This is a selection of notes from over two years of behavioral intervention sessions with a young child who ultimately recovered completely from autism. It includes many of the fundamental principles of behavioral intervention, as well as the thousands of details and patient step-by-step programming needed to help a child reach his maximum potential. The notes are by the parents, Megan and Jim Sumlin (pseudonyms), who feel strongly that this information should be freely available to all who might benefit from it. They ask only that this information, including specific drills, belong in the public domain, and are not to be claimed or copyrighted by any person who is or will in the future be seeking monetary gain for wide distribution of same. Feel free to re-distribute this document, but please include this entire preface.
These notes are just one part of a comprehensive program guided by a behavior analyst; there were other parts of the total program, not included here, that were necessary to the child's development and eventual recovery. They are specific to one individual child. Use them as a resource to help you plan your child or student's curriculum. What works for one child will not work for all. While much of the material here addresses problems common to many or most children with an autism spectrum disorder, you will want to select carefully based on individual needs, learning style, and personality.
A few notes on terminology:
· SD stands for "discriminative stimulus," the instruction given to the child.
· R is the child's (expected) response.
· NNP ('no-no-prompt') is one specific technique for presenting the "SD," then prompting (providing the "R") if the child responds incorrectly.
· T.O. is "time out," a (brief) removal of all reinforcement (the child must sit and do nothing). This is meant to reduce certain unwanted behaviors but it has no moral or emotional overtones; it is not a punishment for "being bad."
· Reinforcement is a reward for a correct response, which may be anything the child loves: a bit of chocolate, a piggy-back ride, an enthusiastic "You're so great!"
Proper reinforcement is the key to learning. Much more common in these notes is DRO, which stands for "differential reinforcement of other behavior." In addition to reinforcement for "getting the right answer," the child was frequently praised for unprompted appropriate behaviors (in place of undesirable, 'stereotypical' behaviors). For example, when playing with dolls, the therapist may say, "I'm glad you're not banging the characters together," or as the notes say in many places, "DRO'd flexibility"--unprompted spontenaity. Remembering to "catch 'em being good" takes a lot of practice, but it is essential to the development of a truly natural repertoire of age-appropriate skills.
See also: Sumlin Social Stories and Teach Me to Play and a personal statement on overcoming autism
Back to ABA Resources
This page is rsaffran.tripod.com/Sumlin.html
(Everything after this point was written by Megan and Jim Sumlin.)
Introduction
If you have a video recorder, or can borrow one, tape the entire workshop (we found that our first workshop and the impression our consultant made with this first "presentation" was very important we were able to narrow three days onto 3 two-hr. videotapes) and give those who can't attend a copy asap. If you can't get hold of a video recorder, audio record and/or take notes on the visuals and make copies for the therapists (and anyone else who has lots of contact with your child grandparents, family members, etc.). We continued doing this (both videotapeing and taking notes) for therapists, whether they attended or not, for all the follow-up [workshop]s too. Each time our consultant came, we made copies of the videotape for every therapist. We felt that even if they were at the workshops, they may lose sight of the goals, and since they continued to have so much respect for our consultant throughout, they were willing to watch the current "tape" just to keep them sharp in terms of what we were currently working on. Every time our consultant came for a follow-up, as we copied the day from 8mm to VHS later that evening, my husband and I would take notes from the stuff she'd say, and put it together on "incidental" sheets that we would type over the next day or so (using a combination of verbatim info from our consultant and our own words, stressing what we believed what was most important re: priorities--we also would ask the consultant usually after the therapists left, in case it wasn't specifically spoken about throughout the follow-up workshop that day, to prioritize the current goals over the next weeks until she would return and also prioritize drills by number of how many times the specific drill should be done each week. We took a very pro-active approach not only with the therapists but w/our consultant too (which we know both she and they appreciated) and copied these for all the therapists to not only take home, but to read prior to each session they did. Although it seems tedious and unnecessary for them to [have done] each time they came over, it really helped a lot and avoided many problems we may have had with inconsistency throughout our program.... we believe it has a lot to do with the success of our program.
Please remember that these [notes] were designed specifically with our child in mind. Before you decide to implement anything here, make sure you've read ALL notes throroughly since sometimes later steps worked faster to give us the results we were looking for. There was a lot of trial and error involved. Please note also that many of the strategies evolved over time and some of the earlier strategies may be prerequisites for later strategies while others were just the result of our learning from our own mistakes. It would be difficult for us to point out which strategies fall into either category, particularly since so much of this was tailor-made for our child. Look over these notes in that spirit. It's fairly clear, through careful reading in the order in which it was written, how and why many of these strategies came into being.
We often discussed, after writing each entry in this series of notes (we've continued to do these up until just a few months ago--those that are here are ordered from #1, a little less than 3 years ago, to the most recent one #26, a little more than 1 1/2 yrs ago, there have been only a handful [here included] since then) how stims/ perseverations, etc. were like an over-inflated tire. Every time [we] tuck[ed] in one part, another part invariably [popped] out. [We kept] pushing those "bubbles" down while they [kept] popping out in other places, although smaller and smaller until the whole tire [fit] ("shaping"!). To reiterate, we employed many different strategies for many different reasons in dealing with these "bubbles" (both new and recurring "bubbles"). Again, the "bubbles" belonged to our child and though the strategies worked for this child, they may not (and will not) for many others.
We spent many precious hours watching, writing, reading, proofing over and over, ad infinitim, all this information which was created for our child and, as a result, always had our program memorized. .....we absolutely feel that without our total involvement in all aspects of the program (incl. videotaping our son's workshops, studying the videotapes while we made copies for all our therapists, putting together the notes from these videotapes on what the current goals were, studying and proofing these notes, being sure our therapists would take home, read, and study these notes, verbally going over them with each therapist the first time they worked with our son after a follow-up, having therapists read these notes prior to sessions, etc.), at least in our son's case, we would never have seen the results we did.
Please pass them to your consultants, other families, or whoever may need them. We think some of the ideas here are very general and many are probably used often by our consultant with many other children. It would be wonderful if some of these ideas and many more that could help the wide variety of stims and problems that exist could someday be put out in book form for everyone who could use help after the more "formal" programs are through. At the same time, we would not want to see these specific notes, written by us specifically for our son, sold or printed anywhere for profit. Thanks for respecting our wishes here.
It's a pleasure to share our journey with you and hope [these] notes can help many of your precious children.
Program Notes
[FIRST FEW WERE OBVIOUSLY BEFORE THESE
"INCIDENTAL" SHEETS BECAME A STANDARD
THING FOR US]
#1
C O M P L I A N C E
- AVOID "DRILL SERGEANT" -- HE'S STARTING TO LIKE IT.
- USE "NO-NO-PROMPT" SEQUENCE TO GET COMPLIANCE
- DON'T DELIVER A FULL SD; CUT HIS BULL OFF
WITH "NO!"
- AFTER 2 "NO"s, PROMPT BY NEUTRALLY PHYSICALLY
RESTRAINING THE OFFENDING BODY PART (LEG, ARM,
HAND OVER MOUTH, ETC.) THROUGH THE ENTIRE SD.
THIS WILL BUILD NEEDED ANXIETY. HIS NEED TO ESCAPE
THE ANXIETY WILL CONTROL HIS COMPLIANCE. NEVER
"NO" AFTER THE PROMPTED TRIAL (IF YOU DO, THE "NO"
WILL BECOME REINFORCING). LET IT SLIDE AND GO
INTO THE NEXT "NO-NO-PROMPT" SEQUENCE AGAIN.
YOU'LL PROBABLY ONLY DO THIS SEQUENCE 2 OR 3
TIMES BEFORE COMPLIANCE IS REGAINED. IF NOT...
"DRILL SERGEANT"!
- DRILL SERGEANT (GO BACK TO EARLIER SIMPLEST
DRILL - RECEPTIVE COMMANDS, ETC.)
a. ONLY USE THIS WHEN YOU HAVE NO CONTROL &
HAVE EXHAUSTED EVERYTHING ELSE.
b. NEVER "NO" OR "NO-NO-PROMPT" DURING DRILL
SERGEANT AT ALL. PHYSICALLY PROMPT
IMMEDIATELY...DON'T WAIT!
c. DRILL SERGEANT WORKS ONLY WHEN IT'S QUICK,
CRISP, AND BUILDS ANXIETY. IF HE'S DOING IT SLOWLY
OR SEEMS TO BE ENJOYING IT AT ALL, HE'S "WINNING"!
d. THE PURPOSE OF DRILL SERGEANT IS TO
RE-ESTABLISH YOURSELF AS "IN CHARGE" [REGAIN
"STIMULUS CONTROL"
================
#2
GENERALIZATION AND INCIDENTAL GOALS
- WHO? NOTHING/NO ONE/NOBODY (WHO'S IN THE CAR?)
- OURS/THEIRS (WHOSE HOUSE/CAR; WHO LIVES HERE?)
[we had notes on the door so none of us would forget to ask
these types of ?s -- I left them there from years ago, just so
we'd never forget!]
- HOW (DOES __ [THIS] WORK)?/HOW DO YOU__?
ANYTIME YOU'RE DOING SOMETHING MUNDANE (TURNING
ON THE SHOWER, MAKING COFFEE, OPENING A DOOR)
ASK THE QUESTION.
- WHY/BECAUSE
- TOILET TRAINING
- INSIST ON THE ARTICLES "A" & "THE" AND PROPER
SENTENCE STRUCTURE IN GENERAL
(e.g., don't let his common mistakes slide anymore).
- NO MORE "NO's" FOR NOT ANSWERING IN A VERBAL
DRILL SAY "HMMM?" INSTEAD AND HAVE THEM COUNT
AS "NO"s IN YOUR "NO NO PROMPT" SEQUENCES.
- THEMATIC DAYS - Yellow Days, etc.
- PLAY BOARD GAMES WITH HIM - Candyland, Teddy Bear Bingo.
=================
#3
INCIDENTAL GOALS
ALL OF THE DRILLS HAVE BEEN REVISED & REVAMPED...
PLEASE READ ALL SHEETS, NOTES, ETC. CAREFULLY!
- Always include a "SNACK TIME" (juice [w/cup] & cookies in
your session).
- Let's keep his "turns" to a minimum. Tell him "no, I'm the
teacher"; "we don't take turns on this"; don't interrupt (the
teacher)", etc. Include these concepts in pretend & doll drills.
- Don't let him grab your things (without asking). Tell him "that's
mine", "you can't have that", etc. Imagine if he did this sort of
thing in school to other kids or his teacher.
- If he obviously acts like he's looking for your attention (he
dresses up, puts on mommy's sneakers, or does something
novel), seize the opportunity and prompt him to say, "watch
me", "look at me, I'm...", "look what I'm doing", etc.
- Do not allow him on the toy chest or window (particularly w/toys)
- When he tells you what to do followed by "OK?", change it to
"will you". For example if he says "after we do this we'll go
outside, OK?" prompt him to say "will we go outside after
we do this?"
- When he states the obvious in "are you/do you/did you" form
change it to "why are/do/did you...". For instance, if he says
"are you wearing shorts?" prompt him to say, "why are you
wearing shorts?" [or maybe "You are/You're wearing shorts"]
- Don't let him use "no" when he means "don't" e.g., if he
says, "no go home" prompt him to say, "don't go home".
- Avoid first, next, last and instead use 1st, 2nd, 3rd, 4th,
5th, 6th, etc. [he was obviously perseverating]
10. Try to get proper sentence structure/grammar at all times
(correct him).
==================
#4
INCIDENTAL GOALS
AS ALWAYS VIRTUALLY ALL OF THE DRILLS HAVE BEEN
REVISED & REVAMPED...PLEASE READ ALL SHEETS,
NOTES, ETC. CAREFULLY!
**THE FORMAT OF THE THERAPY HAS TAKEN A
***
MAJOR TURN
HE HAS DEVELOPED SEVERAL HIGH LEVEL VERBAL STIMS
& ESCAPE BEHAVIORS THAT MUST BE ERADICATED
BEFORE THEY REINFORCE THEMSELVES TOO MUCH AND
BECOME INGRAINED IN HIS BEHAVIOR!
[ME-LISTERS: THIS IS SOMETHING THAT DID GET BETTER
USING THESE INTERVENTIONS; HOWEVER, IT DID CONTINUE
FOR A LONG TIME AND WE LATER TARGETED IT WITH
"SCRIPTING" WHICH FOR HIM ABSOLUTELY DID THE TRICK]
- His repeating is definitely a stim and NOT processing of information!
- These behaviors are extremely subtle. You will have to listen
very carefully to pick them all up (and even then he'll be getting
away with even more subtle stims).
- Consistency across all therapists is critical...we must all get
CRAZY on these or the behaviors will be intermittently reinforced
and increasingly difficult to break.
a. Latency as Escape Behavior - Some of his 1 million and one
stalling tactics include "ummm", "let me think", "I think...";
drifting off into space; and even having you reprimand
behavior during a drill!
b. Verbal Dysfluencies
Tacking on sounds to a phrase as Escape & Stim
Practicing an error (when he repeats wrong answer
several times)
Repeating (your words or his)
Saying part of a sentence more than once (e.g., "the boy
left, the boy left the apartment, apartment building, I
mean apartment house...")
INTERVENTION: Response Prevention as follows is the key to
Compulsive Behaviors:
- Interrupt all hesitancy with "uh, uh" a face, or whatever form
of "no" you use (always differentially) and quickly deliver the
SD again (i.e., if its function for him is as STIM, you must
interfere with whatever intrinsic reinforcement/charge he's
getting from it. He's constantly going to try to prolong
everything -- escape from working).
- Use phrases like "You're taking too long", "hurry up", "I
can't wait forever", etc. Always say something different.
- For rehearsing an error, go into a "no"-prompt-SD sequence
rather than "no-no prompt".
- If all else fails, take the props of the drill away ("we can't
play this if you don't play right"), perhaps come back to it
later in the session or even abort the drill entirely!
OTHER STUFF
- No more turn taking in drills (until he stops perseverating on
this)
- Do not issue a threat you can't (or really don't want to) follow
through with.
- Always avoid threats during drills and even between drills
for now; he's using this as escape tactic (i.e., getting to
have you spend time talking about his behavior, etc.)
Try to work through all his "stuff" (quicken pace - no/prompt/
SD [instead of nnp,sd] etc.) SWITCH DRILLS AS LAST
RESORT.
- Keep non-verbal (play) drills going longer (maintain attention).
We'll do one or two long drills (action/play) for 10-15 in each
session. Other similar drills you're doing in the session will
be done for a little longer than usually. Verbal drills will be
done for a shorter length of time now.
- Do not tolerate any stims anymore!!!!
#5
INCIDENTAL GENERALIZATION GOALS
(NOTE: NEW ITEMS BOLDED [#24-#29]) [i.e. there was one inci
sheet before this that had only up to #23 -- since we just amended
by adding a few, I'm skipping those inci notes here for space
purposes.]
- NEVER USE CONSEQUENCE YOU CAN'T DELIVER ON!
- TREAT HIM AS YOU WOULD A FRIEND/ADULT WHO HAS
A SILLY ANSWER
- NEVER USE SAME CONSEQUENCE TWICE IN A ROW...
OR OFTEN! Write what you use in the "General" section
- AVOID LABELING WHAT YOU'RE CONSEQUATING --
HE'LL PROB GET THE MESSAGE
- NEVER let him verbally circle around point during, after or
between drills (ask and/or state something in two or three
different ways -- e.g., "We're going outside"; "Are we going
outside?"; "Is it time to go outside?") Remember "RAINMAN" --
These are the ELABORATE HIGH-LEVEL VERBAL STIMS
WE'RE VERY CONCERNED WITH RIGHT NOW. BE MORE
THAN VIGILANT ABOUT THIS!
- Speaking of "RAINMAN" ("BEING THERE", etc.), NEVER let
him copy your gestures!!! WATCH FOR THIS! If he does this,
try making elaborate gestures while delivering SDs a few times
and then say something (neutrally) like "OK, now let's try
doing it right", etc.
- Let's LET HIM GET AWAY WITH SIMPLE GESTURAL
STIMS that "pass" for normal, (finger tapping, etc.), but as
soon as he crosses the line to what looks wierd, kill it! This
will allow you to get through more drills and sometimes he
surprisingly will stop these little gestures if they're ignored
or when you distract him by saying something interesting
(contextually familiar in verbal drills, etc.) As always, most
importantly, NEVER BE PREDICTABLE!
- ALWAYS use correction (said by you "in passing") if he
uses a wrong word
intentionally or otherwise in or out of
drills. Try not to prompt correct answer all the time -- which
will usually cause a power struggle if it's being done as a
verbal stim. Just let him know you heard what he said and
say it correctly for him ("You mean [correct word]") Listen for
the "Italian A" [he'd started to "tack" an -A onto all words and
it sounded very italian...pls don't be offended by any of the
"humor" in these notes] and other silly stuff, ESPECIALLY outside
of drills. Use correction if he knocks things over (make him pick
up/clean up).
- Be a little more tolerant with latency than we have been lately
(but, as above, it if gets weird or out of hand -- obvious
escapism, etc. -- kill it!) [when we KILL something in therapy,
unless we note differently, we're very strictly using NO NO
PROMPT -- everyone kills autism in different ways....this is what
worked best for our son almost throughout the therapy (it later
became "no" equivalents or lines that we counted as two "no"s)
and when we killed w/this method for a while, it usually remained
dead].
- REMEMBER NEVER TO LET HIM STIM ON BREAK TIME.
Get him back if he does but, especially here, ALWAYS BE
PLEASANT WHEN YOU CALL HIM BACK -- Show no
displeasure vocally -- He gets the message!!! In cases like this,
PLEASE SAVE YOUR RECORDING FOR LATER -- Make
small notes to yourself or stick paper in section you didn't have
time to write into. PREPARE YOURSELF WITH LITTLE
STRIPS OF PAPER BEFOREHAND IF YOU MUST!
- Black folder in back (or front) of BOOK is for all books read in
any of the book drills: lists for "Storytime", "Tell Me About the
Picture", "I See", "Wh- Book Questions" [all can be found in the
Me-List archives] and "General/incidental bonus/relief/
reinforcement" reading. Record here each time you use a book
for one of these drills and check here BEFORE you begin
using any book. Chances are if he requests one specifically,
he's seen it in the past few days or even within the past few hrs.
10. If he gets mad if you take something from him, or move
something where to a place he doesn't want it (continue to
purposely mess with his stuff when you see he's placing it
w/secret special meaning anywhere) or anything showing
resistance to change, use how his teacher will do this to
him and "how will [he] you feel" i.e. "Will you get mad...?
His ans.: prompt "NO"; -- "you can't get mad, you'll have to
sit down, be a good boy and not let it bother you, etc."
11. In any and all drills in which he's holding anything or doing
anything w/his hands (Drawing, ADL, Pretend, Dolls, etc.),
PLEASE tell him "Both of your hands are needed for
EVERYTHING" "Use 2 hands" "You have to also use your
left/right hand", etc. OVERDO THIS FOR NOW! If he's more
successul in whatever it is he's doing, he'll know both hands
are often needed. THEN we can kill his perseveration on
using two hands.
12. PLEASE read the "GENERAL" section BEFORE you begin
each session. Try to write here w/any helpful info for us and
other therapists (what's working, what isn't, latest perseverations,
etc.) We will continue to make incidental sheets like this one
for you to read before sessions.
13. STOP HIM FROM RUNNING WHILE HE TALKS (ESP
BETWEEN DRILLS). PLEASE ALL get him on this every time.
Tell him that "In school this will not be accepted", etc.
Remember to use "(This is im)PROPER SCHOOL BEHAVIOR"
as often as needed. This seems to really work well--so well
he'll prob tell the teachers about it if we use it often enough.
14. Remember to take notes on "PAINTING" and "OUT OF
HOUSE" drills. After "O/O House" has been done 2 or 3X,
do your "O/O HOUSE" drill without doing a SPECIFIC DRILL.
He needs to go outside WITHOUT what sounds familiar (like
"working") and do more naturalized conversation. Try to
"peer model" if you meet other children (facilitate/prompt his
conversation with them). ALWAYS REMEMBER THAT IF
BOTH OF YOU ARE NOT TALKING AT ALL TIMES THAT
YOU'RE OUT THERE WITH HIM, YOU'RE NOT DOING THE
"O/O HOUSE" DRILL CORRECTLY!
15. When drills are combined (O/O House, Doll Play, Sharing/
Show & Tell, etc.), please record in EACH section. We know
this takes time, but often he's doing better (or worse) than
last time drill was done and this needs reportage as such.
i.e., report in "Out of House" which drills (if any) you did
and within ea. of those drill how he's done (also, as much as
possible, PLAN beforehand which drills you will do so you
can read their last entries before you go out -- Also, we never
want to do the same drills out there each time).
16. (FOR NOW) do not accept his closing the bathroom door
when he "goes".
17. (FOR NOW) kill "sometimes we/I do and sometimes
we/I don't" and all similar statements.
18. ALL Doll drills (& sometimes w/peer modeling outside): Have
his dolls follow yours and then reverse. Kids often play like
this and we need to prepare him on how to do this A LOT! Kids
follow ea other and so do their dolls!
19. Don't allow him to say "bye" to pee pee and poo poo and any
dolls or games he/you put away.
20. VERY IMPORTANT....HE'S DOING THIS SO MUCH
LATELY!!!!!! After you reprimand him for doing something
annoying (and in general), listen for his: "What will I do if I
[thing you just nailed him on]" (DO NOT ACCEPT SILLY
SENTENCE LIKE THIS) or "Why do I/don't I [thing he did wrong]?"
(prompt: "[name]...IT'S 'WHY CAN'T I...'") and in general watch
for his using the wrong "WH" word in question ("WHAT AM I
GOING TO" (prompt "WHERE...?") HE HAS BEEN USING
"WHAT" INCORRECTLY LATELY.
21. CONTINUE KILLING ANY "BEFORE/AFTER/FIRST/LAST"
(PREDICTING) STUFF HE SAYS (FOR NOW -- UNTIL WE
KNOW HE'S REPLACED THIS WITH NOT CARING ABOUT
HOW TO PREDICT EVERYTHING--EVEN IF IT TAKES
FOREVER!)
22. NEVER BE PREDICTABLE & ALWAYS MAKE THERAPY
A POSITIVE EXPERIENCE. Try harder than ever to avoid
power struggles! SCHOOL BEGINS IN LESS THAN ONE
MONTH!
23. Try to keep therapy novel and interesting (MOVE AROUND
AND HAVE FUN!) but remember, even if he's sometimes
bored, he MUST LEARN TO TOLERATE BOREDOM (Life
isn't always interesting!) NEVER make excuses (he's tired,
bored, etc.) and ALWAYS, ALWAYS lots and lots of BREAKS
FOR DOING WELL. Remember: short verbal drills; longer
play drills.
24. NO BABBLING OR "WORD SALAD" IN WORK OR PLAY.
It's time for him to ONLY speak with words that make sense.
If he babbles IMMEDIATELY call us and we will reprimand
him (warning, time out or punishment). DO NOT say "use
your real words" and let it slide! We are in the process of
extinguishing this nonsense talk and we can't have this
INTERMITTENTLY REINFORCED. Consistency here is critical!
Watch for "word salad" when he plays...that is when he uses
chained words that don't form real sentences. Same
consequence for "word salad" - call us immediately for a
consequence.
25. DON'T ACCEPT "WHAT DOES" AS A SUBSTITUTION
FOR "WHAT IS" e.g., "What does this for?"
26. NAIL BODY POSTURES INCLUDING:
Hand flapping when walking/running
Weird skipping while talking
Strange ways of standing, walking, etc.
Tell him he's acting strange/weird. Say "what are you
doing?"; "why are you walking like that?", etc. DO NOT
label this behavior "funny"; you must give your label a
negative spin (weird, strange, peculiar, bizarre).
27. IF THE TELEPHONE RINGS AND HE DOES PICK IT UP
(Please don't encourage this, but if it happens...) GET
MORE APPROPRIATE CONVERSATION OUT OF HIM
(Prompt): - "Who's this?"
- "How are You?"
- "Where are you?"
- "Are you coming over later?" (if a friend, etc)
- "When are you coming home?" (for family)
- "I can't wait to see you"
28. WHEN CONVERSING WITH HIM TRY TO GET HIM TO
STICK TO THE GENERAL TOPIC
29. EXTINGUISH HAND FLAPPING WHEN HE RUNS!
#6
THE FOLLOWING POINTS ARE NOT ON THE VIDEOTAPE SO
PLEASE READ CAREFULLY
- Do not let him babble or use word salad (chained real words with
no meaning) at work or play! Whisper to him that "it doesn't
make sense"; "use words that make sense", etc.
- Be sure to COMPLIMENT HIM FOR USING REAL WORDS
DURING PLAY. NEVER mention that "you're not babbling and
that's good". Just reinforce words in absence of word salad/
nonsensical babble.
- He MUST NOT PERSEVERATE ON TOY TELEPHONES
(he tends to walk around with them while he's doing other
things)...this looks really weird.
- IF HE EVER HITS ANOTHER KID HE IMMEDIATELY GOES
HOME (THIS WILL PROBABLY BE ONE-TRIAL LEARNING).
Let the teachers know in advance that although this is not
likely, this is how it will be handled if it happens.
- DON'T LET HIM RUN BACK & FORTH -- He must stay in one
area for extended periods (redirect him to an interesting activity).
- DON'T LET HIM TAKE TOY CARS (TRUCKS OR PEOPLE)
AND WALK WITH THEM AROUND THE EDGES OF THE
ROOM (in school or during breaks at home). LOOKS WEIRD!
- NAIL BODY POSTURES!
============
#7
S C H O O L I N F O
- "LANGUAGE DELAY" [later "receptive/expressive problem] is
what we will be calling his disorder - Never say "Autism".
- VERBAL MISTAKES
NEVER USE HARD CORRECTION!!! (i.e., no "NO"s or
"UH UH"s, etc. - These will look very weird to other kids/
teachers - ONLY use subtle correction (soft whispers):
[earliest versions of "no" equivalents....used specifically
by shadows in the school situation. At home we were
still mostly using straight NNP and it wasn't until #23 of
the inci notes, I think more than a YEAR later, that we
were using "no"s that were very clearly "no" equivalents]
- "Try again"
- Model appropriate answer ("um hmmm [correct answer]")
- "You know what you could have said..."
- STIMMING
NEVER EVER use the word "STIM". Redirect any stims.
When you see them, never say: "That looks funny/silly." Use
the stronger (and less reinforcing): "That looks weird/strange."
- TANTRUMS
Basically let these be but do try to redirect softly; other kids
tantrum and this will not necessarily be viewed as that abnormal.
- INTERACTION WITH OTHER KIDS
Prompt, facilitate and redirect interaction.
- Use whispered, encouraging prompts to get him to deal
with other kids.
- Don't look for verbal perfection in responses to kids (it's the
interaction that's important).
- You can use turn-taking to get interaction but try to use
an activity you know he's familiar (has a history) with.
- SPECIFIC TYPES OF INTERACTION WITH OTHER KIDS
- NEVER push for a "hi"/"hi" interaction (him to say "hi" to
a kid or kid to say "hi" to him) since this generally stalls
quickly.
- Instead provide a structure or activity to facilitate
interaction.
- You can read a book/play a game with him and another
child, especially something that you know he has familiarity
with.
- SPECIFIC PEER MODELLING [something that because of
the problems at this school w/the teachers re: allowing more
than one or two children in certain areas to socialize had to
change later in the school year*when you see later sheets,
you could see that a many of the strategies & "rules" on these
sheets changed throughout the year--]
- NEVER attempt to train peers to interact or initiate w/him.
We don't want him to be identified as someone who kids
have to interact with or that he needs to answer (we cannot
let him be distinguishable from the other kids). We need
the kids to be kids and nothing more!
- He cannot be viewed as a "project" of the other kids.
- DO encourage him to initiate interactions (remember no
"hi"/"hi").
- Capitalize on opportunities like when kids approach him
on their own (subtly prompt his interaction).
- Do point out appropriate behavior of other kids (e.g.,
"watch Melissa; you try it").
- YOUR PROXIMITY
Bottom line is that we do not want him to be distinguished
from other kids (the teachers will resent this and the kids will
notice):
- Don't be his shadow; NEVER BE ON TOP OF HIM!
- Always, however, be within a few feet of him (if possible) w/a
peripheral (though not obvious) eye and ear.
- Don't worry about being a few feet from him since he now
responds to "I saw that" or "I heard that" (whispered of
course) a few moments after the fact.
- You must blend into the class.
- You should be like an aide to other kids (the school
insisted on this and it's healthier for him).
- You don't want him to keep coming to you for help (bump
him back into the class).
- Do not let him be dependent on you (he tends to flock
to adults over kids and, of course, in class it may be
ESPECIALLY you; ALWAYS redirect this subtly).
- ON THE WAY TO SCHOOL - Treat it almost like the
O/O House drill.
- Touch on, but don't dwell on, school or he will perseverate
(we're sure you can picture him saying, "First we'll, and
then we'll*, etc.", esp because there will prob be specific
routines.
- Spend most of your trip talking about what you're doing
at the moment, the environment, etc.
- NEVER make it drill-like.
10. ON THE WAY HOME - ALWAYS review the school day.
11. YOU AS OBSERVER/REPORTER/TROUBLE SHOOTER
You need to observe what's going on and report back to us.
- THIS IS CRITICAL!!!!!!!!!
- What are the requirements for activities?
- Trouble shooting: what group/individual activities &
social aspects is he struggling with?
- We need PRECISE DETAILS since your observations
will fuel the home program (we will create many drills from
your observations).
12. TALKING TO THE TEACHERS/STAFF
YOU MUST AVOID TECHNICAL (BEHAVIORAL) TERMS
THAT MAY SUGGEST AUTISM (WE'VE AVOIDED THE
LABEL AND NEED TO KEEP ON DOING SO TO GIVE HIM
A CHANCE AT A NORMAL LIFE).
NEVER SAY INSTEAD SAY
DRILLS/PROGRAMS LESSONS/ACTIVITIES
STIM (verbal) SOMETIMES HE ADDS LITTLE
THINGS or HE'S CONFUSED
(about where to end
sentences)
PERSEVERATIVE GETS STUCK
AUTISM LANGUAGE DELAY
- Other terms to avoid include Behavior Mod, Reinforce,
Body Postures, etc. (you get the idea!)
- Using the word "confused" covers a lot of ground.
- NEVER emphasize that he likes to "predict" or "control"
things (PREDICT: "What will we do next?", etc.
CONTROL: "First we'll do this...", etc.) Call it
"ANXIOUSNESS", "he's in a hurry", "he GETS BORED
easily", "he's always INTERESTED IN SOMETHING
NEW" (!), etc. (turning it into a positive). NEVER use the
word "NERVOUS."
13. TEACHER'S QUESTIONS ABOUT THERAPY
- If a teacher asks you how to handle a specific situation
or what we do, just say "we redirect him to a new topic"
rather than saying we "redirect", "distract", etc.
- If you don't know what to say just tell them you'll check
with Dr.
__ (Consultant).
14. NUMBERS & LETTERS & COLORS
The teachers may find it odd that we shift his focus AWAY
from numbers, letters and colors. Keep in mind the [school's]
philosophy promotes working with a child's strengths--so this
is sure to perplex them. Just tell them he often "gets stuck
on that." We will now be working on #s and letters heavily
at home to hopefully lessen this potential problem (we will soon
be able to tell him that numbers and letters are "something to
write/read" ("colors are just how we describe something
sometimes") or re-direct him to writing them, etc.
15. REPORT CARD
We are setting up a home-based reinforcement system
(much like a token economy) consisting of Report Cards
(which you'll fill in every day) and a chart at home (which
we'll fill in).
- This will become a powerful tool to use with him to
promote good behaviors and extinguish aberrant ones
("This will go on your report card"). You'll talk to him about
it on your way back home, etc.
16. FRIENDS
You will need to scope out potential friends for him using
the following criteria:
- Must be non-aggressive
- Must have good social skills
- Outgoing (be careful, sometimes outgoing and aggressive
go hand in hand)
17. RUNNING AWAY
- He's capable of giving you the slip.
- Watch for situations where you're busy with other kids;
he may grab the opportunity to flee.
- Be especially careful when you're outside (class trip,
school yard, etc.).
- The teachers should be made aware of this possibility.
18. HE CANNOT PLAY TEACHER
- Unless he's asked to be a teacher's aid.
This includes (among other things):
- Grabbing materials for future activity
- Announcing what's next
- Wanting to tell class a story (or reversing what teacher
is actually doing)
- Bossing other kids (or you or the teachers) around
19. SPECIFIC PROBLEMS
- HE GETS IN A KID'S/TEACHER'S/YOUR FACE:
Say "Back off"
* - GENERAL NON-COMPLIANCE: Work it through
(No "No"/"Uh. Uh"!); Negotiate & set up contingencies
- NO Physical Prompts, only verbal (he will stand out if you
do this!!!!!)
- Tell him the way it has to be with real subtle re-directions
You don't always have to explain to him what he did
(he usually knows). No "No's" or "Uh Uh's"; this will
look weird! [we didn't stop doing this at home though]
* ALWAYS work it through otherwise you will be intermittently
reinforcing escape behaviors.
===============
#8
INCIDENTAL GENERALIZATION GOALS
REMEMBER.....(Use the "General" section to report during/after
EVERY session you have with him regarding consequences
ised!!!)......
TO READ ALL THAT'S BEEN WRITTEN SINCE YOUR
LAST ENTRY AND ANYTHING (IN "GENERAL" A N D WITHIN
EACH DRILLS' NOTES) THAT'S YELLOW HIGHLIGHTED
IN PAST MONTH AS REMINDER FOR THINGS THAT ARE
STILL IMPORTANT WHEN YOU WORK
- THERE'S SO MUCH GOING ON THAT YOU WILL FORGET
IF YOU DON'T READ EA. DAY. For now, read this sheet before
each session. It'll be in the drill book at all times.
- His primary deficit in school (& life) is SOCIALIZATION.
Always keep this in mind! He needs to improve his
initiation of social interactions as well as the maintaining of
these interactions. He also must start to accept initiations
from others.
- The other significant deficit is in the area of IMAGINATIVE
PLAY. Stimulate this (model, prompt whatever whenever
possible).
- AVOID AS MUCH AS POSSIBLE: "This is boring/interesting"
*same/differe
nt
"
*new/old"
- or any other opposites used to prevent him from doing a
repeat performance on something.
INSTEAD: Just re-direct him. He is perseverating on these
type of phrases particularly to other kids & they think it's weird.
- TIME-OUTS: We're targeting RIGIDITY (with objects NOT
VERBAL!)
- if he insists on putting an object in a certain place
IMMEDIATELY call US
- do not instigate this; just let it happen naturally
(e.g., if you ask him to put something away and he
then says "it goes here", etc---IMMEDIATELY CALL US)
- You may resume using consequences to regain compliance
with the following set of rules:
- MUST BE CASUAL (SAID TO HIM ALMOST IN PASSING;
NEVER OVER-DO IT!)
- MUST BE NON-CONFRONTATIONAL!
- NEVER USE CONSEQUENCE YOU CAN'T DELIVER ON!
- TREAT HIM AS YOU WOULD A FRIEND/ADULT WHO HAS
A SILLY ANSWER
- NEVER USE SAME CONSEQUENCE TWICE IN A
ROW...OR OFTEN! Write what you use in the "General"
section
- AVOID LABELING WHAT YOU'RE CONSEQUATING --
HE'LL PROB GET THE MESSAGE
- ALWAYS use correction (said by you "in passing") if he uses
a wrong word
intentionally or otherwise in or out of drills.
Try not to prompt correct answer all the time -- which will
usually cause a power struggle if it's being done as a verbal
stim. Just let him know you heard what he said and say it
correctly for him ("You mean [correct word]") Listen for the
"*a" at the end of his words and other silly stuff, ESPECIALLY
outside of drills. Use correction if he knocks things over
(have him pick up/clean up).
- REMEMBER NEVER TO LET HIM STIM ON BREAK TIME --
Get him back if he does but, especially here, ALWAYS
BE PLEASANT WHEN YOU CALL HIM BACK -- Show no
displeasure vocally -- He gets the message!!! In cases like this,
PLEASE SAVE YOUR RECORDING FOR LATER -- Make
small note to yourself or stick paper in section you didn't have
time to write into. PREPARE YOURSELF WITH LITTLE
STRIPS OF PAPER BEFOREHAND IF YOU MUST!
- STOP HIM FROM RUNNING WHILE HE TALKS (ESP
BETWEEN DRILLS). PLEASE ALL get him on this every time.
Tell him that "In school this will not be accepted", etc.
Remember to use "(This is im)PROPER SCHOOL
BEHAVIOR" as often as needed. This seems to really work
well--so well he'll prob tell the teachers about it if we use it
often enough.
- (FOR NOW) do not accept his closing the bathroom door
when he "goes".
-
(FOR NOW) kill "sometimes we/I do and sometimes
we/I don't" and all similar statements.
-
ALL Doll drills (& sometimes w/peer modeling outside):
Have his dolls follow yours and then reverse. Kids often
play like this and we need to prepare him on how to do
this A LOT! Kids follow ea other and so do their dolls!
-
Don't allow him to say "bye" to pee pee and poo poo and
any dolls or games he/you put away.
-
VERY IMPORTANT....HE'S DOING THIS SO MUCH LATELY!!!!!!
After you reprimand him for doing something annoying (and
in general), listen for his: "What will I do if I [thing you just
nailed him on]" (DO NOT ACCEPT SILLY SENTENCE LIKE
THIS) or "Why do I/don't I [thing he did wrong]?" (prompt:
"IT'S 'WHY CAN'T I...'") and in general watch for his using
the wrong "WH" word in question ("WHAT AM I GOING TO"
(prompt "WHERE...?") HE HAS BEEN USING "WHAT"
INCORRECTLY OFTEN LATELY.
-
CONTINUE KILLING ANY "BEFORE/AFTER/FIRST/LAST"
(PREDICTING) STUFF HE SAYS (FOR NOW - UNTIL WE
KNOW HE'S REPLACED THIS WITH NOT CARING ABOUT
HOW TO PREDICT EVERYTHING - EVEN IF IT TAKES
FOREVER!)
-
NEVER BE PREDICTABLE & ALWAYS MAKE THERAPY
A POSITIVE EXPERIENCE. Try harder than ever to avoid
power struggles! SCHOOL BEGINS IN LESS THAN ONE
MONTH!
-
Try to keep therapy novel and interesting (MOVE AROUND
AND HAVE FUN!) but remember, even if he's sometimes
bored, he MUST LEARN TO TOLERATE BOREDOM (Life
isn't always interesting!) NEVER make excuses (he's tired,
bored, etc.) and ALWAYS, ALWAYS lots and lots of
BREAKS FOR DOING WELL. Remember: short verbal drills;
longer play drills.
-
DON'T ACCEPT "WHAT DOES" AS A SUBSTITUTION
FOR "WHAT IS" e.g., "What does this for?"
-
NAIL BODY POSTURES INCLUDING:
Hand flapping when walking/running
Weird skipping while talking
Strange ways of standing, walking, etc.
Tell him he's acting strange/weird. Say "what are you doing?";
"why are you walking like that?", etc. DO NOT label this
behavior "funny"; you must give your label a negative spin
(weird, strange, peculiar, bizarre).
-
IF THE TELEPHONE RINGS AND HE DOES PICK IT UP
(Please don't encourage this, but if it happens...) GET MORE
APPROPRIATE CONVERSATION OUT OF HIM (Prompt):
- "Who's this?"
- "How are You?"
- "Where are you?"
- "Are you coming over later?" (if a friend, etc)
- "When are you coming home?" (if it's family)
- "I can't wait to see you"
-
WHEN CONVERSING WITH HIM TRY TO GET HIM TO
STICK TO THE GENERAL TOPIC
-
EXTINGUISH HAND FLAPPING WHEN HE RUNS!
------
#9
[PLEASE NOTE THIS IS DIFFERENT FROM LAST SHEET #8]
INCIDENTAL GENERALIZATION GOALS
[FIRST 4 HERE BOLDED; i.e., new from last sheet]
REMEMBER......
(Use the "General" section to report during/after EVERY
session you have with him regarding consequences used!!!)......
....TO READ ALL THAT'S BEEN WRITTEN SINCE YOUR
LAST ENTRY AND ANYTHING (IN "GENERAL" A N D
WITHIN EACH DRILLS' NOTES) THAT'S YELLOW-HIGHLIGHTED
IN PAST MONTH AS REMINDER FOR THINGS THAT ARE STILL
IMPORTANT WHEN YOU WORK
- THERE'S SO MUCH GOING ON THAT YOU WILL FORGET
IF YOU DON'T READ EA. DAY. For now, read this sheet before
each session. It will be in the drill book at all times.
- Consultant called his inability to "sustain conversation" his
most "global deficit" and thus we must work diligently to fix
this. This is critical and our efforts must permeate everything
we do. Essentially he is not interested in other people's lives
and only asks questions about HIS here and now. In a
conversation he shows no curiosity for others (while his
peers show a great interest). We've devised a series of drills
and steps to work on this but be aware that we were told this
will take more than six months to correct.
- TIME-OUTS: We're targeting LOOKING AT whoever is
speaking or whoever he's speaking to.
MAKE SURE YOU DIFFERENTIALLY REINFORCE
GOOD EYE CONTACT!!
** As we time-out NOT LOOKING, be aware that many of his
old behaviors are returning big time (HAND-FLAPPING,
VISUAL STIMS, FINGER PICKING, LEG KICKING, ETC.)
When he does this label it "WEIRD" and remind him of the
consequences of this kind of behavior (like how friends will
treat him, etc).
** BEWARE!!!!: ECHOLALIA IS RETURNING BIG TIME - - -
Immediately label it "BABBLING" and be sure to call us
(he's been subtle e.g., repeating the end of our sentences
and tacking on "right?")
If RIGIDITY or BABBLING rear their ugly heads again, continue
to call US but be clear that this is the reason you called since
we will not time him out for this but instead will give him a
series of warnings that will culminate in a time out.
REMEMBER: We need to focus our time-outs on one item
at a time.
- Watch for his adding a SECOND REASON when you answer
one of his "why" questions, e.g., "and because..."
- Be aware of the "WHEN/WHERE" SUBSTITUTION.
Child: "Are we going to [place]?"
Ther: "No, we're going to McDonalds"
Child: "WHERE are we going to [place]?"
Correct him to "WHEN" (this is a good thing as he's now
attempting to ask "when" questions but is confusing it).
- SOCIALIZATION continues to be the other major deficit.
Always keep this in mind! He needs to improve his
initiation of social interactions as well as the maintaining of
these interactions. He also must start to accept initiations
from others.
- The other significant deficit is in the area of IMAGINATIVE
PLAY. Stimulate this (model, prompt whatever whenever
possible).
- AVOID AS MUCH AS POSSIBLE: "This is boring/interesting"
*same/differ
en
t"
*new/old"
- or any other opposites used to prevent him from doing a
repeat performance on something.
INSTEAD: Just re-direct him. He is perseverating on these
type of phrases particularly to other kids and they think it's
weird.
- You may resume using consequences to regain compliance
with the following set of rules:
- MUST BE CASUAL (SAID TO HIM ALMOST IN PASSING;
NEVER OVER-DO IT!)
- MUST BE NON-CONFRONTATIONAL!
- NEVER USE CONSEQUENCE YOU CAN'T DELIVER ON!
- TREAT HIM AS YOU WOULD A FRIEND/ADULT WHO
HAS A SILLY ANSWER
- NEVER USE SAME CONSEQUENCE TWICE IN A
ROW...OR OFTEN! Write what you use in "General" section
- AVOID LABELING WHAT YOU'RE CONSEQUATING --
HE'LL PROB GET THE MESSAGE
- ALWAYS use correction (said by you "in passing") if he uses
a wrong word
intentionally or otherwise in or out of drills.
Try not to prompt correct answer all the time -- which will
usually cause a power struggle if it's being done as a verbal
stim. Just let him know you heard what he said and say it
correctly for him ("You mean [correct word]") Listen for the
"-a" at end of words and and other silly stuff, ESPECIALLY
outside of drills. Use correction if he knocks things over
(have him pick up/clean up).
10. REMEMBER NEVER TO LET HIM STIM ON BREAK TIME
-- Get him back if he does but, especially here, ALWAYS
BE PLEASANT WHEN YOU CALL HIM BACK -- Show no
displeasure vocally -- He gets the message!!! In cases like
this, PLEASE SAVE YOUR RECORDING FOR LATER --
Make small note to yourself or stick paper in section you
didn't have time to write into. PREPARE YOURSELF
WITH LITTLE STRIPS OF PAPER BEFOREHAND IF YOU
MUST!
11. STOP HIM FROM RUNNING WHILE HE TALKS (ESP
BETWEEN DRILLS). PLEASE ALL get him on this every time.
Tell him that "In school this will not be accepted", etc.
Remember to use "(This is im)PROPER SCHOOL
BEHAVIOR" as often as needed. This seems to really work
well---so well he'll prob tell the teachers about it if we use it
often enough.
12. (FOR NOW) kill "sometimes we/I do and sometimes
we/I don't" and all similar statements.
13. VERY IMPORTANT....HE'S DOING THIS SO MUCH LATELY!!!!!!
After you reprimand him for doing something annoying (and
in general), listen for his: "What will I do if I [thing you just
nailed him on]" (DO NOT ACCEPT SILLY SENTENCES OF
HIS LIKE THIS) or "Why do I/don't I [thing he did wrong]?"
(prompt: "IT'S 'WHY CAN'T I...'") and in general watch for his
using the wrong "WH" word in question ("WHAT AM I GOING
TO" (prompt "WHERE...?") HE HAS BEEN USING "WHAT"
INCORRECTLY OFTEN LATELY.
14. CONTINUE KILLING ANY "BEFORE/AFTER/FIRST/LAST"
(PREDICTING) STUFF HE SAYS (FOR NOW - UNTIL WE
KNOW HE'S REPLACED THIS WITH NOT CARING ABOUT
HOW TO PREDICT EVERYTHING - EVEN IF IT TAKES
FOREVER!)
15. NEVER BE PREDICTABLE & ALWAYS MAKE THERAPY
A POSITIVE EXPERIENCE. Try harder than ever to avoid
power struggles! SCHOOL [w/shadow] BEGINS IN LESS
THAN ONE MONTH!
16. Try to keep therapy novel and interesting (MOVE AROUND
AND HAVE FUN!) but remember, even if he's sometimes
bored, he MUST LEARN TO TOLERATE BOREDOM (Life
isn't always interesting!) NEVER make excuses (he's tired,
bored, etc.) and ALWAYS, ALWAYS lots and lots of
BREAKS FOR DOING WELL. Remember: short verbal drills;
longer play drills.
17. NAIL BODY POSTURES INCLUDING:
Hand flapping when walking/running
Weird skipping while talking
Strange ways of standing, walking, etc.
Tell him he's acting strange/weird. Say "what are you
doing?"; "why are you walking like that?", etc. DO NOT
label this behavior "funny"; you must give your label a
negative spin (weird, strange, peculiar, bizarre).
18. WHEN CONVERSING WITH HIM TRY TO GET HIM TO
STICK TO THE GENERAL TOPIC
19. EXTINGUISH HAND FLAPPING WHEN HE RUNS!
============
#10
HEY YOU, THE RULES HAVE CHANGED AGAIN !!!!
SITTING STILL
MUST learn to control himself when bored - unfortunately,
he will have to tolerate lots of boredom in school.
- ONLY DO THIS WHEN YOU'RE WITH ANOTHER
THERAPIST (OR US)
- THIS WILL NOT BE A SPECIFIC DRILL BUT RATHER
SOMETHING YOU SHOULD DO WHEN THE
OPPORTUNITY PRESENTS ITSELF. OPPORTUNITIES
INCLUDE:
- WHEN WE'RE IN THE ROOM WITH YOU (or v.v.) AND
WE'RE SPEAKING
- WHEN YOU ARRIVE TO DO AN OVERLAP W/ ANOTHER
THERAPIST [Something we began doing when we needed
to simulate school environment more often]
- WHEN YOU NEED TO DISCUSS STRATEGIES WITH
THE OTHER THERAPIST OR EITHER OF US
- WHEN YOU'RE LEAVING AND TALKING TO US
- WHEN YOU (OR OTHER THERPIST) ARE LEAVING
JOINT DRILL TIME
HERE'S HOW YOU DO IT:
- NEUTRALLY TELL HIM IT'S TIME TO BE STILL, SIT STILL,
SIT QUIETLY (WHATEVER)
- START DISCUSSING WHATEVER YOU HAVE TO
DISCUSS WITH THE OTHER PERSON WHO WAS
ALREADY IN THE ROOM (MUST NOT BE AN ARTIFICIAL
SET UP...SEE EXAMPLES ABOVE).
- IF HE DOESN'T SIT STILL SAY STUFF LIKE: "Be still",
"Sit still", "Sit quietly", "Stop fidgeting", etc.
- START WITH ONLY A MINUTE OR SO OF THIS AND
BUILD UP TO SEVERAL MINUTES.
- DRO ALL PORTIONS OF HIS GOOD SITTING WHEN
HIS TIME IS UP
- WATCH HIS FEET/HANDS....AS ALWAYS, THIS IS THE
FIRST PLACE HE STARTS!
EXTENSIVE NOTES (IN "GENERAL") SHOULD INCLUDE:
a. What he did right/wrong
b. How long he's now capable of sitting still
(increase the time & test his limits and clock it!)
TIME OUTS
TALKING BACK: This includes ANY argument he gives you
("I can't", "I don't want to", "Why can't I..", etc.). This MUST
be old style. Be sure we're there immediately. DON'T LET HIM
GET AWAY WITH THIS! Be consistent in calling him on it.
WATCH OUT FOR:
- HIGH PITCH, SING SONG VOICE / WHINING. We're
going to label it first ("talk deeper"...) immediately followed
w/old VOCAL IMITATION method of modeling the phrase in
a voice too low & work it up to the right voice. We
will quickly fade this prompt based on your notes and
eventually just tell him "deeper", no "sing-song", etc. directly.
CONSULTANT SAID THIS IS A MAJOR PROBLEM WE
MUST TARGET NOW! SAYS IT'S BEEN REINFORCED
VERY MUCH BECAUSE IT WAS ONCE CUTE AS
WERE/ARE THE FOLLOWING PHRASES...
- THE FOLLOWING PHRASES: "Actually", "Sometimes".
These must be consistently corrected across all of you!
If you think there are other words/phrases that need
extinguishing, pls. let us know (write in "General" & tell us
just how critical it seems.
ALL NOTE PLEASE if you're heard/saw (in case of PHYSICAL
stims) same perseveration in your session.
[This became it's own second section AFTER "General" - we
called it "Perseverations" and then "Language". As w/"General"
section, even if therapists had nothing to report there, they had
to initial and date this section after each session--while continuing
reportage in "General" as well]
==================
#11
IN-SCHOOL NOTES [written more for shadows, though in the interest
of maintaining consistency all our therapists, five at this time,
received sheet]
- RAISING HAND - Prompt in school when teacher has group
things. Have at least one 4 kid-group with hand raising per
day. Hand Raising is now included in "LISTENING" to get
a Gold Star.
- FILLING THE NEW SPACES [downtime] HE GETS DURING
SCHOOL TIME
Set up a notebook for him and teach him lessons
Notebook: Write letters/construct simple words
Words that rhyme with cat (pat, hat...)
Words that start with the letter...
Words that start with the sound...
Circle the word that...(as above)