Up early today/patience

Up Early Today

It's Saturday, September 25, and I am up at 6:00 AM. There's a workshop on the North Shore for BCBAs, to teach them how to bill under the new Autism Insurance Act. And, since I am a BCBA as well as a Floortime Specialist, I am going. I hope to be able to provide some private consulting after-school hours to local families and school districts. So, I have a 45-minute drive, then workshop 9-1, then a 45-minute drive home.

Patience.

On Thursday and Friday I was a little tired, and I found myself just a little short of "affect" and patience. And it occurred to me that with the unpredictabilty of Floortime practice (because you follow the child's interests and leads) when a practitioner is a little under the weather, it's hard! I found myself longing for some structure, some checklists, some visuals, some reinforcers to help the kids do what I wanted them to do...and I realized how this might affect practitioners/parents everywhere. Sitting down at a table doing discrete trials might be easier. My legs wouldn't be stiff, I could run the programs, while sitting, and not have to be totally engaged, trying to make the right instant decisions to follow the child's lead, to expand his/her circles, to be engaged in play, to have a constant stream of questions running through my head.

And yet I am a firm believer in this method, in trying to help kids make decisions, follow through, engage and have fun, all the while learning skills. I also believe that there's a time and place for ABA....and I am beginning to see the power ABA has. A practitioner can take her data, graph it, see progress or no progress, make a program note to change something, and then implement it.  While working with these kids (and parenting them, too!) is certainly challenging no matter what method you use, in DIR/Floortime it is just that much harder to be present and creative.

And so I have my challenges set out for me.

A wonderfully different experience

Last night I went to a fabulous new movie called "See What I'm Saying", a documentary  about four Deaf entertainers. This movie is traveling the world, showing one night in each city/town. Tonight it is playing at a movie theater in Cotuit, MA. 


Many years ago, I studied American Sign Language at Northeastern University. I took several classes, then applied to a summer program in interpreter training. However, I was only-wait listed; by the following summer, I was working on my doctorate at BU (not in sign language, though). So I never became an interpreter, but never lost my fascination with sign. However, to be truly competent as a signer, as with any language, a person has to  keep using it, and I didn't.


But! This movie is truly fun, entertaining, heartbreaking, full of talent, music, (Yes, music!)  comedy, acting, and joy. Find a way to go see it. It may be back in Boston sometime!


Here's the link:


http://www.seewhatimsayingmovie.com/


Enjoy!

Thinking about the iPad for kids with autism

Wow.

I've just read two blogs about kids on the spectrum using the iPad as a leisure/entertainment device as well as a communication device AND as a social story device AND as a visual schedule device. I am so impressed! The first is called "We Go with Him", which I've mentioned before...it is a carefully, thoughtfully written blog by a mom who is a Latin and Greek scholar (and I have it in my reading list, but I usually find it just by Googling "We Go With Him"). In today's blog, she connects with another, more specific blog about the applications another child uses. Here is that link:

http://www.blogher.com/ipad-nearmiracle-my-son-autism

I am so impressed.  This blog made me want to run out and buy an iPad just to explore those apps that Leo uses....who'd ever have thought of all this?

Go read for yourself! And also check out these books/resources at Amazon.com:

If you read this....

Hi folks,

I am sort of a shy blogger, not sure where this is going, but someone made a comment to me the other day that she reads my blog. I hope others are reading it also, and I'd like to ask those of you who are reading this make a comment now and then...even just a "Hi, Sue". I'd love to hear from you.

Social Play and autism

I recently read an article by Jordan (2003) on social play and autism spectrum disorders that was fascinating. It starts by relating that it takes two strands of child development  to create social play: social/emotional development and cognitive development. Since play starts in interpersonal transactions, children on the spectrum are compromised perhaps from the beginning. They engage in less reciprocity with their caregivers, since they have social difficulties that often prevent social interaction.

What is play? It is one of those things about which we might say, "I can't define it, but I know what it is when I see it". Play has the following characteristics:

1. pleasurable and enjoyable
2. there is no goal imposed from the outside
3. it is spontaneous and voluntary
4.  involves some active engagement on the part of the player
5. it is something that can be distinguished from non-play (Garvey, 1977).

Child development experts assert this:

"In play a child always behaves beyond his average age, above his daily behavior....As in the focus of a magnifying glass, play contains all the developmental tendencies in a condensed form and is itself a major source of development" (Vygotsky, 1977).

Socially in play, the child starts as socially isolated, engaged in an exploration of himself, developing a sense of agency, and learning about cause and effect in relation to the world. Later s/he notices the play of others, plays alongside, then slowly becomes responsive to the overtures of others. (NOTE: Anyone who knows or who has ever raised a baby knows from experience that young babies, about three months of age, LOVE to watch other children at play). Social play starts with the first interactions with the caregiver, and play development mirrors emotional development.

So what do we do with kids on the spectrum who do not engage in social play? How can we get them to engage? First we try to develop shared attention in a relaxed manner with them, slowly involving them in reciprocal interactions. Eye contact, laughter, tickling, roughhousing, tossing a beach ball around, hiding a favorite toy, these are all ways to begin the process of developing self-initiated social play.

Typical children also develop cognitively through play. They explore roles, skills and strategies. Children with autism have three areas of difficulty that affect their ability to play:

1) Social processes: shared attention and understanding, emotional regulation and social competence.
2) Complexity of cognitive play, fostering longer and more complex interactions.
3) Social status: Evaluation of and by others.

Since play is at the heart of a child's growth and development, it is essential that we find ways to involve children on the spectrum in true, self-initiated play, slowly expanding their rituals and stereotypic play into more complex interactions. For those interested, here are some suggestions for further reading:













However, as I learn and read more, I will be writing more about this topic.

My playroom

 Here are a couple of photos of my playroom at one of the schools I service....at the moment, I do not have permission to use photos of the children with whom I work, unfortunately; I know that makes this blog a little less than lively.

I primarily do DIR/Floortime  with children on the autism spectrum. I am also a certified ABA analyst (BCBA) and continue to read and study the ABA literature. In my travels, I have the opportunity to sit in on many classrooms that use ABA as a teaching technique. For the most part, these are lively, fun classrooms. Kids are treated well, they have fun in school, and the teachers take great pride and joy in each child's accomplishments. My job is to try to figure out how to combine DIR/Floortime  in schools/classrooms where the primary belief system is ABA. More on that later~!

Last unofficial weekend of summer

Well, for those of us who work in schools, this is a big day. This is the last day of freedom before the children return. Now, I know that parents of children on the spectrum do not ever get a whole day off or a week; I am extremely sympathetic to that.

But today I have mixed feelings...I had the summer off due to surgery in July...and I miss my work the excitement of a child's joy in play,  the work with co-workers, working with the families, and just finding ways to encourage the children in their work and play. It's hard work, challenging, fun, and exhausting. But we professionals celebrate the progress each child makes....and so it begins again!

Quick thought: ABA, DIR/Floortime, and Play

Today I had the opportunity to attend a good workshop conducted by a colleague who is extremely well-versed in ABA....just about all my colleagues in the Autism Spectrum Disorders program were there, new hires and very experienced staff. The workshop was on Discrete Trial Training. (I often wonder why teachers don't cringe at the notion of "training" their students, rather than educating them, but that's just me).

Now that I have completed two Floortime classes, one Summer Institute and am on my way to becoming DIR/Floortime certified, (in addition to my teacher certification and ABA certification) I am more alert to the way we treat children and the importance of guiding children on the spectrum to play constructively. While I sat with about 25 ASD teachers and assistance while we were all being "trained" to do discrete trials, I became nervous. How can I as one person, with both points of view (ABA and Floortime) have an impact? Am I just a drop of water in a very large pond? I think that ABA is here to stay and needs to find its place; I also think we as educators need to expand our thinking about what constitutes 'teaching', 'training', and 'learning'.

And I don't mean this next statement to be inflammatory, but I am wondering if people are drawn to ABA because it is simple, it's fairly easy to learn (at least at the beginning stages),  and by taking meticulous data ad graphing it, they can see a child making progress, albeit slow. It is harder to measure progress in Floortime, harder to see the results.

So I think my question for this blog this year is: How do we meld the two? Or, perhaps it is, how do I meld the two?

Play and autism

During my time off, I spent a fair amount of time reading about playing. Play is a child's work, the way s/he learns to make sense of the world. It is not a waste of time!

What about kids on the spectrum? In 1979, Wing and Gould suggested that the features of autism might be categorized in three areas: problems in socialization, communication, and imagination. Generally, instead of creative pretend play, children on the spectrum tend to prefer routines and stereotypical behavior when they have free time and "play". In this type of play, there is no learning occurring, although perhaps it serves as a form of self-comfort. It has been shown in research (Solomon, 2007; Wolfberg, 2009) that children with autism can expand their pretend play. Wolfberg paired children with autism with typical peers and guided the play interaction, guiding both the typical peer and the child with autism, and she provides many examples of pretend play in her groups. Solomon and colleagues (2007) run a program called The PLAY Project in Michigan, I believe, with young children in Early Intervention Programs. They based their methods on Greenspan's DIR/Floortime model. Pre and post testing demonstrated that 45% of the children made god to very good progress.

So, we know that play can be improved in children with autism. Who is responsible for helping with this? Parents, trained by university personnel? After-school program teachers, classroom teachers and aids? In a short school day (6 hours) with many goals on a child's IEP, when will a teacher have time to 'play' with the kids? How do we get the parents involved? To be honest, schools bear the responsibility to educate the child, but a six-hour school day alone cannot remedy everything; parents, guardians, and caretakers have to be involved.

Play does build cognitive, social and emotional growth (Elkind,  2007).  So, how do we bring play into schooling for kids on the spectrum?