Unity Day 14: Visible Changes

From Facebook:

"Another great day today. Mr. Ryan keeps surprising us. We continue to change the programming and goals to keep pace with this little man!"

Today we were working with L. again. It was nice because we were able to keep the flow and momentum going from yesterday. We did a lot of playing around with the programming because Ryan is surprising us so much, and picking up on things so quickly.  We did a lot of tweaking, to the point that Ryan will already need new goal sheets for tomorrow. L. was also hinting at some big plans for Tuesday (Monday is the Family Day holiday). 

Today we started on "push a train" instead of  "push a car."  We went over to the train table and were showing Ryan how to push the trains, but Ryan wanted to mouth everything.  If we put his hand on a train to prompt pushing it, he would pick up the train and mouth it; if we blocked him from mouthing the train, he'd grab a piece of track with is other hand and mouth that. So, it was time to figure out what was making pushing a train difficult for Ryan.  Was it the train or the tracks that were making it difficult for Ryan?  We tried pushing a car on the train table instead. He was still distracted with trying to mouth pieces of track, even when we moved them away from him.  So, we took a train and moved it to the floor (no tracks involved).  Ryan still wanted to mouth the train, but he did give it a few pushes after some modeling and a verbal/wrist prompt. There was less distraction from other items on the floor.  

L. decided we should build on his success with "push a car" and try a higher-level activity: putting a car on a ramp and pushing it down.  We set up the car ramp and showed Ryan how to put the car on it, and then push it down.  Then we gave him a verbal and wrist prompt, and he pushed the car down the ramp for us. That was a good start. Suddenly, he picked up the car without us even asking or prompting, put it on the ramp by himself, and pushed it down! We freaked out with excitement!  Then he did it again, and again, and again . . . all on his own. We weren't even prompting him; he was just enjoying playing independently.  It was awesome!  Then he reached over to his basket of reinforcers, pulled out a rattle, and pushed it down the slide!  He did this with a few other items, too.  L. said that's amazing; he's exploring on his own, and showing generalization of the skill. It was like he was thinking, "Hmm . . . let's see what else can slide down the ramp!" So, now we have to decide how we can build on this skill next week.

Related to the story above, at the end of our morning, L. was watching Ryan for me while I packed up. When I came back into the room, she had shown him how to use the more complicated, twisty ramp for the car. He was doing that one with minimal prompting.  Even more impressive, L. showed me how Ryan had made the connection to start it at the top and watch for it to come out the bottom at another side.  As soon as he started it, he would lean over and watch for it to come out the other side!

We also practiced some of the incidental "go play" today.  Once or twice he headed over when I gave him the verbal prompt and gestured to his toys a few feet away, but we also had to give him a  nudge a couple of times to get him going in the right direction.  I think the whole idea of free time at S.C. is lost on him because most of our time there is so structured.  So, this is a good way for him to learn to connect the words "go play" to the idea that he can wander off and explore what toys he wants at those times.

When we practiced requesting "more" today, we used the uncooked noodles again. Those are one powerful reinforcer and motivator for Ryan! He loves playing with those noodles.  We get a big bin and let him run his hands through them and throw them around a bit. I think he likes the texture and the rattle sound they make.  Anyway, for requesting more, today L. put the noodles in a clear bin with a lid, and gave Ryan a little tub for a few noodles.  Ryan would go wild with his noodles, running his hands through them so swiftly and roughly that they soon tumbled out of his tub. Then he wanted more. L. showed him the big bin which had the rest of the noodles. Ryan tried to grab it and open it. Instead, L. showed him to tap it gently to indicate he wanted more.  We had to verbally, HOH and wrist prompt at first, to remind Ryan the proper way to ask for more noodles, especially when he got excited and wanted to grab.  When he started to just put his hand on the bin to ask for more, L. changed the prompt to verbal/gestural: she tapped the lid and said, "I want more noodles."  Next thing we knew, Ryan was imitating her gesture!  When he reached for the bin, she would model the tap and say the words, and then he would gently tap it on his own. What a change from the beginning to the end of the session! By the way, he managed to get a noodle into his mouth and bite it.  We thought he'd spit it out, but crunch, crunch, crunch . . . he actually finished it off! LOL

Oh, and with regards to food, an incidental "more" opportunity came about unexpectedly. J.'s mom had brought in Valentine's cookies, and L. and I had snitched a couple during our transition between rooms. As I was munching on mine, Ryan looked interested. I broke off a little piece and gave it to him. Now, you know he prefers soft foods. To my surprise, he enjoyed that little piece of cookie! He worked it around for awhile, then reached out to grab another piece from me!  I HOH'ed and said "more cookie" for him, then gave him a second piece. He enjoyed that one, too. 

We also did some work with the shape sorter. We took out the circles and wrist prompted him to pick them up and place them in the holes. I had to do a lot of blocking because he really wants to mouth those shapes. L. taught me something important here, though, that I need to work on: Block with a flat hand above the item.  Try not to touch Ryan's hand because as soon as he feels Mom's hand he drops the item. We don't want him to drop the item; we just don't want it in his mouth. Besides the mouthing, Ryan was trying really hard to put the circles in the holes with me wrist prompting.  He even picked up a few circles and tried to put them in all by himself (no prompt!) and threw a few over the top of the lid to L. We were just happy he wasn't mouthing them!

Ryan did some excellent work in circle, too. For "Wheels on the Bus," he was patting away at the leader's hand for "the horn goes beep beep beep" with me only holding up his wrist.  He was also putting some intention into my wrist prompts of "the doors go open and shut": I could feeling him pushing and pulling a bit.  He continued to do well independently pulling the velcroed pictures off the circle board with just a little wrist prompt in the right direction.  He did pretty good for holding and matching his animals, too; we'll probably start fading back the wrist prompt at circle time soon.

Oh, I forgot to mention Ryan was improving with his "stand up" and "come with Mommy" today. We've noticed that shutting off the lights in the room we're leaving, and walking out but calling Ryan to follow us, seems to work as a good prompt. At least twice today, those were sufficient prompts for him to get up and follow me on his own. L. still had to go back and physically prompt him once or twice, too, but it was great to see when he just stood up and came along!

However, Ryan hit his limit during circle time. We don't know if it was because of all the amazing new things he did today, and he was worn out. Another factor was circle time was a bit louder today (we had a third little guy join us, who unfortunately is a screamer at times), and we also had a new leader for circle who has never done it with us before.

Snack time went pretty well. Ryan was a bit whiny, but we got him to eat some of his yogurt independently and got a few mands for bottle and yogurt. Unfortunately, he bumped his yogurt and it hit the floor when he was only about a third through, and the rest was splattered under the table.  So, we cleaned him up and I took him over to the carpet with his bottle to snuggle for a bit and relax. Dr. G. came in, and we explained that she'd missed the best of Ryan's day. By the time she showed up, he was cranky and tired.

Still, we ended on our terms with a little more pushing the car, since he'd been so successful and had fun with that earlier.

This afternoon/evening . . .  

It's been rough. After a successful day at S.C., Ryan's had a rough afternoon/evening. He did well when we first got home, and thank goodness I chose to do homework then, because it went well. But soon Ryan was having some wild mood swings, with tantrum-like crying off and on, for no reason I could guess except he was tired and maybe having some tummy discomfort (as evidenced by a few nasty diapers).  On top of that, he fell asleep 20 minutes before we had to go pick up the kids. I didn't want to bother Papa for a third day in a row, so I woke him up and brought him along. He was okay until just before we left the school. Then he got really mad again.

Now here's where having two autistic boys becomes really difficult: they begin setting each other off. Ryan's crying upsets Kevin, who starts to yell and scream.  When Kevin yells and screams, Ryan gets upset, and he cries more loudly.  Then Kevin screams more loudly. You see how this cycles on and snowballs until both are out of control and I can't calm either one.  These moments are the worst.  And they've been happening off and on all night: Kevin's in a bad mood because, according to him, "Valentine's Day is my worst day of the whole year." When asked why, he says he doesn't know why he has to give things to other people and not to himself (i.e. Valentines and treats). He also says, "They already know I love them." He also doesn't like all the Valentine's activities/crafts they've had to do at school over the past few days. So basically, Kevin's already moody because he hates Valentine's Day, so he's being difficult with everyone.  He picks fights with Andrea, and then she screams, and he laughs.  Then she screams more, and he laughs more. When she's screaming, Ryan gets upset and starts to cry again, which makes Kevin start to scream again . . . And I'm so overwhelmed because I can't stand the screaming, either (I swear I have sound sensory issues, too)!

Eventually, I get Kevin to sit on the couch, Andrea doing her homework, and I'm rocking Ryan. It settles. It's relatively peaceful. And of course, that's when Daddy comes in the door!  I love how he always shows up just after the chaos, so I look like I'm totally exaggerating/overreacting to whatever happened earlier.

Or maybe not. As I sit here typing, trying to finish today's entry, Ryan broke into another seemingly random tantrum. However, it appears my tummy discomfort theory from earlier is correct.  Daddy said, "He smells just like diarrhea," checked him, and got a finger full of yes, you guessed it. What a romantic Valentine's Day! ;P