I have mixed feelings about Alanna's clinical psychologist lately. On the one hand, he impressed me greatly this week when he said that Alanna is making good progress but he is concerned about her engagement and lack of initiation.
He is concerned she is too passive; taking direction but not initiating on her own enough. Now, I agree with him completely, but Alanna does initiate to ask for things. She asks for things all the time and if she wants you for something, she can be persistent! However, she is often content to observe in a social situation and either zone out or wait to be invited to participate rather than go and do something. For example, at pre-school, she will play with toys, but she will not go and pick something out she likes and play spontaneously. You have to ask her to pick one or show her one to play with it. This is fairly typical of how she is at home as well.
He is concerned she is too passive; taking direction but not initiating on her own enough. Now, I agree with him completely, but Alanna does initiate to ask for things. She asks for things all the time and if she wants you for something, she can be persistent! However, she is often content to observe in a social situation and either zone out or wait to be invited to participate rather than go and do something. For example, at pre-school, she will play with toys, but she will not go and pick something out she likes and play spontaneously. You have to ask her to pick one or show her one to play with it. This is fairly typical of how she is at home as well.
So the psychologist agrees with me in that he believes the ABLLS-R is not helpful for social programming. His solution is to adapt RDI activities to increase engagement and initiation. We will definitely be doing that. However, he is also leery of us consulting with another behaviour analyst to get the programming and training in place. Many ITs are very comfortable with discrete trial but engagement activities need to be more natural environment because by prompting you are kind of defeating the purpose. The person with which we want to consult is someone with lots of experience in this area. We think everyone will benefit from their knowledge. How frustrating!
Have you ever read my posts about learned helplessness and mommy radar? (Read from the bottom up):
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Thanks Penny, good reading. I am just realizing that now and it is ironic that I was telling the psychologist and senior therapist the other day sometimes I don't know what Alanna can do because frankly I don't let her try! Then she learns she doesn't need to do it herself.
ReplyDeleteSlow down and give her opportunities to join you, to be competent with you at non-verbal levels. Don't dress her without her *active* participation. Hold the neck opening of her shirt open and sit, silently, but invitingly, waiting for her to shift her attention, her gaze, and notice, and to take her own action to insert her own head. The more silent you are, the more she has to reference you - her attention will change, and improve, then allow her opportunities to join you, to be competent, to be successful *with* you. Don't tell her "good job" - let her competency be the reward - and the more non-verbal interactions you can offer her, the more quickly she'll join others outside her relationship with mom and dad. Allow her opportunities to feel her own body reaching, stretching, inserting an arm into a coat sleeve - she needs to feel herSELF taking an action - and then she will begin to join others without prompting. That's what we experienced when we quit prompting and began slowing to offer more opportunities. Being quiet and stopping the prompting was hard for me because that's what we'd been taught, what we'd done for 3+ years, and I thought that was the only way my girl could learn. (I was wrong.)
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