Unity Day 48: Finally Back at Summit Centre!

From Facebook:

"Finally back to SC with Ryan today. We are both feeling rough still and are very tired, but we survived. Got Papa to do some of the ABA today and Ryan liked that. :)"

Thursday night into Friday, I was hit with the second wave of the illness that knocked out our family last week.  I was in bed till Sunday, so no, we didn't go back to Summit Centre until today.  Neither Ryan nor I are 100% better, but we really needed to get back to the Unity program.

Then, in a rush of guilt and panic after being off for so long, I went crazy with the homework and planning for our last two weeks in Unity.  It is in this exhausted and frenzied state of mind that I now make today's entry in the blog, so please excuse my rambling, succinctness, or wandering, or whatever this entry turns out to be.

The day started with getting to the S.C. and getting all my data sheets ready to go for this week. Thank goodness Papa was there to entertain Ryan while I got myself re-oriented with the data paperwork and S.C. schedule.  It took me a good 20 minutes to get sorted out and ready for our morning.

T. thought I wouldn't need much of a meeting with H. since I basically missed a whole week. They didn't even do an evaluation for last week, because we only had the home day! But I knew I had a bunch of issues to clear up and information about our closing weeks to receive, so I asked to go for my meeting with H. first. 

Evaluation
Well, I did have an evaluation . . . for the week before the Easter holidays! So, I reviewed that one. It was fine, except that I needed to explain the three parts of a trial a bit more clearly to my support people (I know it, I do it, but can I explain it to someone else?)

I also still have about 170 Parent Points. No plans for those yet.

This week, I need to focus on getting my support people more hands-on involvement with Ryan's therapy (so explaining, but guiding them in trying it with him, too).

Homework

Homework has changed a bit for our last 2 weeks:

1. 2 Play Goals:  I'm going to use the giraffe toy mentioned in the last home-visit post to work on Ryan's pushing-down hand strength.  I can rotate different push-down toys, but that one's the focus for now.  For my other play goal, we discussed using a new type of blocks for stacking, and tried them out at the centre, but they didn't give them to me to bring home. (?) So, for now, I'm going to do "bowling" as my other play goal for Ryan.  I'll use the soft set as T. suggested at our home visit on Thursday.
2. 1 Incidental Goal: The one incidental goal I really wanted to stick with was "making choices," but it kind of interferes with me trying to teach Ryan the new sign, "milk."  (He was making a choice between milk or food and another desirable object; then I expect him to try a new sign at the same time? That's too much.) So, I've switched our at-home incidental goal to getting Ryan to do the sign for "milk" when he sees and wants his bottle.
3. Reading: Get caught up on the Theory readings by Friday.
4. Craft for Friday: I mentioned before we'd have to make up a craft project for the boys in one of the last 2 weeks. So, I agreed to do mine this Friday. That means I have to obtain the materials, get them ready, and do a sample craft by Thursday night.
5. Paperwork: As Unity draws to a close, certain paperwork must be completed, such as filling in consent forms for information sharing between the many people and agencies working together to support Ryan. I also have some decisions to make in terms of what kind of post-program support I'd prefer from S.C. in the months after Unity ends.
6. ABLLS: Assessment of Basic Language and Learning Skills: This is a book I have to go through and fill in over the next week or so. Here is Wikipedia's explanation of this very complex and time-consuming process: "The Assessment of Basic Language and Learning Skills- Revised (The ABLLS-R), is an assessment tool, curriculum guide, and skills-tracking system used to help guide the instruction of language and critical learner skills for children with autism or other developmental disabilities. It provides a comprehensive review of 544 skills from 25 skill areas including language, social interaction, self-help, academic and motor skills that most typically developing children acquire prior to entering kindergarten." L. did some of the ABLLS for Ryan when he first started at S.C., and now I'm doing a concluding one to see what skills Ryan has gained over the last 10 weeks.

Remember how I mentined earlier I went a bit crazy with the homework? This afternoon and this evening, I completed the following:

• The rest of the theory readings in our binder.
• Bought all materials to make the craft on Friday.
• Finished all the consent forms and post-Unity paperwork.
• Completed the ABLLS to the best of my ability. (Yes, I reviewed all 544 skills in about 3 hours. It went quickly because many skills do not not apply to Ryan at this point, although it's discouraging to see all those blanks in the summary grid.)

Ryan's Day

Ryan's day started off pretty well from what I could tell. He got to play with Papa while I was in my meeting. He got a lot of time in the wagon.  I could hear B. coaching Papa on how to prompt Ryan to sign for "more" when Ryan got confused (he was doing "pat head" a bit) or lazy. When I came out, we went to the Blue Room to get on with the day's work.

I showed Papa how to do "pat head" and "clapping" with Ryan.  Ryan did his usual "I'll do it if you give me physical prompts" routine.  Hold his forearms/elbows with hands positioned by each other, and he'll clap; hold his right elbow and he'll pat his head. But today, if he didn't get the physical prompts, he woasn't doing it for us.

Then, T. brought out some new types of blocks for us to try with Ryan (which I thought were going to be transferred to the home program).  We tried the bristle blocks, but Ryan ended up liking running his hands through the bin of blocks and mouthing them; the texture was too much to resist! So, we decided that could be a reinforcing "sensory bin" for him. In fact, we are still having trouble finding powerful reinforcers for him, and he liked those, so we went with it.  Next, T. tried this magnetic set that had 4 arms with a ball holder on each arm and one in the middle.  The magnetic pull was strong enough that if Ryan let go of the ball overtop the holder, it would stay firmly in place.  However, Ryan quickly discovered he had the strength to pull the balls off, if he really wanted to!  But when we made pulling the balls off the arms part of the program, he lost his motivation!  I put one demand on him, and the motivation evaporated. How frustrating!

I decided to go up to the table and show Papa how we do our "colouring" trial. It was a good choice; Ryan enjoys colouring, and he did well. He gripped and pushed the marker a bit (with Papa holding the top) for all 5 trials.

Keeping with the positive momentum, I decided to show Papa how we do Play-Doh next.  Ryan was a bit too quick for Papa, though; he kept grabbing his Play-Doh ball and Papa would help him squish it.  I had to remind Papa to model the squish using his own Play Doh first, then HOH with Ryan (or fade back to wrist prompt).  Ryan surprised us by squishing the Play Doh--just a little bit--all by himself, before Papa even did the model!  Another time, Ryan did a little squish, independently, after Papa modeled. That was great improvement! I've never really seen him push down and try to flatten it on his own before. Sometimes, he tries to squeeze it, but pressing down with the palm is diffrent.

Seeing how well he was doing with the pushing-down movement, I showed Papa our program for the pop-up toy.  Working with a wrist-prompt from Papa, Ryan pushed one down, needed HOH for one, but then pushed down two independently!  For popping them back up, Ryan got 2/4 with a wrist prompt and the other two HOH.  That's pretty good considering some of the pop-up functions are tougher (switches and dials).

Next it was circle time, and Ryan was getting worn out.  He cried a lot during circle and needed lots of tissues (nose-wiping!), and lots of reinforcement to sit nicely and participate.  Thankfully, snack time was right after, and it gave Ryan some time to recharge.  After a snuggle and a bottle with Papa, Ryan was much more relaxed and ready to get back to work.

We spent a bunch of time working on "matching" with the pictures, using cars and balls today.  It took some time to get Ryan to purposefully place the matching pictures together; he was letting them drift lazily from his hand, or holding them and fumbling them around.  Once he got focused, we got some good matching going.  He matched ball-to-ball a few times for us, then ball -to-ball verus the car as a distractor.  When I switched the position of the ball and the car pictures, he was less accurate (about 50%); when I tried to get him to match car-to-car, he just got fed up. So, we HOH'ed the last few matches and ended on a positive that way.

Next, We did "coins in the piggy bank." Ryan got 4/5 in with a wrist prompt, which is good because we haven't done this in a while. He was also attempting to put the coins in the slot independently.  Papa also added to the activity by prompting Ryan to retrieve the coins from the side of the pig by opening it and having Ryan reach  in and pull them out.  I thought that was a good expansion to the activity, and Ryan seemed to like doing it. He always likes taking things OUT better than putting them in!

Finally, we moved into the Rainbow Room to do some gross motor work. It was already 11:15, so we practiced some "kick ball."  Ryan wanted to be picked up and held, so I suggested Papa use that as Ryan's reinforcement for kicking the ball.  T. approved of my use of Ryan's current desire (Papa's cuddles) as a reinforcer, so extra Parent Points for me!  Ryan responded so well to this that T. suggested we increase the work Ryan had to do to get his reinforcement. So, we had him kick the ball two or three times to get picked up cuddled by Papa. We also had Papa stand a bit to the side when he asked Ryan to kick the ball; usually, someone stands right behind him or right in front of him to prompt.  This was a bit more challenging for Ryan, but we did get a few more kicks out of him.  On that successful note, we ended our day.

We made it to 11:30, which was amazing, considering both Ryan and I are still worn out and sick, and he had been pretty grumpy before snack time. I think we deserve bonus points for sticking it out today!