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

CAN I PLAY WITH YOU? NO

playground, play set, park, suburbs, slide, fun, playing, spring, trees, sky, cloudsBuilding Resilency In Your Child with Autism When They Hear the Word NO

This morning I watched Daniel Tiger.  For those unfamiliar, it is a cartoon  and take on Mister Rodgers’ teachings with Daniel Tiger and his friends.  In this particular episode, Daniel politely asked to join a play group and the kids said No.

I was quickly reminded that neurotypical kids accept and reject each other in play groups all the time.  In fact adults, do the same.  But how do we teach our kids with autism to accept the word No and move on.  Truth is, sadness ensues when you are rejected (whether you have the ability to articulate the feeling state or not).  But, teaching our kids to move on to another group, another activity, and even playing alone well is the resilency builidng and the skill building of Moving On.

The inevitable NO will enter any child’s life.  I’m talking about the kind or mean NO.  The nasty malicious NO exists too and requires monitoring and addressing by an adult.  This post is about the NO that says, “I don’t want to play with you right now” or “I only want the best people who play dodgeball or kickball on my team”.  Either way, how do we teach kids with ASD to accept the NO and move forward.

  1. Insert NO in social group dyads.  Similar to teaching the social and declarative language phrases or even the how to nonverbal language patterns found in certain conversation exchanges.  We have to insert rejection into our role plays.  Why? Because role plays should mirror real scenarios so that there is a framework to pull from when social situations (or unwritten social scenarios) play out in the real world. And with that, let’s do practice No with the various vocal inflections and body postures….no sitting at the table in your social groups.
  2. Build Leisure Skills.  Human beings are comprised of three large categories that keep us going: Work (academic, school, job,career), Relationships (friends, family, social), and Leisure.  Great attention needs to be given to leisure not from a reinforcment or as a set of reinforcers, but real skills we need to build in our clients.  After all, lots of relationships draw from similar leisure affinity we see in our peers.  Nonverbal or not, leisure skills can be built.  If you observe, lego groups or otherwise…not much talking, but more hands on building.  I’m working with a classroom now, to support leisure as a rotation within the classroom chock full of task schedules so that the learners can follow a visual schedule of building, creating, and improving leisure.  When learners with ASD or neurotypical people are rejected from a social group, having leisure skills and a leisure reportoire is the skill set you lean on to occupy yourself to draw in, build, or create the next social opportunity with people.

3. Look Social.  This section may offend…but let’s talk about.  There is an entry in most social groups, the visual presentation of YOU.  Before you think, I am emphasizing a high shopping bill, I am clear that each group has a look to them.  My husband is an engineer and each time I drive to his office, there is a look that 90% of the engineers have in their dress and outward appearance.  People are visual.  We give each other the look over to decide if we want to play, date, partner, and become friends with.  If this is acknowledged as true, then the same would arise for social opportunities between learners with ASD and those who are neurotypical.

One of my mentors has always stated that beyond the third grade, we can no longer make (manufacture friendships) any child invite all the kids to the party, play dates, or be friends.  This is a sad truth.  However, as a therapist, I want my kids to not only get invited…but throw the party (if they want).  This means that I am working in social individual and group sessions with this in mind.  What do I do in my sessions?

  • Lots of Perspective Taking
  • Conversation Fluency
  • Social Nonverbal Patterns
  • We do not do social at the table
  • We use real words that people use (annoying, frustrated, upset, okay, happy).
  • We take real scenarios and play them out again.
  • We write it down.
  • Video tape.
  • Social Concept Stories
  • Comic Strips
  • Carol Gray Conversation Colors (to make the socially abstract concrete)
  • We use the word No and soically pattern how to accept it, reject the No, have a rebuttal if we need it, and respond.

The challenge is children with autism need to practice these social skills and social cognition strategies learned in treatment in real interactions with neurotypical peers.   WE, THE THERAPISTS, must do an increasingly better job at moving away from “My Turn. Your Turn” (because kids don’t really say that) towards real language.  And for me, Daniel Tiger assisted me.

Enjoy and Let’s Teach Our Kids to THRIVE!

Pause. Reflect. Contemplation.

landscape, mountains, yoga, sunset, river, water, hills, cliffs, girl, woman, people, adventure, nature, outdoors, fitness, exercise, sunbeams, sun rays
Yesterday my son began preschool at a great early learning center.  Actually, next week is his first time alone.  This week, it is the two of us together supporting his transition.  A plus of a mommy SLP, is that I love to buy toys and I love to watch children play.  Truth is, before I became a mom I loved to buy toys and watch children play.  One of the biggest reasons, I love to watch children play is simply it helps me as a therapist really create social cognition, social skills, and social play goals that are meaningful and move my clients closer (and exceed) to their neurotypical peers.

At the end of each day, my son’s schools send pictures of all the kids in his class depicting their day.  Instead of joyful smiles of glee, were faces of serious contemplation, concentration, and thinking.  Initially, I thought “oh they are not smiling”.  Then later, I was reminded and then deeply reflected on the fact that play is work.  Particularly to young learners, play is contemplative problem solving, negotiation, processing, and much more.  Sometimes we hear voices of joy and tones of satisfaction and even groans when the coveted toy is captured.

But, more often than not we see the nonverbal negotiation:

  • The looks children give one another
  • The smiles of satisfaction
  • The intent observation to understand how something works
  • The working and reworking to get a block structure upright
  • The pause
  • The reflection

Often times in treatment, we teach play and go for the declarative language, the “I want ” phrasing in young learners.  When, in fact, young learners playing do not speak as much in “I want” phrasing as they look and communicate nonverbally.

The observation of the Pause. Reflection. and Contemplation…are all critical for ABA (Radical Behaviorism…thinking about the toy, what to do with the toy, how do I use this toy), OT, and Speech -Language Therapy.  The task is for us as therapists to write these nonverbal transactions and skills in our programs as measurable goals and program prescriptions.

Beginning with the End in Mind is where this is leading me and where I am headed.  What do I want my clients to do?  How does that look in the neurotypical population?  Then we move towards goal writing and never leaving out evidenced based practice and research.

Learning from the preschoolers yesterday was a powerful gift to me as a therapist and a human.

Pause. Reflect. Contemplate. Move.

Continuing to Thrive!

~Landria, SLPGURU

Autism on the Playground

This week was the season premiere of one of the shows I have a like/love relationship with: Parenthood on ABC.    My love relationship is because its good TV.  My like relationship is because I can’t stop being a therapist when I watch it.  So true to form, I must provide lessons and strategies for playground success.

Truth be told it is a challenge for the person with social language deficits (whether its ADD, ADHD, Autism, Aspergers) to navigate the unwritten rules of the playground.  More than that, therapists/coaches/psychologists teaching social skills groups must think about HOW they are teaching these skills.  As a parent reading this, you would probably be shocked  at how many hands do not raise or how many quizzical looks I get when I ask  “Do any of you watch Phineas and Ferb, Do any of you watch Zach and Cody, etc?”   As therapists teaching these skills, we must understand that teaching the skills of social behavior does not place the therapist as peer, but as coach.  As a coach, we must know the social information that our clients need to know in order to better coach and facilitate the real skills of being social.

For therapists, refer to a past blog post on the social connection:  http://slctherapy.com/blog/landria/the-social-connection/

In order to teach playground skills at any age range or skill level:

  1. Get up from the table!  It’s clear that Max’s social teaching was very formal, taught by an social coach focused on etiquette. ..and lacking flexibility and social thinking.  How do I know this?  Because Max extended his hand.

Parent tip: Make sure that your child’s social group (school, private) focuses on the importance of role play.  Role play and getting up from the table will remove those kinks.  AND MOST IMPORTANTLY, the therapist is coach…not peer.  The therapist should not be creating mini-me’s or little adults but teaching and providing REAL information and feedback.

Therapist tip: Motor patterning and Role Playing.  Excuse my small yell of encouragement…GET UP FROM THE TABLE! If we want our kids to be social…we have to get up from the therapy table.  We need to have social postures: sitting, walking, playing, sports, hanging out and all those physical postures in between.  Role playing is crucial as embedding social thinking does not mean thinking in solitude and the quiet…true social thinkers do this on the fly.  They are walking and talking.  They are dribbling the basketball and thinking and talking.  They are gesturing and talking.  We have to teach our kids to read and understand social information (using static pictures and short snipets of movies) as well as inhabit the motor pattern of what it means to participate socially.

  1. Codeswitching:  Codeswitching is referred to moving between various language styles.  It is frequently used for speakers of African-American English (AAE) and Standard American English (SAE) as those are two different language dialects.  I would go as far to say and backed up with research that dialects and language are based upon: age, culture, race, geographic region.  It is clear that Max’s character is very formal in his language presentation, but he has been shown to have moments on past episodes when he is a tad bit more relaxed in his verbal and nonverbal language presentation.

Parent Tip: Make sure your child’s social language group is working not on changing them, but giving them flexibility in how they present.  When you watch the Parenthood episode, it wasn’t that Max said “hello”.  The social turnoff was when he said “my name is Max ___, (and extended his hand)”.

Therapist Tip: Move away from teaching the many ways to say hello.  But have your clients/learners participate in lessons on perspective taking.  Turn on You Tube..show formal/informal ways to say hello. Let them judge other people and use terms like Weird (Good Weird or Bad Weird), Great, Comfortable, etc.  Get them to give you information on how they want people to feel when they are around, and let them work toward that.

  1. The little people and adults are more forgiving, same age peers are not.  Okay!  We cannot create nor manufacture relationships for our children beyond the 2nd grade.  Third grade is when the real social silos are developed.  And adults teaching social groups and adults in the community are very forgiving for social nuances (well except me, I am a social coach I can be proud of J.  (I digress).  Little people or younger peers are more forgiving as well.  BUT little people grow up and become the third graders with tastes and opinions, leaving the person with social deficits behind.  So what’s a parent to do?!?

Parent Tip: Raise your social expectation and barometer.  Think about it, if my child did not have these social deficits..what would I tell them? How would I help them?  Then , in the modified words of Nike, “Do just that!”.  Why?  Because they need you to teach them, model them, tell them the truth in love.  And find places that work for them.  I had  a student who loved to ask people about the number of  stairs, doors, etc.  inside their house.  Now the “normals” balk at the relevancy of such questions.  My recommendation…find a club, group of kids that love to build things.  That group (social deficits, normals, real/regular people who like to create) will be at ease with those questions…and as a parent you don’t have to manufacture or keep that playdate going.  Rather, it is a natural meaningful situation that provides reinforcement to all its participants.  The stage has been set for the natural relationship to emerge.

 

Therapist Tip: Stop hooking up your students by telling parents…”oh Susie and Laura would get along so well”.  Instead, find the natural stage and allow the relationships to develop.  Because (as a side note), what are you going to say to mom/dad when they don’t get along so well….

Teaching Honesty to People with Aspergers and Other Social Language Challenges

For as long as I can remember, the very popular phrase “Honesty is the Best Policy”.  While there are many others, I remember hearing this one frequently in classrooms, in church, and at home.  It is true, honesty equals peace. And peace is priceless.  Recently on a list serve to which I belong the question was posed “Do we Teach Honesty is the Best Policy” to people with social language challenges such as Aspergers.  The person who posed the question went on to illustrate how this particular population may be too honest when following this rule based policy regarding honesty.  While it is true that honesty does not always make everyone feel comfortable, it is needed.

So my emotional, personal, and professional answer to the question “Do we Teach Honesty is the Best Policy?”  is a resounding Yes!

The challenge to the provider is how you teach, the underlying brain processes that are necessary to address, and much more.

In the HOW  of teaching honesty.  It’s important to move towards teaching Perspective Taking and Theory of Mind.  Here we want to teach the learner to understand the perspective of another from an Emotional and Situational Perspective.  When we teach from a systematic, schema building, and fluency standpoint ( the brain building process of perspective taking); we are bringing to light the common phrase “Think Before You Speak”.

With Theory of Mind and the thought process of Perspective Taking, we can begin pairing “thinking about how another person may feel” and using language with another person in mind.  This is when the application of the speech-language therapy targeting sentence forms, reasoning, vocabulary specificity, tone of voice, and body language all become very important.

Honesty that hurts is often a combination of truth, words, vocal tone, and body language.  With learners and people with ASD the tone of voice, body language may not appear to be as empathetic; and when combined with the clear truth…it becomes an OUCH! situation for the conversation partner.

When teaching formal and informal language, SLPs will often work on the HOW from a language perspective.  In teaching honesty, it is never (or should never be the goal) in taking away or dampening a learner’s ability to tell the truth.  It is teachign them HOW  and WHEN to deliver the news and to know the intent:

Here’s an example:

Samantha is with her mom at the grocery store.  She sees her neighbor Mr. Bill.  Samantha says hello and begins small talk.  Mr. Bill is enjoying the conversation with Samantha and her mom.  At the end of the conversation, Samantha tells Mr. Bill that his breath stinks.  Mr. Bill is embarrassed and mom is mortified.

Do we teach Samantha NOT  tell another when their body odor offends her?  NO!

What do we do:

1. Examine her intent.  Did you want to embarrass him?  She answers No.  (side note: If embarrassment was her intent…change focus of teaching).

2. Thought bubble and speech bubble exercise.  Fact: Mr. Bill is in the store.  Fact: You enjoy talking to him.  Fact: His breath stinks

3. If your goal is to NOT embarrass (turn his stick figure yellow…credit to Carol Gray conversation color)….then what can you do…

4. Let the problem solving begin!  (Here are a few choices generated by Samantha: Whisper to her mom after Mr. Bill leaves, purchase mints for Mr. Bill and tell him why you are giving them to him and you did not want to hurt his feelings by talking about it at the grocery store).

Side note: We did not teach her to just randomly offer a mint (that can be rejected) to Mr. Bill.  Her Verbal Behavior was telling him the problem.  You have to teach her to use that same modality to continue to the current relationship. That is, you must teach her to pair a solution with her stated version of the problem. Employ the use of an empathetic voice for HIS feelings not hers.

This was a real scenario and a real HONESTY teaching experience for mom, Samantha, and me (her therapist).  This happened in her Keep the Conversation Going social group 🙂

Resources:

Teaching Children with ASD to Mind Read

Great Video by Dr. Uta Frith – Autism and Brain’s Theory of Mind

Using Patterning to Teach Social Skills

I read an article today posted on the web about teaching social skills.  The authors of these articles are correct: We cannot leave the teaching of social communication to the teacher.

I’d like to add some other lessons as we enter the school year

1. Magic is magic and only left to the magicians.  With this, we cannot put our kids in social situations and expect them to just get it…it’s like putting me in a football field and expecting me to make a tackle, touchdown, and win the game.  Sure I would run..but have no idea about the purpose, whose team I’m on, and what I should be getting from this game of football.  So yes, teaching the why, the how, and giving practice (scrimmage..for you football fans), and then getting in the game makes much more sense.

2. Tolerance must be taught to the typicals.  Therapy and social groups are always for the people with social language deficits.  May I suggest that those without social language challenges need some support too!  Not support to be fake friends, allowing our kids not to get the real social experience they need…but support to be real people…not hand holders with gentle voices, with a bombardment of questions.  Tolerance is teaching the difference, what to expect, and how special doesn’t mean treat so differently that real relationships cannot be cultivated.  But tolerance teaching emphasizes how this experience is a win win for everyone.

3. Some things happen because its what kids do…not because he’s autistic.  One of my therapists had this fabulous conversation with a mother.  The mother was saying that her son was not telling her everything that happened at camp.  She wanted details.  Instead she was getting one word responses.  The therapist gently reminded the mom that her 13 year old son may be like most 13 year olds…they don’t have much to say about their day and an increase in questions may result in a decrease in the length of the response.

4. Let’s focus on talking and not the Q&A. One of my greatest pet peeves when observing a social group (not the Keep the Conversation Going groups run by our staff) is the barrage of questions and the responses by our kids versus teaching them to have statement to statement communication.  If you listen to the typicals talk, watch Nick or Disney..you will see there is more social commenting and opinions rather than the questions.  Questions are only asked if the statements are not informative enough.

5. Motor patterning or Role Playing.  Excuse my small yell of encouragement…GET UP FROM THE TABLE! If we want our kids to be social…we have to get up from the therapy table.  We need to have social postures: sitting, walking, playing, sports, hanging out and all those physical postures in between.  Role playing is crucial as embedding social thinking does not mean thinking in solitude and the quiet…true social thinkers do this on the fly.  They are walking and talking.  They are dribbling the basketball and thinking and talking.  They are gesturing and talking.  We have to teach our kids to read and understand social information (using static pictures and short snippets of movies) as well as inhabit the motor pattern of what it means to participate socially.

6. Social therapy is just not for those with high functioning or Aspergers.  Everyone needs to understand social information and be social.  Social interaction is at least 60% nonverbal…40% talk.  So those who are nonverbal or use AAC systems should be participating in social groups and social therapy too!  There was a study by Kuehn and Weiner that discussed how those even with low IQs had the ability to be more social despite the IQ number.  BUT  their social IQ was dependent upon opportunities.  This means, that going to the one time a week social group or lunch bunch is not enough opportunity.  And being included without appropriate and faded support is not opportunity.  Systematic teaching, systematic coaching is opportunity.

Let’s get in this school year and BE SOCIAL!