TOUCH.....is a very powerful sensory experience!
Just think about it... when you shake a person's hand for the first time, what feelings go shooting through your body when the connection is made? Is this person strong, secure, dominant, or weak, wimpy, afraid or even wet and sweaty? Lots of different types of touch influences our daily lives. Think of a scratchy wool sweater, or cashmere socks tickling your toes. What if someone from behind you comes up and tickles you, or if someone gave you a nice tight hug? For each individual it can be a totally different experience. What one person might love, another might hate. As different feelings of touch occur throughout the day, it effects our ability to focus or not focus on tasks, increase or decrease our anxiety, make us feel happy, sad, relaxed, and even angry. It is important to keep in mind that not everyone interprets touch in the same way. We need to be empathic, when it comes to feelings of others concerning the power of TOUCH.
Sarah OT
Saturday, February 10, 2007
Friday, February 9, 2007
Man on Bicycle
One of our parents wrote this essay and gave us permission to share it with you here. It paints a wonderful picture of the importance of broadband communication and meaning-making between people. Thanks to Penny Ray for sharing this with us and for allowing us to share it with others.
I was at a busy intersection at rush hour, (Green Lake and Pontiac Trail) and I was the first car stopped at a red light in a left-turn lane. This intersection is always crazy, with people turning right on red from two different locations at the intersection. And drivers ignore red lights, and instead try to push two or three cars past the red light in each cycle.
A driver in my left-turn position, can't immediately hit the gas pedal when the green turn arrow appears. Rigidly following rules and laws (The law is go on green, stop on red) don't apply here, where other drivers are ignoring the law and pushing through their red lights and ruining my “green means go” opportunity. I must try to determine the intentions of the other drivers by their speed as their side of the light shifts to yellow.
On this day at the intersection, my wait for a green turn arrow is complicated by something unexpected. A young man on a bicycle approached on the sidewalk to my right, and his bicycle wheels are pointed to cross in the street directly in front of me.
I watched as he looked around in all directions, far up the road ahead to see how long the line of traffic turning into his projected path is. He looked at the line of cars turning right, directly in front of him. The button to prompt the light to change doesn’t work when he presses it. He scanned the situation in all directions again, saw a possible window of opportunity, and he put one foot on a pedal, leaned forward in his seat. I knew that he was preparing to take a chance against the "don't walk" sign.
Finally, he looked right at me; we made eye contact for a moment. He knew that I saw him. That's important, because his safety is at stake. He doesn't want me turning left on my green arrow if he makes a dash across the road in front of me at that same time. In that brief moment, where our eyes touched, we shared an experience. He needed to know that I saw him, needed to know that I recognized his communicative intent to cross that street, because when our eyes touched, I acknowledged that I knew he might try to cross in front of me without regard to the "don't walk" signal.
Watching him, silently, from my car, I "read" all sorts of communicative intent in this young man's body language. We did not have a conversation with spoken words, but I clearly saw meaning in his movements; I clearly saw his intentions, and he saw mine: His body language told me that he knew the intersection is dangerously busy; that he was going to try to cross in front of me; and that he needed to know that I saw him. He knew that I wanted to turn left when I saw the green arrow.
(Interestingly, my two minutes were spent shifting attention between the young man and the traffic lights. I did not consciously think about the experience we shared until after I returned home and sat down to write about it. I didn’t encode the color of his bicycle or his clothing in my memory. Our children on the autism spectrum have difficulty with both attention shifting, which is also a piece of non-verbal communication and experience sharing, and they tend to overemphasize unimportant elements of communication.)
Ultimately, traffic never paused long enough for the young man to cross the street while I was there, and I made my left turn and went on my way. A lot of experience sharing, meaning making happened in a couple of minutes. And then he and I moved on to meet new meaning to make, new situations to experience and navigate in dynamic ways.
Before RDI®, we taught our child that communication is about things spoken: words, talk, length of utterance, mands, tacts. Until RDI®, I never thought about communication being described as experience sharing or meaning making. One of the core deficits of autism is experience sharing. I never considered just how much experience sharing we do that is non-verbal, that happens as we don’t consciously think about it as we’re processing it. But now, having a child with autism and learning about relationship development, I’m paying attention to aspects of communication I’ve previously taken for granted. And nowhere is this new awareness spotlighted like it is when I am behind the wheel of a car, where I richly share experiences with other drivers, but without the benefit of “talk”.
I think back to when we began intervening before she was two years old, and wonder, "What was I thinking?" When we began intervening at home with our child, one of the very first steps was "Look at me." And then we did one of two bizarre things: We prompted her to complete a gross motor imitation (“Do this!”), or we gave her a visual field of three answers, asked her a question, and, to keep the data “clean”, we refused to look at the correct response with our faces, teaching her a) that communication is about looking and copying and b) that human faces do not share information.
How we must have confused my child. What was the point of teaching "Look at me?" I wonder, if we were going to discourage looking at me in situations where our child could actually practice referencing for communicative intent, for information? Look at me; then don’t look at me! Talk about a mixed message! And if non-verbal back-and-forth interactions are a prototype for dialogue and conversation, then is “Look at me” + “Do this” a prototype for echolalia?
We gave her words, phrases, sentences, skills upon skills, all without giving her any inkling of communication outside the one channel of talk. Often we told her, “GOOD JOB LOOKING!” as if eye contact and “looking” is an end in itself, and again, we reinforced that communication is not about experience sharing, not about meaning making, not about recognizing errors and breakdowns and making repairs. We failed to show her that there is meaning and communication in the direction a person faces when he speaks, that there is meaning to read from the eyes, faces, hands, gestures, pitch, volume and tone of voices of others.
We wondered why we saw so much echolalia in our daughter; wondered why she recalled bits and pieces of information that were so drastically different from the rest of us, like the color of a single object we’d seen instead of a broader memory of the fun and excitement in the experience we’d shared together. Could we possibly have taught her to communicate and encode experiences in the way she was demonstrating? And if so, could we give her a “do-over” in those areas and the other core deficit areas? The answer is an exciting YES!
I now know that an early part of typical infant and toddler emotional and social development is to practice what to do in uncertainty, which is watching Mom's and Dad's faces for information, clues, signals, experience sharing, meaning making which leads to active participation in interaction at a non-verbal level. It’s recognizing errors and breakdowns and making repairs. Part of a mind is understanding the perspective of another person based upon where that person looks and glances, based upon his actions; it's seeing the quiet wink that says "I love you" or a slight movement of exasperation with your eyes that lets me know you think the singers entertaining us at the fancy dinner are, well, horrible. Another part of a mind is understanding my half of that interaction.
The Michigan Department of Education words it this way in the English Language Arts Vision Statement, from Standard 7. Skills and Processes: Effective communication depends upon our ability to recognize when attempts to construct and convey meaning work well and when they have broken down. We must monitor, reflect, and adjust our communication processes for clarity, correctness, purpose, and audience. We need multiple strategies for constructing and conveying meaning in written, spoken and visual texts. Our literacy development depends upon on-going, personal-self-regulated assessment.
Dr. Gutstein defines communication “…as the desire to determine the relationship between what is in your mind and what is in my mind…”. Before RDI®, I always assumed that communication is mostly about spoken words and rules of grammar, syntax, social rules. I realized at that intersection that I use a lot of meaning making, experience sharing that has nothing to do with talking, words, length of utterance, social skills, and all in a matter of a minute or two. The many channels of communication serve me for this dynamic moment, and are then forgotten as I encounter a new moment to appraise, a new experience to share. We want nothing less for our children.
A relationship approach has made an incredible difference, and has given me new hope. I love moments when I’m searching in the pantry for something and my daughter walks into the kitchen and asks, “Mom, what are you looking for?” or when I’m getting ready to go somewhere, and she asks, “Mom, where are you going?” She’s seeing intent in my actions, seeing my perspective!
When the eyes of the young man on the bicycle met mine, we were not engaging in social skills, and we were not just making eye contact for the sake of making eye contact. A rote rule from a social skills course would fall short in this situation. We did not have a "Look at me!" moment. Instead, we "danced" briefly; we exchanged important meaning non-verbally, with gestures and facial expression and body language, which, at that moment, impacted his safety.
I want all of my children to experience that kind of "dancing".
A driver in my left-turn position, can't immediately hit the gas pedal when the green turn arrow appears. Rigidly following rules and laws (The law is go on green, stop on red) don't apply here, where other drivers are ignoring the law and pushing through their red lights and ruining my “green means go” opportunity. I must try to determine the intentions of the other drivers by their speed as their side of the light shifts to yellow.
On this day at the intersection, my wait for a green turn arrow is complicated by something unexpected. A young man on a bicycle approached on the sidewalk to my right, and his bicycle wheels are pointed to cross in the street directly in front of me.
I watched as he looked around in all directions, far up the road ahead to see how long the line of traffic turning into his projected path is. He looked at the line of cars turning right, directly in front of him. The button to prompt the light to change doesn’t work when he presses it. He scanned the situation in all directions again, saw a possible window of opportunity, and he put one foot on a pedal, leaned forward in his seat. I knew that he was preparing to take a chance against the "don't walk" sign.
Finally, he looked right at me; we made eye contact for a moment. He knew that I saw him. That's important, because his safety is at stake. He doesn't want me turning left on my green arrow if he makes a dash across the road in front of me at that same time. In that brief moment, where our eyes touched, we shared an experience. He needed to know that I saw him, needed to know that I recognized his communicative intent to cross that street, because when our eyes touched, I acknowledged that I knew he might try to cross in front of me without regard to the "don't walk" signal.
Watching him, silently, from my car, I "read" all sorts of communicative intent in this young man's body language. We did not have a conversation with spoken words, but I clearly saw meaning in his movements; I clearly saw his intentions, and he saw mine: His body language told me that he knew the intersection is dangerously busy; that he was going to try to cross in front of me; and that he needed to know that I saw him. He knew that I wanted to turn left when I saw the green arrow.
(Interestingly, my two minutes were spent shifting attention between the young man and the traffic lights. I did not consciously think about the experience we shared until after I returned home and sat down to write about it. I didn’t encode the color of his bicycle or his clothing in my memory. Our children on the autism spectrum have difficulty with both attention shifting, which is also a piece of non-verbal communication and experience sharing, and they tend to overemphasize unimportant elements of communication.)
Ultimately, traffic never paused long enough for the young man to cross the street while I was there, and I made my left turn and went on my way. A lot of experience sharing, meaning making happened in a couple of minutes. And then he and I moved on to meet new meaning to make, new situations to experience and navigate in dynamic ways.
Before RDI®, we taught our child that communication is about things spoken: words, talk, length of utterance, mands, tacts. Until RDI®, I never thought about communication being described as experience sharing or meaning making. One of the core deficits of autism is experience sharing. I never considered just how much experience sharing we do that is non-verbal, that happens as we don’t consciously think about it as we’re processing it. But now, having a child with autism and learning about relationship development, I’m paying attention to aspects of communication I’ve previously taken for granted. And nowhere is this new awareness spotlighted like it is when I am behind the wheel of a car, where I richly share experiences with other drivers, but without the benefit of “talk”.
I think back to when we began intervening before she was two years old, and wonder, "What was I thinking?" When we began intervening at home with our child, one of the very first steps was "Look at me." And then we did one of two bizarre things: We prompted her to complete a gross motor imitation (“Do this!”), or we gave her a visual field of three answers, asked her a question, and, to keep the data “clean”, we refused to look at the correct response with our faces, teaching her a) that communication is about looking and copying and b) that human faces do not share information.
How we must have confused my child. What was the point of teaching "Look at me?" I wonder, if we were going to discourage looking at me in situations where our child could actually practice referencing for communicative intent, for information? Look at me; then don’t look at me! Talk about a mixed message! And if non-verbal back-and-forth interactions are a prototype for dialogue and conversation, then is “Look at me” + “Do this” a prototype for echolalia?
We gave her words, phrases, sentences, skills upon skills, all without giving her any inkling of communication outside the one channel of talk. Often we told her, “GOOD JOB LOOKING!” as if eye contact and “looking” is an end in itself, and again, we reinforced that communication is not about experience sharing, not about meaning making, not about recognizing errors and breakdowns and making repairs. We failed to show her that there is meaning and communication in the direction a person faces when he speaks, that there is meaning to read from the eyes, faces, hands, gestures, pitch, volume and tone of voices of others.
We wondered why we saw so much echolalia in our daughter; wondered why she recalled bits and pieces of information that were so drastically different from the rest of us, like the color of a single object we’d seen instead of a broader memory of the fun and excitement in the experience we’d shared together. Could we possibly have taught her to communicate and encode experiences in the way she was demonstrating? And if so, could we give her a “do-over” in those areas and the other core deficit areas? The answer is an exciting YES!
I now know that an early part of typical infant and toddler emotional and social development is to practice what to do in uncertainty, which is watching Mom's and Dad's faces for information, clues, signals, experience sharing, meaning making which leads to active participation in interaction at a non-verbal level. It’s recognizing errors and breakdowns and making repairs. Part of a mind is understanding the perspective of another person based upon where that person looks and glances, based upon his actions; it's seeing the quiet wink that says "I love you" or a slight movement of exasperation with your eyes that lets me know you think the singers entertaining us at the fancy dinner are, well, horrible. Another part of a mind is understanding my half of that interaction.
The Michigan Department of Education words it this way in the English Language Arts Vision Statement, from Standard 7. Skills and Processes: Effective communication depends upon our ability to recognize when attempts to construct and convey meaning work well and when they have broken down. We must monitor, reflect, and adjust our communication processes for clarity, correctness, purpose, and audience. We need multiple strategies for constructing and conveying meaning in written, spoken and visual texts. Our literacy development depends upon on-going, personal-self-regulated assessment.
Dr. Gutstein defines communication “…as the desire to determine the relationship between what is in your mind and what is in my mind…”. Before RDI®, I always assumed that communication is mostly about spoken words and rules of grammar, syntax, social rules. I realized at that intersection that I use a lot of meaning making, experience sharing that has nothing to do with talking, words, length of utterance, social skills, and all in a matter of a minute or two. The many channels of communication serve me for this dynamic moment, and are then forgotten as I encounter a new moment to appraise, a new experience to share. We want nothing less for our children.
A relationship approach has made an incredible difference, and has given me new hope. I love moments when I’m searching in the pantry for something and my daughter walks into the kitchen and asks, “Mom, what are you looking for?” or when I’m getting ready to go somewhere, and she asks, “Mom, where are you going?” She’s seeing intent in my actions, seeing my perspective!
When the eyes of the young man on the bicycle met mine, we were not engaging in social skills, and we were not just making eye contact for the sake of making eye contact. A rote rule from a social skills course would fall short in this situation. We did not have a "Look at me!" moment. Instead, we "danced" briefly; we exchanged important meaning non-verbally, with gestures and facial expression and body language, which, at that moment, impacted his safety.
I want all of my children to experience that kind of "dancing".
Thursday, February 8, 2007
Non-verbal Communication
As promised last week I am going to talk about my observations of non-verbal communication. It is amazing how relevant these topics become when you really start to focus and think about them.
This past Friday we held a teacher workshop at Horizons talking about the core deficits of autism and ways that school personnel can make changes to improve those deficits. Of course one of the topics and activities that we talk about is communication. Nicole started this portion of the workshop by showing the short film One Man Band which is on the Cars dvd. I had never seen this short film, but it is an excellent example of how non-verbal communication can be used to convey an entire story. No words are used in this film, but the meaning can be derived simply by the actions, expressions and music made by the characters. Amazing!
Following this we split the attendees into groups and give each group a prop to use together. The rule is that there is no talking allowed, but they must find a way to use the material together as a group. This is one of my favorite activities because I love to see how people will try to communicate and work together without words. Some of the groups had no problem. One person took charge and then the others followed such as the bean bag group. They divided the bean bags equally and then began tossing them one at a time into the bucket. The card group also divided up the cards and then started to drop them on the floor into sorted number groups. The first person to get rid of all of their cards won. However the group that had the index cards, tape, scissors and paper clips started by sharing the materials, but then just worked independently of each other. No true communication going on or cooperation other than if someone needed the scissors or tape. The amount of gestures and animated facial expressions increased during this exercise. I think it is fascinating to see how different people try to communicate especially with people they don’t know.
As far as my other observations go I was walking down the hall behind a teacher and a student one day here at school. The student began by following her teacher, but when he put his hand behind his back and used a gesture to indicate that she should walk next to him she immediately interpreted that gesture and moved to walk by him. One night a few weeks ago we were meeting with a group of parents while Nicole was talking I was observing and one parent had his head turned and was looking off to the side with a passive look on his face. I wondered if he was listening. A few minutes later he came up with a great question that proved he had been listening, but his non-verbals sure weren’t communicating that. One more great example, yesterday I went to a classroom to pick up a student with asd for his speech session. As I went into the room I had my arms folded across my chest. He said to me “Why are you nervous?” After standing there for a minute stunned and trying to think why he would say that it hit me that he was interpreting my folded arms as my being nervous. I quickly assured him I wasn’t nervous just cold. Just think if that is the way he was interpreting my folded arms how often we guess what other people are thinking by what their body is telling us and how wrong we might be.
So for my words of wisdom this week just be careful of what your non-verbal communication might really be “saying” to other people. Next week I’ll be talking about processing as it relates to communication.
Till then,
Erin
This past Friday we held a teacher workshop at Horizons talking about the core deficits of autism and ways that school personnel can make changes to improve those deficits. Of course one of the topics and activities that we talk about is communication. Nicole started this portion of the workshop by showing the short film One Man Band which is on the Cars dvd. I had never seen this short film, but it is an excellent example of how non-verbal communication can be used to convey an entire story. No words are used in this film, but the meaning can be derived simply by the actions, expressions and music made by the characters. Amazing!
Following this we split the attendees into groups and give each group a prop to use together. The rule is that there is no talking allowed, but they must find a way to use the material together as a group. This is one of my favorite activities because I love to see how people will try to communicate and work together without words. Some of the groups had no problem. One person took charge and then the others followed such as the bean bag group. They divided the bean bags equally and then began tossing them one at a time into the bucket. The card group also divided up the cards and then started to drop them on the floor into sorted number groups. The first person to get rid of all of their cards won. However the group that had the index cards, tape, scissors and paper clips started by sharing the materials, but then just worked independently of each other. No true communication going on or cooperation other than if someone needed the scissors or tape. The amount of gestures and animated facial expressions increased during this exercise. I think it is fascinating to see how different people try to communicate especially with people they don’t know.
As far as my other observations go I was walking down the hall behind a teacher and a student one day here at school. The student began by following her teacher, but when he put his hand behind his back and used a gesture to indicate that she should walk next to him she immediately interpreted that gesture and moved to walk by him. One night a few weeks ago we were meeting with a group of parents while Nicole was talking I was observing and one parent had his head turned and was looking off to the side with a passive look on his face. I wondered if he was listening. A few minutes later he came up with a great question that proved he had been listening, but his non-verbals sure weren’t communicating that. One more great example, yesterday I went to a classroom to pick up a student with asd for his speech session. As I went into the room I had my arms folded across my chest. He said to me “Why are you nervous?” After standing there for a minute stunned and trying to think why he would say that it hit me that he was interpreting my folded arms as my being nervous. I quickly assured him I wasn’t nervous just cold. Just think if that is the way he was interpreting my folded arms how often we guess what other people are thinking by what their body is telling us and how wrong we might be.
So for my words of wisdom this week just be careful of what your non-verbal communication might really be “saying” to other people. Next week I’ll be talking about processing as it relates to communication.
Till then,
Erin
Wednesday, February 7, 2007
Episodic Memory
Episodic memory is one of the more difficult core deficits to really grasp and to understand both conceptually and also to know when we see it being remediated in those with autism. First I'm going to give you a quick description of what episodic memory is and then give some examples we have heard or seen in some of our current families. It's my hope that you'll be able to recognize the little moments of episodic memory being formed in your child's life if you are a parent of a child with autism.
Episodic memory can also be know as an autobiographical memory. Think about it as a picture of our past strongly anchored by our emotional memories. Daily we use these pictures of our past to adapt the way we do things now. Those with autism don't have the ability to readily pull from their past to help them think about how to do thing differently today or to help them remember what the most important part of the memory was supposed to be.
An example of the deficit of episodic memory:
A family of mine shared an experience of going to grandpa's house. Whenever their son with autism would see grandpa, they would run off to the back yard and do special grandpa time playing with things in the shed. After this boy's grandfather passed away he continued to run out to the shed when he would go to grandpa's house and do the same things he would do with his grandpa. The memories of going to grandpa's house were encoded as playing in the shed. The memories were not being encoded as going to grandpa's house and playing with grandpa in the shed. Notice the difference? The procedural memory was there, the emotional memory of that being a special moment with grandpa was not.
Examples of seeing episodic memory:
The boy mentioned above (I'll call him "Sam") was playing a game of catch with dad. As dad was playing he would occasionally throw the ball away and "Sam" would run and get the ball. After doing this a few times dad would switched locations on "Sam" so "Sam" had to find a new spot to stand in order to continue the game. The second time dad threw the ball away, "Sam" looked back to catch dad in the moment of moving. "Sam" was able to remember dad's action from before and adjust his actions in the future to catch dad in the action.
"James" gets up at 7:00 a.m. to catch the bus at 7:45. One day he goes out to get on the bus and the bus had shown up at 7:40. He had missed the bus. "James" realized that he needed to do something different in the future to ensure that he wouldn't miss the bus again. That night he set his alarm for 6:55 to make sure he had plenty of time to get ready. He took a memory from the past, figured out what he needed to do to fix it and applied it to his future! What an awesome discovery for "James"!
It's critical that we slow things down for those with autism and "spotlight" the moments that are important in the activity so they know what to remember. Simple things like "wow, we made a nice tower" can help to encode memories of doing something with another person and also increase their competence to want to build a tower again in the future. Helping them to solve a problem, or letting them help solve a problem for you can help them to encode memories of coming up with other solutions to challenge. The ideas can go on and on of what we can do to help encode these memories. The most important? Slow life down to speed up.
Next week - flexible thinking!
Until then,
Michelle
Episodic memory can also be know as an autobiographical memory. Think about it as a picture of our past strongly anchored by our emotional memories. Daily we use these pictures of our past to adapt the way we do things now. Those with autism don't have the ability to readily pull from their past to help them think about how to do thing differently today or to help them remember what the most important part of the memory was supposed to be.
An example of the deficit of episodic memory:
A family of mine shared an experience of going to grandpa's house. Whenever their son with autism would see grandpa, they would run off to the back yard and do special grandpa time playing with things in the shed. After this boy's grandfather passed away he continued to run out to the shed when he would go to grandpa's house and do the same things he would do with his grandpa. The memories of going to grandpa's house were encoded as playing in the shed. The memories were not being encoded as going to grandpa's house and playing with grandpa in the shed. Notice the difference? The procedural memory was there, the emotional memory of that being a special moment with grandpa was not.
Examples of seeing episodic memory:
The boy mentioned above (I'll call him "Sam") was playing a game of catch with dad. As dad was playing he would occasionally throw the ball away and "Sam" would run and get the ball. After doing this a few times dad would switched locations on "Sam" so "Sam" had to find a new spot to stand in order to continue the game. The second time dad threw the ball away, "Sam" looked back to catch dad in the moment of moving. "Sam" was able to remember dad's action from before and adjust his actions in the future to catch dad in the action.
"James" gets up at 7:00 a.m. to catch the bus at 7:45. One day he goes out to get on the bus and the bus had shown up at 7:40. He had missed the bus. "James" realized that he needed to do something different in the future to ensure that he wouldn't miss the bus again. That night he set his alarm for 6:55 to make sure he had plenty of time to get ready. He took a memory from the past, figured out what he needed to do to fix it and applied it to his future! What an awesome discovery for "James"!
It's critical that we slow things down for those with autism and "spotlight" the moments that are important in the activity so they know what to remember. Simple things like "wow, we made a nice tower" can help to encode memories of doing something with another person and also increase their competence to want to build a tower again in the future. Helping them to solve a problem, or letting them help solve a problem for you can help them to encode memories of coming up with other solutions to challenge. The ideas can go on and on of what we can do to help encode these memories. The most important? Slow life down to speed up.
Next week - flexible thinking!
Until then,
Michelle
Tuesday, February 6, 2007
Apples and Tuna Fish
I recently watched from afar as a group of people on a message board argued vehemently back and forth over the merits of various autism treatments, particularly ABA and RDI®. There were strong sentiments on both sides and the battle became quite heated at times. Statistics were thrown around as evidence that ABA methodologies (discrete trial, pivotal response training, verbal behavior, etc.) are “proven” treatments for autism. Those on the RDI® / other therapy side of things went for the quality of life argument and gave testimony to their experience of ABA treatments not working for them.
I always find it interesting, if not a bit absurd, to listen to these kinds of arguments because it’s the equivalent of comparing two totally different things. It’s not even comparing apples to oranges, it’s like comparing apples and tuna fish! To engage in a discussion of the merits of any treatment (for any disorder), we need to start by examining what is being treated. In order to determine whether or not a treatment is appropriate and may be successful, we need to know what it is we are treating and what we want the outcome to be. Here is an oversimplified example: If I get a cold I may want to take cold medicine to help me feel better. When I go to the pharmacy there are 50 different kinds of cold medicine on the shelf for me to choose from. In order to make a good choice I need to know what my symptoms are and what I want the desired outcome to be. If I have a stuffy nose and sinus pain I will probably choose a different medicine than if I have a runny nose and a bad cough. I wouldn’t take cough medicine and then wonder why it didn’t take care of my stuffy nose – that wouldn’t make sense!
Now let's take this and apply the same line of thinking to autism treatment. If I have a child with autism I will most likely want to do something to help them make improvements in areas of deficit for them. As a parent we all want the best quality of life possible for our children! There is an array of options out there as far as autism “treatments”, and just like the cold medicine example we need to make a choice. In order to make a sound choice we need to know what the issues are that we are trying to treat and then choose the treatment that addresses those problems.
ABA-type therapies (insert your choice of specific method) have been shown to accomplish things such as improving academic skills, teaching self-care skills, and reducing inappropriate or maladaptive behaviors. There is a solid amount of research to show that this type of teaching / treatment is effective at addressing these skills areas. If a parent were interested in treating those areas, then ABA-type therapies would be a logical choice for them to make as a treatment for their child.
RDI® focuses on the developmental foundations for abilities such as flexible thinking, self-awareness, and reciprocal relationships with others, which begin to form in neurotypical children from birth. The goal is to help parents learn to guide their child through a developmental sequence that leads to the child becoming competent in the areas that they currently are not due to their autism. If a parent wants to address these developmental foundations for their child then RDI is the logical choice in terms of treatment.
When you look at treatment through this lens – what needs to be treated and what each treatment addresses – we see that comparisons need to be made very carefully. Once we know that two treatments, such as ABA and RDI, address totally different things, to compare them to each other doesn’t make sense. It’s the equivalent of comparing a cold medicine that reduces coughing to a cold medicine that clears a stuffy nose – they don’t do the same thing so you can’t begin to compare them on outcomes. It’s the equivalent of comparing apples to tuna fish!
There are obviously other factors that impact the process of making treatment decisions, and I plan to explore them in upcoming posts as I think this is an important issue that deserves attention. My main point here, though, is that it is critical to understand the goals of various treatments in order to best align them with a child’s needs. As parents we need to critically analyze any treatment for any problem by comparing what our child needs to the outcome goals for various treatments. It’s not necessarily about one being better or worse than another, it’s about knowing what obstacles autism creates for your child’s development and then determining which treatment outcomes best address them. Next week I am going to focus on the process of prioritizing a child’s needs in relation to treatment and how this plays a major role in treatment selection. In relation to this discussion on treatment outcomes and aligning needs with treatment, I would encourage readers to review Michelle’s ongoing discussion of the core deficits of autism. Check back in the blog archives to see her posts on this topic that goes hand in hand with making treatment decisions.
Until next week,
Nicole
Friday, February 2, 2007
Get started - but it's not a race!
Again, since everyone talked about so many different topics this week, I'll have to branch out on my own as well. So, thanks to Nicole for finding this quote.
"How you start is important, but in the end it is how you finish that counts.
"How you start is important, but in the end it is how you finish that counts.
It is easier to be a self-starter than a self-finisher.
The victor in the race is not the one who dashes off swiftest but the one who leads at the finish.
In the race for success, speed is less important than stamina.
The sticker outlasts the sprinter in life's race.
The sticker outlasts the sprinter in life's race.
In America we breed many hares but not so many tortoises."
-B.C. Forbes
-B.C. Forbes
Start making a difference in your child's life. You need to be the one to "take the bull by the horn" and make something happen. Stick with it - don't give up! Be a tortoise (even though they are slower) rather than a hare - make a difference!
Have a great weekend!
Betsy
Thursday, February 1, 2007
Communication - What happens when it breaks down?
I know I said I would be talking about my observations of non-verbal communication today, but something came up this week that I have been thinking a lot about and it ties in with communication so I am going to blog about that this week and come back to my observations next week. Plus that will just give me more time to observe. So today I am going to write about what happens when there is communication breakdown.
We’ve all been there you think you told someone something and you didn’t or the way you said something led the listener to misinterpret your meaning. This happens all the time on a day to day basis. Most of the time this isn’t a big deal and can be easily corrected. Unfortunately sometimes it can cause a problem, hurt someone’s feelings or make someone mad. It can become an even bigger issue if it happens over and over again.
In my job here in the schools one of my responsibilities is to oversee the para-professionals that work with our autism spectrum disorder students in the general education setting. This week a para-pro switch was made without consulting me. I found out second hand that this was happening. Ultimately the principal and special education director are responsible for assignments and determining where the greatest need is at the time which is great and I don’t want that responsibility. It just makes it difficult when the lines of communication don’t always flow smoothly. It makes planning hard and breaks down trust and respect. The funny thing is that this situation ties in directly with appraisal which is what Michelle blogged about yesterday. If a little appraisal had taken place earlier then this situation could have been handled a bit better and it wouldn’t have been a case of needing to put a fire out, but preventing the fire from happening in the first place.
I think about this in terms of the communication difficulties that our students on the spectrum have and what happens when we are not able to communicate clearly with them. How frustrating that must be and no wonder they go back to static patterns. My reaction when things like this happen is to be mad or upset and to then sometimes just not care (which isn’t really the best reaction, but a human one). If that is my reaction then no wonder our students on the spectrum react the way they do.
Okay, enough complaining on my part. I challenge each of you to really think about your communication. Are you being clear, is there some other way of saying what you need to say, have you communicated with everyone necessary in that particular situation? Next week back to observing non-verbal communication.
Talk to you soon,
Erin
We’ve all been there you think you told someone something and you didn’t or the way you said something led the listener to misinterpret your meaning. This happens all the time on a day to day basis. Most of the time this isn’t a big deal and can be easily corrected. Unfortunately sometimes it can cause a problem, hurt someone’s feelings or make someone mad. It can become an even bigger issue if it happens over and over again.
In my job here in the schools one of my responsibilities is to oversee the para-professionals that work with our autism spectrum disorder students in the general education setting. This week a para-pro switch was made without consulting me. I found out second hand that this was happening. Ultimately the principal and special education director are responsible for assignments and determining where the greatest need is at the time which is great and I don’t want that responsibility. It just makes it difficult when the lines of communication don’t always flow smoothly. It makes planning hard and breaks down trust and respect. The funny thing is that this situation ties in directly with appraisal which is what Michelle blogged about yesterday. If a little appraisal had taken place earlier then this situation could have been handled a bit better and it wouldn’t have been a case of needing to put a fire out, but preventing the fire from happening in the first place.
I think about this in terms of the communication difficulties that our students on the spectrum have and what happens when we are not able to communicate clearly with them. How frustrating that must be and no wonder they go back to static patterns. My reaction when things like this happen is to be mad or upset and to then sometimes just not care (which isn’t really the best reaction, but a human one). If that is my reaction then no wonder our students on the spectrum react the way they do.
Okay, enough complaining on my part. I challenge each of you to really think about your communication. Are you being clear, is there some other way of saying what you need to say, have you communicated with everyone necessary in that particular situation? Next week back to observing non-verbal communication.
Talk to you soon,
Erin
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