From Facebook:
"Okay day today. We worked with each other's boys a bit and it went well. Ryan was having a hard time focusing, though. I think he was tired. No major excitement, just slow and steady today."
At the start of theory each Friday, Dr. G. shakes our hands and says, "Congratulations on completing ___ weeks of Unity! How does it feel?" Today, she said, "Congratulations on making it to the half-way point!" Wow. I'm amazed that we've already finished half the program. The time is going by so quickly. I don't want it to end! Yes, it's mentally and emotionally exhausting, but Ryan has changed more in the past 6 weeks than he has in the past year. I'm glad that we have another six weeks to learn together, but I wish the program was longer.
Okay, now on to a description of how this morning unfolded.
Ryan wasn't on his A-game today. It was a kind of meh, so-so day. It was better than two days ago, not as good as yesterday, and somewhere in the middle, I guess. (Did that make sense?)
Anyway, Ryan was happy because the wagon had reappeared in the Rainbow Room by the time we arrived, and he got his morning cruise. He did some good signing for "more," and as usual, was not too happy when it was time to get out of the wagon and go to work. Oh, well. He got more wagon later when the students took over while the moms went for theory and research. They couldn't get him out of the wagon, either; when I came back to take him home, three students/volunteers were all working to coax him out of the wagon with toys and reinforcements. He wasn't crying, but he wouldn't budge. When Ryan wants something, he can be stubborn!
Back to the beginning of the day (sorry, it's 10:05 PM here, and I'm tired). We did "Itsy Bitsy Spider" as an opening song in the Yellow Room. Ryan wasn't enthusiastic, but he had no major objections. When we started talking about moving over to the Blue Room, he jumped right up and headed over to the door. Of course, when we let him out, he tried to wander into the Rainbow Room, and then down the hallway, but we managed to herd/guide him into the Blue Room.
Ryan was protesting a bit when we started our activities. We did "push a train" on the train table with 4 pieces of track, but he was crying and didn't want to focus on the activity. I think he got 3 out of 5 trials correct, versus doing it perfectly yesterday. I also had to ask T. how to record when Ryan pushes it with force, or awkwardly, and it goes off the track. T. decided it's a judgement call: If the train goes off the track due to loss of manipulative control, that's still a + and he gets reinforcement. If the train goes off the track because he shoves it when upset or angry, that gets a - and no reinforcement. As his mom, I'm the best judge of whether he's losing muscle control or emotional control. Today, I definitely caught him shoving the train off the track because he was mad, at least one time.
Next I pulled out the ball ramp program, figuring he'd cheer up and participate better because he likes the toy. Well, he didn't, at first. With his success and interest in that toy shown over previous days, I faded him back from HOH to a wrist prompt. The first two trials were -'s because he did not even try to cooperate. However, the toy eventually won him over, and we moved on to the rest being +'s and even a fading back to a forearm prompt. When he started enjoying the toy, I let him keep playing with it for a bit (it became its own reinforcement) and he even put a few balls in the top independently! Of course, we still have to help him push them in, but he often puts his hand on the ball and waits for help. T. suggested positioning his hand so more of the palm was on the ball, to give it more pressure, but that didn't seem to make much difference. He's still doesn't have the strength in his hands to push the ball in independently. That will come with time and eventually, when he's back to working with an occupational therapist, they'll work on that.
Then I decided to set up the matching program. Ryan was enjoying the ball ramp toy so much that we brought it over to the table to use as reinforcement for his matching. For some reason, Ryan was very interested in his surroundings today. It was good that he was so attentive to the sounds and voices in the room, but it was interfering with him concentrating on his programs. He kept turning his head to listen to T. talking to L.A., or watch J. and L.A. play a game. B. was helping me try to keep Ryan focused. We turned his chair, turned his body, and he was still craning his neck around to see what everyone else was doing! This really threw off his matching attempts because he wasn't paying attention. I would hand him something to "match," and he'd grab it, but look the other way and randomly fling it at a bowl. He only matched 50% correctly today, at both Step 1 and Step 2. Even when he was watching me, he would get hyper and fumble the items, miss the bowls, or even try to mouth them. It's clear that when it comes to matching, he needs to focus on the task at hand to be successful. In her notes, T. said that I did well redirecting his attention, but I had a lot of help from B., too.
Then we had an opportunity to work with each other's child again. Today, J. was much happier. He was even being a bit silly with me. We worked on patterning strips again. This time, J. had to correctly place the last 2 pieces on the pattern, with a third distractor piece thrown in. When I was reading through the pattern with him, he kept putting his head down on his arms and peeking up at me with the cutest sparkle in his eye. I was trying so hard not to laugh, and kept saying, "J., look at the pattern with me!" He did listen well, though; he always did as I asked when I told him to look at the pattern, come back and sit down, or put his dinosaurs (reinforcers) on the table. With him putting two pieces of the pattern on the end, T. reminded me that I had to wait until J. attached both pieces firmly to the velcro before I praised/reinforced/corrected, because he might change his mind and move something, or I might accidentally influence his choice of answer. I also learned that I need to "work until correct" which means I have to keep repeating that "target" (pattern) until J. gets it all by himself, and then he gets a + and we move on to the next pattern.
We finished our pattern activity before L.A. was done with Ryan (they did shape sorter and chunky puzzle), so B. and I were talking to J. about his dinosaurs. Coincidentally, the STEPS kids had an activity out with dinosaur pictures and their matching skeletons stuck to a board. J. started taking out toy dinosaurs and matching them to the pictures, and saying their names! B. and I were amazed. He knew more dinosaur names than we did. I think I need to brush up on my dinosaur knowledge. LOL
L.A. said Ryan did well with his shape sorter and puzzle. He was working at a wrist-prompt level, but managed to get one in independently! L.A. noted how he needed help with the manipulation part of these activities. Ryan now understands what he needs to do with the shape sorter and puzzle pieces, but he just can't get his little hands to cooperate with his brain. As I said earlier, this should improve with time and good therapy.
Next we moved back to the Yellow Room, where I set up Ryan for some colouring. He wasn't as focused today, and his intention was not as strong. He still got a + on 4/5 trials, but I had to keep redirecting him to the task at hand. At least he was still making happy sounds. [On a side note, I was at the store tonight and spotted the latest style of toddler markers that Crayola created. I think they are designed better than the old Tadoodles. I bought two sets: one for home, and one to take to S.C. I'll update you on how well they worked after we try them out tomorrow.]
Then we tried "coins in the piggy bank." We're still doing it HOH because this one really requires that fine motor finesse that Ryan struggles with. Think about it: You have hold the coin, and turn it in just the right position, to slip it into a thin slot. However, Ryan shows good intention; he knows where it's supposed to go, and tries to put it on the slot, or at the slot. He just needs help getting it in the slot. Today, I would help him get it partially into the slot, and then he was pushing it down the rest of the way independently.
After that, we worked on clapping. I'm not sure what got into Ryan today, but he was really stuck on that one-handed clap. He one-handed clapped every time, and then moved into the proper clap when I eventually gave him the elbow prompt. He wasn't looking for the prompt today; he actually needed it. Again, it could be due to his lack of focus this morning. (?)
Finally, it was time for circle. Ryan was getting tired by this point. His circle time wasn't as spectacular as yesterday. Dr. G. came in to share circle with us, and I'll admit, I felt a bit let-down by Ryan's performance. He was yawning, so Dr. G. cheerfully noted that he was tired, and that explained his lack of motivation. Ryan didn't do the actions to most of the songs; I was a prompting puppeteer today. He did pull the pictures off the circle time board when asked, but he also tried to mouth most of the items we handed to him. He was, however, excited by "Busy Farm" today; he kept grabbing the animals off the floor and reaching for the book when it wasn't his turn! I liked his enthusiasm, but we are also teaching the boys to "wait" and "take turns," so I had to give him a few gentle reminders to put the animals down. At the end of circle, Ryan did a good job waving good-bye with a forearm prompt from me.
Snack comes after circle, and we moms left during snack to do our research and theory.
Theory today focused on the process called "extinction," which basically means that if you stop reinforcing a behaviour that you've been positively reinforcing, then that behaviour will decrease. We discussed how extinction can be used, some factors influencing its effectiveness, and some of the pitfalls of this method.
Well, onward and upward. For now, good night. I'm off to sleep (I hope).
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