From Facebook:
"I would call it a good day at Summit Centre. Starting to get into the routine. Only a little fussing from Ryan. Left at 10:30, but on positive terms."
I didn't start out feeling all that positive today. I was overtired (and so was Ryan) from our Super Bowl party last night, I'm coming down with a cold, and Ryan's winter coat zipper fell apart upon arrival at Summit Centre. Not to mention, it was a bit of a white-knuckle drive in (and home) on the Expressway with the snowy conditions.
However, I'd say things are starting to have an "as per usual" feeling at Summit Centre, which is a good thing. It means we're settling in, and things are becoming more familiar. I know things will begin to change up over the next week or two as more programming responsibility falls to me, but today was pretty straightforward. There were only a few changes/interruptions in the routine because there was a group touring the Centre today.
Ryan was fairly cooperative today. One new thing we focused on was "stand up" and "sit down": getting him to follow those commands with minimal prompting. Today we were working with T. again, and she was having him stand and sit using a chair. We noticed he liked the nubbly ball today, so we were using that as a reinforcer and an incentive to encourage him to stand up to get it. Most times I had to prompt him by taking his hands (and sometimes lifting from his bum) for "stand up," but once for T. and once for me he stood up as soon as we took his hands and told him to "stand up." The work for "sit down" was similar: we had the chair ready, positioned him in front of it, and usually had to guide him from behind or at the legs to get him to "sit down."
We also tried more imitation today. First we tried to get Ryan to hold a little hammer and tap it on the floor, after T. modeled it for him. I had to HOH every time; he didn't really try to imitate on his own. He still got reinforcement if he let me help him do it, though. Then we tried getting him to imitate patting the floor with one hand; he did that a couple of times on his own. We tried to imitate patting our legs, but I had to HOH that one. Then we tried to work with a skill he already has: rolling the ball. T. had a ball she would roll with her hand. She'd make Ryan wait for his turn, then imitate her by rolling his ball. He actually did very well with that, since he enjoys rolling the ball. Oh, and with the ball today, we were focusing on the word "ball" and emphasizing the "b" sound, but he hasn't attempted it yet for us.
Another area we concentrated on today was manding, especially in terms of "more" (pointing, signs, or word approximations). We basically used it during all our activities today, and for anything he showed an interest in: the ball; access to the beans (which he still loves to run his hands through and throw all over!) in a closed plastic container; access to balls for the ball popper toy; snacks; having T. open and close the expanding ball for him; etc. Ryan continued to need HOH prompting to form the sign for "more," and verbal prompting in the hopes he'd try to say it himself. We didn't see the sign or hear the word from him independently today. He was reaching out and gently touching things he wanted, and we saw him moving his lips like he was getting ready to say "more," but that was the closest we got.
We are also working on playing with toys appropriately (instead of just everything in the mouth!). With the ball popper toy, I was HOH showing him how to put the balls in the holes and push them down. Eventually, we hope he will pick one up and place it on the hole himself, or even put one in after I've placed it for him. We used the Winnie the Pooh music toy he liked last week, too, and we saw some nice things: he was running his fingers over the keys (after I modeled) in an attempt to produce music. Then, on his own, he figured out a cause and effect part of the toy: if he turns the wheel, the characters will spin. We were so excited he figured that part out on his own! Finally, we tried a shape sorter for the first time. T. and I had to model, and prompt HOH, to get him to hold the shape, put it over the hole, and press it in. Who ever realized how many steps went into using a shape sorter (not even including selecting the shape and the right hole)?! He was cooperative, but will need a lot more practice before he can do these steps independently.
Circle time was okay. He tried to lay down a few times, so I had to sit him up and give him reinforcement for "nice sitting." He paid very good attention during "Brown Bear, Brown Bear, What Do You See?" and surprised us at one point by anticipating his turn, and scrambling up toward the book and pictures! He also continued to do well during "Roll the Ball," and stayed calm for most of circle time. He also did a nice job of choosing a picture for which action we would do for "Wheels on the Bus."
However, Ryan was a bit distracted today. Between the tour going on and all the STEPS program kids being in today, he kept responding to the other activities going on around the centre. When we were in the STR trying to do our program, he kept attending to (listening to, paying attention to) the songs, games, and children he could hear outside the door. At snack time, we had a lot more children at the snack table, so he was more interested in watching them and their therapists than participating in snack-time manding with Mommy.
Anyway, we did achieve our goal of ending each activity, and the day, with Ryan in a good mood. We are going to try and slowly increase his length of time at Summit Centre each day, by about 5 or 10 minutes, and see how it goes from there. I think we did a longer circle time today, and lasted till about 10:30, so I'd say we did pretty well.
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