For many reasons, some children in the spectrum become passive: executive function glitches, feelings of incompetence, overprompting, doing too much for them, doing too little for them, etc. Pamela was born passive, which we mistook for patience, sweetness, and gentleness. As an infant, she hardly cried about anything. Unlike her brother, who demanded attention from day one, Pamela sat there and watched, waiting for us to read her mind. She never connected crying to getting fed, changed, and held faster. She was so passive we took her out of daycare when she was four months old and placed her with a family where she would have more one-on-one attention from a friend and her children.
Today, Pamela is anything but passive. Not only does she figure things out for herself, she can be rather demanding and bossy at times. Now, we have to work on the other side of the equation: not letting her control us. Helping her learn to initiate has been a life-long process and requires more scaffolding than being dumped into a new home with strange people (Mary Lennox and Elizabeth Ann). People often ask how to teach chores to children who can easily get stuck into a mindless routine in which they become stuck if something goes wrong or who have executive function issues that make it hard for them to initiate or shift to another step.
First, there is atmosphere. I try very hard to avoid tying performance to rewards because I'm not a behaviorist. When working on new habits, I make sure that Pamela and I have sweet moments during the day that have nothing to do with following instruction. I go out of my way to smile at her for no reason, tickle her sweetly at random moments, say things that spark giggles out of the blue, etc. I never want her thinking "Mom is only nice to me when I do what she wants." When we are forming a new habit, I make declarative comments on what we are doing, "We're washing towels" rather than clap and gush,"Yaaaaay! Good job!"
Why should she do chores if there are no rewards? Why do I do chores? I am not Mary Poppins: I take no delight in chores, even with a spoonful of sugar. Chores are things that need to be done so life runs smoothly. Laundry needs washing or we would all be running around naked. If rewards were the only reason to do chores, I would rather skip it, sit down with a cup of coffee, and read a book. I hope Pamela will notice something needs doing and do it rather than work for rewards or stick to a mindless schedule. The atmosphere of doing chores together is slow, attentive, warm and encouraging. We are sharing an experience: we are doing something together, knowing that the relationship means more than mastering every single step of laundering in two weeks or less.
We live in a performance-oriented world. It is easy to think our kids aren't learning fast enough and give up. I try to keep in mind that doing chores is more than the task. Chores are the context for us to work many areas of development: exchanging declarative comments (communication and language), embedding body language and facial expression (nonverbal communication), adjusting to each other's pace (referencing), knowing what to do when the washer is already full or the door is hard to open (problem solving), knowing that there is such a thing as too full (judgment), etc. Because I teach life skills in a contextualized manner, I don't worry if it takes two months to master every step and contingency.
Building interaction patterns (shared with me by our RDI consultant) through chores and anything that is part of your day sets up a framework that does two things: create a framework for learning many tasks and lay a concrete foundation for the flow of conversations. Most interactions follow one of three patterns, or a sophisticated combination of them: simultaneous, alternating, and assembly line (you can read about all three here). Once kids recognize the pattern, it is easier to take an active role in a wide variety of interactions with people rather than feeling confused and withdraw.
Another important ingredient worth including is going very slowly and waiting for them to take a step. Our kids process much more slowly than we realize. When we rush and push, they feel incompetent and give up, making them more passive. We must go slowly enough for them to observe, think, and react--at their pace, not ours. Slow interactions invite our children to join in because they feel like they can keep up and succeed. Enough positive memories of taking an active role encourages them to initiate more. RDI consultants suggest waiting as long as 45 seconds to avoid missing an opportunity to think.
So, what if you had an extremely passive child? How would this look? Planning is everything: you want to set them up for success by making it easy at first. Sort the laundry and have the laundry that needs washing accessible. Have the detergent out and the cap slightly loosened. If they are too short to reach the washer, think about how your child will physically do it. An energetic child might enjoy taking turns "shooting hoops" while a sedentary child might sit on top of the dryer and drop clothing into the washer in assembly line fashion.
Another thing to think through is your hierarchy of prompting. You want to try the least direct prompt possible and wait for a reaction before trying a more direct prompt. The very first thing you do in any interaction is seek the person's attention. How would you do that in real life with a non-autistic person? Clear your throat and wait. Wave your hand. Move closer. Would you ever say to a friend, co-worker, or boss, "Look at me"?
If your child is not used to shifting attention to you, you may need to get extreme. Do or say something completely surprising like sing "Who let the dogs out?" You may need to move your face in an odd angle until your child cannot avoid seeing that you want her attention. Attention is not the act of eyeballing a person. There is a mental shift to observe you as a whole person: what you are doing and saying. I know Pamela is paying attention in how she reacts to me, not how long she gazes at me.
Timing is important too. Interrupting the credits of a movie is not a good idea (that is an issue for another day). Set everything up and wait for the right time such as after the child is in the process of transitioning from one thing to another. With a bright face and cheery voice, you might announce, "We're going to start the laundry." Then, grab her hand, walk with her into the laundry area, and guide her to the position where she will be working.
If your child is completely passive, this is the time for many long, awkward pauses. They are not used to thinking and acting! Do something to encourage her to shift attention to you and wait. Move through the hierarchy for getting attention (each time waiting) until she turns her gaze toward you and then point to the door. Pointing to something is more indirect than commanding, "Open the door." It requires the child to think: What is Mom pointing at? Why is she pointing? Does she want me to do something? What does she want me to do? Why does she keep staring at me?
Until your child opens the door, you could try a variety of indirect prompts (waiting between each one): tap on the door, put your hand on the latch, try shoving a piece of clothing through the door, guide her hand to the latch, help her partially open it, help her open it all the way, etc. You could even think out loud, "We have to put clothes in the washer" and wait. Or say, "I wonder what we should do first" and wait. Or try, "Uh, oh! The door is closed." This sounds very slow and laborious but will be worth the effort when your child starts showing initiative. If we just verbally command (or look at a picture schedule), it will be hard for them to learn to think for themselves. When she finally opens the door, you might gasp with a big smile and, when she looks at you, say, "We opened the door!" Give her some time to reflect on that big moment before going on to the next step.
Once the door is open, you start the interaction pattern of transferring pieces of clothing into the washer. At first you want to be very predictable and build their confidence in knowing what to do. Before the process becomes mindless, you inject a little uncertainty (drop a piece of clothing, put it on your head, put it in the hamper, etc.) and see how your child handles it. Without uncertainty, the interaction becomes mindless and you miss the change to foster flexible thinking and problem solving.
Pamela initiates very well and takes active roles. Here is how it went down with us. Before we started, I sorted the towels and sundry cloths in a hamper. I put the detergent on top of the washer and the hamper in front of the dryer. Then I waited. We were going shopping (something she wanted), so I waited for her to come in the kitchen and ask about it. Then, I told her we would go after starting laundry. We stepped into the laundry room, and I pointed to the washing machine door. She opened it.
Then, we hit our first glitch: David had washed his clothes the day before and forgot to transfer them to the dryer. Pamela looked in and said, "They're wet!" Then, I smelled them (my sense of smell is shot because of my cold), and I couldn't tell if they needed rewashing. I explained to her my thinking, "I'm not sure if they're clean," and I closed the door.
I pointed to the tray where we pour in the detergent. She tried opening it but couldn't because you have to shift a hidden latch to the right. She looked at me, "It's stuck." So, I pulled it a little way open and she finished. I took the cap off the detergent and gave it to her. She held the cap while I poured. I pointed to the section for the detergent, and she poured. I placed my palm on the door like I was closing it and she closed it. I showed her what button to push (which you have to push twice). I handed her the big detergent bottle and pointed to the corner of the shelf where it belongs. She put it away. We paused and I put my hand on my ear. Why? Sometimes, the door isn't closed quite right and it makes a grinding noise. When I heard the correct noise (the water being released), I smiled and said, "Whooossh!" so she knew that is the sound you need to hear.
We have started two more loads of laundry since. Because the first round went so smoothly, I added some challenges. I waited for her to open the door without any indirect prompting. I left the detergent on the shelf, so she had to retrieve it and let her open the bottle. I didn't open the detergent tray for her. I placed her hand on the latch and helped her shift it to the right. Everything went so smoothly that the third time, I added more variation. I held the cup while she poured the detergent (a more challenging task). The only problem she had was with the latch, but eventually she will figure it out. Because she is a quick study at learning chores, I suspect she will be self-sufficient in a week or two.
Talk about bliss: both of my kids starting a load of laundry!
Showing posts with label Relationship Development Intervention. Show all posts
Showing posts with label Relationship Development Intervention. Show all posts
Thursday, June 23, 2011
Monday, May 30, 2011
AO, and I Don't Mean Ambleside Online
Isn't it ironic that two things in my life have the initials AO: Ambleside Online and the Autism One conference, which has graciously posted videos. Since I am not sure how long they will be available online FOR FREE, I suggest you stop reading and start watching Dr. Nicole Beurkens' presentation on Relationship Development Intervention (RDI). She hits all the things that helped us so much when we started down this path back in 2007.
Now, I don't mean to be ugly or controversial, but I want to contrast what I know about RDI with the one on Verbal Behavior by Dr. James Partington. I admit I am biased against behaviorism, not only in how I handle autism but in how I teach children. My goal is to help people see that we must put first things first in teaching language-delayed children. Assuming that children in the autism spectrum cannot learn pre-verbal relationship skills is a mistake. Some can! Mine filled in these holes in her development after she turned 18—18 years old, not months old. She still has a long way to go but she has made progress in her social skills because of it. Autism therapies can be expensive, so it helps to learn from the school of hard knocks. This post represents that!
First Issue - Partington lost me four minutes into it when he talked about hitting language hard. I know you are dying for your child to speak, much less speak well. I know that! Both of my children talked late (David had back-to-back ear infections for two years). Pamela is still learning English as a first language (and Spanish too—the other day she constructed her own unique sentence, "God es mi padre." Muy bien, mi hija). What is so wrong about teaching your preverbal child to talk?
If they lack the nonverbal receptive and expressive skills, they will be missing vital components of communication when you focus on words only. I know! I made that mistake and I hope to help others avoid doing the same. As I am trying to be fair, I do applaud Dr. Partington for cautioning parents about academics (letters, colors, shapes) before their time, but now I must add a caution. He is skipping a vital step: broadband communication (and, if you don't know what that means, I refer you back to Dr. Beurkens).
Second Issue - I also applaud Dr. Partington at minute five for encouraging the first intellectual habit that Charlotte Mason prized above all others: attention, a sign of active, engaged minds. See, I'm fair! But—you knew that was coming, right—but, he focused on having many trials. Being fully engaged and attentive is an exhausting process, especially in the rapid drills typically found in behaviorism. The pace is so fast it often requires you to reward children with food. When allowed to work at a slower rate and given time to process and think rather than automatically act, children do not need artificial rewards.
Third Issue - I thank Dr. Partington at minute six for recognizing the importance of parent participation, the home, and other environments. I love how he contextualized asking a child to recall the word leaf by being outdoors when he pointed to one and asked the student, "What is it?" He used this anecdote to illustrate the importance of having many trials. Well, I have a much larger point. Does the child care what a leaf is? Has she pet a velvety bud? Has she watched a leaf emerge from its bud in the spring? Has she felt its smoothness, traced veins with her fingers, and smelled fresh green? Has she collected them in the fall and wondered how they changed color? Or, does she feel manipulated about having to learn a word for a thing that doesn't interest her in the least? While she may know how to label leaf through drilling, she does not know its essence. To quote Mason, "The question is not,—how much does the youth know? when he has finished his education—but how much does he care?" (page 170).
Fourth Issue - At 7:20, the speaker points out the need to vary what you are doing and not engage in the same type of activity. Mason educators know the value of short lessons and going from one style of lesson to another (doing math for ten minutes and shifting to singing when attention lags). However, we could completely avoid drilling the same kind of activity in trials if we worked with children in context and focused on developmentally appropriate tasks. Why would a child want to learn imitation if they see no point to it? If the child doesn't find it intrinsically interesting and doesn't understand why anyone would want to imitate, then it is just monkeywork.
When a child wants to eat an orange, that is the moment to work on imitation. Scaffold the child into success by scoring and partially pulling the peelings of two oranges. Sit at the table with your child and, once you have full attention (I will get to that in a bit), do one little thing like pick up the orange, smile expectantly, and wait for them to imitate you, even if it takes 45 seconds for the child to figure out what to do. Once they hold the orange, grab one pre-pulled corner, smile, and wait. This is imitation (and a whole host of other things) in context, rich in meaning for the child with a natural consequence, not an artificial reward. You can think of all sorts of opportunities for teaching imitation in daily life for things our children already need to learn.
Fifth Issue - At about 10:45, I agree with Dr. Partington's concern about social interaction. But, I want you to think very carefully about this. The ways in which VB teaches language sets up a very unnatural style of interaction: prompt, quick action, reward. What do you think repeating this cycle over and over tells the child? Other people think. Other people command. The only point to getting the right answer is a reward. It puts the child in a passive, receive mode for long periods of the day. Something interesting happens when the child learns to speak well. They have seen controlling the conversation modeled for them for years, and monologues about things that only interest them becomes their modus operandi! Conditioning any person in that manner might prepare children for schools as they are today. Will it prepare them to live for anything other than awards?
Sixth Issue - Yes, I appreciate the work of Lovaas in the 1970s, described in minute 13:30. I know that we should never give up on our children: there is always hope. Where are the Lovaas children now? They are adults. What kind of lives are they leading? Why has his original research never been followed into adulthood? Where are long-term studies of children who have graduated from ABA and transitioned into mainstream schools? (By long-term, I meant the adult years.)
Seventh Issue - The scariest quote in the first half of the presentation for me was this at minute 16:15: "We know how to make these kids to want to work for us." If what they are learning had meaning, if it was contextualized, if it was done at the pace in which they could process and think, if they were allowed to acquire missing developmental milestones rather than learn discrete skills, you wouldn't need to make them work for you! As the two of you share experiences, the child gleans knowledge and new thoughts from them.
Eighth Issue - At minute, 17:50, Dr. Partington gets into the whole expressive versus receptive language thing in his example of using the word book. He is missing some vital things about books and young children. Books are meant to be shared. Books are more than things to want and get. For a child to able to enjoy a book with you, many things must happen first. They must have joint attention. They should coordinate actions with you. They must be able to anticipate and enjoy novelty so that, when you read slightly differently to spotlight another way to experience the book, they find it fun. Children must have an idea of the context in the story, or the story will make no sense to them. Finally, I'm having a hard time remembering the last time I said to a friend in conversation, "What is something you can read?" But, I digress.
Ninth Issue - Again, I love what Dr. Partington said twenty-three minutes into the presentation about dogs. Through the window, a child sees a dog walking outside. The temptation is to go into teacher mode and ask a bazillion questions about dogs. Well, some teachers, that is. That is not what I would do from a Charlotte Mason and RDI perspective. He is right about punishing a kid with a bunch of impertinent questions about dogs. However, I disagree with his recommendation to say all you want. That is ineffective, too. What I would do is what Amy Cameron calls match plus one. To "dog," I might say, "Cute dog!" To "brown dog," I might say, "Brown like Loa," tugging at Pamela's episodic memories about her favorite dog from childhood. Then, I would smile and wait to see if Pamela felt competent enough to make another comment. In other words, give the child a chance to be an equal partner in the conversation.
Here is a sample conversation that just happened: Pamela just came into the room with a bowl of grapes that she had washed. Focused on writing this post, I ignored her. Suddenly, I heard, "Grapes." Without turning to look at her, I said, "Grapes are yummy!" Pamela said, "Grapes are healthy!" I turned to her and smiled, "Grapes are healthy and juicy." Now, that she had my-face-to-face, full attention, she laughed and started eating. Sometimes, people with autism complain about having to make small talk. We probably have been so focused on what must be done that we have not modeled chit-chat. When we have to work so hard to drill proper speech, grammar, and syntax, we lose track of little conversations with no agenda, no demands, no purpose. RDI allowed me to relax and appreciate small talk for what it is.
Tenth Issue - Twenty-five minutes into it is a slide about identifying existing language skills. What ever happened to pre-language skills? Does the child shift attention? Share joint attention? Understand facial expressions? Use them? How rich is the vocabulary of gestures? Do they understand gestures? Do they look to trusted adults when unsure? Do they watch others to learn? Words can only take a person so far if they are missing out on pre-language skills! I know because I had a sixteen-year-old who didn't have them! Verbal Behavior is missing out on a huge gap in nonverbal communication skills. If they lack these abilities, then they will not learn like other children, which is one reason why they become bully magnets in school. Of course, that is not their fault. It is our fault for not teaching them pre-language skills.
Eleventh Issue - Minute Thirty-Two. In the speaker's clinic, they make children look at every person in the room and greet them. Can you imagine what typical kids will think the first time that child gets on the bus? There is a time and place to do this sort of thing. For example, Pamela knows that, when we get together with Steve's side of the family, the Salvadoran custom is to greet and give your cheek to each person in the room. She also knows that my side of the family is more lax about greetings. In a small gathering, my family greets people individually, but, in a large gathering, a general "hi" works, too. Context makes a huge difference for any behavior that we have. A behavior in one situation is often the wrong thing to do in another. That is where our children get into trouble. They look at social interaction as following a set of rules, but context sometimes changes how we interact.
Twelfth Issue - At 33:25, the speaker talks about routines. Following a routine is usually not the problem with our kids. Transitions from one task to another is the problem. Deviating from the routine such as canceling a trip to the playground because of rain causes a meltdown. Thinking flexibly about the routine is the problem (it is okay to start lunch at 11:59 instead of 12:00). Seriously! Some kids are that locked into routine.
Thirteenth Issue - Responding is not thinking. Another scary quote for me was, "I'm never going to make those connections for them" at minute 35:06. I find this problematic in the school system for all children. Making connections for children robs them of the joy of thinking for themselves. To quote my friend Jenn Spencer, "I am not the fountain from which knowledge springs for my thirsty students. It is not my job to provide all the answers. When I do I rob my children of an opportunity to exercise their own minds, and a lack of exercise leads to atrophy.... One of the hardest things for me to let go of was the need to ask questions that pointed them to my way of thinking. This included giving 'comprehension tests' in which I drew out all the important ideas for my students and held my opinion as the correct answer. The result of leaving this behind has been that sometimes they do not get the ideas that I got at all, sometimes they come to the same ideas I had after having lots of time to ruminate on the material (making it theirs forever, since they were the ones doing the thinking), and sometimes they enlighten me with ideas I might not have thought of." If you focus on what a child thinks and how a child thinks, they will learn to make connections for themselves.
Fourteenth Issue - Finally, thirty-nine minutes into it, the speaker talks about non-verbals, and I'm glad he recognizes the importance of sign language for children who haven't developed their vocal musclelature! He also sees that having an ability means nothing to the child unless they use it spontaneously, without prompting, in a real-world context. Then he spent over fifteen minutes listening to his explanation of ABLLS before I became unglued at minute 56:05 when he equated "establish yourself as a conditioned reinforcer" to "make friends with them" and "make them want to do things to please you." While I completely support developing warm relationships with children, a danger in relying the same motivator most of the time: if you please people, you get rewards. I value helping a child (1) create meaning where there was none before, (2) feel competent about what they are doing, (3) trust you to provide enough support for them to feel successful but enough challenge to make it interesting, and (4) have just enough novelty to keep attention without overstimulating them. The intrinsic reward for the child is that "aha" moment, which in Pamela's case is accompanied by a giggle. Playing to one motivator "getting the good things faster" concerns me because people work for many reasons, not just utilitarian ones.
Fifteenth Issue - I was so glad to see footage of Dr. Partington working with a real child with autism at 1:04:00 (we are into hours now). Because he thinks the child is ready to express her needs in signs and words, I made a few assumptions. By the time an child is ready to communicate in words, he has mastered the art of nonverbal communication. He doesn't just walk into the kitchen and stand there like this little girl did. He doesn't simply walk to the refrigerator and wait, which is often what an autistic child without language does. He actively seeks your attention, follows your eye gaze, and, when you shift your face in his direction, he points and gestures. He watches for your response to see if you understand. If not, he finds another way to communicate. He is also at the stage where he is beginning to share joint attention with you. So, when Dr. Partington starts teaching the little girl in the video language, I assumed she had all of these pieces in place. She did not. I did not see any effort to work on these vital components: shifting attention to him, following his eye gaze, waiting to see if he is paying attention before signing eat, and sharing her enjoyment of the pizza with him. To put it crassly, Dr. Partington is nothing more than a pizza dispensing machine to her.
So, how would one go about eating pizza with this child? How do you feed infants? Often it is a game where you encourage the child to shift attention to you and the spoon by making novel sounds and closing the distance between the baby and the spoon. Then, you smack your lips, lick your lips, and say, "Mmm. That tastes so goood!" If you need a refresher go, check out a first spoon feeding video on youtube. You can see how the little boy is already communicating a desire for more: reaching for the bowl, kicking out with his legs, leaning into his mother, opening his mouth for more, etc. He checks his mother's face for reassurance, but, when he is no longer hungry, he turns away. The mother carefully watches what he is communicating and responds to him. Notice how much mutual enjoyment the mother and her son share.
Compare the two interactions. The baby boy is already communicating volumes more than the little girl does through his facial expressions, body language, and attention shifts. Dr. Partington and the girl completely miss out on any joy, mutual enjoyment, etc. Of course, they have no relationship because this is the first time they have worked together. That ought to be a greater aim. He is very instrumental with her: the minute she signs, he dispenses the food, and there's no effort at communicating any delight or mutual satisfaction. She is the manding machine for him, and he is the vending machine for her. Nothing else matters in the interaction.
In the swing segment (1:13:45), her father is wonderful. You can see how he focuses on experiencing sharing as well as the long e sound, the laughter, the joy. Notice what he does when she stares at her feet, he moves into her line of sight. He gets experience sharing. For him, the interaction is more than reinforcing her: it is emotions shared, the delight.
Sixteenth Issue - When Dr. Partington shifts to working with her mother, again you see the instrumental style. Even though the little girl is signing, she is completely tuned out from her mother. Think back to the baby and those moments of enjoyment between mother and child. That vital ingredient is missing here. Sharing food is more than nourishing our bodies. It is communal. There is joy and fellowship and enjoyment of one another's company. I will commend Dr. Partington for saying at 1:18:30 the importance of letting the little girl come to her and slowing down!
How did we work on face-to-face gazing without food? In the first two weeks of transitioning to RDI, I would walk up to Pamela and wait. If she did not shift to me, I would make a novel sound, each time different: "Yoo hoo!" Clear my throat. Or I might wave or do a silly dance move to encourage that shift. My final maneuver was to move into her line of sight. Once she shifted her gaze (which does not mean I expected her to eyeball me to death either). Then, I would tell her something. Anything. "I'm going to take a shower." "I'm going to call Dad." "I'm going to use the computer." Sometimes, my message contained a naturally rewarded consequence. "Dinner is ready." "I'm going shopping."
Very quickly, Pamela realized that Mom expects me to pay attention to her when she speaks. In fact, Dr. Partington mentions this point about waiting until a child looks at you before speaking later in the video (1:36:30). The big difference between what he does and what I do is the pace and intent of communication. When Dr. Partington speaks, he expects you respond quickly. When I speak to Pamela, I am telling her something that may or may not require a response. Think about it. Communicating is more than making demands of one another. Because I wasn't commanding her every time I opened my mouth, Pamela was learning that sometimes people share information without expecting you to act on it. Some of our communication is like that.
Seventeenth Issue - I appreciate Dr. Partington's take on stim toys at 1:19:45. I can drink a cup of coffee and enjoy my conversation with you. In fact, I might savor the moment more because of the aroma and my delighted taste buds. I agree with Dr. Partington that the little girl does something cool at 1:21:45. She uses her eye gaze to let them know that she wishes to eat from a different bowl. But, there is something vital missing that young children do when they communicate. The whole point of learning to shift attention to watching you is to see if you are paying attention to them. She is missing the key component called referencing here. This pre-verbal skill is when the child points to the bowl, checks your face to see if you are seeing the communication, and waits for your response. At this stage of development, being able to reference another person for a variety of reasons is far more important than using words. In this segment, the little girl broadcasts her intent for a different bowl like radio waves sent out into space. The mother and Dr. Partington move so quickly to respond, they do not give the little girl the opportunity to watch what they are doing and see if they get her message. I can see they were excited, but they missed that chance for the girl to look at her mother and see that mother understands.
Eighteenth Issue - At 1:24:00, Dr. Partington spends a lot of time on reinforcers. Why? His goal is to teach children to ask for what they want and make demands of you. Because he is ignoring the missed developmental stages, such as appreciating novelty, he must use artificial reinforcers. Think about peek-a-boo. Why do we spend so much time on a silly little game when we could be teaching infants to make demands of us!
We are teaching them foundational elements of mutually enjoying each other, which is naturally reinforcing. At first, peek-a-boo is done very slowly until the baby gets the pace and sees the fun of dad covering baby's face and slowly pulling off the blanket. Then, as the baby gets it, dad adds little variations, or novelty. If she adds them too soon, the baby cries because he doesn't understand the fun of anticipation and change. After baby learns that, peek-a-boo becomes a wild game with all sorts of unexpected events, false expectations, and surprising pops-up. Learning to appreciate anticipation and novelty naturally reinforce our social interactions. A child who finds novelty fun will not need fewer artificial rewards. Likewise, children who are making meaning (not just learning labels) and feeling competent about what they are doing (not just going through the motions) need fewer artificial reinforcers.
Nineteenth Issue - At 1:28:00, I admit I cracked up at his warning to parents to avoid teaching children to ask for things they wouldn't want in their wildest dreams (bed, toilet, etc.) Very few kids ever want to go to bed, so that makes sense. But, I do have qualms about his reasoning for not teaching children to say things you don't want to hear until they are bigger than you and can hurt you ("leave me alone" and "no"). Why wouldn't we want them to tell us that? Sometimes, our children are truly worn out and need downtime. That is just as much a need for them as food. I understand that children with autism may need treatments and therapies in their early years to help fill in developmental gaps. We also need to keep in mind as Dr. Beurkens pointed out that we are vastly overscheduling the lives of our children, whether they are autistic or typical. The sensory systems of autistic children are so easily overwhelmed. Because they process more slowly, a slow pace to us is a merry-go-round to them. We ought to be very careful about what therapies we chose for them: just because something is available does not mean we must do it.
I think what Mason wrote about the rights of children ought to apply to those with autism. We should not mistaken organized games and structured recreational activities as play. It is work to them because of everything they must filter out, filter in, process, and monitor. They need free time like any other child. We must allow opportunities for personal initiative in what they do without us taking over and ruining it (pages 36-39). Yesterday, I pulled out some pony beads to sew on eyes on a stuffed toy for a friend. A few hours later, Pamela came to me and showed me a bead necklace she made out of about 50 pony beads. I warmly acknowledged her effort and told her they were beautiful. Then I waited. Sure, I wanted her to wear them. But, I waited. About a minute later, she was proudly wearing them and twisting them around her finger like all girls do. Mind you, Pamela is not a dress up kind of girl, so it was a sweet moment that I could have ruined by doing the thinking for her.
Twentieth Issue - At 1:35:00, I loved how Dr. Partington shared a very important point about all people, including autistic ones. People don't mind unpredictable payoffs as he describes in the slot machine analogy! I would like to take this a wee step further. Unpredictability, one of the secret ingredients of peek-a-boo, is very hard on our kids, which is why they need it in small doses. When we worked on Pamela's anxiety's during the whack-a-mole campaign, we discovered that unpredictability heightened her anxiety, leading her to control people. We spent a long time working on it, and we still have to work at it. David and I discovered yesterday that he had spent too much time being predictable by watching movies in his room. When he tried watching one in the television room downstairs, Pamela had a nuclear meltdown. It took at least fifteen minutes for her to get a grip (and it didn't help that she has a nasty cold sore inside her lip). She eventually chose to sit on the back porch in the rocking chairs and wait for David to finish watching the movie before she came inside. After I calmed her down, David told me, "Mom, I have to make a point to watch movies downstairs sometimes, don't I?"
How do you start working on unpredictability? By adding little variations into a predictable routine. Even when Pamela was little, I made a point not to get trapped by routines. Pamela cried if I skipped an aisle at the grocery store. To help her prepare, I would smile, say "One, two, three, weeeee!" and push the cart really fast to the next aisle. Because we moved every few years, Pamela was forced out of the normal routine until she established new ones at the new neighborhood. In RDI, we use this term called productive uncertainty. You add just enough unpredictability to challenge a child without pushing them into meltdown. A very practical way is to set up doing chores, baking, putting groceries in a bag at the self-checkout, or any activity through interactions patterns. You get the pattern going, and you add a teeny, tiny variation.
Suppose the little girl wants some grapes. You get a bowl of water, place it at the table, and show her how to drop it in the water. You start an assembly-line pattern: mom picks off a grape and gives it to the girl, girl drops it in the water. Then, repeat. You go as slowly as she needs to go. Once she is competent and gets her role, then you add a variation. Just like you might gasp or make an alerting sound in peek-a-boo, you do that first to let her know that something different is about to happen. Then, you take an unexpected action: you drop the grape on the table and wait for her reaction with smile on your face. If she calmly picks it up and finishes her role, you go back to the pattern and then throw in a different variation: you put your hand at a higher or lower level than she expected, you gently bop yourself on the nose with it first, you gently bop her on the nose with it, etc. As long as she goes with the flow, you randomly insert a little variation into the interaction pattern. You might even do something really silly like eat the grape first! However, if she cries or gets frustrated, you help her to recover her emotions, get back to the predictable pattern, and wait until she is really confident before you try a smaller variation than the one that upset her. Basically, you apply peek-a-boo to routine activities into which you can weave an interaction pattern.
Twenty-First Issue - At 1:38:30, I like how Dr. Partington points out that we should encouraging our children with smile and warm facial expressions. That is true for all children! (A quick mathematical rabbit trail SMILE—breathe deeply for no purple math problems are on the horizon—do you want to know how to trip up a student who feels competent in math? Frown and look puzzled while they answer the question!) I also agree with him on timeout: sometimes, autistic children want to be left alone and act up just get a timeout.
Then, Dr. Partington shows some errorless training, which caused me to pause again. I can understand why we think it is necessary because autistic children often feel incompetent at everything. Even in RDI, we scaffold a child by setting up the situation to allow the child to succeed in some small way while still being challenged. However, when you are working for an external reward like food, then making mistakes are far more devastating. You didn't get what you expected (the reward) because you made an error! When discovering something new or mastering a step motivates you, then the stakes are lower. When you focus on process (learning to tie shoes) rather than product (a reward for tying them correctly), you feel less pressured by making mistakes.
Life is messy. Humans make mistakes, and, in fact, to err is human. Too many of our spectrum children are perfectionists by nature. Some require us to work hard to model the fine art of making mistakes, remaining calm and neutral when something runs astray, and figuring out what to do about the mistake. One of the most common questions I get from parents new to homeschooling is how to help their autism spectrum child stop melting down over wrongs answers! Making errors is not the issue: the issue is whether or not you make an error, you know you made an error, but you find a way to repair the situation. The video of Pamela making mistakes in learning to tie her shoe illustrates this beautifully.
Twenty-First Issue - From 1:40:00 to 1:47:00, Dr. Partington spends a lot of time labeling names with flashcards, a decontextualized way to learn labels. It reminds me of a friend whose child was drilled with flashcards: I am changing the situation somewhat for anonymity. Suppose we drill, "What do you find in a pool (common here in the Carolinas)? Water, ladder, and floats." The child memorizes the exact response and has it perfectly. One day, you see a duck in the poll and you head the child outside, point to the unexpected thing in the pool, and ask with great excitement, "What do you see in the pool?" The child misses the novelty and mechanically replies, "Water, ladder, and floats." This is the kind of thing that was happening to the child, and my friend had to work very hard to contextualize understanding.
Dr. Partington does recommend we "show them what a tape is and does" but it sure looks like "do as I say, not as I do." How do I teach Pamela new words in context? Here are two examples: copper and fungus. Because we look for meaning and connections, living books and real life offers opportunities to reinforce new words (copper kettle at the Revolutionary War encampment). I also like his point about the giraffe and zebra at 1:42:00. If a child can only express thirty words, I would certainly go for new words that have meaning in the child's life as he suggests chicken in Hawaii where they run on the road or iguana if that happens to be one of your pets. However, some people carry the concept of functional (1:45:07) too far, especially in choosing books for our children. If we only read books that spotlight functional understanding, then they will miss out on embracing fantasy and laughing at the ridiculous. I think focusing on meaning is more helpful than focusing on function because most of us hope that some day our children will have an active imagination and a lively sense of humor.
Now, I don't mean to be ugly or controversial, but I want to contrast what I know about RDI with the one on Verbal Behavior by Dr. James Partington. I admit I am biased against behaviorism, not only in how I handle autism but in how I teach children. My goal is to help people see that we must put first things first in teaching language-delayed children. Assuming that children in the autism spectrum cannot learn pre-verbal relationship skills is a mistake. Some can! Mine filled in these holes in her development after she turned 18—18 years old, not months old. She still has a long way to go but she has made progress in her social skills because of it. Autism therapies can be expensive, so it helps to learn from the school of hard knocks. This post represents that!
First Issue - Partington lost me four minutes into it when he talked about hitting language hard. I know you are dying for your child to speak, much less speak well. I know that! Both of my children talked late (David had back-to-back ear infections for two years). Pamela is still learning English as a first language (and Spanish too—the other day she constructed her own unique sentence, "God es mi padre." Muy bien, mi hija). What is so wrong about teaching your preverbal child to talk?
If they lack the nonverbal receptive and expressive skills, they will be missing vital components of communication when you focus on words only. I know! I made that mistake and I hope to help others avoid doing the same. As I am trying to be fair, I do applaud Dr. Partington for cautioning parents about academics (letters, colors, shapes) before their time, but now I must add a caution. He is skipping a vital step: broadband communication (and, if you don't know what that means, I refer you back to Dr. Beurkens).
Second Issue - I also applaud Dr. Partington at minute five for encouraging the first intellectual habit that Charlotte Mason prized above all others: attention, a sign of active, engaged minds. See, I'm fair! But—you knew that was coming, right—but, he focused on having many trials. Being fully engaged and attentive is an exhausting process, especially in the rapid drills typically found in behaviorism. The pace is so fast it often requires you to reward children with food. When allowed to work at a slower rate and given time to process and think rather than automatically act, children do not need artificial rewards.
Third Issue - I thank Dr. Partington at minute six for recognizing the importance of parent participation, the home, and other environments. I love how he contextualized asking a child to recall the word leaf by being outdoors when he pointed to one and asked the student, "What is it?" He used this anecdote to illustrate the importance of having many trials. Well, I have a much larger point. Does the child care what a leaf is? Has she pet a velvety bud? Has she watched a leaf emerge from its bud in the spring? Has she felt its smoothness, traced veins with her fingers, and smelled fresh green? Has she collected them in the fall and wondered how they changed color? Or, does she feel manipulated about having to learn a word for a thing that doesn't interest her in the least? While she may know how to label leaf through drilling, she does not know its essence. To quote Mason, "The question is not,—how much does the youth know? when he has finished his education—but how much does he care?" (page 170).
Fourth Issue - At 7:20, the speaker points out the need to vary what you are doing and not engage in the same type of activity. Mason educators know the value of short lessons and going from one style of lesson to another (doing math for ten minutes and shifting to singing when attention lags). However, we could completely avoid drilling the same kind of activity in trials if we worked with children in context and focused on developmentally appropriate tasks. Why would a child want to learn imitation if they see no point to it? If the child doesn't find it intrinsically interesting and doesn't understand why anyone would want to imitate, then it is just monkeywork.
When a child wants to eat an orange, that is the moment to work on imitation. Scaffold the child into success by scoring and partially pulling the peelings of two oranges. Sit at the table with your child and, once you have full attention (I will get to that in a bit), do one little thing like pick up the orange, smile expectantly, and wait for them to imitate you, even if it takes 45 seconds for the child to figure out what to do. Once they hold the orange, grab one pre-pulled corner, smile, and wait. This is imitation (and a whole host of other things) in context, rich in meaning for the child with a natural consequence, not an artificial reward. You can think of all sorts of opportunities for teaching imitation in daily life for things our children already need to learn.
Fifth Issue - At about 10:45, I agree with Dr. Partington's concern about social interaction. But, I want you to think very carefully about this. The ways in which VB teaches language sets up a very unnatural style of interaction: prompt, quick action, reward. What do you think repeating this cycle over and over tells the child? Other people think. Other people command. The only point to getting the right answer is a reward. It puts the child in a passive, receive mode for long periods of the day. Something interesting happens when the child learns to speak well. They have seen controlling the conversation modeled for them for years, and monologues about things that only interest them becomes their modus operandi! Conditioning any person in that manner might prepare children for schools as they are today. Will it prepare them to live for anything other than awards?
Sixth Issue - Yes, I appreciate the work of Lovaas in the 1970s, described in minute 13:30. I know that we should never give up on our children: there is always hope. Where are the Lovaas children now? They are adults. What kind of lives are they leading? Why has his original research never been followed into adulthood? Where are long-term studies of children who have graduated from ABA and transitioned into mainstream schools? (By long-term, I meant the adult years.)
Seventh Issue - The scariest quote in the first half of the presentation for me was this at minute 16:15: "We know how to make these kids to want to work for us." If what they are learning had meaning, if it was contextualized, if it was done at the pace in which they could process and think, if they were allowed to acquire missing developmental milestones rather than learn discrete skills, you wouldn't need to make them work for you! As the two of you share experiences, the child gleans knowledge and new thoughts from them.
Eighth Issue - At minute, 17:50, Dr. Partington gets into the whole expressive versus receptive language thing in his example of using the word book. He is missing some vital things about books and young children. Books are meant to be shared. Books are more than things to want and get. For a child to able to enjoy a book with you, many things must happen first. They must have joint attention. They should coordinate actions with you. They must be able to anticipate and enjoy novelty so that, when you read slightly differently to spotlight another way to experience the book, they find it fun. Children must have an idea of the context in the story, or the story will make no sense to them. Finally, I'm having a hard time remembering the last time I said to a friend in conversation, "What is something you can read?" But, I digress.
Ninth Issue - Again, I love what Dr. Partington said twenty-three minutes into the presentation about dogs. Through the window, a child sees a dog walking outside. The temptation is to go into teacher mode and ask a bazillion questions about dogs. Well, some teachers, that is. That is not what I would do from a Charlotte Mason and RDI perspective. He is right about punishing a kid with a bunch of impertinent questions about dogs. However, I disagree with his recommendation to say all you want. That is ineffective, too. What I would do is what Amy Cameron calls match plus one. To "dog," I might say, "Cute dog!" To "brown dog," I might say, "Brown like Loa," tugging at Pamela's episodic memories about her favorite dog from childhood. Then, I would smile and wait to see if Pamela felt competent enough to make another comment. In other words, give the child a chance to be an equal partner in the conversation.
Here is a sample conversation that just happened: Pamela just came into the room with a bowl of grapes that she had washed. Focused on writing this post, I ignored her. Suddenly, I heard, "Grapes." Without turning to look at her, I said, "Grapes are yummy!" Pamela said, "Grapes are healthy!" I turned to her and smiled, "Grapes are healthy and juicy." Now, that she had my-face-to-face, full attention, she laughed and started eating. Sometimes, people with autism complain about having to make small talk. We probably have been so focused on what must be done that we have not modeled chit-chat. When we have to work so hard to drill proper speech, grammar, and syntax, we lose track of little conversations with no agenda, no demands, no purpose. RDI allowed me to relax and appreciate small talk for what it is.
Tenth Issue - Twenty-five minutes into it is a slide about identifying existing language skills. What ever happened to pre-language skills? Does the child shift attention? Share joint attention? Understand facial expressions? Use them? How rich is the vocabulary of gestures? Do they understand gestures? Do they look to trusted adults when unsure? Do they watch others to learn? Words can only take a person so far if they are missing out on pre-language skills! I know because I had a sixteen-year-old who didn't have them! Verbal Behavior is missing out on a huge gap in nonverbal communication skills. If they lack these abilities, then they will not learn like other children, which is one reason why they become bully magnets in school. Of course, that is not their fault. It is our fault for not teaching them pre-language skills.
Eleventh Issue - Minute Thirty-Two. In the speaker's clinic, they make children look at every person in the room and greet them. Can you imagine what typical kids will think the first time that child gets on the bus? There is a time and place to do this sort of thing. For example, Pamela knows that, when we get together with Steve's side of the family, the Salvadoran custom is to greet and give your cheek to each person in the room. She also knows that my side of the family is more lax about greetings. In a small gathering, my family greets people individually, but, in a large gathering, a general "hi" works, too. Context makes a huge difference for any behavior that we have. A behavior in one situation is often the wrong thing to do in another. That is where our children get into trouble. They look at social interaction as following a set of rules, but context sometimes changes how we interact.
Twelfth Issue - At 33:25, the speaker talks about routines. Following a routine is usually not the problem with our kids. Transitions from one task to another is the problem. Deviating from the routine such as canceling a trip to the playground because of rain causes a meltdown. Thinking flexibly about the routine is the problem (it is okay to start lunch at 11:59 instead of 12:00). Seriously! Some kids are that locked into routine.
Thirteenth Issue - Responding is not thinking. Another scary quote for me was, "I'm never going to make those connections for them" at minute 35:06. I find this problematic in the school system for all children. Making connections for children robs them of the joy of thinking for themselves. To quote my friend Jenn Spencer, "I am not the fountain from which knowledge springs for my thirsty students. It is not my job to provide all the answers. When I do I rob my children of an opportunity to exercise their own minds, and a lack of exercise leads to atrophy.... One of the hardest things for me to let go of was the need to ask questions that pointed them to my way of thinking. This included giving 'comprehension tests' in which I drew out all the important ideas for my students and held my opinion as the correct answer. The result of leaving this behind has been that sometimes they do not get the ideas that I got at all, sometimes they come to the same ideas I had after having lots of time to ruminate on the material (making it theirs forever, since they were the ones doing the thinking), and sometimes they enlighten me with ideas I might not have thought of." If you focus on what a child thinks and how a child thinks, they will learn to make connections for themselves.
Fourteenth Issue - Finally, thirty-nine minutes into it, the speaker talks about non-verbals, and I'm glad he recognizes the importance of sign language for children who haven't developed their vocal musclelature! He also sees that having an ability means nothing to the child unless they use it spontaneously, without prompting, in a real-world context. Then he spent over fifteen minutes listening to his explanation of ABLLS before I became unglued at minute 56:05 when he equated "establish yourself as a conditioned reinforcer" to "make friends with them" and "make them want to do things to please you." While I completely support developing warm relationships with children, a danger in relying the same motivator most of the time: if you please people, you get rewards. I value helping a child (1) create meaning where there was none before, (2) feel competent about what they are doing, (3) trust you to provide enough support for them to feel successful but enough challenge to make it interesting, and (4) have just enough novelty to keep attention without overstimulating them. The intrinsic reward for the child is that "aha" moment, which in Pamela's case is accompanied by a giggle. Playing to one motivator "getting the good things faster" concerns me because people work for many reasons, not just utilitarian ones.
Fifteenth Issue - I was so glad to see footage of Dr. Partington working with a real child with autism at 1:04:00 (we are into hours now). Because he thinks the child is ready to express her needs in signs and words, I made a few assumptions. By the time an child is ready to communicate in words, he has mastered the art of nonverbal communication. He doesn't just walk into the kitchen and stand there like this little girl did. He doesn't simply walk to the refrigerator and wait, which is often what an autistic child without language does. He actively seeks your attention, follows your eye gaze, and, when you shift your face in his direction, he points and gestures. He watches for your response to see if you understand. If not, he finds another way to communicate. He is also at the stage where he is beginning to share joint attention with you. So, when Dr. Partington starts teaching the little girl in the video language, I assumed she had all of these pieces in place. She did not. I did not see any effort to work on these vital components: shifting attention to him, following his eye gaze, waiting to see if he is paying attention before signing eat, and sharing her enjoyment of the pizza with him. To put it crassly, Dr. Partington is nothing more than a pizza dispensing machine to her.
So, how would one go about eating pizza with this child? How do you feed infants? Often it is a game where you encourage the child to shift attention to you and the spoon by making novel sounds and closing the distance between the baby and the spoon. Then, you smack your lips, lick your lips, and say, "Mmm. That tastes so goood!" If you need a refresher go, check out a first spoon feeding video on youtube. You can see how the little boy is already communicating a desire for more: reaching for the bowl, kicking out with his legs, leaning into his mother, opening his mouth for more, etc. He checks his mother's face for reassurance, but, when he is no longer hungry, he turns away. The mother carefully watches what he is communicating and responds to him. Notice how much mutual enjoyment the mother and her son share.
Compare the two interactions. The baby boy is already communicating volumes more than the little girl does through his facial expressions, body language, and attention shifts. Dr. Partington and the girl completely miss out on any joy, mutual enjoyment, etc. Of course, they have no relationship because this is the first time they have worked together. That ought to be a greater aim. He is very instrumental with her: the minute she signs, he dispenses the food, and there's no effort at communicating any delight or mutual satisfaction. She is the manding machine for him, and he is the vending machine for her. Nothing else matters in the interaction.
In the swing segment (1:13:45), her father is wonderful. You can see how he focuses on experiencing sharing as well as the long e sound, the laughter, the joy. Notice what he does when she stares at her feet, he moves into her line of sight. He gets experience sharing. For him, the interaction is more than reinforcing her: it is emotions shared, the delight.
Sixteenth Issue - When Dr. Partington shifts to working with her mother, again you see the instrumental style. Even though the little girl is signing, she is completely tuned out from her mother. Think back to the baby and those moments of enjoyment between mother and child. That vital ingredient is missing here. Sharing food is more than nourishing our bodies. It is communal. There is joy and fellowship and enjoyment of one another's company. I will commend Dr. Partington for saying at 1:18:30 the importance of letting the little girl come to her and slowing down!
How did we work on face-to-face gazing without food? In the first two weeks of transitioning to RDI, I would walk up to Pamela and wait. If she did not shift to me, I would make a novel sound, each time different: "Yoo hoo!" Clear my throat. Or I might wave or do a silly dance move to encourage that shift. My final maneuver was to move into her line of sight. Once she shifted her gaze (which does not mean I expected her to eyeball me to death either). Then, I would tell her something. Anything. "I'm going to take a shower." "I'm going to call Dad." "I'm going to use the computer." Sometimes, my message contained a naturally rewarded consequence. "Dinner is ready." "I'm going shopping."
Very quickly, Pamela realized that Mom expects me to pay attention to her when she speaks. In fact, Dr. Partington mentions this point about waiting until a child looks at you before speaking later in the video (1:36:30). The big difference between what he does and what I do is the pace and intent of communication. When Dr. Partington speaks, he expects you respond quickly. When I speak to Pamela, I am telling her something that may or may not require a response. Think about it. Communicating is more than making demands of one another. Because I wasn't commanding her every time I opened my mouth, Pamela was learning that sometimes people share information without expecting you to act on it. Some of our communication is like that.
Seventeenth Issue - I appreciate Dr. Partington's take on stim toys at 1:19:45. I can drink a cup of coffee and enjoy my conversation with you. In fact, I might savor the moment more because of the aroma and my delighted taste buds. I agree with Dr. Partington that the little girl does something cool at 1:21:45. She uses her eye gaze to let them know that she wishes to eat from a different bowl. But, there is something vital missing that young children do when they communicate. The whole point of learning to shift attention to watching you is to see if you are paying attention to them. She is missing the key component called referencing here. This pre-verbal skill is when the child points to the bowl, checks your face to see if you are seeing the communication, and waits for your response. At this stage of development, being able to reference another person for a variety of reasons is far more important than using words. In this segment, the little girl broadcasts her intent for a different bowl like radio waves sent out into space. The mother and Dr. Partington move so quickly to respond, they do not give the little girl the opportunity to watch what they are doing and see if they get her message. I can see they were excited, but they missed that chance for the girl to look at her mother and see that mother understands.
Eighteenth Issue - At 1:24:00, Dr. Partington spends a lot of time on reinforcers. Why? His goal is to teach children to ask for what they want and make demands of you. Because he is ignoring the missed developmental stages, such as appreciating novelty, he must use artificial reinforcers. Think about peek-a-boo. Why do we spend so much time on a silly little game when we could be teaching infants to make demands of us!
We are teaching them foundational elements of mutually enjoying each other, which is naturally reinforcing. At first, peek-a-boo is done very slowly until the baby gets the pace and sees the fun of dad covering baby's face and slowly pulling off the blanket. Then, as the baby gets it, dad adds little variations, or novelty. If she adds them too soon, the baby cries because he doesn't understand the fun of anticipation and change. After baby learns that, peek-a-boo becomes a wild game with all sorts of unexpected events, false expectations, and surprising pops-up. Learning to appreciate anticipation and novelty naturally reinforce our social interactions. A child who finds novelty fun will not need fewer artificial rewards. Likewise, children who are making meaning (not just learning labels) and feeling competent about what they are doing (not just going through the motions) need fewer artificial reinforcers.
Nineteenth Issue - At 1:28:00, I admit I cracked up at his warning to parents to avoid teaching children to ask for things they wouldn't want in their wildest dreams (bed, toilet, etc.) Very few kids ever want to go to bed, so that makes sense. But, I do have qualms about his reasoning for not teaching children to say things you don't want to hear until they are bigger than you and can hurt you ("leave me alone" and "no"). Why wouldn't we want them to tell us that? Sometimes, our children are truly worn out and need downtime. That is just as much a need for them as food. I understand that children with autism may need treatments and therapies in their early years to help fill in developmental gaps. We also need to keep in mind as Dr. Beurkens pointed out that we are vastly overscheduling the lives of our children, whether they are autistic or typical. The sensory systems of autistic children are so easily overwhelmed. Because they process more slowly, a slow pace to us is a merry-go-round to them. We ought to be very careful about what therapies we chose for them: just because something is available does not mean we must do it.
I think what Mason wrote about the rights of children ought to apply to those with autism. We should not mistaken organized games and structured recreational activities as play. It is work to them because of everything they must filter out, filter in, process, and monitor. They need free time like any other child. We must allow opportunities for personal initiative in what they do without us taking over and ruining it (pages 36-39). Yesterday, I pulled out some pony beads to sew on eyes on a stuffed toy for a friend. A few hours later, Pamela came to me and showed me a bead necklace she made out of about 50 pony beads. I warmly acknowledged her effort and told her they were beautiful. Then I waited. Sure, I wanted her to wear them. But, I waited. About a minute later, she was proudly wearing them and twisting them around her finger like all girls do. Mind you, Pamela is not a dress up kind of girl, so it was a sweet moment that I could have ruined by doing the thinking for her.
Twentieth Issue - At 1:35:00, I loved how Dr. Partington shared a very important point about all people, including autistic ones. People don't mind unpredictable payoffs as he describes in the slot machine analogy! I would like to take this a wee step further. Unpredictability, one of the secret ingredients of peek-a-boo, is very hard on our kids, which is why they need it in small doses. When we worked on Pamela's anxiety's during the whack-a-mole campaign, we discovered that unpredictability heightened her anxiety, leading her to control people. We spent a long time working on it, and we still have to work at it. David and I discovered yesterday that he had spent too much time being predictable by watching movies in his room. When he tried watching one in the television room downstairs, Pamela had a nuclear meltdown. It took at least fifteen minutes for her to get a grip (and it didn't help that she has a nasty cold sore inside her lip). She eventually chose to sit on the back porch in the rocking chairs and wait for David to finish watching the movie before she came inside. After I calmed her down, David told me, "Mom, I have to make a point to watch movies downstairs sometimes, don't I?"
How do you start working on unpredictability? By adding little variations into a predictable routine. Even when Pamela was little, I made a point not to get trapped by routines. Pamela cried if I skipped an aisle at the grocery store. To help her prepare, I would smile, say "One, two, three, weeeee!" and push the cart really fast to the next aisle. Because we moved every few years, Pamela was forced out of the normal routine until she established new ones at the new neighborhood. In RDI, we use this term called productive uncertainty. You add just enough unpredictability to challenge a child without pushing them into meltdown. A very practical way is to set up doing chores, baking, putting groceries in a bag at the self-checkout, or any activity through interactions patterns. You get the pattern going, and you add a teeny, tiny variation.
Suppose the little girl wants some grapes. You get a bowl of water, place it at the table, and show her how to drop it in the water. You start an assembly-line pattern: mom picks off a grape and gives it to the girl, girl drops it in the water. Then, repeat. You go as slowly as she needs to go. Once she is competent and gets her role, then you add a variation. Just like you might gasp or make an alerting sound in peek-a-boo, you do that first to let her know that something different is about to happen. Then, you take an unexpected action: you drop the grape on the table and wait for her reaction with smile on your face. If she calmly picks it up and finishes her role, you go back to the pattern and then throw in a different variation: you put your hand at a higher or lower level than she expected, you gently bop yourself on the nose with it first, you gently bop her on the nose with it, etc. As long as she goes with the flow, you randomly insert a little variation into the interaction pattern. You might even do something really silly like eat the grape first! However, if she cries or gets frustrated, you help her to recover her emotions, get back to the predictable pattern, and wait until she is really confident before you try a smaller variation than the one that upset her. Basically, you apply peek-a-boo to routine activities into which you can weave an interaction pattern.
Twenty-First Issue - At 1:38:30, I like how Dr. Partington points out that we should encouraging our children with smile and warm facial expressions. That is true for all children! (A quick mathematical rabbit trail SMILE—breathe deeply for no purple math problems are on the horizon—do you want to know how to trip up a student who feels competent in math? Frown and look puzzled while they answer the question!) I also agree with him on timeout: sometimes, autistic children want to be left alone and act up just get a timeout.
Then, Dr. Partington shows some errorless training, which caused me to pause again. I can understand why we think it is necessary because autistic children often feel incompetent at everything. Even in RDI, we scaffold a child by setting up the situation to allow the child to succeed in some small way while still being challenged. However, when you are working for an external reward like food, then making mistakes are far more devastating. You didn't get what you expected (the reward) because you made an error! When discovering something new or mastering a step motivates you, then the stakes are lower. When you focus on process (learning to tie shoes) rather than product (a reward for tying them correctly), you feel less pressured by making mistakes.
Life is messy. Humans make mistakes, and, in fact, to err is human. Too many of our spectrum children are perfectionists by nature. Some require us to work hard to model the fine art of making mistakes, remaining calm and neutral when something runs astray, and figuring out what to do about the mistake. One of the most common questions I get from parents new to homeschooling is how to help their autism spectrum child stop melting down over wrongs answers! Making errors is not the issue: the issue is whether or not you make an error, you know you made an error, but you find a way to repair the situation. The video of Pamela making mistakes in learning to tie her shoe illustrates this beautifully.
Twenty-First Issue - From 1:40:00 to 1:47:00, Dr. Partington spends a lot of time labeling names with flashcards, a decontextualized way to learn labels. It reminds me of a friend whose child was drilled with flashcards: I am changing the situation somewhat for anonymity. Suppose we drill, "What do you find in a pool (common here in the Carolinas)? Water, ladder, and floats." The child memorizes the exact response and has it perfectly. One day, you see a duck in the poll and you head the child outside, point to the unexpected thing in the pool, and ask with great excitement, "What do you see in the pool?" The child misses the novelty and mechanically replies, "Water, ladder, and floats." This is the kind of thing that was happening to the child, and my friend had to work very hard to contextualize understanding.
Dr. Partington does recommend we "show them what a tape is and does" but it sure looks like "do as I say, not as I do." How do I teach Pamela new words in context? Here are two examples: copper and fungus. Because we look for meaning and connections, living books and real life offers opportunities to reinforce new words (copper kettle at the Revolutionary War encampment). I also like his point about the giraffe and zebra at 1:42:00. If a child can only express thirty words, I would certainly go for new words that have meaning in the child's life as he suggests chicken in Hawaii where they run on the road or iguana if that happens to be one of your pets. However, some people carry the concept of functional (1:45:07) too far, especially in choosing books for our children. If we only read books that spotlight functional understanding, then they will miss out on embracing fantasy and laughing at the ridiculous. I think focusing on meaning is more helpful than focusing on function because most of us hope that some day our children will have an active imagination and a lively sense of humor.
Twenty-Second Issue - The little boy at 01:47:00 is doing many wonderful things: he shares joint attention with the adult in looking at the book. He is using body language and looking at the therapist. I like what Dr. Partington suggests in having a child "tell me about the woman." That is narration in a nutshell. Where we do it differently in the Charlotte Mason world is that we teach in context: when outdoors, children sight-see and picture-paint by sharing what they observe. The art of knowing and narrating occurs in context in concrete, real-life situations. That prepares them for the shift to more abstract settings when they hit formal lessons starting in Year 1 (starting at age six or later for some children): picture study, nature study, narrating a passage from a book, etc.
We even follow-up narrations very differently. Rather than focus on instrumental, imperative "gotcha questions," we focus on meaning and episodic memory. When a character breaks a bone, we think back to the times when I broke my arm (1974), Pamela broke hers (1999), and David broke his arm (2003 and 2005). When a character botches a recipe, we talk about culinary horror stories. When we read about a hawk, we recall our own hawk rescue and Pamela even remembers this incident every time she catches an insect in the house and gently releases it outdoors. We seek opportunities to ponder, wonder, and share what we feel, not poke holes in her sense of competency.
Twenty-Third Issue - At 1:49:00, Dr. Partington talks a bit about intraverbals (talking about things in their absence). The contextual way to do this is telling the absent parent what happened. When Dad comes home from work, children tell him about what they did while he was away. When children come home from a trip to the hardware store with Dad, they tell Mom all the things they saw and did. When Grandma calls, they tell her about the birthday party. I see a clear pattern in how Verbal Behavior approaches tasks versus a relationship-oriented way (Charlotte Mason and RDI). We seem to focus on the whole in a real, concrete context that has meaning for the child while VB seeks to fragment and decontextualize in an abstract manner. We seem to tie an unknown to a prior known, tapping into episodic memory, while VB seeks to drill unknowns until they are memorized, which is quite a different thing from known.
Twenty-Fourth Issue - At 1:57:00, Dr. Partington makes a vital point about paying attention to what people are doing. Inattention to people becomes a problem when you focus on words before nonverbal communication. Because RDI concentrates on referencing (watching what people do and think about how we might alter our actions or stay the course), children are more able to transition to social situations even when their verbal skills lag. First, we focus on teaching them to reference their parents. They discover that people with more experience provide clues on what we should do. A great example for Pamela was when she was not sure about what to do with metered mail and she referenced me to find out. Then, they learn to reference other trusted adults and eventually peers in small groups such as when Pamela took watercolor classes.
Watching what people do is not an afterthought once we have taught them language. Watching what people do is a means by which children learn to do and learn more language. Rather than focusing on discrete details about what Michael is eating and wearing at 1:58:00, we are focusing on the relationship. The kind of thought pattern we aim for our children to learn is not focused on objective details: "Michael is eating a sandwich and baby carrots. He has brown hair and eyes. He wears glasses. He wore a red T-shirt and blue jeans." We focus on subjective details: "Michael is frowning at me. I wonder why. Maybe he doesn't like my tapping the table with my finger. What happens if I stop tapping? He still looks upset. What if I move away a little? He is relaxing. I bet I was too close to him. I'll have to remember that next time."
If you have never heard of any of this heretical, completely topsy-turvy way of addressing autism, I encourage you to study Dr. Beurkens' presentation and chew on that only for awhile. Drink it in and absorb it. What sounds so simple is really a challenge in our "more is more" and "now is better" world. Think about it. Learn to live it.
Teaching our children from a developmental, relationship-oriented point of view requires a huge paradigm shift—a major change in how we interact with our children that runs counter to the culture of enlightenment thinking. In the beginning, we focus on what we are doing as parents: are we slow enough, are we more careful with our nonverbal communication, have we cut out therapy for the sake of therapy because it is available and fairly inexpensive, are we being more declarative in my language to let our children think. It may require the guidance of an RDI consultant (ask your friends for not all consultants are created equal). You may end up changing schools or homeschooling or changing how you homeschool. Change is hard!
This change in my thinking started at the turn of the century (whoa, that makes me feel old), and I am still learning as I go. Friends of mine like Jennifer Spencer and Lisa Cadora have found the change sometimes painful but worth it. We no longer worry about learning because we are learning to live and enjoying the new life we live.
Teaching our children from a developmental, relationship-oriented point of view requires a huge paradigm shift—a major change in how we interact with our children that runs counter to the culture of enlightenment thinking. In the beginning, we focus on what we are doing as parents: are we slow enough, are we more careful with our nonverbal communication, have we cut out therapy for the sake of therapy because it is available and fairly inexpensive, are we being more declarative in my language to let our children think. It may require the guidance of an RDI consultant (ask your friends for not all consultants are created equal). You may end up changing schools or homeschooling or changing how you homeschool. Change is hard!
This change in my thinking started at the turn of the century (whoa, that makes me feel old), and I am still learning as I go. Friends of mine like Jennifer Spencer and Lisa Cadora have found the change sometimes painful but worth it. We no longer worry about learning because we are learning to live and enjoying the new life we live.
Friday, June 5, 2009
The Courtship of Mr. Collins
When I explain what we are doing with Pamela, some people do not get the importance of nonverbal communication, viewing it as insignificant, impossible for autistic people, or cheating to get the right answer to instrumental questions. They even snort and roll their eyes, demonstrating the very point I am trying to make!
Most studies point to the fact that adults with autism, even those with college degrees, struggle for quality of life. Why are they having difficulty staying employed and living independently without assistance? Why do those who yearn for friends and marriage have to settle for living alone without friendships? Rising IQs do not change the outcome nor does learning to speak. Even under the best of circumstances, only one-fourth hold paid employment without extra support, held important social relationships, and maintained a high degree of independence in daily life.
Highly structured, repetition-driven programs often focus on instrumental interactions (using people to get something, not simply to share experiences), spoken language, and academics, ignoring the nuances of nearly item under social interaction in the DSM IV criteria:
I am trying to balance between developing static intelligence (facts, procedures, mechanics of language) to help Pamela get through school and dynamic intelligence (experience sharing, flexible thinking, problem-solving) to have a life. When we overemphasize static intelligence, we end up with a talkative, smart person with autism. If you do not believe what happens when you ignore the nuances of relationships, I introduce to you, Reverend William Collins, the respectable, at times ridiculous rector of Hunsford in Kent, nephew and heir of Elizabeth Bennet's father, graduate of one of the Universities, about whom Jane Austen wrote,
Nonverbal Communication
Mr. Collins does not pay attention to the gestures, facial expressions, and noises (a la Lydia's snorts) very well, otherwise he would not have proposed to a woman who despised him (Elizabeth Bennet), ignored a woman who admired him (her sister Mary), and married a woman who only put up with him to avoid becoming a spinster (Charlotte Lucas). His gestures and facial expressions are almost as "unstudied" as the "little elegant compliments" with which he flatters the ladies.
Black-and-White Interpretation
Mr. Collins seems incapable of reading between the lines of dissembling remarks. His cousin Elizabeth words herself to sound complimentary but means something otherwise. When he asked for her permission to play cards, she smiled and said, "With all my heart," because she was glad to be rid of him. After he was invited to a ball, she questioned him with a serious tone, "Would your bishop approve?" hoping he would decline. On the occasion of their last visit to his patroness, Elizabeth mockingly said, "A very cruel deprivation. Indeed, I hardly know how I shall bear the loss of Lady Catherine's company," and he bought it, "You feel it keenly!" When he came to lecture the family after Lydia's fall from grace, Elizabeth dissuaded him from staying any longer, "You may fell that it would be unwise for you to stay any longer now. I always feel that a clergyman cannot be too careful, especially one so fortunate as to enjoy the condescension and the patronage of the Lady Catherine de Bourgh" and he credited her for her thoughtfulness!
Narrow Range of Topics
To boost his self-esteem and preserve his job, Mr. Collins discusses one topic and one topic only: his noble patroness the Lady Catherine de Bourgh. He often unwittingly insults his listeners when he lauds her wealth, possessions, and condescension. He practically stalked Mr. Darcy at the Netherfield ball when he found out who Darcy was.
Courtship
Mr. Collins' courtship reveals how instrumental he is in his interactions with women. When he proposed to Elizabeth, he told her his number one reason for marrying was at the recommendation of Lady Catherine! He also believed it important to set the example for his parish and it might make him happy in the process. He felt obligated to marry one of the Bennet girls because he was to inherit their father's property. As an afterthought, he mentioned his violent affections for her, never bothering to read her expressions of dismay. When she refused, he pointed out the benefits of marrying him: not only did he have money, situation, and connections, but she might end up as a spinster if he refused.
Most studies point to the fact that adults with autism, even those with college degrees, struggle for quality of life. Why are they having difficulty staying employed and living independently without assistance? Why do those who yearn for friends and marriage have to settle for living alone without friendships? Rising IQs do not change the outcome nor does learning to speak. Even under the best of circumstances, only one-fourth hold paid employment without extra support, held important social relationships, and maintained a high degree of independence in daily life.
Highly structured, repetition-driven programs often focus on instrumental interactions (using people to get something, not simply to share experiences), spoken language, and academics, ignoring the nuances of nearly item under social interaction in the DSM IV criteria:
- Marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
- Failure to develop peer relationships appropriate to developmental level
- A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)
- Lack of social or emotional reciprocity
- Delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
- In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
- Stereotyped and repetitive use of language or idiosyncratic language
- Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
I am trying to balance between developing static intelligence (facts, procedures, mechanics of language) to help Pamela get through school and dynamic intelligence (experience sharing, flexible thinking, problem-solving) to have a life. When we overemphasize static intelligence, we end up with a talkative, smart person with autism. If you do not believe what happens when you ignore the nuances of relationships, I introduce to you, Reverend William Collins, the respectable, at times ridiculous rector of Hunsford in Kent, nephew and heir of Elizabeth Bennet's father, graduate of one of the Universities, about whom Jane Austen wrote,MR. COLLINS was not a sensible man, and the deficiency of nature had been but little assisted by education or society.Why is Mr. Collins "one of the stupidest man in England"? (Note: I base this character sketch upon the 1996 Pride and Prejudice mini-series, which is ripe with opportunities for studying dynamic intelligence.)
Nonverbal Communication
Mr. Collins does not pay attention to the gestures, facial expressions, and noises (a la Lydia's snorts) very well, otherwise he would not have proposed to a woman who despised him (Elizabeth Bennet), ignored a woman who admired him (her sister Mary), and married a woman who only put up with him to avoid becoming a spinster (Charlotte Lucas). His gestures and facial expressions are almost as "unstudied" as the "little elegant compliments" with which he flatters the ladies.Black-and-White Interpretation
Mr. Collins seems incapable of reading between the lines of dissembling remarks. His cousin Elizabeth words herself to sound complimentary but means something otherwise. When he asked for her permission to play cards, she smiled and said, "With all my heart," because she was glad to be rid of him. After he was invited to a ball, she questioned him with a serious tone, "Would your bishop approve?" hoping he would decline. On the occasion of their last visit to his patroness, Elizabeth mockingly said, "A very cruel deprivation. Indeed, I hardly know how I shall bear the loss of Lady Catherine's company," and he bought it, "You feel it keenly!" When he came to lecture the family after Lydia's fall from grace, Elizabeth dissuaded him from staying any longer, "You may fell that it would be unwise for you to stay any longer now. I always feel that a clergyman cannot be too careful, especially one so fortunate as to enjoy the condescension and the patronage of the Lady Catherine de Bourgh" and he credited her for her thoughtfulness! Narrow Range of Topics
To boost his self-esteem and preserve his job, Mr. Collins discusses one topic and one topic only: his noble patroness the Lady Catherine de Bourgh. He often unwittingly insults his listeners when he lauds her wealth, possessions, and condescension. He practically stalked Mr. Darcy at the Netherfield ball when he found out who Darcy was.Courtship
Mr. Collins' courtship reveals how instrumental he is in his interactions with women. When he proposed to Elizabeth, he told her his number one reason for marrying was at the recommendation of Lady Catherine! He also believed it important to set the example for his parish and it might make him happy in the process. He felt obligated to marry one of the Bennet girls because he was to inherit their father's property. As an afterthought, he mentioned his violent affections for her, never bothering to read her expressions of dismay. When she refused, he pointed out the benefits of marrying him: not only did he have money, situation, and connections, but she might end up as a spinster if he refused.
Tuesday, October 28, 2008
The Second Unit of Language from an RDI Perspective (Part II)
As promised in my first post on the second unit of language, I want to share some ideas about where I think RDI dovetails with the Association Method. If I could boil RDI down into one over-arching principle, I would say the goal is to redo developmental milestones missed originally. Therefore, I believe the key to figuring when to implement the Association Method ought to flow from the development of typical children. Since many readers may be "lone rangers" (without consultants), I plan to refer to readily available documents found on line (such as Zero to Three handouts), rather than RDI stages. As you read through this post, think about your child and try to assess if the language delay is due to the overall delay or something co-occuring, above and beyond what is seen in typical autistic children. If you are dealing with garden variety autism with no extra-special language delays, maybe the answer is to keep doing RDI and reevaluate language in a few months.
Focus on Typical Development
Babies spend the first year of life becoming masters of nonverbal communication (both receptive and expressive). In the early stages of development, nonverbal trumps verbal. So, before going crazy with fifty nouns and six repetitive sentences, it makes sense to follow the path of babies if your child is nonverbal or low-verbal. Should you follow this exactly? No, every child is unique and the key is to fill in gaps. I am just attempting to give a broad outline to help you figure out where the Association Method might fit:
0-3 months - Build trust between you and your child; be a source of comfort when they are melting down; respect their need to take a break when overwhelmed; encourage times when you are both nonverbal and expressing yourself through sound, facial expressions, and body movements.
3-6 months - Continue the foundation previously built; sounds become more structured (babbles, coos, gurgles). In my opinion, this is a great time to introduce simple phonemes in a playful, unstructured manner.
6-9 months - Continue the foundation previously built; frame situations in which your child has a chance to learn by copying you; spotlight feelings in your sounds; pair common gestures with your words. In my opinion, this is a great time to continue simple phonemes, going back and forth like conversation.
9-12 months - Continue the foundation previously built; frame situations in which your child can (1) follow simple directions and (2) communicate through sounds and body; develop interaction patterns. In my opinion, this is a great time to get serious about phonemes if vocal play seems stalled.
12-15 months - Continue the foundation previously built; frame situations in which your child can (1) communicate what they want through actions, (2) point to common things you name, and (3) imitate what you do; join in and elaborate any pretend play your child starts. In my opinion, this is a great time to continue working on phonemes and make plans for the fifty nouns.
15-18 months - Continue the foundation previously built; frame situations in which your child can (1) respond to simple questions and directions through their actions, (2) react to the emotions of others, and (3) perform simple roles in household chores. In my opinion, this is a great time to get serious about the fifty nouns, if no nouns have emerged.
18-24 months - Continue the foundation previously built; frame, elaborate on, and speak declaratively about pretend play, problem solving, and testing things out; whenever your child uses nouns, add another word in response ("apple" "Want apple?") In my opinion, this is a great time to continue working on the fifty nouns.
24-30 months - Continue the foundation previously built; frame, elaborate on, and speak declaratively about pretend play, problem solving, testing things out, and interactions with another child; whenever your child puts words together, add another word in response ("want apple" "You want apple?") In my opinion, this is a great time to continue working on the fifty nouns and make plans for the six repetitive sentences and questions.
30-36 months - Continue the foundation previously built; spotlight sentences with two ideas. In my opinion, this is a great time to get serious about six repetitive sentences and questions . In time, stories in the second unit will cover developmental milestones listed in the link: personal stories (own name and characteristics of people), past tense stories (what happened yesterday), present progressive stories (acting out own stories), etc.
Focus on Cognition
Another principle to consider is that cognition (thoughts and ideas) precede communication. When Pamela was eighteen months old, she had no clue that crying was a cause producing the effect of getting what you want more quickly. Therefore, she saw so no point in learning the names of things because she saw no connection between using the name to get the object of desire faster. We started suspecting autism at two years of age (Steve's sister helped us zero in that quickly), so I took sign lessons to learn the names of nouns of things I believed Pamela wanted most: grapes, cookies, yogurt, milk, etc. Although my strategy was sound, it still took Pamela a long time to make connection between signing a word and getting what she wanted! We never had a "Helen Keller at the water pump" miracle. Once Pamela did make the connection (around age three), she quickly dropped the signs and started learning nouns at a rate of about one noun a month! We called it the word of the month! I stopped keeping a spreadsheet tracking every noun when she turned four. At that point, nouns and animal sounds came more quickly.
Applying cognition to the developmental profile above, it helps to understand the function of phonemes, nouns, and the six repetitive sentences and questions. Early in development, infants figure out how to make sounds with their mouths. After months and months of play and experimentation, the babbling, cooing, and gooing become predictable phonemes, the building blocks of words. When you are doing interactive patterns with a nonverbal child in the early stages of RDI (tossing a ball back and forth), you might want to try vocal games in which sounds are the object in the pattern. I do not think it needs to be formal and structured at first, but playful, fun, and joyful.
Once vocal play becomes easy, it makes sense to start playing around with putting two or more phonemes together in a playful manner, well before nouns enter the picture if your child is still low-verbal. At this point, you should have more opportunity for lots of variation, sound effects made from phonemes in their pretend play, imitation games with multiple phonemes, even little words when you do things together (uh-oh, oh-no, y-ay, uh-p, w-ee, ow-ch), etc. I still remember Pamela's first two spoken words when she was three years old: coo-coo (cookie) and so-see (music). If your child comes up with her own phonemes for a word, why not repeat it with joyful nonverbals to celebrate their accomplishment? From there, you might even be able to guide coo-coo into coo-kee with more back and forth sound games.
Again, cognition is the key. A child who starts coming up with their own words understands the concept of labeling nouns. A child who points to things she wants or sees is grasping the idea of a noun. A child who follows the simple direction to get her Beanie Baby understands a set of words identifying a particular noun. These are all signs of readiness to begin work with the fifty nouns. I think picking nouns with simple phonemes that are part of every day life or of special interest to the child are great ones to target at first. Meaning and context fuel the need for nouns.
Well before you consider starting the six repetitive sentences and questions, you might need to make sure cognition leads the way. If you have a new object in a group of familiar ones, does your child look curiously at the new one? Does she point with a questioning look? If so, the first question, "What is this?" will help her ask for names. When you are driving to the store, does your child observe the new restaurant that just opened up or point out a truck that made a wrong turn near a ditch. If so, "I see a/an/some _____" will serve that function. If your child requests things, then "I want a/an/some _____" will suffice. Without the desire to ask questions, share observations, or make requests, the new and improved syntax has no meaning or benefit to a child.
Focus on the Unique Child
The hardest thing about autistic children is that they are so scattered in development. Even though our RDI stage reflects the dynamic intelligence of a toddler, Pamela is working on decimals in math, reading sixth grade level books, writing at about a third grade level, and speaking like a preschooler. That is a wide range of ability! The key is to focus on those strengths and scaffold through their weaknesses.
Suppose a child's fine motor delays prevents her from doing all of the writing. Try using magnetic letters for the kinesthetic channel and figure out the reason for the delay. Pamela was very delayed in writing until we did patterning exercises to improve her bilateral coordination, worked on strengthening her fingers and pincer grasp, and figured out that she was left-handed and treated her as such! If a child has dyslexic tendencies, the Association Method may be a solution for that, too, because it falls under the same umbrella as Orton-Gillingham and the Spalding Method. So, even though reading or writing are well above the developmental level you are targetting in RDI, if the child can do these things, by all means, incorporate it into your work with the Association Method!
At first glance, the association method seems very static and drill-like. To be honest, a child with a severe language disorder that goes beyond the scope of autism may very well need some focused, drill-like work on language. It would be no different from a child with autism and cerebral palsy needing some focused, drill-like work on motor skills. However, I have embedded some RDI principles into what we do with the association method. When reading stories, I try to make sure I react in nonverbal ways. We reflect on any emotional highs or problem solving abilities of the characters. We talk about what the story reminds us of (perhaps, something that happened to us). I give Pamela much more time to think and process before she speaks, showing a warm, encouraging smile. Rather than correct syntax errors directly during oral work, I wrinkle my forehead and frown, say "What?" or "Huh?" or repeat the question, using my voice to emphasize the word giving the best syntax clue. Our Association Method work is much more fun since we started RDI as you can see in this video clip I made for the Charlotte Mason Conference in 2007.
Part III of the second unit is here!
Focus on Typical Development
Babies spend the first year of life becoming masters of nonverbal communication (both receptive and expressive). In the early stages of development, nonverbal trumps verbal. So, before going crazy with fifty nouns and six repetitive sentences, it makes sense to follow the path of babies if your child is nonverbal or low-verbal. Should you follow this exactly? No, every child is unique and the key is to fill in gaps. I am just attempting to give a broad outline to help you figure out where the Association Method might fit:
0-3 months - Build trust between you and your child; be a source of comfort when they are melting down; respect their need to take a break when overwhelmed; encourage times when you are both nonverbal and expressing yourself through sound, facial expressions, and body movements.
3-6 months - Continue the foundation previously built; sounds become more structured (babbles, coos, gurgles). In my opinion, this is a great time to introduce simple phonemes in a playful, unstructured manner.
6-9 months - Continue the foundation previously built; frame situations in which your child has a chance to learn by copying you; spotlight feelings in your sounds; pair common gestures with your words. In my opinion, this is a great time to continue simple phonemes, going back and forth like conversation.
9-12 months - Continue the foundation previously built; frame situations in which your child can (1) follow simple directions and (2) communicate through sounds and body; develop interaction patterns. In my opinion, this is a great time to get serious about phonemes if vocal play seems stalled.
12-15 months - Continue the foundation previously built; frame situations in which your child can (1) communicate what they want through actions, (2) point to common things you name, and (3) imitate what you do; join in and elaborate any pretend play your child starts. In my opinion, this is a great time to continue working on phonemes and make plans for the fifty nouns.
15-18 months - Continue the foundation previously built; frame situations in which your child can (1) respond to simple questions and directions through their actions, (2) react to the emotions of others, and (3) perform simple roles in household chores. In my opinion, this is a great time to get serious about the fifty nouns, if no nouns have emerged.
18-24 months - Continue the foundation previously built; frame, elaborate on, and speak declaratively about pretend play, problem solving, and testing things out; whenever your child uses nouns, add another word in response ("apple" "Want apple?") In my opinion, this is a great time to continue working on the fifty nouns.
24-30 months - Continue the foundation previously built; frame, elaborate on, and speak declaratively about pretend play, problem solving, testing things out, and interactions with another child; whenever your child puts words together, add another word in response ("want apple" "You want apple?") In my opinion, this is a great time to continue working on the fifty nouns and make plans for the six repetitive sentences and questions.
30-36 months - Continue the foundation previously built; spotlight sentences with two ideas. In my opinion, this is a great time to get serious about six repetitive sentences and questions . In time, stories in the second unit will cover developmental milestones listed in the link: personal stories (own name and characteristics of people), past tense stories (what happened yesterday), present progressive stories (acting out own stories), etc.
Focus on Cognition
Another principle to consider is that cognition (thoughts and ideas) precede communication. When Pamela was eighteen months old, she had no clue that crying was a cause producing the effect of getting what you want more quickly. Therefore, she saw so no point in learning the names of things because she saw no connection between using the name to get the object of desire faster. We started suspecting autism at two years of age (Steve's sister helped us zero in that quickly), so I took sign lessons to learn the names of nouns of things I believed Pamela wanted most: grapes, cookies, yogurt, milk, etc. Although my strategy was sound, it still took Pamela a long time to make connection between signing a word and getting what she wanted! We never had a "Helen Keller at the water pump" miracle. Once Pamela did make the connection (around age three), she quickly dropped the signs and started learning nouns at a rate of about one noun a month! We called it the word of the month! I stopped keeping a spreadsheet tracking every noun when she turned four. At that point, nouns and animal sounds came more quickly.
Applying cognition to the developmental profile above, it helps to understand the function of phonemes, nouns, and the six repetitive sentences and questions. Early in development, infants figure out how to make sounds with their mouths. After months and months of play and experimentation, the babbling, cooing, and gooing become predictable phonemes, the building blocks of words. When you are doing interactive patterns with a nonverbal child in the early stages of RDI (tossing a ball back and forth), you might want to try vocal games in which sounds are the object in the pattern. I do not think it needs to be formal and structured at first, but playful, fun, and joyful.
Once vocal play becomes easy, it makes sense to start playing around with putting two or more phonemes together in a playful manner, well before nouns enter the picture if your child is still low-verbal. At this point, you should have more opportunity for lots of variation, sound effects made from phonemes in their pretend play, imitation games with multiple phonemes, even little words when you do things together (uh-oh, oh-no, y-ay, uh-p, w-ee, ow-ch), etc. I still remember Pamela's first two spoken words when she was three years old: coo-coo (cookie) and so-see (music). If your child comes up with her own phonemes for a word, why not repeat it with joyful nonverbals to celebrate their accomplishment? From there, you might even be able to guide coo-coo into coo-kee with more back and forth sound games.
Again, cognition is the key. A child who starts coming up with their own words understands the concept of labeling nouns. A child who points to things she wants or sees is grasping the idea of a noun. A child who follows the simple direction to get her Beanie Baby understands a set of words identifying a particular noun. These are all signs of readiness to begin work with the fifty nouns. I think picking nouns with simple phonemes that are part of every day life or of special interest to the child are great ones to target at first. Meaning and context fuel the need for nouns.
Well before you consider starting the six repetitive sentences and questions, you might need to make sure cognition leads the way. If you have a new object in a group of familiar ones, does your child look curiously at the new one? Does she point with a questioning look? If so, the first question, "What is this?" will help her ask for names. When you are driving to the store, does your child observe the new restaurant that just opened up or point out a truck that made a wrong turn near a ditch. If so, "I see a/an/some _____" will serve that function. If your child requests things, then "I want a/an/some _____" will suffice. Without the desire to ask questions, share observations, or make requests, the new and improved syntax has no meaning or benefit to a child.
Focus on the Unique Child
The hardest thing about autistic children is that they are so scattered in development. Even though our RDI stage reflects the dynamic intelligence of a toddler, Pamela is working on decimals in math, reading sixth grade level books, writing at about a third grade level, and speaking like a preschooler. That is a wide range of ability! The key is to focus on those strengths and scaffold through their weaknesses.
Suppose a child's fine motor delays prevents her from doing all of the writing. Try using magnetic letters for the kinesthetic channel and figure out the reason for the delay. Pamela was very delayed in writing until we did patterning exercises to improve her bilateral coordination, worked on strengthening her fingers and pincer grasp, and figured out that she was left-handed and treated her as such! If a child has dyslexic tendencies, the Association Method may be a solution for that, too, because it falls under the same umbrella as Orton-Gillingham and the Spalding Method. So, even though reading or writing are well above the developmental level you are targetting in RDI, if the child can do these things, by all means, incorporate it into your work with the Association Method!
At first glance, the association method seems very static and drill-like. To be honest, a child with a severe language disorder that goes beyond the scope of autism may very well need some focused, drill-like work on language. It would be no different from a child with autism and cerebral palsy needing some focused, drill-like work on motor skills. However, I have embedded some RDI principles into what we do with the association method. When reading stories, I try to make sure I react in nonverbal ways. We reflect on any emotional highs or problem solving abilities of the characters. We talk about what the story reminds us of (perhaps, something that happened to us). I give Pamela much more time to think and process before she speaks, showing a warm, encouraging smile. Rather than correct syntax errors directly during oral work, I wrinkle my forehead and frown, say "What?" or "Huh?" or repeat the question, using my voice to emphasize the word giving the best syntax clue. Our Association Method work is much more fun since we started RDI as you can see in this video clip I made for the Charlotte Mason Conference in 2007.
Part III of the second unit is here!
Friday, October 17, 2008
I Was Wrong!
Made you look!
No, actually, I was wrong about Pamela's ability to learn non-verbal communication. As a faithful subscriber to ARRI, I had read numerous articles about how difficult it was for autistic people to read and make facial expressions and perceive eye gaze direction due to differences in the amygdala and have trouble interpreting gestures due to a deficit in mirror neurons. (If you do not really know what mirror neurons are, check out this fourteen minute video--my cyber friend Poohder gave me this link and pointed out that Daniel Glaser is a lead researcher, but there's no relation that I know of). I remember listening to Eric Courschene present his findings on the attention-shifting difficulties due to difference in the cerebullum.
Not only that, I saw it with my own eyes. When Pamela took sign language classes at homeschooling co-ops when we lived in Minnesota, I saw clearly how much she struggled with picking up the nonverbal nuances like facial expressions when she signed. So, like most parents, I assumed that, because of the brain anomalies found in autism, she would never be able to learn these things, so why bother!
When I read about the possibility of Pamela learning to read and do nonverbals, I was skeptical. Afterall, she was seventeen years old--way, WAY, WAY beyond the cut-off for neural plasticity according to the experts. Sure, it took Pamela three weeks to learn to follow my eye gaze, but now she doesn't think twice about following mine or directing me with her eye gaze. She uses her eyebrows a lot now and her face no longer requires extreme emotion to register an expression. She has mastered a limited gesture vocabulary of her own, and she can read many more of mine. Our consultant remarked the other day that Pamela is showing signs that her mirror neurons are at work because she watches me so intently and learns from it.
If you want to know more about the kind of nonverbals RDI parents and professionals address, Horizons put out a great article called Nonverbal Communication: What’s it all about?
You may think that having a purely nonverbal conversation is unnatural, but it's not! The other day we were in line at the store, and it was a long line! A cashier at the other end of the checkout aisles caught my attention and, when he noticed my eye gaze was in his direction, he pointed to me and then pointed to his check-out line. Then, I pointed to myself and he nodded, so I started walking. As I got closer, he pointed to the correct aisle more deliberately and I nodded.
Pamela can have conversations like that. Last week at the store, I put a shopping basket on the conveyor belt and Pamela put five items behind it. Suddenly, she handed the cashier one item after another, being careful to match her pace with that of the cashier's. She forgot the fifth item, so the cashier pointed to it and Pamela followed the eye gaze and point, grabbed the item, and handed it to her communication partner. I just stood back and admired the whole thing! Their conversation was beautiful.
Sometimes, it may feel like you are taking a step backwards when focusing on nonverbals, instead of verbals. However, the first thing infants learn is nonverbal communication. It seems backwards to focus exclusively on verbals first with autistic children, when typically nonverbals lead to verbals. The difference is that we have to be more deliberate about teaching them to autistic children, but I am finding with Pamela that the effort is worth it.
My consultant and I agree that Pamela is making progress in using expressive gestures, and we will continue to spotlight it for a long time. As Pamela's teacher and parent, I try to balance working on verbals during school time (at least with the association method and oral narrations) with being overly nonverbal when we are not in school mode. When I can get away with it, I try to be nonverbal during school time, but that is not always feasible. The key is to be mindful of opportunities as they arise.
I have noticed Pamela is using more and more declarative language and is doing some higher level thinking. Here are some examples that may seem little to you, but are big, big advancements:
No, actually, I was wrong about Pamela's ability to learn non-verbal communication. As a faithful subscriber to ARRI, I had read numerous articles about how difficult it was for autistic people to read and make facial expressions and perceive eye gaze direction due to differences in the amygdala and have trouble interpreting gestures due to a deficit in mirror neurons. (If you do not really know what mirror neurons are, check out this fourteen minute video--my cyber friend Poohder gave me this link and pointed out that Daniel Glaser is a lead researcher, but there's no relation that I know of). I remember listening to Eric Courschene present his findings on the attention-shifting difficulties due to difference in the cerebullum.
Not only that, I saw it with my own eyes. When Pamela took sign language classes at homeschooling co-ops when we lived in Minnesota, I saw clearly how much she struggled with picking up the nonverbal nuances like facial expressions when she signed. So, like most parents, I assumed that, because of the brain anomalies found in autism, she would never be able to learn these things, so why bother!
When I read about the possibility of Pamela learning to read and do nonverbals, I was skeptical. Afterall, she was seventeen years old--way, WAY, WAY beyond the cut-off for neural plasticity according to the experts. Sure, it took Pamela three weeks to learn to follow my eye gaze, but now she doesn't think twice about following mine or directing me with her eye gaze. She uses her eyebrows a lot now and her face no longer requires extreme emotion to register an expression. She has mastered a limited gesture vocabulary of her own, and she can read many more of mine. Our consultant remarked the other day that Pamela is showing signs that her mirror neurons are at work because she watches me so intently and learns from it.
If you want to know more about the kind of nonverbals RDI parents and professionals address, Horizons put out a great article called Nonverbal Communication: What’s it all about?
You may think that having a purely nonverbal conversation is unnatural, but it's not! The other day we were in line at the store, and it was a long line! A cashier at the other end of the checkout aisles caught my attention and, when he noticed my eye gaze was in his direction, he pointed to me and then pointed to his check-out line. Then, I pointed to myself and he nodded, so I started walking. As I got closer, he pointed to the correct aisle more deliberately and I nodded.
Pamela can have conversations like that. Last week at the store, I put a shopping basket on the conveyor belt and Pamela put five items behind it. Suddenly, she handed the cashier one item after another, being careful to match her pace with that of the cashier's. She forgot the fifth item, so the cashier pointed to it and Pamela followed the eye gaze and point, grabbed the item, and handed it to her communication partner. I just stood back and admired the whole thing! Their conversation was beautiful.
Sometimes, it may feel like you are taking a step backwards when focusing on nonverbals, instead of verbals. However, the first thing infants learn is nonverbal communication. It seems backwards to focus exclusively on verbals first with autistic children, when typically nonverbals lead to verbals. The difference is that we have to be more deliberate about teaching them to autistic children, but I am finding with Pamela that the effort is worth it.
My consultant and I agree that Pamela is making progress in using expressive gestures, and we will continue to spotlight it for a long time. As Pamela's teacher and parent, I try to balance working on verbals during school time (at least with the association method and oral narrations) with being overly nonverbal when we are not in school mode. When I can get away with it, I try to be nonverbal during school time, but that is not always feasible. The key is to be mindful of opportunities as they arise.
I have noticed Pamela is using more and more declarative language and is doing some higher level thinking. Here are some examples that may seem little to you, but are big, big advancements:
- We usually do math in the morning but forgot. I did not pull out her math book after lunch, and she said, "You forgot math!"
- Steve drove the radio-less red car to work today. When Pamela realized it, she ran into the house and, "Daddy drove the red car. Go in grey car!" She raised her fists and said, "Hurray!"
- When we were in the car, I made a point to be very nonverbal and expressive. At stop lights and at the drive through, we were reacting to her talking about lions, bears, shots, claws, etc. She loved it and her face lit up. None of these were stims either--it was fresh conversation.
- Pamela usually listens to CDs in the car. At one point, she decided to listen to the radio and told me, "FM!"
- When we reviewed Miracles on Maple Hill, she seemed concerned about Joe being lost. With The Story of the Trapp Family Singers, she talked about how sad they were because they have to go back to Europe. A few days later when she found out they were in jail (immigration glitches at Ellis Island), Pamela was shocked!
- When we were sitting on the rockers doing schoolwork, some birds and squirrels got noisy and Pamela commented about that.
- A paper had flown into the bushes (unbeknownst to me). I had been looking for it while Pamela worked and, when I found it, I told her. She said, "Ew!!!" because she thought it would be dirty. She looked surprised when it was only a little wet, but not dirty.
- One cool morning, Pamela walked in the room and said, "I'm wearing a sweater and socks." Then, we talked about how it is good to pay attention to the weather and wear a sweater and socks if it feels cold.
- I walked out to the back porch, and Pamela was all excited about a wasp she killed with a rock. It was merely stunned so we negotiated back and forth until we decided I better finish the job.
- I bought the complete New Testament of The Illustrated Bible: Complete New Testament from eBay. I showed it to Pamela and told her it was hers. I opened it to the first page of Matthew with the genealogy. She was okay about it--like how much can you do with a bunch of names? Then, when I turned the page and showed her the pictures and text, she loudly gasped. She was very surprised! Then she said, "Gasp!" spotlighting her surprise even more.
- Pamela frequently asks me, "Where's great grandma?" followed by a little sign language stim for "died" and "heaven." The other day, Pamela asked me if great grandma's soul could talk to God. When I answered in the affirmative, she wanted to know what they talk about! I guess she thought, if the body was in the ground, it would be hard for a person to talk to God.
- I was at the computer. Pamela was talking to me so I turned to give her attention. She didn't like me being low verbal so she got a little rude. I looked down and pouted and she said, "I'm sorry," and kissed me on the top of my head!
- Pamela and David were sitting on a bench about Wal-mart while I checked out. They were at the other end of where I checked out, so I headed the cart in their direction. David was listening to his iPod and was not paying attention. Pamela saw me walking toward her and headed in my direction, but David did not. I decided not to say anything to see what she would do. She turned around and noticed David was still sitting. So she went up to him and tapped him to get his attention!
Monday, June 30, 2008
Final RDA (Sixth One)
The final session in our RDA went very smoothly today. Even though I did not follow-through on the exact plan we mapped out last time, Pamela managed to accomplish what we needed. While I did seek opportunities to practice the points, nods, and gestures, she managed to transfer these abilities into real-life situations like when we chatted about the princess dress. Our consultant was very impressed at how quickly Pamela takes responsibility for applying new skills in real life. She asked me how we do it and, honestly, I have no clue! Apparently, it typically involves a four-step process for most children to own a new skill. All I can think is that, between her struggles with speech and her desire to communicate, she latches onto every nonverbal thing we show her.
Our consultant gave me a broad vision of what we will be doing in the next month or two. We are hoping for Pamela to discover how to be more declarative in her communication rather than imperative. Since she finds nonverbal communication easier, we focused on gestures. We determined that most of the time her gestures are also imperative (because that is how we have always communicated with Pamela--she picked up what we have modeled for years).
We focused on receptive gestures first--gestures people use as listeners to let others know whether or not they are listening and understanding. Just about any website on body language lists what constitutes attentive body language. Pamela already gives attentive eye contact because she references our facial expressions and body language to improve her understanding. First, we worked on pointing, nodding, and head shaking to tell me she was receiving and processing my communications. We also established Pamela has no problem showing me her lack of interest by walking away or changing the subject!
Now, I need to assess in a non-sedentary situation how well she orients to me if I am turned away from her. Pamela already knows to tap me on the shoulder, but I am not sure what she will do if I do not automatically turn to her. After that, we will work on the posturing skills of an active listener: leaning forward, tilting head, or furrowed brow.
If Pamela does not automatically transfers these skills, I may need to let her know how much body language helps me know if she understands or is confused. We will role play to see if she can tell if I am listening or tuning her out. Think about how often autism spectrum children turn people off by their long monologues. Part of the issue could be ignoring the body language of someone who is not listening.
Once she masters these steps, we can move onto expressive imperative, which Pamela has already aced, the the final piece, expressive declarative, which has five major components which our consultant will cover in our July phone call.
In case you are wondering what an RDA is . . . The RDA is an assessment collaboration between a consultant and parents (and actually child, if the child is at a higher stage) to figure out where children and parents are in the various stages and objectives, to set up a program and working relationship between all parties, and to select an objective and break it down. Our consultant did not follow the usual plan for us because after the first two sessions she knew we had several major pieces in place (master-apprentice and co-regulation). She also reads my blog and knew that I have a working knowledge of RDI.
Before the RDA, our consultant collects background information through paper work and conversations with the parents to assess commitment to working with their child and understanding of RDI principles. Typically, consultants and parents proceed along this six-step path:
Session 1: Film each parent interacting with the child according to RDA-1, basically a set of playful activities under various frameworks (verbal, no words, etc.).
Session 2: Having viewed footage collected in session 1, the consultant develops hypotheses about the child's abilities and then tests them out during this session.
Session 3: The consultant debriefs the parents on the information gathered and explains guiding principles of RDI.
Session 4: The consultant coaches the parents in guiding the child to practice important components of the RDI lifestyle.
Session 5: The consultant and parents discuss goals, objectives and strategies for an RDI program, discuss how to implement and modify goals as needed, address any potential obstacles, and identify potential strategies to overcome them. They focus on the working relationship between the consultant and parents, too.
Session 6: The consultant coaches the parents in guiding the child on the specifics discussed in the previous session, so they can make any revisions. The consultant outlines the overarching goals for the next few months.
Our consultant gave me a broad vision of what we will be doing in the next month or two. We are hoping for Pamela to discover how to be more declarative in her communication rather than imperative. Since she finds nonverbal communication easier, we focused on gestures. We determined that most of the time her gestures are also imperative (because that is how we have always communicated with Pamela--she picked up what we have modeled for years).
We focused on receptive gestures first--gestures people use as listeners to let others know whether or not they are listening and understanding. Just about any website on body language lists what constitutes attentive body language. Pamela already gives attentive eye contact because she references our facial expressions and body language to improve her understanding. First, we worked on pointing, nodding, and head shaking to tell me she was receiving and processing my communications. We also established Pamela has no problem showing me her lack of interest by walking away or changing the subject!
Now, I need to assess in a non-sedentary situation how well she orients to me if I am turned away from her. Pamela already knows to tap me on the shoulder, but I am not sure what she will do if I do not automatically turn to her. After that, we will work on the posturing skills of an active listener: leaning forward, tilting head, or furrowed brow.
If Pamela does not automatically transfers these skills, I may need to let her know how much body language helps me know if she understands or is confused. We will role play to see if she can tell if I am listening or tuning her out. Think about how often autism spectrum children turn people off by their long monologues. Part of the issue could be ignoring the body language of someone who is not listening.
Once she masters these steps, we can move onto expressive imperative, which Pamela has already aced, the the final piece, expressive declarative, which has five major components which our consultant will cover in our July phone call.
In case you are wondering what an RDA is . . . The RDA is an assessment collaboration between a consultant and parents (and actually child, if the child is at a higher stage) to figure out where children and parents are in the various stages and objectives, to set up a program and working relationship between all parties, and to select an objective and break it down. Our consultant did not follow the usual plan for us because after the first two sessions she knew we had several major pieces in place (master-apprentice and co-regulation). She also reads my blog and knew that I have a working knowledge of RDI.
Before the RDA, our consultant collects background information through paper work and conversations with the parents to assess commitment to working with their child and understanding of RDI principles. Typically, consultants and parents proceed along this six-step path:
Session 1: Film each parent interacting with the child according to RDA-1, basically a set of playful activities under various frameworks (verbal, no words, etc.).
Session 2: Having viewed footage collected in session 1, the consultant develops hypotheses about the child's abilities and then tests them out during this session.
Session 3: The consultant debriefs the parents on the information gathered and explains guiding principles of RDI.
Session 4: The consultant coaches the parents in guiding the child to practice important components of the RDI lifestyle.
Session 5: The consultant and parents discuss goals, objectives and strategies for an RDI program, discuss how to implement and modify goals as needed, address any potential obstacles, and identify potential strategies to overcome them. They focus on the working relationship between the consultant and parents, too.
Session 6: The consultant coaches the parents in guiding the child on the specifics discussed in the previous session, so they can make any revisions. The consultant outlines the overarching goals for the next few months.
Sunday, May 11, 2008
The Why, the What, and the How of RDI
Happy Mother's Day to All Y'all!Pamela gave me the flower in my stationary box, and how she went about it shows why we are working on her concept of self versus other. Our consultant and Pamela taped a pen to the flower, wrapped it in tissue paper, and decorated it as a Mother's Day present to me. Pamela was supposed to ask David to hide the gift in his backpack so that I would have no clue about it. Unfortunately, I inadvertently caused the situation to be dynamic because, while Pamela and our consultant were busy making plans, I had moved from my original spot to the same room as David. Our consultant quickly explained their plan, so I bolted and let them hide the gift.
I patiently waited until this morning for the gift. Pamela never forgets special occasions, and she wished me a happy Mother's Day this morning as always. But, she did not give me my gift. After lunch, I put on a sad face and said, "I am sad. I thought I was getting a Mother's Day present." Pamela did not realize that, even though she and David knew where they had hid the gift, I had no clue. She did not react. I tried reminding her about the secret gift she made with our consultant, but Pamela did not understand why I could not find the gift.I explained a bit further and said, "I don't know where my present is." Pamela blurted out, "A thief stole it!" Why? Since she assumed I knew about the hiding spot, she assumed I had looked for the present myself. Since she was confused, I walked her to David and repeated what I said. He knew that I did not know where the present was, and I told him that Pamela needed help remembering where it was. He started nonverbally guiding her to find the present. She interprets facial gaze and nonverbal communications well, so David and Pamela quickly located the present and gave it to me.
The Why
Our consultant gave us a stack of papers explaining RDI in her own words to make sure we are all singing off the same sheet of music. Two things caught me attention from the very beginning: parent-based and developmental. Relationships within a family are the first and most important relationship any person will ever have, for better or for worse. Not only that, parents have the most opportunities to hang out with a child, especially when homeschooling. From the very beginning, I have always spent time learning from professionals, parents, and people with autism and tried what made sense for our family and situation. I have resisted formal therapies with certified professionals working with Pamela because it makes more sense to teach me to teach Pamela. The people who spend the most time with a child ought to be the ones implementing whatever needs to be done.
The focus on development rather than behaviors also intrigued me. Our consultant is helping us to figure out where Pamela is developmentally and what objective is most likely to emerge at this point in her development. Steve and I will not be prompting her to jump through hoops a la operant conditioning. We will be seeking and creating opportunities in every day life to help Pamela make discoveries on her own with her sharp eye for detail and great attention span. These discoveries will enable her to share and communicate her experiences, borrow our perspective when unsure, become aware of herself versus others, think even more flexibly than she already does, add personal meaning to her phenomenal memory for events in her life, and cope with an ever-changing world--explained in greater detail here.
Let me illustrate with a sweet example from our stay with Steve's cousin and her three children. Pamela had announced her intentions to go to bed. Her cousin Jenna, a fifth-grader, said, "Good-night, Pamela!" I could have prompted her by telling her directly what to do, "Say good-night!" By doing so, I steal an opportunity for Pamela to appraise a situation and think of possible actions. In fact, this would limit her choices to two that require pure reaction and no thought--obey or disobey.
Instead, I said, "Pamela, Jenna said good-night to you." Pamela had to think of her possible actions: tell Jenna good-night, give her a hug, kiss her on the head or cheek, shake her hand, do a combination of any of the previous, or keep walking to the bedroom. Pamela walked over to Jenna, waved, said "Good-night!" and kissed her on the top of the head.
The What
I am the world's biggest skeptic. I did not jump into RDI right away until I studied its guiding principles. We started our "lone ranger" RDI program back in March 2007. I blogged our journey, and you can read for yourself how we did.
As a lone ranger RDI mom, I read books and blogs and networked with other RDI families to figure out how I can create opportunities to guide Pamela in making the discoveries listed earlier. While I learned how to guide Pamela in our first four years of homeschooling, other RDI families explained to me how to refine my skills even more by speaking in declarative language, slowing down, and expanding my nonverbal communications. They helped me figure out what my next objective might be. They encouraged me to seek situations in our real life (chores, cooking, shopping, games, puzzles, conversations, book discussions, etc.) to frame whatever objective planned to target. They pointed the book Awakening Children's Minds to me as a great way to learn more about scaffolding.
Trying to implement RDI is not easy without a consultant, but generous and wonderful parents are willing to throw ideas at you at email lists like HS-RDI and Autism Remediation for our Children to help you get started. You can find all sorts of RDI blogs through your favorite search engine. You can find some explanations and helpful video clips (free once you register and log-in). If the five-hour DVD is too pricey, it often sells on eBay for a good deal, but I would hold off buying Solving the Relationship Puzzle new because an update is in the works.
Flying solo is not easy. A dedicated mom and dad with no other options will find a way to make it work! At first, I felt drained with every encounter in which I worked on changing my communication style. I had to think of so many things about what I was doing and what Pamela was doing. I had to figure out how to use my video camera so that I could film our interactions and get a chance to review what happened. Trust me! When you are in the moment, you miss so much. Seeing the recordings helped me glean so many details that I missed in the heat of the moment. In time, I felt more comfortable but never completely sure if I was on the right track.
I must have gotten some things right because our consultant found Pamela smack dab in the middle of stage 2 (out of 30 stages): she has mastered the two most daunting tasks (being an apprentice and co-regulating). Her nonverbal communication is quite good.
The How
I decided to find a consultant because I thought I needed more direction and accountability plus I wanted to be sure I was on the right track. I know some people complain about being left out of the new operating system with objectives and resources available only to parents with certified consultants (or ones in training). I can see both sides of the argument here because I have been around long enough to know that sometimes professionals claim to be knowledge in therapy X because they attended a workshop on it five years ago and then completely confuse parents with outdated information. This insures a level of quality control for parents spending their hard-earned cash. Even so, since parents are people as are consultants, some personalities clique while others do not. If you are searching for a consultant, find a person with whom you connect because that consultant will be your guide. Driving an extra hour or two might be worth it if it means finding the right consultant for your family and situation.
Time will tell how it will go with our consultant. My first impression tells me this is the beginning of a great relationship!
Subscribe to:
Posts (Atom)