help me work with DS

[Sweetum]

DS, who recently has been diagnosed to be on the spectrum, is quite stubborn. We are unable to figure out if it is a personality related thing or if it is becuse he has Autism, or maybe they are the same. The issue is that I find it very difficult to work with him. Today morning, I sat at the table with some blocks and asked him to copy me. He didn't want to do it. I know he is capable of doing the task but not copying is what bothers me. And he went about complaining quite agitatedly that I wanted him to copy me. I didn't give up and kept building and kept insisting (no pressure, but just repeated, "copy me when I do this", and built something). My tone was calm and even and it was not a power struggle at all (of course, I was feeling one brewing up). he eventually sat down and did some stacking on his own, but never once copied me. This is just an example. He just won't listen or pay attention when something new is being taught to him. He is always looking away when someone is instructing something, even if he is interested. And copying is something that he seems to be inherently against. I just don't get it and don't know how to get through to him. I have tried reinforcements before but they only last for that time and and he is really set on getting the reinforcement and ends up paying less attention. Sometimes he get frustrated enough that he goes away and doesn't care about the reward even if it is an activity that he knows. Any ideas would be really appreciated.

btw, we don't have any behavioral therapist working with us right now - we are still understanding how and who is going to provide ABA. hopefully soon enough we will have something.

[Gena]

Part of ABA is breaking things down into smaller tasks, teaching each of those tasks separately, and then gradually reassembling the tasks.

For my son, we had to do a lot of work before tackling "block modeling". First we had to teach him to tolerate sitting at the table with me for simpler tasks. Then we had to teach motor imitation. This involved teaching him to watch me when I said "Do this", and I would do a simple action like move my arm back and forth or wiggled my fingers. Eventually we moved on to imitating more complicated actions and then, eventually to things like block modeling. For us it also involved some hand-over-hand direction to get DS to understand what he was supposed to do.

If you want to try to some ABA at home before getting a therapist lined up, you might want to look into these books:

A Work in Progress: Behavior Management Strategies and a Curriculum for Intensive Behavioral Treatment of Autism (http://www.difflearn.com/product/A_Work_in_Progress/ABA)

Behavioral Intervention for Young Children With Autism: A Manual for Parents and Professionals (http://www.amazon.com/Behavioral-Intervention-Young-Children-Autism/dp/0890796831/ref=pd_sim_b_5)

I found these two books very helpful, especially when DS was young. For our main program guide, we used the Assessment of Basic Language and Learning Skills - Revised Edition (http://www.difflearn.com/product/Revised_ABLLS_Set/Verbal_starting_program) This really helped me break tasks down and teach them in order. It also has a graphing tool so you can track your child's progress.

The Different Roads to Learning website has a lot of great resources and tools: http://www.difflearn.com

[Gena]

I just wanted to add that ABA and similar types of therapy can be really difficult at first while you and your child try to get used to it. It's easy to get discouraged at the beginning. Try not to let these early difficulties get you down. It does get easier for both you and your child as you go along.

Hang in there! Hugs!

[Sweetum]

Thanks for the resources, Gena. And also for the word of caution about being difficult in the beginning. It it seeming mroe and more likely that we had better start working on it ourselves and right away since all these routes (SD, insurance) are taking time to settle down. We don't want to waste time - I say that because in the last few months DH and I have seen some changes in DS and they are not good - he now has behaviors that he did not have before (repetition of words and phrases, chewing on his clothing all the time) - maybe they would've happened anyways, but we are not feeling good that we kinda let him languish. thanks, I will get started with these asap.

[Pyrodjm]

I wanted to send you a hug and commend you for getting started on working with your son. I know how frustrating it can be sometimes.

ABA is based mainly on reinforcement. I can't teach a child anything unless he has a reason to want to work with me. It's great when a child really likes me and my praise is enough encouragement to keep him going but it almost NEVER starts out that way. Copying your block structure is not rewarding to him on it's own. You need to give him a reason to do it. The key to reinforcements is to always keep him wanting more so he remains motivated. For instance, for each block structure he builds he gets a minute or two with a favorite game or toy. Once his time is up he has to continue to earn more time. It's ok if he is very focused on the reinforcer, just keep redirected him to the task he has to do to earn it. Set aside a few choice treats or activities for him to earn only when you work with him. Keep the put away until then.

Children on the spectrum often have difficultly focusing and maintaining eye contact, that's probably why he is always looking away. Most also don't naturally imitate actions like typical children, they need to be taught how. I agree with the previous poster about starting out with simpler imitation activities. He has to get used to copying behavior and being rewarded for it.

Feel free to pm me, I'm a special ed teacher and provide ABA services..

[Sweetum]

Also, wanted to add that DH and I are considering a 5-day PRT training which apparently is a naturailstic form of ABA. Any opinions? (btw, it's $3000 for a 5 day training with DS, DH and me). I was looking into the P.L.A.Y. project, but it seems easter seals in my area is the only one providing it, and they seem to have certain restrictions on area etc. so, nothing is coming of that. I have started to read Greenspan's book "Engaging Autism", and am hoping that PRT and Floortime can go together since both are family oriented and are naturalistic. Any thoughts?

[Sweetum]

Pyrodjm, thank you so much for that piece of advice. I also want to apologize for all the frustration I have been expressing regarding the SD - it's not personal, it's the system. It really is nice to get this type of input from a spl. ed teacher. I'll PM once I have gotten started in more earnestness. So far it's been engaging DS whenever we have a few moments here and there. But I intend to set up a routine and get to work so to speak.

[niccig]

Not sure if this will help with the looking at you, as I know children on the spectrum have difficulty with this. DS sees a student SLP at the department where I am studying to be a SLP, he has an articulation delay. I get to observe all of his sessions.

The student wanted DS to look at her, say the sentence before shooting a ball in the basketball hoop (DS needs to break up seated activities with some movement). DS wasn't looking at her when he said the sentence, too intent on shooting the basket. She told him if he looked at her and then said the sentence, he would get 2 extra shots. For the rest of that session and every other session since, he looks at her without her saying anything and he earns the 2 extra shots each turn (not at the end of therapy as that's too long too wait, it's 2 extra shots after each set of sentences, eg. he'll roll a dice and get a 3 so has to say a sentence he picked from a deck of cards 3 times, if he looks at her for all 3 sentence, he gets 2 bonus shots). It's the motivation he needs.

I filed this away for when I work with a similar client - I'll have to work out what motivates them and will keep them working to complete a therapy activity.

I'm not sure what will motivate your son, but I agree with the others with starting out with smaller baby steps with motivation to complete each sub-step, and working up to your goal of imitating you with blocks. That's one big goal and you have to break it down into baby steps to get there.

[Sweetum]

Thanks. I think you could be right that I am viewing copying block building as a simple activity whereas it is complex for him and likely needs to start with sitting down with me and getting rewards for it. On that note, I am not sure what DS' currency is at this point - he does like food and sweets in particular, but I am afraid that he will latch on to that even when we are not working for something. I guess I have to think of something that I completely and strictly restrict to work time. I know that the spl ed teacher in school uses stickers but tell me (and I know so too) that they are not motivating. TV shows, books and videos on youtube are rewarding for him, but I they are not small/quick enough to get back to task. Any ideas towards that would be great.

[annex]

One trick with stickers (or other small tokens like marbles) are that they can earn 1 for each step in the task, and then get the larger (more motivating) reward after completing it. At DS' school he would get a sheet of paper with 5 squares on it, and a picture of the reward item in the middle. Having that visual for when he had filled up the 5 squares with stickers, he would get the x reward (5 min fave youtube video, etc.) was very helpful.

[niccig]

TV shows, books and videos on youtube are rewarding for him, but I they are not small/quick enough to get back to task. Any ideas towards that would be great.

I observed a therapy session where they played games on an iPad. It was at the end of the session and the child saw it as the reward, but the clinician had the student explain to her how to play the game, so it was part of therapy for working on connected speech.

Another child loved basketball so the clinician had 5 mins of a Lakers game on youtube. She would stop the video and have the client tell her what happened, again under guise of needing it explained

Boardgames are another. Not sure if this can be incorporated, I've seem many a boardgame created by the therapist, roll the dice, move your piece and then you have to do whatever the therapy is. Motivation is winning the board game.

You may also find that it's difficult for you to be the therapist. I worked with a boy of similar age to DS and he was doing everything I asked. I tried same thing at home and DS wasn't having any of it. My supervisor suggested at first I set aside 5-10 mins to work with DS a day and to not push for anymore. I'm his mum not his speech therapist. With time, I might be able to increase time we work together.