons why she no longer does home visits…”section 8 families never home, too busy to answer the door because of drugs, sex, and alcohol”.  Because we live in a world of screen shots, I was flabbergasted.  I also thought…this therapist could not have any true friends-colleagues to remind her that arrogance has no place in the heart work of therapy and to take that #$@# down!  So the getting to know our clients is simply taking on each as an individual.  Not all families who speak a second language are dysfluent in English, they can be fluent in both and have a great language rich home.  A child of surgeons, can have poor opportunities and exposure because they may not fit the picture of what is imaged.  Never assume.  Get to know them, lay down your profiling and stereotypes,  and MAKE A DIFFERENCE!

3. CREATE COMMUNITY RELATIONSHIPS.

You want your client’s to have social opportunities. You want them to experience the vocabulary and actually engage with the concepts and words you teach.  Well this where the extra mile gets impactful.  Make calls to your local library, supermarkets,museums, and arrange discounts or make it more autism friendly so that the loudness, etc. of the place doesn’t get in the way of them experiencing the target goal.  And how about those supports coordinators for autism waivers and such…this is what they should really be doing to make the therapy work. So let’s help them be better at and more integral in coordinating and establishing those community relationships for you.  It takes a village. Yes.  And village creation is not magical.  It takes reaching out, reaching across, and communication.

4. BE IMPACTFUL. MOVE AWAY FROM WORKSHEETS.

I don’t like worksheets for most things especially therapy homework.  Circle the_____. Cross out the _____.  Versus write down your dinner,circle the vegetable, the dairy.  Look through this article on USA today or Time for Kids, make a video summary and tell me about what you read.  In a world of SnapChat, Instagram, Facebook Live and all things to come…I don’t want my client on these platforms engaging in ways that look as if therapy were never part of his world.  To be impactful in 2016 and beyond, today’s therapist will need to assign relevant homework with applicable outputs.  The therapist will have to assign experiences and discuss them rather than the solitary worksheet that may support acquisition but will not readily yield fluency and out of touch generalization.

Seeing is Being.  And on the flipside…how can a therapist assign a client to make an Instagram video and give a movie review (2 things you like and don’t like about a movie), if they themselves don’t use the tools.  Going to the baseball game is a two part.  The coach had already experienced this phenomena and studied it…he enjoyed it and saw the relevance and therefore exposed his apprentice.  As people in this world, we experience life…and don’t bring the “baseball” game to the therapy room and we lack relationship with our families…never getting to know them beyond the surface.  Time out for this!  Life is not only short, but our time spent together must be impactful.

Therefore, my clients have no room for my assumptions about their life…I need to bring them to the baseball game…to frame the words from the Statue of Landria, SLP GURU

Bring me your behaviors. Food Aversions. Sarcastic say anything selves.  Bring your spitting, bolting, and focused interests.  Bring your inflexibility, large vocabulary and small experiences.  Bring me your large experiences that you keep to yourself.  Bring me your hitting. Bring your slang, defensiveness…I am your Autism Therapist…it is my job to accept you, broaden your world, and make you better for having known me…not from any pseudoscience, but from evidenced based practice, real world application, and data collection.  Bring yourself. I bring myself. And let’s get to work!  ~Landria Seals Green

We WILL THRIVE!!

~Landria Seals Green, SLP GURU

Establishing Instructional Control via Teletherapy

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Using Technology During Your Sessions with Learners with Behavior Challenges

Instructional Control.  Not as bad as it sounds, I promise.  Truth is, in most cases we all want and need it.  When a speaker is standing in front of the room and the audience is quiet: control.  See…not as bad as it sounds.

But how about the therapist that needs it so that a skilled learning (acquisition or fluency) can take place and the therapist cannot use his or her hands?  By this, what if the behavior of noncompliance is present and the session is via teletherapy or over the web?  What is a well-meaning therapist to do?  You’d do the same, with some variation, as if the child is in front of you.  That is, if you take the perspective that instructional control is about presence or owning the room in such a way that yelling or holding become completely unnecessary because YOU, therapist, have the floor.

Today I worked with a student who is constantly told “NO” all day.  So by the time he has a another provider he is, at my husband would say, full of hearing the same admonishment. This particular student is classic in escape.  We’ve all met versions of him in size, color, gender, age….doesn’t want to do anything at anytime except what he’d like to do at the time.  So when he told me I was boring, I ignored him.  Recognizing that wasn’t enough for me to change. He then started doing other things with not so kind language and then plain moving away.  Could I have used a variety of reinforcers?  Of course, but for him the only effective reinforcer would be the escape.  And getting him back to task after a break would have prolonged his escape.  So here is what I did and it worked.

  1. Planned Ignoring of client’s off task language (including insults)
  2. Restatement of the Consequences when the behavior escalated to property damage (break something, your parents will pay for it).
  3. Reminder: Work First. Then Leave.  No work done.  We will sit until you are ready.  I have the next two hours free (too much language…but he needed to know I was in it for the long haul)

My voice: Firm

Client Responded to the Consequence and the Reminder.  He completed his work.  I congratulated him (even though he was still disgruntled).  I then had him survey the room and posed this question “Is the room in the same condition at the beginning of our session or messier?”.  His response: Messier.  My response: Clean up for two minutes then leave.

He complied.  I instructed the adults in the room, we were not looking for perfection but for compliance.

Here is the lesson:  Hearing NO or admonishment all day can ruin your mood BUT  it is no excuse to break, destroy, or not complete assigned tasks.  In teaching children resilience in learning and extending their ability to stay with it…we teach them communication (telling another you are annoyed or irritated) and we implement realistic situational consequences.

After cleaning for two minutes, I called him to the computer and reviewed: Come in the room. Sit Down. Get the work done. Leave.  He responded: Yes.  I then said “I’m proud of you for getting it down.  It’s over. Now go enjoy the rest of your day”.

My voice: Soft and pleasant

In the It’s Over part, we as providers teach them to understand how NOT to carry the feeling of anger.  The challenge for us is not to carry on in our case and school meetings about the student’s behavior.  (Don’t you know when you’ve been discussed and the discomfort you feel…now imagine being a child or teen).

Still looking for a well written behavior plan and some data collection…but hey, Rome was not built in a day and neither are adults.  Everybody’s learning 🙂

Let’s THRIVE!

~Landria, SLP Guru

 

The Burden of Challenging Behavior for Children with Autism

broken crayon

How We Set Up Children With Autism and Behavior Challenges to Fail 

Today I watched a child answer questions accurately, give great answers, generate a story all the while his shoes were off, he was jumping out of his seat every three seconds, and making silly faces.  Focusing and marveling at his ability to multi-task and provide accuracy with some admiration was my position.  Other adults…did not care as much about his accuracy or aptitude, but complained about his ability to sit and attend.

Don’t get me wrong,  I think sitting is an important skill.  But clearly, not a perquisite for learning, intellect, or expression of thought.  Sitting just makes us feel more comfortable, at ease, and allows people within a school setting to do their jobs easier.   The challenge is that NOT sitting, silly faces, behavior issues of noncompliance, carry the weight of gossiped negative reputation.  The kind of reputation where people do not smile when you enter a room, they don’t cheer you on, nor do they give you the room of “typical development” allowance granted to more compliant children.  Can you imagine walking into a learning environment daily where people are sad you came?!?  And they expect you to live up to the expectation of having a bad day.   Now imagine being a child carrying this obvious weight at least six hours daily.  This is what happens in classrooms, private therapy organizations, and schools across the country.

Not Fair is it?!? To judge someone based upon what we hear, even observed third hand, and then decide to treat them accordingly.  This is the unspoken truth at IEP meetings and within schools.  It’s what we do often as adults, if we are not careful, to one another.  So let’s not be super surprised that we impose this on to children.  Do I sound angry?  Well this is particularly a hot button issue for me.  I will try to keep my emotions in check :-).

Given that this adult judgement does not appear over night, it is safe to say this happens when we view children who have behavior challenges.  Honestly, you get one chance to make a great impression. Children with autism will often display certain behaviors that are deemed challenging.  Sometimes aggressive. Sometimes brutally honest language. Sometimes a little bit of both.  Often times a child autism and related behaviors makes one false move, this may often carry him through elementary school.  It’s not what is written as much as what is said between staff, staff to students, and within administration.  A shameful truth.  So where does this dilemma leave a parent? What is a parent to do?

1. Maintain a good running record of any incidents and documentation of such.

2. Understand and discuss the reinforcers being used within the school setting and support the team in creating items that are particular for the school environment knowing that the reinforcer should adjust based upon the task and its challenge.

3. Create and enroll your child in activities that support their interest and feelings of accomplishment and camaraderie.  This could include music, singing, lego clubs, train clubs and more.

4. Ensure that functional behavior assessments and/or analysis have and are being conducted.  A full day observation on more than one occasion would provide ample information about social interactions, antecedents to behavior.  Also include with this an evaluation of work task ease or difficulty, language provided during directions, and staff interviews (paraprofessionals, lunch staff, etc.).

5. Add a matrix to the behavior intervention plan.  A matrix is the schedule and strategies of implementation of the actual plan across your child’s day.  It is a large spreadsheet that displays each class by day, the providers, goals to be implemented, and specific strategies by each provider inclusive of time of day and class.  Although lengthy to create, I have found the matrix to be most helpful when observing for implementation and program planning purposes.

6. Schedule monthly matrix meetings.  This supports the IEP and its implementation as an active viable document to be followed and analyzed by each professional and the specific role they play.

7. Allow your child to feel all the feelings of happy, sad, frustration, joy, proud and honor each one through taking the time to language it for them and discuss the feeling states.

8. Maintain communication with the school and have targeted non IEP based meetings with the Director of Special Education to arrive at decisions and provide insight into program planning and how things are moving for your child.  Often times, this relationship can support better decisions for your child and those with similar profiles.

9. Consider exploring other educational options.

10. Attend professional development workshops and conferences to understand best practices within the fields of study in which your child receives services.  This will arm you with better tools in IEP development collaboration, matrix planning, and more.

Children are people with feelings and insight sometimes unexpressed.  When people with autism are looked over, looked beyond, and not honored because of specific behaviors (learned, allowed, or not yet fully shaped), this level of reputation following does not escape them at all.  This puts parents in a challenging position to knowingly send their children to an educational environment or therapy practice that has not found the love or like-ability yet.  Our job as practitioners is to not only find it, but be the people called to support our families and making our clients better for having known us.

Until next time…keep THRIVING!

~Landria Seals Green, MA., CCC-SLP, BCBA

 

 

 

 

 

 

My Son Put His Pants On Backwards

pants…and other Things I applaud to Encourage and Teach Independence

In my mind I had several things to get accomplished at the same time.  And I was holding my three year old son’s pants.  I handed his pants to him and said “Put your pants on”.  In his wisdom, he paused, moved his head to the side and repeated the direction.  As I then tended to other things, I could hear see him sit on the floor and hear him slowly saying “Right…Left”.  A few minutes later he walks up to me and I remember  thinking “PANTS. HE’S WEARING PANTS backwards.” I immediately screamed with glee, clapped, hugged, and we did a dance.  Why? All of this for something incorrect?

It was his effort.  

His generalizing something he hears as a slow down prompt…Right, Left.

He went for it.

He did his best work.  

In working with people with autism and other special needs.  I’ve always believed the importance of honoring the present level in such a way that gives that “I believe in you feeling”.  It is possible for the therapist to have human engagement beyond “he’s so cute”…and actually Collect Data, Teach and Expect more all at the same time.

Here is what happened that I did not expect.  Later as I was putting on my own pants (TMI), my son clapped for me, screamed in glee, and told me congratulations.  Social reciprocity, Experience Sharing, and other nonverbal social development skills is what we see on the playground and want for our clients and children.  Where does that social connection piece begin?  At the beginning of our interactions and we teach it.  We show it. We embody that which we want them to become…better versions of themselves not many therapy “me’s”.

A larger lesson is that I did not measure my three year old by my standards of putting on pants.  I measured him against himself.  Ha!  What a lesson for adults.  Less negative competition, topper comparison, and pointing out the wrong.  But the positive authentic acknowledgement of the person standing before us and celebrating how far they have come.

The celebration of HUMAN EFFORT in the YOU DID IT!  And then the I SEE YOU experience humans need and want.  Then the teaching of

  1. Putting on pants in the correct direction
  2. Placing silverware in the correct location
  3. Putting socks in the sock drawer.
  4. Putting shoes on the correct foot.
  5. Reading….And more!

Moving toward Generalized Independence is not just about data collection.  It is about seeing the individual as they are, celebrating them, collecting data, and giving the informational supports needed to exceed themselves!

To THRIVING!

~Landria Seals Green, SLP GURU

 

 

Autism. Restaurant. Family Outings

From Dream To REALITY

Photo By Bonnie MeiselsB.C. and D.C. are now beautifully coined “Before Child” and “During Child”. Before child was filled with spontaneous dining out during the week with out a forethought of high chairs, snacks, sippy cups, and wipes. It is easy to believe that in my wanting to be a mother, I did not enjoy that B.C period enough. Note to self: the BFF was right on.
But here is the thing, while I am thinking of my own D.C. experience, I am thinking about the many families of children with special needs and the list of things to bring or the longing for a quiet, nice, easy, relaxing evening at a restaurant…where YOU (parent) are being asked “How can I help you?” and someone bringing you a meal.
Here are some tips that I now employ, that you may find helpful:
1. Bring a hungry child to a restaurant. This applies even if your child has food specifics, picky eating, etc. Pack what they like. Don’t make the restaurant the place we want to try asparagus. Pack their snacks. Pack their favorite foods. Bring them hungry, timing the restaurant outing around meal time.
2. Focus on your focus. There are some many things to focus on during meal time besides eating. Talking, Looking, People Watching. This applies even if your child is nonverbal. Sitting and Staying for the duration of the meal (of others) is a real goal and life skill.
3. Walk behind the waitstaff and immediately scope out what is in arms reach. MOVE the ketchup, sugar packages, knife, and fork.
4. Immediately place some of the reinforcers (snacks and favorite foods) next to you, within your child’s visual field.
5. Bring help. Yes. Bring the babysitter, nanny, cousin. This is especially if you want a family meal and want to be served as well.
6. Pack small toys that are only used for these outings. Here are my new goodies. I keep these toys in my bag so they are not part of the usual stash.

Octonauts (my son’s favorite TV Show)

Magnetic Blocks (http://www.tegu.com/)

Shop Tegu blocks

Puzzled Blocks 4 in 1 (http://www.treehoppertoys.com)

Puzzled Blocks™ - Construction

I made this list without suggesting technology! But guess what, it is my secret #7 and YouTube is my secret weapon. Don’t judge us .

Grownups often want to dine in a REAL restaurant and the benefits of exposing children are endless. Crying is okay. Fussing is permitted. Keep going out, your family needs to see its community and the community needs to see you out there more often.

Let’s THRIVE together!

~Landria Green, MA., CCC-SLP