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Original poster

*****Moondog*********

57 replies

Jimjams2 · 10/12/2006 19:49

Whilst dealing with the hell that is dinner time in this house I came up with the perfect business for you (honestly I should make a career in thinking up businesses I keep winning blumming business competitions- now need to put one of them into practice).

I am not being completely altruistic I would need your services.

Do you want to know more????

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Original poster
Jimjams2 · 11/12/2006 20:13

I wanted to lamp the dietician we saw with ds1 - she seemed to be suggesting that I had MSBP (because I thought ds1 had autism- this was a year before he was diagnosed). She said he couldn;t be autistic because he picked up the toys when I told him to (!!!) She also gave me a load of incorrect info about the gfcf diet.

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moondog · 11/12/2006 23:40

I have been thinking about this all evening.

It would be interesting sifting through what is a real and what is a 'created' problem.

I would be loathe to pathologize what some would term an eating problem when in fact it is really one of too much choice/overindulgent parents and so on (but hey,people have always paid through the nose for others to state the bleeding obvious haven't they,otherwise why else would life coaches and personal trainers exist?)

I wonder also how many dieticians there are with an interest in and expertise in this field?

One of the people on my course (alreadyan ABA therapist and,form what I have seen of her work,a damned good one) was telling me about how she sorted out the eating habits of a child with Downs Syndrome recently.I must go back and ask her more.

Hub,I have used loads of non food reinforcers with children with Autism.
The company Hawkin's Bazaar is a fantastic source of reinforcing gizmos and contraptions.

(I worked through an entire analogue assessment of eating issues in my step class.The session flew.)

sallyhollyberry · 12/12/2006 00:25

This reply has been deleted

Message withdrawn at poster's request.

Original poster
Jimjams2 · 12/12/2006 08:44

moondog- for autism you would need to take on board the sensory issues around eating as well- as I think that contributes a lot. It can still be worked through using ABA, but you need to start very very small - tiny speck of unfavoured food on something the child will eat. Then build up slowly.

DS1 is frustratingly uninterested in the Hawkins Bazaar type things (his tutor would turn up with bag loads- we tried and tried)_. Reinforcement is generally a problem for him, as his old teacher said its a struggle too find something that floats his boat consistently. in a DTT type environment the sort of thing hub2dee mentions would work quite well for him. Are you thinking of inventing something hub2dee. We'll trial it (and we're mac based )

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hub2dee · 12/12/2006 09:06

It's nothing I've thought particularly about, jj... it's just that I understand electronics (a teeny bit) and interfacing them with computers, and I appreciate the idea of 'utility' in its broadest sense IYSWIM, so it seems sensible to use a computer (or some other electric gizmo) to deliver a nice dose of reinforcement using a trigger (mouse click / mouse down on a Power Mate knob etc. linked to whatever audio-visual stimuli the child's parents think might work (a favourite cartoon, or probably something tailor-made to deliver 5 second bursts of a funny voice / something visually exciting like Baby Einstein on steroids IYSWIM...

I suppose it might all drive you mad, and it raises the question of how portable the solution is - do you want to have a laptop out in a restaurant making funny noises ? But they do standalone DVD playing machines for next to nothing these days and having some kind of input switch to it to deliver the next 'micro chapter' in the reinforcement DVD can't be impossible.

moondog · 12/12/2006 09:38

Yes,that's what I meant JJ,a dietician who understood the dietary issues as well as the sensory one.There can't be many eh?

Hub,a company we use a lot is Inclusive Technology (would link but about to go out) who have lots of absolutely fabulous stuff.It is run by people who understand both ICT and special needs.I cannot recommend them highly enough.
They have been up to see us here in North Wales twice for a day long workshop/demo. which they do for free I may add.

Jimjams,the bible for those into ABA is JABA (Journal of Applied Behaviour Analysis)Has this been mentioned to you before?
All copies available on t'Internet.
I'm off to the library now so if I have time after completing all work for my essay ('It is more ethical to reduce self-injury by behaviour modification than waste time attempting to understand the function of behaviour.Critically discuss.')I will do a search.

moondog · 12/12/2006 09:40

Bummer about the lack of interest in HB.

Hey,what about various tickling games?
Does he like these?
I know jkids who would do anything for my 'Dot dash,dagger in your back' routine complete with physical stimulation.

Takes a bit of explaining when they go home muttering the words though....

moondog · 13/12/2006 22:22

I talked to my supervisor about this today JJ.
The students who are parents of children with Autism all nodded vehemently when I mentioned this discussion.

He reckons that a woman called Kathleen Piazza has done a lot of work on this and also told me that there are a couple of ABA Masters students (this is Bangor uni)working on this for their thesis.

Original poster
Jimjams2 · 13/12/2006 22:27

He likes all sorts for one day only. HIs last teacher described it as "a curiour passivity", also said it was very difficult to find things that would float his boat consistently. He's not really interested in toys full stop, which is why it is so difficult to go to places- very difficult to find distractors- he;s far rather be running around checking out every door and window- that's what he LIKES doing.

In DTT work social reinforcement works quite well now - but that's because he quite likes DTT work anyway. He'll drag me to the table quite frequently. The problem is reinforcement for something he doesn;t want to do. Like eat. The only strong enough reinforcers are chocs/bits of broken biscuit. 1/4 choc button is enough though, doesn't have to be a whole one. So a small pack of choc buttons will do a mealtime.

will google kathleen piazza- cheers.

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moondog · 13/12/2006 22:37

Hmm,what are the consequences if he doesn't do something?
Have you tried manipulating those or working on him choosing his own reinforcer from a choice (maybe on PECS cards) at the start of a session?

My supervisor told me that he had worked with a child with Autism who only ate digestive biscuits and as he had coeliac disease.... well you can imagine the consequences.

He eventually was fitted with a PEG.

As an aside,I remember we discussed the use of punishment in ABA therapy a while back. I seem to recall you saying that it wasn't part and parcel of ABA.
Actually it is (although only as a last resort and with very strict guidelines and ehical considerations to wade through)

Reading something now where it was used with a chap who was self injuring to such an extent that he had deteached both retinas and was blind.

Original poster
Jimjams2 · 13/12/2006 22:48

He's not really capable of choosiing his own reinforcer (doesn't really do choice- well kind of starting with choosing videos but often gets confused by that).

There aren't any punishments either. Actually there is one - I threaten to shut the door of his room which works at the moment. It will stop working though. That's about as aversive as we get.

I still think that physical punishment is very dangerous territory to get into - especially in a situation where the bigger, stronger person is already frustrated. It can quickly escalate to violence.

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Original poster
Jimjams2 · 13/12/2006 22:49

The reaosn there aren't any punishments is because there's nothing he strongly dislikes that can be used as one. He is very very placid (hence trouble choosing etc, he doesn't have a strong opinion).

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moondog · 13/12/2006 22:52

Funny that he likes dtt and yet isn't into choice......
I have seen lots of people who operate the other way round but not this way.

I agree with you completely about the punishment issue.

However,as I have learnt,'punishment' as a term used in a behavioural context is not the same as the term used by a layperson.

Original poster
Jimjams2 · 13/12/2006 22:59

oh yes agree about that- only really avoid physical punishment (I have a quick temper). If I had an aversive that worked I would use it to stop hanging over the bannisters, climbing on dodgy windows etc. Lucy Blackman's mum used to say "shall we have a CHINESE take away" when Lucy wasn't behaving as Lucy hated chinese. She would instantly behave

He is very complex. Quite sociable - LOVES to tease. He has different teasing games he plays with different people, and he just loves that.

DTT- I think he likes it because its something to do- he cannot fill his time at all when left alone. He doesn't really have a single toy he can play with, and he is too compulsive so if left to play wiith something independently will be distracted by some soort of touching, flicking, sniffing compulsion. Even the computer which he loves- the compulsion to flick it on and off is too high. been consulting with Donna Williams a lot and from listening to her, and Growing Minds, and reading Lucy Blackman (he is VERY like Lucy) and observing I think the compulsions are very frustrating for him. DTT sessions remove the compulsions (well they don't, but I manage them and don't allow him to engage in them during a session- can't stop them completely of course). So he can actually have his time filled.

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moondog · 13/12/2006 23:11

Have you tried intensive sensory work with him,stuff like massage,swinging,rocking and so on?

I did my final year salt thesis with a very interesting sal called Karen Bunning who did a PhD on using this sort of stuff with people with profound learning disabilities (I know your ds comes under a different remit but bear with me).

Basically she was flooding them with sensory stimulation of this kind to reduce self stimulation,compulsive behaviours and to develop a more interactive communication with very passive people.

Original poster
Jimjams2 · 13/12/2006 23:16

He gets a lot of sensory work at school (reallly an awful lot). It helps definitely- one of the reasons why he is so much better at his school than in mainstream. We see the difference when he arriives home.

He's actually now very interactive with people (all the teasing for example- and he knows exactly how far to go and is often very funny- he had his escorts in stitches a while back because every day he got on the bus he'd sit where they didn't want him to- litle gleam in the eye, and if they tried to outwit him he'd usually manage to get one over them). It's sustaining attention in a free environment that is really hard for him. If he knows a room then he will settle and engage. If we go somewhere different he has to check out everything (and of course has a very poor sense of boundaries).

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Original poster
Jimjams2 · 13/12/2006 23:17

I'm dying to show you a short video clip I have of him, because it just sums him up- but I am too embarrased by the state of my kitchen (middle of summer holidays - bomb had hit)

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moondog · 13/12/2006 23:18

Tough eh?

The game playing sounds brilliant though.

Pretty sophisticated use of pragmatic skills.

Original poster
Jimjams2 · 13/12/2006 23:19

yes, and lots of understanding of what other people think. He's very tuned in like that. His first special school teacher used to call him "the enigma"

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moondog · 13/12/2006 23:20

Oh I'd be most interested and honoured if you chose to share it with me.

Kitchen schmitchen. Pah!!!

You must ignore my Mumsnet persona.

I'm really exceedingly non judgemental in PL.
Couldn't give a crap what people do,wear, eat or how they choose to live.

Original poster
Jimjams2 · 13/12/2006 23:20

Having been on Growing Minds I would say that a lot of his problems are due to very poor executive function. It was fascinating, really a case of hearing about him iykwim. Suddenly a lot of things made a lot of sense.

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moondog · 13/12/2006 23:21

Ah,I have a couple of children that I use exactly the same term for.
I so know what you mean!

Original poster
Jimjams2 · 13/12/2006 23:32

it's all in there- you know he's smart, but it's actually accessing it, that's so difficult.

You would need quicktime to view the movie (its about 40 seconds worth). I may be able to put it on a webpage.

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moondog · 13/12/2006 23:36

Don't know owt about quicktime.
Am a dunce with IT.
Leave it all to dh who is home in a week.

Original poster
Jimjams2 · 13/12/2006 23:42

I've sent you a link.....

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