Thursday, June 23, 2011

Overcoming Passivity

For many reasons, some children in the spectrum become passive:  executive function glitches, feelings of incompetence, overprompting, doing too much for them, doing too little for them, etc. Pamela was born passive, which we mistook for patience, sweetness, and gentleness. As an infant, she hardly cried about anything. Unlike her brother, who demanded attention from day one, Pamela sat there and watched, waiting for us to read her mind. She never connected crying to getting fed, changed, and held faster. She was so passive we took her out of daycare when she was four months old and placed her with a family where she would have more one-on-one attention from a friend and her children.

Today, Pamela is anything but passive. Not only does she figure things out for herself, she can be rather demanding and bossy at times. Now, we have to work on the other side of the equation: not letting her control us. Helping her learn to initiate has been a life-long process and requires more scaffolding than being dumped into a new home with strange people (Mary Lennox and Elizabeth Ann). People often ask how to teach chores to children who can easily get stuck into a mindless routine in which they become stuck if something goes wrong or who have executive function issues that make it hard for them to initiate or shift to another step.

First, there is atmosphere. I try very hard to avoid tying performance to rewards because I'm not a behaviorist. When working on new habits, I make sure that Pamela and I have sweet moments during the day that have nothing to do with following instruction. I go out of my way to smile at her for no reason, tickle her sweetly at random moments, say things that spark giggles out of the blue, etc. I never want her thinking "Mom is only nice to me when I do what she wants." When we are forming a new habit, I make declarative comments on what we are doing, "We're washing towels" rather than clap and gush,"Yaaaaay! Good job!"

Why should she do chores if there are no rewards? Why do I do chores? I am not Mary Poppins: I take no delight in chores, even with a spoonful of sugar. Chores are things that need to be done so life runs smoothly. Laundry needs washing or we would all be running around naked. If rewards were the only reason to do chores, I would rather skip it, sit down with a cup of coffee, and read a book. I hope Pamela will notice something needs doing and do it rather than work for rewards or stick to a mindless schedule. The atmosphere of doing chores together is slow, attentive, warm and encouraging. We are sharing an experience: we are doing something together, knowing that the relationship means more than mastering every single step of laundering in two weeks or less.

We live in a performance-oriented world. It is easy to think our kids aren't learning fast enough and give up. I try to keep in mind that doing chores is more than the task. Chores are the context for us to work many areas of development: exchanging declarative comments (communication and language), embedding body language and facial expression (nonverbal communication), adjusting to each other's pace (referencing), knowing what to do when the washer is already full or the door is hard to open (problem solving), knowing that there is such a thing as too full (judgment), etc. Because I teach life skills in a contextualized manner, I don't worry if it takes two months to master every step and contingency.

Building interaction patterns (shared with me by our RDI consultant) through chores and anything that is part of your day sets up a framework that does two things: create a framework for learning many tasks and lay a concrete foundation for the flow of conversations. Most interactions follow one of three patterns, or a sophisticated combination of them: simultaneous, alternating, and assembly line (you can read about all three here). Once kids recognize the pattern, it is easier to take an active role in a wide variety of interactions with people rather than feeling confused and withdraw.

Another important ingredient worth including is going very slowly and waiting for them to take a step. Our kids process much more slowly than we realize. When we rush and push, they feel incompetent and give up, making them more passive. We must go slowly enough for them to observe, think, and react--at their pace, not ours. Slow interactions invite our children to join in because they feel like they can keep up and succeed. Enough positive memories of taking an active role encourages them to initiate more. RDI consultants suggest waiting as long as 45 seconds to avoid missing an opportunity to think.

So, what if you had an extremely passive child? How would this look? Planning is everything: you want to set them up for success by making it easy at first. Sort the laundry and have the laundry that needs washing accessible. Have the detergent out and the cap slightly loosened. If they are too short to reach the washer, think about how your child will physically do it. An energetic child might enjoy taking turns "shooting hoops" while a sedentary child might sit on top of the dryer and drop clothing into the washer in assembly line fashion.

Another thing to think through is your hierarchy of prompting. You want to try the least direct prompt possible and wait for a reaction before trying a more direct prompt. The very first thing you do in any interaction is seek the person's attention. How would you do that in real life with a non-autistic person? Clear your throat and wait. Wave your hand. Move closer. Would you ever say to a friend, co-worker, or boss, "Look at me"?

If your child is not used to shifting attention to you, you may need to get extreme. Do or say something completely surprising like sing "Who let the dogs out?" You may need to move your face in an odd angle until your child cannot avoid seeing that you want her attention. Attention is not the act of eyeballing a person. There is a mental shift to observe you as a whole person: what you are doing and saying. I know Pamela is paying attention in how she reacts to me, not how long she gazes at me.

Timing is important too. Interrupting the credits of a movie is not a good idea (that is an issue for another day). Set everything up and wait for the right time such as after the child is in the process of transitioning from one thing to another. With a bright face and cheery voice, you might announce, "We're going to start the laundry." Then, grab her hand, walk with her into the laundry area, and guide her to the position  where she will be working.

If your child is completely passive, this is the time for many long, awkward pauses. They are not used to thinking and acting! Do something to encourage her to shift attention to you and wait. Move through the hierarchy for getting attention (each time waiting) until she turns her gaze toward you and then point to the door. Pointing to something is more indirect than commanding, "Open the door." It requires the child to think: What is Mom pointing at? Why is she pointing? Does she want me to do something? What does she want me to do? Why does she keep staring at me?

Until your child opens the door, you could try a variety of indirect prompts (waiting between each one): tap on the door, put your hand on the latch, try shoving a piece of clothing through the door, guide her hand to the latch, help her partially open it, help her open it all the way, etc. You could even think out loud, "We have to put clothes in the washer" and wait. Or say, "I wonder what we should do first" and wait. Or try, "Uh, oh! The door is closed." This sounds very slow and laborious but will be worth the effort when your child starts showing initiative. If we just verbally command (or look at a picture schedule), it will be hard for them to learn to think for themselves. When she finally opens the door, you might gasp with a big smile and, when she looks at you, say, "We opened the door!" Give her some time to reflect on  that big moment before going on to the next step.

Once the door is open, you start the interaction pattern of transferring pieces of clothing into the washer. At first you want to be very predictable and build their confidence in knowing what to do. Before the process becomes mindless, you inject a little uncertainty (drop a piece of clothing, put it on your head, put it in the hamper, etc.) and see how your child handles it. Without uncertainty, the interaction becomes mindless and you miss the change to foster flexible thinking and problem solving.

Pamela initiates very well and takes active roles. Here is how it went down with us. Before we started, I sorted the towels and sundry cloths in a hamper. I put the detergent on top of the washer and the hamper in front of the dryer. Then I waited. We were going shopping (something she wanted), so I waited for her to come in the kitchen and ask about it. Then, I told her we would go after starting laundry. We stepped into the laundry room, and I pointed to the washing machine door. She opened it.

Then, we hit our first glitch: David had washed his clothes the day before and forgot to transfer them to the dryer. Pamela looked in and said, "They're wet!" Then, I smelled them (my sense of smell is shot because of my cold), and I couldn't tell if they needed rewashing. I explained to her my thinking, "I'm not sure if they're clean," and I closed the door.

I pointed to the tray where we pour in the detergent. She tried opening it but couldn't because you have to shift a hidden latch to the right. She looked at me, "It's stuck." So, I pulled it a little way open and she finished. I took the cap off the detergent and gave it to her. She held the cap while I poured. I pointed to the section for the detergent, and she poured. I placed my palm on the door like I was closing it and she closed it. I showed her what button to push (which you have to push twice). I handed her the big detergent bottle and pointed to the corner of the shelf where it belongs. She put it away. We paused and I put my hand on my ear. Why? Sometimes, the door isn't closed quite right and it makes a grinding noise. When I heard the correct noise (the water being released), I smiled and said, "Whooossh!" so she knew that is the sound you need to hear.

We have started two more loads of laundry since. Because the first round went so smoothly, I added some challenges. I waited for her to open the door without any indirect prompting. I left the detergent on the shelf, so she had to retrieve it and let her open the bottle. I didn't open the detergent tray for her. I placed her hand on the latch and helped her shift it to the right. Everything went so smoothly that the third time, I added more variation. I held the cup while she poured the detergent (a more challenging task). The only problem she had was with the latch, but eventually she will figure it out. Because she is a quick study at learning chores, I suspect she will be self-sufficient in a week or two.

Talk about bliss: both of my kids starting a load of laundry!

2 comments:

poohder said...

excellent explanation and BTW I get it. My ASD dd does laundry very well now. It's a GREAT feeling

Di said...

Thank you for such an interesting post. My Nick is very passive and we are building interactive patterns......slowly but surely we make progress!
Are you able to give a more specific list of the hierarchy of prompts for your readers?
I am now off to make a a list of patterns that make use of an object / do not include an object!