"Wow, between holidays and illness, it's been a week since we've worked with S.C. staff. We had our usual Thursday in-home day today. Got some good advice, and had Papa there for nose-wiping and cuddling duty for Ryan. LOL Was a short morning because Ryan's still feeling a bit rough."
(Friday = Holiday) + (Saturday & Sunday = Weekend/Holiday/Illness) + (Monday = Holiday/Illness) + (Tuesday & Wednesday = Illness) = Today is day 7, and we finally got to work with S.C. staff again!
It was a good thing we had a home day to ease our way back into the routine. I've been trying to get Ryan to do a program or so each day to keep him on track, but it's been tough. We did well on Friday and Saturday, but the kids all fell ill on Sunday (at different times as the day went on). It appeared to be a three-day virus with fever/headache/sore throat, but Ryan's has moved into his ears, nose, chest . . . and is lingering. At least the fever is gone, but he's still fairly cranky and tires easily.
It was Papa's turn to be support person today, and T. came from S.C. to join us at home. Like I did for the last home visit, I'll outline some of the things we worked on/questions I asked and what observations/suggestions T. made.
- Matching with Pictures: I got out the matching with pictures, and Ryan started out a bit irritated. He didn't want to work. He was dropping/flinging the cards down carelessly. After a bit of persistence and consistent correction on my part, Ryan began to cooperate more. We eventually made it up to a Step 2 match, where he was matching the correct picture and ignoring the distractor picture. One thing T. mentioned was, to prevent mouthing, I hold the picture about halfway down Ryan's body, closer to the floor. Also, when he's reluctant to participate (at first), I can give an extra prompt by tapping the floor next to the correct answer. Once he gets more engaged, I can drop the extra prompt.
- Pat Head/Clapping: He totally surprised us with these today. He did them almost perfectly, and with very little prompting! He only made one mistake on "clapping," and he did lots of both imitations independently. We noticed that he was enjoying his rocking chair today (preferred to work from there), so we used it to our advantage. When he did the imitation well, we gave him a big, long rocking session in the chair. When he did a decent approximation, he got a little rock. When he didn't participate or did it incorrectly, he got no rock (I made sure it stayed still). So, working while on the rocking chair has the built-in reinforcement of letting him have a good rock if he responds correctly to the task.
- Giraffe Push Toy: Ryan got this toy as a Christmas gift, but I put it aside because I thought he wasn't strong enough to push the top down to get the desired spin effect. Well, since we'd been talking about Ryan's push-down skills last time they were here, I thought of bringing out that toy as another alternative. The nice thing about this toy is there is really no other way to get the spin, the natural reinforcement, out of it. (Other toys have had various ways for Ryan to get the feedback he wants without pushing down.) When I put his hand on it to push it down, he did the usual wait-for-mom-to-HOH-the-pressure. So, I decided to fade back a bit, and grasp him by the forearm when he put his hand on the top; then, I gently pulled his arm down, making the top go down and the toy spin. He got really excited. We let him try it on his own a few times, too. Sometimes, he can do it independently, just enough to get the spin and the balls rolling! He only did it once or twice independently, but of course he got HUGE praise (what we sometimes call "the big party!") when he did it all by himself.
- Push Train Round/Curves: I got out Kevin's new, portable Thomas the Train track he got from the Easter Bunny, to let Ryan do the "push train" trial. It's not very big, so Ryan didn't have a lot of track to push along until it derailed. Ryan has only been working on straight lengths of track so far. This situation naturally brought up the question: How do I teach Ryan to push the train around the curves (full/closed track)? T. suggested that since he knows how to push the train straight, let him do that part, and then HOH the curves until he gets it by himself. Therefore, it would look like Ryan pushes the train straight, and gets reinforcement; Then I HOH the curve with him, and he gets reinforcement; then Ryan does the next straight track and gets reinforcement; etc. Eventually, I would fade back the prompt on the curves until he's doing it all independently. We tried it a few times, and it worked well; he even pushed it through a curve independently about 2 times.
- Musical Shape Sorter: The Easter Bunny brought Ryan a musical shape sorter. He enjoys that there are sounds/music when the shapes go in the box. However, T. pointed out this one was a bit more challenging for Ryan because the shape holes are on the sides of the box, instead of the top. The one we'd been using at S.C. has the shape holes on top, so it's a bit easier to manoeuvre the shapes into place. Our one at home also has a big opening in the top, so Ryan sometimes puts them in/takes them out of there, and gets his musical reinforcement too easily. T. had a simple solution for these issues: turn the shape sorter box on its side. Then, the shape holes are on the top for Ryan to put them in more easily, and the large opening is not accessible to him. As Ryan gets more confident putting in these shapes, I can begin to tilt the angle of the sorter until it is upright again.
- Pencil Grip?: I asked T. where I could get a special pencil grip like the one they have at S.C. for Ryan's colouring. It's hard to do the colouring program properly, at home, without the special grip. She said she'd check to see exactly where the one we are using came from, but that I might find something at Teach N Toys or Scholar's Choice stores.
- Bowling: Ryan's got a pretty good throw when he feels like it. L. had previously suggested that a bowling toy set might be a good activity to try with Ryan. Well, it just so happens that I got Ryan a set of a soft, animal bowling game last year. The ball and pins have fun jingle and rattle sounds. Ryan plays with the different parts sometimes, but has never shown an interest in actually using it for bowling. Today, I pulled it out and asked T. for some suggestions as to how to re-introduce this toy to Ryan. After some trials to see what stage was best to start with, T. said to have Ryan sit with his legs apart, and put two pins in front of him, not too far away. Then, give him the ball and tell him to roll it/throw it. When he is knocking down both pins consistently, then we can move a little further away. Eventually, he would do this from sitting on a stool, then on a chair, and then standing. We would also add in more pins as he consistently showed success/accuracy with further distances and moving toward standing. Ryan surprised us by knocking down one of the pins on many of our initial trials. In terms of reinforcement, he got lots of praise and cheers when he knocked one down, and a little less reinforcement if he hit one. Ryan was funny; he seemed to enjoy the cheering and clapping, more than reinforcers from his basket, when he knocked a pin down! That's actually good, because we want things to become naturally reinforcing, in the long run.
- Farm Stick-On: Last year, when we did the weekend-long ABA course pre-requisite for Unity, I had received an activity to use with Ryan, but I'd never really received an explanation of the best way to use it for him. So, I pulled it out and talked to T. There is a little poem on the back of it about animals and the sounds they make, but T. agreed it might be used differently for Ryan. Since Ryan likes songs/music, she suggested I sing "Old MacDonald" and start out by putting the picture of one animal in front of him, like "cow." Then when I sing, "And on his farm he had a COW," Ryan would pick up the cow and stick it to the barn. Later, I could expand the activity by putting two different ones in front of him to choose from (throw in a distractor with the cow), and so on. Eventually, Ryan would be picking up and putting each animal on the barn, from the selection of animals, when I say its name.
- Shapes Stick-On: They came up with a Velcro activity for me to help Ryan learn his shapes. Like the farm one, we have to take it one slow step at a time. The page has several examples of the same shape on it, but I would only start with one example, getting Ryan to stick it on. Then we'd move to adding choice of two, and eventually expand to all examples of a given shape. Then, I would get the sheets for two very different shapes (like circle and square), and put them side by side. I would pull off one of each, and get Ryan to match the right shape to the right sheet, and expand the activity from there.
- ABC Flowerpots: Similarly, I asked for an activity to help Ryan start learning ABC's. They gave me a set of flowerpots with simple letters on one side and images of items starting with that letter sound on the other side. Then, there are little letter flowers to stick to each flower pot. T. suggested that I start with only a few letters at a time (2 or 3) and make sure they look very different (i.e., don't put O and Q together). I would do it like matching at the start; match the flower letter to the letter on the flower pot, and start throwing in a distractor to test his understanding. Eventually, we will expand to matching more letters and having more letters to choose from. The final step would be to flip the flowerpots over and match letters to sounds, but that's for future expansion.
- Signing for "Milk": I've tried a few times, over the last week, to show Ryan how to sign for "milk" (his bottle). This is our new sign we're working on. The problem is, he wants to use his old manding for milk (reach for it or tap it), and he gets mad if I don't give it to him after he's done those things. He doesn't understand that we are changing the way he asks for milk, making it more appropriate and specific. T. said I've basically been doing the right thing: try my best to "HOH" the milk sign, then give the milk to him, and repeat the sign and say the word again for him to see and hear. The next step is for me to HOH the sign, then have him do it once, and then give him the milk. From that, I'll fade back the prompt as per usual, until he's doing it independently. Here's something interesting, though: right after T. left, I got Ryan a bottle and showed Ryan the sign, but I had to put it in the microwave to heat up. While Ryan was waiting he got impatient, and I kept telling him yes, the milk's in the microwave (while doing the sign when I said "milk"). I looked down, and Ryan was opening and closing his hand in the squeezing motion that signifies "milk!" He didn't hold it up by his chest, but the sign was clear, even though his hands were at his sides. He did this two or three times in the 25 seconds we waited for the bottle to warm up! I hope it was not a coincidence. When I finally handed the bottle to him, he was opening and closing both hands in the "milk" sign. He really wanted it! I hope this sign catches on quickly. I'm so excited to see if signs work for us, so we can get some real communication going!
On a positive note, I got my feedback sheet from last week's in-home day, and H.'s comment that my circle time was "not too shabby" was clarified. It was, in fact, a compliment. The feedback sheet said I did "excellent" in choice and length of activities, and "perfect" in providing reinforcement instruction to Grandma, who was our support person that day. Well, now I feel much better about that!
Tomorrow we head back to S.C., and Grandma will have her first in-centre experience. Friday is a good day to go back, especially if Ryan's still feeling blah, because he has less demands on him. He basically gets to play while Mom goes off to do research and theory, and Grandma will be there to cuddle him while I'm off doing that portion of the program. :)
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