Monthly Archives: February 2013

I’m done with this; now where do I put it?

13 Wednesday Feb 2013

Posted by in Behavior Analysis, Behavioral Cusp, Early Intervention, Education

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This is a story about a little girl, about five years old. Before she learned where things went, she learned where they DIDN’T go.

(First, a note to the teacher or student in all of us: Do you notice that adults often tell us what NOT to do? Sometimes it’s easier for adults to think about what NOT to do than what TO do.

But do you also notice that when little children hear what NOT to do, they don’t automatically understand what TO do?

This makes sense!

If it’s hard for US to articulate, it’s even more difficult for children or students to understand.

It takes practice, but you can learn to give almost ALL instructions or requests, in a way that lets the person know exactly what to do.

It’s the first lesson of being a great therapist, and it’s better than wishing a significant other could read your mind.

And you can do it. These stories show two different ways this strategy could be used.)

Carlie was a little artist and avid reader, and with alone time, loved nothing better than taking out ALL the art supplies, all the stuffed animals who needed to watch, and surrounding herself in the bedroom with piles and piles of STUFF. She changed clothes often, and changed shoes just as often, and the piles grew every afternoon.

Often at night, before getting tucked into bed, she scrambled to push the piles to the corners, and artfully arranged pillows over the piles. Other piles she pushed under her bed, where a perfectly positioned bedskirt hid them from mama’s eyes during a bedtime story or conversation about kids at kindergarten that day.

And it worked for a while. But one rainy Saturday morning, her other chores were all finished, and Mama said the dreaded phrase: “Why don’t you clean your room? I can help if you need me to.”

No! Not the offer to help! And sure enough, the little girl sat sobbing on the floor for what seemed like hours, as Mama lay on the bed, sometimes only her feet showing, as she pulled out pile after pile of clothing, moldy bowls and cups, ruined art projects and half-eaten cereal science projects. And the little girl was embarrassed, for now Mama knew her messy (somewhat naughty) secret.

But wait!

Now that Mama knew the secret, Mama could solve the problem. Now she knew that the REAL secret was this: The little girl, even after all this time, had no idea where to put things! At least, it hadn’t “stuck”. Now, Mama and the little girl organized the room TOGETHER. The little girl decided where everything went. Mama helped her make places for things: they hung up a net for stuffed animals, Carlie made colorful signs labeling spots for books, art supplies, and even “things to take to the kitchen”! Now she had a place to put everything. And Mama had a much more specific way to help. Saying “clean up your room” hadn’t usually resulted in a clean room. Instead, saying “put everything back where it goes” somehow made a huge difference for Carlie.

It’s not that hard, unusual, or impressive. 

But if you’re not already helping kids figure out where they CAN put things, try it: it’s a lot easier to clean up when you do!

It’s true for their behavior too.

A couple of years ago, three year old Carlie had just graduated to a “big girl seat” but was kicking at the breakfast table. Every day mom threatened to put her back in her “little girl”seat and every breakfast ended in tears with Carlie back in her “little girl” seat.

But wait, thought Carlie’s mom. She’d just enrolled in a parenting course, and remembered to apply a strategy from class. “Where CAN Carlie kick? When can she kick? Who will play with her? And most importantly… what can Carlie do at breakfast, INSTEAD?”

Fast forward 1 day. Carlie’s mom has purchased a tiny stool. Carlie’s feet rest there. Each breakfast begins with a happy discussion of what she can do with her feet. She can put them on the stool! Then they discuss what they can do after breakfast. We can go outside in the yard and play ball! We can practice our kicks, we can bring our dolls, and we can have fun!

Fast forward 2 minutes. Usually, Carlie starts kicking about 3 minutes after breakfast started. So today, Mom said “Wow, Carlie! Your feet are safe on the stool! I love it. It’s fun having breakfast with you in our big girl chairs!”

Now, this was just one example, with a minor behavior. The behaviors some parents think are problematic are not priorities to other parents. Find what will work for YOUR family or team. Cusp Emergence offers family empowerment coaching. Contact us for more information or to share your story!

Bottom Line: Give clear instructions and involve learners in creating and enjoying supportive structure or alternative behaviors, the way Carlie learned to enjoy active playtime after her breakfast, or participated in creating her bedroom’s “places to put things”.

Note: Did you wonder why this post is in the “behavior cusp” category? Giving clear instructions is so important a skill for caregivers and teachers, that I have often observed them able to access new levels of teaching and instruction when they learn how. Mastering a strategy like this can be a “cusp” for teachers and parents, making it easier to promote appropriate behavior and engagement in their families and teams.

Look! I’m playing with a monster from my toybox!

08 Friday Feb 2013

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Welcome back. 

Part 2 of Helping caregivers and teachers support children to meet fearful challenges

Last time, we met Shannon and Devon. When we first met Shannon, she was crying as a peer played with a new toy. Although Shannon’s experience has been repeated with children affected by developmental challenges such as PDD-NOS, Rett’s Syndrome, or Autism, children who are typically developing may also experience a range of responsiveness to stimuli like loud noises or strange sounds. Long-term, it’s supportive to give children resources to handle inevitable changes in their environment, startling sounds like chairs scraping, animal sounds, or other children crying- especially when entering a new preschool environment! Similarly, Devon in the story struggled to face his fears of animals. His mother was afraid to take him to a park because of his fears, and yet she also wondered what would happen one day if he was invited to a friend’s birthday party in a park, or whether he would ever be able to play sports.

 Instead of stopping or thwarting learning opportunities, we can expand them.

  1. Resolve situations by providing the child experience successfully interacting with a stimulus he or she once feared. It’s great to “end on a good note”. Shannon’s program provided her many opportunities to push the toy away until she was doing it with a smile or even a laugh. When a given step wasn’t scary anymore, we moved on.

  2. Teach others to support the individual to resolve challenges and communicate (including asking for help) when needed, instead of minimizing the opportunities to interact with the challenge. Instead of moving an object away which looks scary, we can acknowledge what the student is feeling and empower her to do something about it. One of Shannon’s first major steps was learning to reach for a toy and push it away. Instead of screaming and laying down, she began to stay in the situation playing with her own toys. This allowed more teaching to occur. She even learned to take toys that had frightened her at first, and offer them to other peers who enjoyed them. Lessons about taking turns, offering choices, sharing, and helping friends find things, were now able to be enjoyed by the entire class.

  3. Broaden the child’s repertoire, instead of diminishing or limit it. After supportive strategies were used to re-introduce the toy to Shannon, she quickly learned different ways of using it. She eventually requested to play with the same toy that was scary at first. Similarly, instead of refraining from visiting or discussing parks, Devon’s mom learned to provide many opportunities to do park related activities, and Devon ultimately began to enjoy them.

  4. Build in learning opportunities to help the child deal with the fear, making it possible to enjoy activities that were off-limits before. Does the child have the skills to access (or ask for) assistance, a break, materials or calming activities? If the child is practicing something that is difficult, does s/he understand when this try will be over? Does s/he understand what she can do for this try to be successful? Does s/he know what will happen next? Devon had a safe space where he could sit down and take a chill out break if he became too scared to be near the creatures. He learned to request appropriately to leave the park, instead of screaming and kicking and pulling her clothes (which usually happened in the past). He also learned to stay and play for longer periods of time, and eventually was able to play in the park even if a dog played nearby.

  5. Enlist others to help if necessary, to help a parent or other caregiver through stressful or anxiety-involved times as the program begins. If a child has been avoiding or escaping fearful situations by using screaming and tantrums to refuse, it may be necessary to enlist the support of a behavior analyst or specialist to identify specific strategies and build a program helpful for the individual child and his or her history. And parents can face challenges especially when helping a child to follow through on trying a thing he previously refused with inappropriate behavior. “Helpful” community members may cause further distress when parents help their child face these fears in public. Devon’s mom introduced him to the park again during visits with a behavior analyst providing supportive coaching. But this can be practiced with a sibling, babysitter, parent or grandparent, too. Similarly, Shannon’s parents and preschool teachers were all able to implement supportive procedures after a quick review with her behavior analyst.

Bottom Line: Facing the difficult or scary thing will make it less difficult or scary, and is a great thing to model for the children and caregivers around you.

Final Notes: Care should be taken when introducing an individual to new skills, new environments or toys, or when reintroducing ones that have been paired with fear or anxiety. Individuals and their families select learning targets that are useful and valued by their family and community, with input from professionals as appropriate. Some of the additional factors considered by Behavior Analysts when developing goals and helping caregivers strengthen skills, include whether others in the individual’s natural environment will support task being taught and whether the task is needed in the individual’s life. For example, a fear of the dentist might be more important to address quickly than a fear of the dinosaur museum, although both could be addressed using similar procedures.

As always, the scenarios represented in this series are general and are not recommendations or procedures for your child. Behavior treatment should be implemented under the guidance of a qualified Board Certified Behavior Analyst or other appropriate professional if needed.

HELP- There’s a monster in my toybox!

06 Wednesday Feb 2013

Posted by in Autism, Behavior Analysis, Community, Early Intervention, Education, play, Rett's, Social Interaction

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Part 1 of Series: Helping caregivers and teachers support children to meet fearful challenges

Shannon’s Story

Shannon and Gina sat in a free play area near their preschool teacher. “SQUAWK!” came the loud animal sound when Gina pushed the button on a new toy. As the toy noise grew louder, Shannon’s eyes opened wider and wider until she froze, a look of sheer terror on her face. She started to back away and wailed, sinking onto the floor and crying.”Oh no,” gasped her teacher. “Put that toy away!” While Shannon cried, their teacher pulled Gina aside and said “I’m sorry, but Shannon is afraid of that toy. Next time we will remember to play with it when she’s in another room.”

Devon’s Mom’s Dilemma

Devon and his mom Jenny walked down the sidewalk with their next door neighbors. As they neared the playground, Devon suddenly grabbed his mother’s skirt tightly and shrieked. “NO BIRDIES! NO DOGGIES!” At this, Jenny’s face grew red as she picked up Devon and held him tightly. She looked at her neighbor helplessly and apologized: “I’m just so sorry… We can’t go any further with you. He’s been doing this every time. He has this issue with ducks and dogs and birds now. I think even if we don’t see one he’ll be afraid one might get him.”

Toward more supportive, long term strategies

At first, it may seem supportive to shield a child from their fears.

But both teachers and parents want and need solutions that will ultimately help children face and overcome challenges. So when there is a question, especially when a particular strategy feels good or soothing or produces relief in the short term, it’s a good idea to ask ourselves, “is this procedure also supportive in the long term?”

If not, how can Shannon’s teacher and Devon’s mom learn a more therapeutic approach? And why is that important? Let’s review these scenarios again, to better understand why and how to take a supportive long term approach. What might Shannon’s interaction with the toy, and Devon’s interaction with park creatures, have in common?

First, these scenarios are similar in how they are resolved.

In both interactions, a pattern is being established: the child first encounters a fear, or “fear inducing stimulus”, and then others respond by helping the child to escape or avoid it.

Second, these scenarios are similar in how they affect other people.

From the perspective of Shannon’s peers, her inability to play with that toy meant that they couldn’t either, at least not when she was around. From the perspective of Devon’s neighbor, the neighborhood kids couldn’t play with Devon in a park. This concept, the idea that Devon can’t play in the park, and that Shannon can’t play with toys that make animal sounds, limits interaction opportunities. It also risks changing the way peers think about approaching Shannon and Devon.

Third, these scenarios have similar “reductive” effects on the children’s “repertoire” or world. Have you ever met a family member or caregiver who says, “we used to love to do ___” but we can’t anymore”? Perhaps a family used to go to the movies, or out to dinner, or have friends over, or go to museums, or go hiking. During the initial conversation with families, that blank is filled in by all the things they need to avoid now because of fears of how people will react, fears that it won’t go well, fears that it will be too difficult, embarrassing, or noisy. Often those fears are REAL at the time! Perhaps people DID stare and talk at church when a family’s child loudly refused to stop standing on the pew. Perhaps all the teachers and mothers DID stare and talk in the parking lot as a child disrobed in public and threw a tantrum before leaving the store. Perhaps it WILL be difficult, embarrassing, or noisy. But keep reading. We can do this together.

Fourth, understand it’s a cycle: handling scenarios by allowing “fear habits” to persist, allows learners to skip learning opportunities and continue to repeat old harmful habits instead.

If Shannon and Devon can’t play with certain toys or in certain places, they have reduced opportunities to learn about those things and places, and no opportunity to learn that they are NOT scary.

Fifth, if these scenarios become habits, they make it more difficult for the child to handle or face similar or other fears in the future. These situations do not teach the child how to be more successful in coping with scary, new or different events.

Bottom Line: Instead of stopping or thwarting learning opportunities, we can expand them.

Come back Friday to learn how!