Wednesday, May 28, 2008

Putting Pamela in the Driver's Seat

Because most of Pamela's gestures are imperative, our first objective is to teach Pamela how to use gestures declaratively. Since verbal language is such a challenge because of her aphasia, we decided to scaffold this by focusing on nonverbals first. We hope Pamela will transfer the discovery of declarative gestures to declarative language. We focused on three common gestures:
  • Pointing - Draws my attention to whatever she is sharing with me.
  • Nodding - Tells me I am getting what she is seeing.
  • Shaking her head - Tells me I am on the wrong track in what she is seeing.
We wanted to come up with an activity in which she would be the active person driving the conversation. We decided to go on data collection walks in which I am the recorder and Pamela is the observer. One side benefit is that I can turn the data into a math lesson!

Before our walk to a nearby playground, I told Pamela we were going to do a project about house colors in our neighborhood. I needed help figuring out what colors to use. Then, she told me a bunch of colors, and I typed them into a spreadsheet. I printed out the tally sheet, and we left.

At each house, I stopped and looked down at my feet as if I had shut down. It took a bit for Pamela to realize she had to activate me. She poked me! Then, I looked at her face, waiting for her to take action. Again, it took a bit for her to realize she had to point to draw my attention to the house she was describing. Then, I overemphasized turning and looking at the house, and I turned back to her to tell her a color. Sometimes, I would say the right color so she could nod her head. Sometimes, I would say the wrong color so she could shake her head. Then, I recorded the data. Occasionally, I looked at a building, like a church, library, or office. I left it for her to decide whether or not to count them in our study--she shook her head.

That activity could become very static, so, on the way home, we expanded it dynamically. I heard a siren and exclaimed, "An airplane!" I looked at Pamela, and she shook her head. I went through several guesses before I got it right. I waited to see if she would direct my attention to something; if not, I would point out something else, either correctly or incorrectly, so she could give her observation by nods or head shakes.

Because RDI is about lifestyle and not activities, I am finding ways to incorporate it into our daily life. For example, she can get my attention in several ways: shoulder-touch, poke, move in front of me, etc. During the day, I found times to "shut down" so she would have to do something active to "reboot" me.

The language is not the only component of our plan to put Pamela in the driver's seat. Some of Pamela's passive nature might be due to sensory under-responsivity, which I will address tomorrow. By the way, the math lesson I wrote based on our walk is pictured below!

Tuesday, May 27, 2008

RDA 4: Spotlighting Communication

The RDA is the Relationship Development Assessment in which consultants help families figure out where a child and family are, select achievable goals, and break down the first goal into bite-sized chunks. We just finished RDA Session 4 (of a total of 6) with our consultant in two phone calls.

In reviewing all of the objectives in Stage 2 (where Pamela is developmentally in her dynamic intelligence abilities), one huge gap became clear: almost all objectives we have not accomplished fall under the category of communication and social competence! Since Pamela's aphasia makes declarative communication a major challenge for her, we decided to work on this goal through gestures. If she begins to feel competent in nonverbal declarative communication, she might transfer that to her verbal comments.

My assignment was to spend the weekend paying attention to all of Pamela's gestures and assigning a function to them. I put the information in a spreadsheet, and we came up with some fascinating conclusions. The first revelation for me was that Pamela has a rich and varied gesture vocabulary. First, we focused on distinctions made in RDI: declarative versus imperative communication.

Declarative - Pointing something out to me

Imperative - Go away!

However, we saw a sizable number of gestures in which Pamela reacted to a situation and showed her emotion with a gesture. If she directed the gesture toward me to share her feeling, we called it declarative. If she directed the gesture to me to get something she wants, we called it imperative. If the gesture was internal to her and I was just a fly on the wall to her, then we called it reactional.

Reactional - Happy

Putting my degree in statistics to use, I summarized our observations of Pamela's repertoire of gestures in the following chart (click it for a larger view).

The three slices of pie represents reactional (pink), imperative (light blue), and declarative (dark blue). The first conclusion is that two-thirds of her gestures are communications with other people. The second conclusion is that only 7% of all gestures are declarative. To put this in context, RDI teaches parents to speak declaratively 80% of the time so that the child will learn to speak more declaratively. The good news, Pamela has many wonderful, varied gestures. The bad news, she uses most of them in a bossy, imperative manner because we inadvertently trained her to do that through our example!

Tomorrow, I will cover our plan to work on declarative gestures.

Saturday, May 24, 2008

In Sync

We wrapped up our mini-blitzes this week with simultaneous patterns. You may be wondering why RCR patterns are so important or why our consultant typically has families do blitzes, two or three weeks per pattern! Because Pamela caught on to the patterns when our consultant tried them with her, she assigned mini-blitzes for us, two or three days per pattern. I think she wanted me to learn from them more than Pamela!

What did I learn? I can take something as dull, boring, and possibly static as a pattern and imbue it with the joy of interacting. Whenever I showed facial expression and other nonverbal communication and slowed down enough for Pamela to process, the quality of our interactions shot up. The most fun patterns for us were the ones which did not come naturally: reverse assembly and simultaneous (to be described in this post). Why? We both were forced to slow down and work together as a team. We felt like we were in the zone, even if we were moving slowly. One person commented that Pamela and I shone in one of the video clips! In the RDI world, that is called dancing . . . the intangible ingredient that "makes everyday social encounters so wonderful" and "the simplest forms of communication" that "lead to the most wonderful moments" as described in the book, My Baby Can Dance.

Simultaneous patterns are when you do something at the same time. As always, I came up with a list, simultaneous patterns that include an object and those that do not include an object. The ones in italics are the ones are shown on the video clips:

With Object
Hitting drum, cowbell, cymbal with a drumstick.
Moving maracas side-to-side or back-and-forth.
Building paper cup towers.

Folding clothes.
Making a bed.
Taking trash to the trashcan.
Tossing balls at the same time.
Counting coins.
Folding paper (airplane, basket, origami, etc.)
Rocking in a rocking chair.

Without Object
Doing the alphabet in sign language.
Spelling words for shopping list in sign language.
Clapping games.
Walking up and down stairs.
Hopping on two feet or one foot.

One thing you will notice in the clips on the maracas and rocking chairs is that I broke down the actions into clear steps and slowed down the action to a pace that she could manage. I gave her nonverbal feedback so that she had to pay close attention to me and what I was doing. I varied the pattern enough that she could not go into automatic pilot. I would love some insight on something we picked up on the rocking chair segment. David, the cameraman, zoomed in on Pamela's face and we noticed how she couldn't give me a steady gaze. She consistently shifts her eyes away from me and back to me when I stopped the action. That makes me admire her even more because it must take much more work to offer full attention! Any thoughts?

Thursday, May 22, 2008

Who's the Boss?

One of the hardest things to do in getting started with RDI and even homeschooling is establishing the master-apprentice relationship between parents and children. We managed to figure this out in our first four years of homeschooling (1995-1999), and I wish I would have had Awakening Children's Minds when I first started teaching Pamela at home! One key element is how to respect what Pamela wants without letting her take complete control. One way to do this is to keep in mind your objective and reframe it! In the following clip, we were taking turns building a house with index cards (an idea from 365 TV-Free Activities). Pamela wanted to shop and told me she was tired of the task. I realized that I could reframe turn-taking around writing a shopping list and picking out items at the store.

The activities we did on this day revolved around reciprocating (turn-taking patterns). We either share from a pile or perform a task, alternating between Pamela and me. Here is a short list of some of the things we did:

Moving dining room knick-knacks
Dusting dining room
Feeding dogs
Working on puzzle
Putting kitchen rugs in wash/hamper
Sweeping kitchen floor
Putting away clean dishes
Wetvac kitchen floor
Folding clothes
Putting gemstones on magnets
Camping trip
Washing and refilling hummingbird feeders
Building index card house
Chain drawing
Guess the objects

Pamela enjoys drawing, something she did not enjoy when we first started homeschooling. Actually, she hated it. She kicked and screamed at the sight of pencil and paper. Another idea I found in 365 TV-Free Activities is chain drawing: we take turns drawing a picture together. The first time we started going back and forth with different shapes and no plan. When finished, Pamela called it "Christmas Tree Machine." On different day, we started another chain-drawn picture, but Pamela had a plan, unbeknownst to me. When she did not like what I was drawing, she cried, fussed, and SCRIBBLED OVER my drawing. I was glad to see how she communicated her ideas well and we flipped over the paper and started again. The following clip is another example of playing "Who's the Boss?"

Pictured are really cool capsules for productive uncertainty--I found them at Wal-Mart in packages of twelve capsules for three bucks per package and saw the potential for RDI lifestyle activities. First, you place a capsule in warm water and watch the gelcap slowly melt away. Little shapes and parts start popping out, unfolding the shape of the item made out of foam. During the minute it takes for the object to emerge, you have plenty of time for guessing what it is. Pamela LOVED it!

Then, we took all twelve sea creatures (that was the theme) and played a guessing game. I closed my eyes, picked out a sea animal, and guessed what I was holding. Pamela could tell me if I was right or wrong. Then, we switched and she had to guess. This activity also worked on separating self and other because she could see the object and I could not. Then, I could see the object and she could not. The clip below shows our guessing game.

Saturday, May 17, 2008

The Fruit of Our Labor!

Last Thursday, we picked, washed, and cut up strawberries to liven up our work on patterns! We even made strawberry ice cream from scratch and rolled a canister back and forth to freeze the ice cream as one of our turn-taking patterns!

At the autism remediation email list, we discussed the question of chores. Many parents doing RDI turn to chores as activities to frame objectives. For example, right now, I am working on RCR cycles with Pamela and we have been focusing on reciprocal (think turn-taking) patterns. So, I included getting hangars, hanging clothes, and putting away folded clothes for my list of patterns. Choosing chores means they actually get done (you should see my lovely hampers) and frees up more of my time. Pamela can learn valuable life skills that will serve her well whether or not she is ever able to live independently because she will always be a blessing to the people who care for her. You can see a wide variety of activities, some more fun than others, for Thursday's list.

Material Place Type
Getting hangars Basket Reverse Assembly
Hanging clothes Closet Reverse Assembly
Putting away clothes Drawer Reverse Assembly
Putting away dishes Cabinet Reverse Assembly
Picking strawberries Basket Reverse Assembly
Washing strawberries Collander Reverse Assembly
Cutting strawberries Bowl Reverse Assembly
Rolling canister Canister Sharing
Eating ice cream Spoon Sharing
Tossing ball Ball Sharing
Coloring Diego Crayon Sharing
Playing War Cards Sharing
Throwing frisbee Frisbee Sharing
Scooping seeds in feeder 1/4-cup Sharing

The turn-taking styles we used were reverse assembly line and sharing an object. The first is alternating between Me-You-Place and You-Me-Place. Pamela and I are so used to other forms of turn-taking we found this one tricky! Sharing an object came more naturally to us.

One of my problems as a "get on with it" kind of person is I have a hard time slowing down for the sake of the interaction. I go checkmark crazy with a list in my hand! In my mind, I do not always separate the efficiency of doing a chore on my own from the objective of framing chores, slowing down enough to give Pamela time to process and express her thoughts and feelings. If you watch the video clips, you will see how the quality of Pamela's expressions shot up when we played catch and Frisbee. Why? Dropping and retrieving the tossed object stops the action long enough for Pamela to process and react.

Picking/Washing/Cutting Strawberries/Putting Away Laundry

Filling Birdfeeder/Playing Catch/Tossing Frisbee/Making Ice Cream

Pamela has not done a major coloring project in years. I have not bought coloring books in years because they end up in the toy box with a couple of sporadic scribbles. The other day Pamela picked up Diego Color Pencil By Number. Since she has not colored something like this in years, I thought it might make a great lifestyle activity. I figured it would take at least a week to finish! When I pulled her out of school in 1995, she cried at the sight of things like this because she hated drawing, coloring, and writing. Imagine my surprise when it took us only two days to finish it! Rather than use the pencils provided, Pamela choose from her 64-crayon collection. She would color one spot, and then I would touch it up before going onto the next spot. When we did the frame, she colored the paw prints and I colored the frame, going back and forth.

When Steve saw the finished product, his jaw dropped. He blurted out, "I can't believe how well she stays in the lines!" Yep! She has come a long way in her years as a homeschooler!

Monday, May 12, 2008

Butterflies, Everywhere!

My consultant's handout listed five skills for parents to learn under the "how" of RDI. I have blogged three of them many times (declarative communication, framing, and scaffolding). I will address the fourth skill today: RCR cycles. The acronym RCR means Regulation-Challenge-Re-organization. Basically, the parent sets-up an interaction with competent roles for parent and child, performed in some kind of pattern. When the child is doing well in the interaction, the parent makes little variations to the pattern to make it slightly more unpredictable, but not overwhelming. The child learns to accept the slight change and continue the pattern without getting confused.

You can see this in the clip of us putting butterflies away in an assembly line pattern. The pattern is Me-Pamela-Elephant. She quickly gets into the swing of it, so I start doing little variations for fun.

My consultant assessed Pamela for all three beginner patterns, and Pamela had no problem. The first year we homeschooled Pamela and I did patterning for her fine motor issues. I have never thought of interactions as patterns, but I know we have been doing all three patterns for years and years. I am not surprised Pamela did well with them. Just to be sure that I am on track, the consultant asked me to do two or three days of each pattern (15 to 18 patterns each day). She wants to make sure that, when Pamela struggles, I will remember to fall back on these RCR patterns. If Pamela gets angry at a restaurant, we could do something as simple as empty sugar packets out of the holder one by one and then put them back one by one. Reestablishing a sense of competence is an effective way to prevent meltdowns.

First, I made a list of activities that had patterns. Interaction patterns are in almost any activity. Random on-the-fly thinkers can probably join in what their child is doing. I am not one of them. I need a plan from which I can vary.

Then, I picked a competent role for both of us. Some roles might be too difficult (such as putting clothes already on a hanger in a closet), so I took the harder role. Physical roles help children get regulated. Since Pamela is under-responsive, I made her the active person in some roles (the one who goes first).

I made a list of assembly line patterns I had planned to do today. I tried to spread them out into three batches during the day, all patterns done one after the other. I tried to balance practical things like chores with fun things like toys and crafts.

Homeschool booksPamela-Me-Shelf
Wet clothesMe-Pamela-Dryer
Dry clothesPamela-Me-Basket
Lite Brite Me-Pamela-Paper
Knick-knacks Pamela-Me-Furniture
Stuffed animals Me-Pamela-Floor
Stuffed animals Pamela-Me-Basket
Dry dishes Me-Pamela-Cabinet
Dishwasher dishes Me-Pamela-Cabinet
Crayons Pamela-Me-Bowl

Pamela is a great apprentice. Some children might fuss, argue, and complain (feel free to ignore them, if you can)! The handouts my consultant gave me talk about doing the pattern first so the child can see the roles. Then physically turn one role over to the child when ready.

Pamela has an acute eye for patterns because her mind is so sequential. She caught on to all of my patterns right away. I always know when the light bulb goes off and she smiles. Once she grew competent in the role, I varied the actions in my role.

Our patterns ended when we placed all of the items in the right place. I usually vary how I acknowledge completion, but some times I just move onto the next pattern. For each batch, I tried to put the most fulfilling, emotionally engaging activity last to end on a positive note.

The high for me was playing the Elefun game for the first time ever! I thought she might enjoy this game which just might inspire her to move. She helped me add the batteries, fix up the nets (first clip), and position the butterflies. Her nonverbal and verbal communication is beautiful when she sees the fake butterflies floating in the air (last clip). They do not inspire her enough to move, but I plan to use a sensory integration approach to address her under-responsivity. If your time is limited, watch the last clip--it is a treasure that will make you smile!

I plan to cover two more patterns on the days in which we will be doing them. The fifth skill covered in the handout is elaboration. I have not talked much about elaborating on my blog because I am not knowledgeable enough to go there. I will quote directly from the handout,
Elaboration is how the parent grows what the child learns and makes it increasingly dynamic. It is a way for the parents to help the child increase areas of competency. Elaboration is how the parents will take a discovery, and help the child develop a deeper meaning to it. Elaboration techniques include use of same-but-different thinking, relative thinking, and retrospective and prospective thinking. Elaboration grows directly with Episodic Memory development.

Sunday, May 11, 2008

The Why, the What, and the How of RDI

Happy Mother's Day to All Y'all!

Pamela gave me the flower in my stationary box, and how she went about it shows why we are working on her concept of self versus other. Our consultant and Pamela taped a pen to the flower, wrapped it in tissue paper, and decorated it as a Mother's Day present to me. Pamela was supposed to ask David to hide the gift in his backpack so that I would have no clue about it. Unfortunately, I inadvertently caused the situation to be dynamic because, while Pamela and our consultant were busy making plans, I had moved from my original spot to the same room as David. Our consultant quickly explained their plan, so I bolted and let them hide the gift.

I patiently waited until this morning for the gift. Pamela never forgets special occasions, and she wished me a happy Mother's Day this morning as always. But, she did not give me my gift. After lunch, I put on a sad face and said, "I am sad. I thought I was getting a Mother's Day present." Pamela did not realize that, even though she and David knew where they had hid the gift, I had no clue. She did not react. I tried reminding her about the secret gift she made with our consultant, but Pamela did not understand why I could not find the gift.

I explained a bit further and said, "I don't know where my present is." Pamela blurted out, "A thief stole it!" Why? Since she assumed I knew about the hiding spot, she assumed I had looked for the present myself. Since she was confused, I walked her to David and repeated what I said. He knew that I did not know where the present was, and I told him that Pamela needed help remembering where it was. He started nonverbally guiding her to find the present. She interprets facial gaze and nonverbal communications well, so David and Pamela quickly located the present and gave it to me.

The Why
Our consultant gave us a stack of papers explaining RDI in her own words to make sure we are all singing off the same sheet of music. Two things caught me attention from the very beginning: parent-based and developmental. Relationships within a family are the first and most important relationship any person will ever have, for better or for worse. Not only that, parents have the most opportunities to hang out with a child, especially when homeschooling. From the very beginning, I have always spent time learning from professionals, parents, and people with autism and tried what made sense for our family and situation. I have resisted formal therapies with certified professionals working with Pamela because it makes more sense to teach me to teach Pamela. The people who spend the most time with a child ought to be the ones implementing whatever needs to be done.

The focus on development rather than behaviors also intrigued me. Our consultant is helping us to figure out where Pamela is developmentally and what objective is most likely to emerge at this point in her development. Steve and I will not be prompting her to jump through hoops a la operant conditioning. We will be seeking and creating opportunities in every day life to help Pamela make discoveries on her own with her sharp eye for detail and great attention span. These discoveries will enable her to share and communicate her experiences, borrow our perspective when unsure, become aware of herself versus others, think even more flexibly than she already does, add personal meaning to her phenomenal memory for events in her life, and cope with an ever-changing world--explained in greater detail here.

Let me illustrate with a sweet example from our stay with Steve's cousin and her three children. Pamela had announced her intentions to go to bed. Her cousin Jenna, a fifth-grader, said, "Good-night, Pamela!" I could have prompted her by telling her directly what to do, "Say good-night!" By doing so, I steal an opportunity for Pamela to appraise a situation and think of possible actions. In fact, this would limit her choices to two that require pure reaction and no thought--obey or disobey.

Instead, I said, "Pamela, Jenna said good-night to you." Pamela had to think of her possible actions: tell Jenna good-night, give her a hug, kiss her on the head or cheek, shake her hand, do a combination of any of the previous, or keep walking to the bedroom. Pamela walked over to Jenna, waved, said "Good-night!" and kissed her on the top of the head.

The What
I am the world's biggest skeptic. I did not jump into RDI right away until I studied its guiding principles. We started our "lone ranger" RDI program back in March 2007. I blogged our journey, and you can read for yourself how we did.

As a lone ranger RDI mom, I read books and blogs and networked with other RDI families to figure out how I can create opportunities to guide Pamela in making the discoveries listed earlier. While I learned how to guide Pamela in our first four years of homeschooling, other RDI families explained to me how to refine my skills even more by speaking in declarative language, slowing down, and expanding my nonverbal communications. They helped me figure out what my next objective might be. They encouraged me to seek situations in our real life (chores, cooking, shopping, games, puzzles, conversations, book discussions, etc.) to frame whatever objective planned to target. They pointed the book Awakening Children's Minds to me as a great way to learn more about scaffolding.

Trying to implement RDI is not easy without a consultant, but generous and wonderful parents are willing to throw ideas at you at email lists like HS-RDI and Autism Remediation for our Children to help you get started. You can find all sorts of RDI blogs through your favorite search engine. You can find some explanations and helpful video clips (free once you register and log-in). If the five-hour DVD is too pricey, it often sells on eBay for a good deal, but I would hold off buying Solving the Relationship Puzzle new because an update is in the works.

Flying solo is not easy. A dedicated mom and dad with no other options will find a way to make it work! At first, I felt drained with every encounter in which I worked on changing my communication style. I had to think of so many things about what I was doing and what Pamela was doing. I had to figure out how to use my video camera so that I could film our interactions and get a chance to review what happened. Trust me! When you are in the moment, you miss so much. Seeing the recordings helped me glean so many details that I missed in the heat of the moment. In time, I felt more comfortable but never completely sure if I was on the right track.

I must have gotten some things right because our consultant found Pamela smack dab in the middle of stage 2 (out of 30 stages): she has mastered the two most daunting tasks (being an apprentice and co-regulating). Her nonverbal communication is quite good.

The How
I decided to find a consultant because I thought I needed more direction and accountability plus I wanted to be sure I was on the right track. I know some people complain about being left out of the new operating system with objectives and resources available only to parents with certified consultants (or ones in training). I can see both sides of the argument here because I have been around long enough to know that sometimes professionals claim to be knowledge in therapy X because they attended a workshop on it five years ago and then completely confuse parents with outdated information. This insures a level of quality control for parents spending their hard-earned cash. Even so, since parents are people as are consultants, some personalities clique while others do not. If you are searching for a consultant, find a person with whom you connect because that consultant will be your guide. Driving an extra hour or two might be worth it if it means finding the right consultant for your family and situation.

Time will tell how it will go with our consultant. My first impression tells me this is the beginning of a great relationship!

Saturday, May 10, 2008

Why RDI?

I have not pursued any new autism therapies for a very long time. For years, I have resisted the newest therapies on the block because they did not seem like a good fit for Pamela or us. I do not want to put us through anything simply because it is a new thing under the sun.

Our consultant made up a very helpful web that illustrated the elements of what we do every day with Pamela: diet (true allergies and sensitivities that affect behavior), academic (three R's and some), and aphasia (specific language issue beyond autism). Our consultant plans to help us figure out two things: Pamela's passive nature which may be related to sensory under-responsitivity and developmental gaps in her dynamic relationship skills. I love this visual image of what we are doing from day to day.

Now, please do not take this the wrong way. I love my daughter! She is a joy and a dear! Our consultant enjoyed their time together: they had so much fun hanging out and doing crafts. Pamela is a wonderful person; we love her for who she is; we respect her for all the things she has done; we are amazed at her phenomenal memory.

But, we worry about her. She is 19 and we recently obtained guardianship because she is not able to live on her own at this point in time. We have no problem with her staying with us as long as she needs. She is a great companion. We hope that an RDI lifestyle can help us fill in some developmental gaps that will open more doors for her in the future. At present, she has memory skills that surpasses most people; she can do math and reading at a fifth-sixth grade level; she can write at about a second-third grade level; she can communicate her needs, but not everyone can understand her. Her relationship skills are at a toddler level. We would be negligent if we did not work together as a family to fill in those gaps! If she can relate to people better, then she will be even more of a joy to others. And, when we are not able to care for her, she will be welcomed by the younger generation of our family rather than put in some neglectful home (our church ministers to one in our town--it breaks my heart to know Pamela could end up in a place like that if we let her down).

So, why RDI? I am relying on my background in the Navy to illustrate this. Neurotypical children have a pattern of development. They may achieve different milestones at different times, but they tend to follow a similar course of development that is documented and can be outlined. RDI focuses on how children relate to people and how their abilities mature over the years. Whatever the cause, children with autism go a very different path of development. We can treat what we suspect may be related to the cause of autism. We can treat health and environmental issues that make life more difficult. Some kind of course correction is required to steer the child back to a development path that helps her learn to live in a dynamic, confusing, and ever changing world.

What I hope to achieve with RDI is to fill in some gaps. I hope that Pamela can learn to be more resilient in the face of change. I hope that she can learn to think about what is happening and react in dynamic ways based on her understanding rather than rote compliance. I hope that, when she wants friendship beyond her family, she will be able to reach out without being blindsided and rejected because she struggles to make herself understood and to understand others. I hope that, when her interests lead to friendships outside the home, she will be street smart enough and savvy to avoid those who might wish to harm her. As always, we focus on improving quality of life. Our joy and zest for life have increased since we started our RDI lifestyle.

Thursday, May 08, 2008

RDA 3: Dad Onboard with RDI

Pamela and our consultant made this beautiful mirror during their session yesterday. To wrap up RDA segment one from yesterday, Steve and Pamela worked together. I watched them on television, and they blew me away. Steve has never gone nonverbal with Pamela, and I was so amazed at how well he played, made things up, and hung out with Pamela. Another fascinating tidbit popped off the screen. Pamela works so hard when she speaks because of her aphasia (the consultant, an SLP in a former life, completely agrees with what I have thought along: aphasia, but not apraxia). She feels so incompetent with her verbal skills that Pamela and Steve fell into rigid, static conversations (maps, highways, calendars, and any topic in which she excels). If you try to get her off the Pamela Express, Pamela gets annoyed. However, when Pamela and Steve went nonverbal, her interactions were so beautiful, expressive, fluid, dynamic, go with the flow. In fact, you would not see autism right away when she is nonverbal.

Yesterday, Pamela and I made this picture by putting paint in the middle of a piece of paper, folding it in half, and squishing it. We agreed it looked like flowers in a vase. After Steve and Pamela finished their session, we sat down with the consultant for RDA segment three. She gave us a great overview of RDI, comparing the behaviorists approach versus the developmentalists approach, covered the five core deficits, explained how the operating system is set up, compared parent objectives versus child objectives, etc. Steve finally saw how the scattered pieces of what I have been doing for years on instinct have enabled Pamela to come as far as she has. The consultant told him that Pamela was the first client to arrive in her practice with apprenticeship and co-regulation nailed in place.

One thing that blew Steve away was how scattered Pamela is in her development. He did not realize that Pamela's savant skills with calendars and her ability to work at a sixth grade level were purely static thinking. He was shocked to hear that stage two represents the relationship skills of children between the ages of 18 months and 24 months! I expected this (actually expected a younger age). Her dynamic abilities shoot up when she is nonverbal; but, when she is verbal, she goes very static and rigid.

Our consultant impressed me with her ability to uncover Pamela's strengths and weaknesses. She definitely knows autism inside and out!!!!!! She helped me put into perspective how various things I did on instinct helped Pamela become an apprentice and co-regulate. I cannot emphasize enough how well she did with co-regulation, especially when going nonverbal.

Her co-regulation breaks down a bit when verbal because she falls into static routines. Steve and I experimented with getting off the Pamela Express at lunch. She tried to loop us into one of her rigid conversations. First, she hit up Steve and he stayed off the train by speaking declaratively about other topics. Then, she turned to me and I was more emotional. I would pout and say, "I'm tired of talking about highways. I want to talk about what we are ordering for lunch." When I failed her, she went back to Steve, even poking him, which gave us another topic. "That hurts! I don't like getting poked." She tried about five or six times and finally stopped pestering. Then, I made faces and did some nonverbal interactions to get her thinking nonverbally. She relaxed and went with the flow in her verbal exchanges.

We need to work hard on separating Pamela's awareness of self with her awareness of others. She tends to apply everyone's conversation to herself. So, when her aunt talked about her parents planning to sell their house, Pamela yelled, "Don't sell the house." So, I pointed to Brenda and explained, "Aunt Brenda's mom and dad are selling their house." Then, I pointed to myself, "Daddy and I are keeping our house." I have a hunch this technique will be a great way to separate self from others during conversations.

The consultant gave me some clear directions on what I need to do in the next two weeks: blitz and film some interaction patterns to fall back on when Pamela becomes unglued, figure out what objectives need work (both parent and child), pick a parent and child objective of interest, etc. Steve will be doing one e-learning assignment at a time to get up to speed. While I am doing the bulk of the work, he will go with the flow with me more easily once he understands RDI more.

Here is the second squish picture we made yesterday. It started out as a hamburger with mustard but it looks like what ends up on a diaper.

We still have three more segments of the RDA left but will be doing them nonverbally over the next couple of weeks.

RDA 1 and 2: Co-Regulating "New Stage 2" Apprentice

Yesterday, Pamela did her first RDA (Relationship Development Assessment) with a bona fide consultant to help me plan out objectives under the new operating system. In the morning, Pamela and I did the first segment: 10 different blocks of five or ten minutes where we follow very simple instructions that basically involve hanging out. Pamela acted like her typical self, and her consultant got to see Pamela as she really is.

After segment one, we had a long lunch and headed to a local park. I wanted Pamela to get some fresh air and completely relax by having a change of pace and beautiful scenery. While I felt completely calm with the first session since Pamela was enjoying herself, I was a bit nervous about the second segment because Pamela and our new consultant would work alone. While they were busy upstairs, I sat downstairs and filled out paperwork, pages and pages of paperwork.

For those of you who are told the myth that homeschooling with your autistic child will make them completely dependent, DON'T BELIEVE IT! I have been Pamela's one and only teacher since 1995. I think we spent about four years working on the master-apprentice relationship: me, figuring out how to guide and she, learning how to follow my lead. Pamela did a wonderful job working with Amy. They worked together for 45 minutes, without making a peep. They made crafts (I suspect a mother's day gift for me) and our consultant framed it to test out various theories she had about Pamela's level of development. They took a short break and headed back for 15 minutes.

Steve did not arrive until 530 thanks to a board meeting scheduled by his boss at the last minute. So, he and Pamela will do their segment today. I think the goal is to see how he interacts with Pamela. Then, our consultant will debrief us and focus on me to teach me how to use the system, nail down where Pamela is in stages one and two objectives, and figure out which core deficit of autism requires the most attention.

Here is the upshot of where Pamela is. She is in new stage two (perhaps, some of my RDI buddies can help me translate that to old stage terms). Our consultant said we have the most challenging aspects of RDI behind us: master-apprenticeship and co-regulation. While we nailed master-apprenticeship many moons ago, I know we figured out co-regulation during the past year. Pamela's referencing skills were practically non-existent when we started lone-ranger RDI back in March 2007. The consultant told me that, at one point, their session felt like two chicks doing crafts. She saw through Pamela's challenges with language and noticed her creativity, imagination, gentleness, focus, and persistence.

The biggest hurdle is language. The consultant (who started out life as an SLP) agrees that Pamela's language issues go beyond autism into the world of aphasia. She was very inspired by Pamela because, even though she struggles with her language, she has conquered to two hardest hurdles of RDI. From this point on it is a matter of figuring out objectives and working on them. It may be because Pamela is older and more mature, but she is the first client in years of experience to walk in with co-regulation mastered. Pamela is a perfect example of someone who is able to accomplish many things in spite of difficulties with language.

Monday, May 05, 2008

Why Not?

When did your children start asking why? Pamela has not quite reached the stage of asking why questions, but she is starting with "Why not?" Today, during math, I decided to review adding and subtracting fractions because we have been working so hard on multiplying and decided. She excelled at everything except when she had to borrow for subtraction. She fell back on carrying the one as a ten, not as the fraction indicated by the denominator.

First, I tried showing the chain of logic involved and ask Pamela along the way what I should write next. She had a very hard time and clearly had forgotten the concrete meaning of these steps.

Second, I tried drawing pictures but the steps were not clear-cut enough to demonstrate the chain of logic. Pamela has a very sequential, organized mind, and I knew this was within reach. But, she told me, "It's too hard!"

Third, I tried color-coding, pink for whole and green for fraction. I would do the color-coded diagram, two pink boxes for whole and 3/4 for fraction, and she would have to tell me what to write, 2 + 3/4. Then, I would make the next set, one pink box for whole and one green box and 3/4 for fraction, and she would have to tell me what to write, 1 + 1 + 3/4. Then, I would make the next set, one pink box for whole and 4/4 and 3/4 for fraction, and she would have to tell me what to write, 1 + 4/4 + 3/4. I had to give Pamela lots and lots of guidance. I even wrote the numbers in pink and green. She improved a little bit on the second problem, but not much!

By the second sheet, I continued to ask her as we went along because I was trying to figure out if she understood. Everytime, I had to correct her, she would ask in a semi-whiny voice, "Why not?" I was so glad that she asked that question because usually she just gets fussy or argues. But, this time, she asked why! Suddenly, something clicked. I can always tell because she starts to giggle and flash a smile. I can almost see the light bulb flick on in a cartoon buble over her head. She did the last two problems without help or correction. I like to end on a positive, so we will see what she remembers tomorrow.

Pamela decided to hang up this Bronco calender in the kitchen. Her Uncle Randy would be proud!

Saturday, May 03, 2008

Youtube? What Youtube?

At exactly 9:20 AM, the Glaser household weathered a Youtube crisis of epic proportions. While my friends in cyberspace have stared down the jaws of tornadoes the past two nights, hurricane Pamela nearly struck our home all because Youtube had the audacity to be down this morning! Whenever she tried to access the site, the words "Internet Explorer cannot display the webpage" appeared after Exploder tried to load it for her.

My first line of defense was to try Google Video but she would not accept any substitutes! Then, I decided to try tossing Pamela a softball by introducing her to the wonderful world of Mapquest. Pamela loves maps. When we lived in St. Cloud I bought a 1992 Hammond Ambassador World Atlas for only two bucks. Whenever we read books, we consult the atlas and mark all over it! On Thursday's trip to Wal-Mart, Pamela asked for a Large-Scale, Spiral-Bound Rand McNally 2008 Road Atlas. For the past four days, she has poured over the atlas, mapping out fantasy road trips!

I figured it might be worthwhile to try Charlotte Mason's idea of changing your thoughts. Pollyanna did this with her being glad game. In The Sound of Music, Maria chased the fears of thunderstorms away with a song about her favorite things. Anne of Green Gables diverted her thoughts to her favorite tragical scenes from literature. Perhaps, Mapquest might help Pamela forget the tragical loss of Youtube for a little while.

I spent a few moments showing her how to navigate through the site. The waterworks stopped. Pamela's face lit up as the magic of Maquest swept away her disappointment. Before long, she was planning trips to our old homes in cities like West Newton and St. Cloud. She mapped out trips to Detroit and Nashville, two places she has never been. When I came to check on her, she sat in rapture with the atlas in her lap and Mapquest on the screen!