In So Many Words

Title: Behavior Solutions for the Inclusive Classroom
Author: Beth Aune, OTR/L, Beth Burt & Peter Gennaro
Length: 151 pages
Genre: Nonfiction
Publisher/Date: Future Horizons, 2010
Source: Review copy

See A Behavior, Look It Up

Behavior Solutions for the Inclusive Classroom is a great new resource for teachers who are attempting to provide a positive learning environment for ALL students, including those with challenging behaviors. The team of authors behind this book includes an Occupational Therapist, a Director of Special Education, and a Parent/Advocate, thus providing a well-rounded look at the issues and the solutions that can arise in a general education setting.

The premise of Behavior Solutions is that teachers need a convenient resource so that when they see a behavior occurring in their classroom, they can look it up and quickly find several possible solutions that may help them get through a particular situation and continue on with the regular agenda of the day.

Forty of the most commonly observed behaviors are listed, organized into four main sections:

1. Movement Issues
2. Avoidance and Retreat Behaviors
3. Difficulty with Routine and Academics
4. Social-Emotional Issues

The book includes a detailed table of contents and comprehensive index for ease in locating specific behaviors easily, and there are also appendices with more information on movement breaks/goal-directed tasks, sensory input devices, and calming techniques. An additional resources list provides direction to those who wish to learn more about responding to the needs of students with a variety of educational challenges.

One very nice feature of this book is that the authors work to educate the readers (who presumably have not had a lot of background in special education) about the rationale for the suggested solutions without overwhelming them with too much information.

For example, under the behavior of “Chewing on Shirt or Other Inappropriate Items,” which is in the Movement Issues section, they offer solutions such as providing certain types of food to eat instead, allowing the student to drink from a water bottle with a large plastic straw, or giving a younger child something like a Chewy Tube. Then they go on to explain:

The key here is to replace the socially unacceptable behavior of chewing on shirts (or pencils) with chewing on objects that are less likely to stigmatize the student. As educators, we must not let established policy be a substitute for wise and successful decision-making. . . . Remember, educators have greater decision-making control than the students whose disability causes inappropriate behaviors.

I think this would be the perfect book to give your child’s regular classroom teacher or aide. It is a great size and extremely easy to navigate through on the fly. There are also a lot of helpful ideas that parents could implement when overseeing homework or involving the child in other structured activities within the community.

For more information or to order a copy for yourself, visit Future Horizons online store.

I’ve been too busy with a psychiatric evaluation and an annual IEP meeting to keep up with email, let alone blog, but there have still been a number of great articles that caught my eye this week.

My Crystal Ball and My Checkmark Chart at Welcome to Normal – My last token economy system for home had kind of fallen by the wayside with the recent difficulties in school, especially since I wasn’t letting him play the Wii or computer if he was aggressive that day. It kind of makes it hard to earn privileges at home when you aren’t allowed to redeem them.

But after reading this and seeing how Caitlin is converting the checkmarks to money, I thought that might work for Michael at this point in time. I am making them equal to a dime, which is the same amount he gets at school (although theirs go towards school dollars and not real ones, of course!). Michael has been highly motivated by it for the last few days, so hopefully that will continue.

Interview With Taylor Morris — An Exceptional Teenage Girl with Aspergers at Hartley’s Life with 3 Boys – A fascinating interview with a young lady who shares about her experiences with sensory processing disorder and Aspergers.

In Honor of Dr. Stanley Greenspan at 5 Minutes for Special Needs – Dr. Greenspan, who among many other things started the D.I.R./Floortime therapy, died on April 27th following a stroke. He will be greatly missed.

Eating for Autism at autism community – This is a review of a book by Elizabeth Strickland regarding the GFCF Diet and having a healthier diet overall. I’m wondering if any of you have read or used this book at all and whether you like it. One of the things I need to focus on with Michael is improving the quality of his diet, which has been difficult due to his sensory issues and the number of different foods and textures that he avoids.

Well, that’s is for this week. I’m clearing out the GReader and starting fresh in the morning!

I have been reading so many great posts by bloggers lately, and whenever I see something that really speaks to me in some way, I feel an urge to share it. Rather than flood Twitter or Facebook with links that may or may not be seen by anyone, I decided to list a few of them here.

So here are some things that caught my eye in the past week:

On Advocacy – a subject that is near and dear to my heart:
What Is Advocacy? An Inside Scoop From Pathfinders For Autism from The Gift: A Blog for Caregivers of Sensational Children

An Amazing Moment When a Kid is Just a Kid
The Power of You and I from Welcome to Normal, Population 0

Insights Regarding the Division Between Biomed Moms and Neurodiversity
Desperate, huh? and Bridging the Gulf from Life as the mother of 4

Practical Tips
Simple Accommodations to Help Your Autistic Employee Excel from Spectrum Siblings

Autism Treatment – How to Use Supplements to Treat Autism, Part 1 and Part 2 from Dr. Kurt Woeller’s Autism Recovery Treatment Blog

And on a separate, somewhat superficial note, did you know that you can now put a Facebook “Like” button on your web site? It allows you to see how your Facebook friends are interacting with sites around the web. I put one on Another Piece of the Puzzle just for kicks, so feel free to pop over and “like” me (and let me know if you add one to your site)!

Besides revisiting the behavior plan and the level of positive reinforcement being provided, the other thing the IEP team did in response to Michael’s aggressive behavior at school was to add a safe crisis plan.

We had had a safe crisis meeting earlier in the school year when the school secretary had (inappropriately) gotten involved and physically moved Michael from the hallway into a classroom, but all we did at that point was clarify for everyone in the building who to contact if the adult in charge of Michael felt they needed assistance with him (i.e. NOT the secretary!).

Now we had started seeing some out of control behavior, with Michael jumping straight from a calm state to yelling and screaming at people, and then a variety of aggressive behaviors, including hitting, kicking and throwing things such as his shoes and socks, chairs and even a trashcan. So the team met to create a safe crisis plan.

The way it was explained to me, the behavior plan tells the adults what to do so the child will (hopefully) not have a meltdown, and the safe crisis plan tells the adults what to do so THEY don’t have a meltdown! Our plan does not include any form of restraint; in fact, the purpose of the plan is to give everyone the information they need on what to do so that restraint will not be needed.

Our Safe Crisis Plan
The basics of the plan are pretty simple – if Michael is hitting, kicking or throwing things at anyone, the teacher will physically block the behavior if possible and will clear the other students from the room.

Next, a second adult will be called to take charge of Michael. Once he is calm enough to leave the room himself, he will go to a separate room with the adult. We chose the speech room so we would have a consistent location; the SLP is only in the building two days per week and does a lot of her work in the various classrooms, so it is usually available.

Then, once Michael has left the room, the other students can return and continue with their lessons. Michael will stay in the speech room until he is completely calm and ready to return to class If he is unable to calm down after 30 minutes, they will call me to come and get him.

Of course, we are all very focused on lots and lots of positive reinforcement of desired behaviors and on intervening as soon as we see Michael start to become upset to avoid any of this, but it is good to have it in place so everyone knows exactly what to do if there is a problem and to lessen the possibility of anyone getting hurt.

NOTE: I thought I had posted this last night, but I just realized it was still in draft form. We actually used this plan today, as he had an incident that turned into a major meltdown and I had to come and get him from school. I’m still trying to process the details and figure out where to go from here as far as he is concerned, but I am thankful at least for a good team that is working so well together.

I just got the graph from the learning support teacher showing Michael’s timeouts from March. He currently gets a timeout only for yelling or screaming and for any aggressive actions (hitting, kicking or throwing things). Outside of these, he is prompted toward the desired behavior and positive behavior is reinforced through a visual token system.

This had been working quite well for a while, although lately the timeouts have been gradually increasing in frequency and it was discovered after a recent series of aggressive episodes that the reinforcement scheduled had been thinned considerably because of how well he was doing.

Oh, beware the words “well” and “fine,” I tell you – they’ll get you every time!

He attended 20 days of school from March 3rd to 31st (not sure why the 1st and 2nd aren’t on the graph) and had a total of 10 timeouts.

• 13 days with no timeouts
• 4 days with 1 timeout
• 3 days with 2 timeouts

The most days in a row with a timeout was 2; whereas the most days in a row without a timeout was 9. So what was different about those 9 days in a row?

Simple – we increased the positive reinforcement.

Yep, we upped the visual reinforcement back to its original level on March 15th and then had 9 days without a timeout. In fact, even after that, he only had three timeouts the rest of the month, and one of those was on a day when he had been on a study trip. He had done an amazingly fantastic job through the entire day to that point, but just couldn’t recover from being upset when he got out during a spelling game due to mis-hearing the word that was asked.

I have quoted this before, but it’s still so true:

The power of positive reinforcement is the most under-utilized tool we have.
~ Peter Gerhardt, Organization for Autism Research

In fact, our autism consultant has introduced another visual reinforcement schedule, which is set up like a game and based on Super Mario Bros, that specifically targets his behaviors during competitive situations. At least for now, it is motivating enough to help mitigate the negative feelings he has when he doesn’t win or isn’t the first or best one in an activity. (I’ll see if I can get a copy of it to post here; they keep the book at school.)

Have you found this to be true for your child? What motivates them even when the emotional stakes are high?

The regular students in my son’s first grade classroom have to complete a think sheet if they pull all four of their cards in one day, so when we created my son’s behavior plan, we wanted to include a think sheet for use after a timeout (timeouts are for yelling or physical aggression only at this point).

His OT created one just for him. I wasn’t sure what it would look like and how much writing would be involved, so I was very pleasantly surprised when I saw that it was mostly circling things. She used emoticons for the emotions and other colorful icons to illustrate the other areas, and it has worked beautifully.

I scanned one of the think sheets so you could see it – sorry it’s not a better image.

A couple of notes:

• Stop and Think is something the speech teacher uses with all the kids.
• Park It is something we pulled from the training world and included in his behavior plan. It basically means that when you have a question or comment that is inappropriate for a particular time, it can be written down and addressed by the proper person later. Sometimes that’s the teacher and other times it comes home to me. We have it right on his communication sheet. I’m not sure if I’ve posted about that before, but I’ll try to scan a copy of that for a future post.

Michael has even asked to fill the think sheets out when he goes to his quiet space because of being upset about something (that is not the same as a timeout, just a place for when he is overwhelmed or starting to get out of sorts). The OT has encouraged this because it will help him become more aware of how he is feeling before he gets out of control.

We have been following the new behavior plan for one month now, so I am emailing the team to get their feedback and ask for the numbers on how many timeouts there were for each thing. But I know they are pleased with his progress overall, as well as relieved that the new TSS is so much better.

If anyone would like a copy of the Word document, just email me or leave a comment below requesting it and I will email it to you.

This post was written for the Steady Mom 30-Minute Blog Challenge I would encourage to check out the other posts and also the Steady Mom site as there are some great changes happening over there.

As any mother of young children can attest, there are lots of theories about approaching potty training, and there are usually as many people willing to offer their suggestions on the “right way” to accomplish the goal.

But, just as with any other area of parenting, success comes down to what is right for each individual child and family. This is even more true when dealing with a child who has special needs. A child with a disability may have physical, mental or communication challenges that make it difficult to know when to start the training, what method to use and even how to know if you are making progress.

How Do I Know When To Start?

The most common advice given in parenting books is to watch for signs that your son or daughter is ready to begin potty training. Some of the readiness signs mentioned by Heidi Murkoff in What to Expect the Toddler Years include:

• Staying dry for an hour or two at a stretch
• Having fairly predictable bowel movements
• Awareness of bodily functions
• Interest in being clean and dry
• Ability to communicate needs and follow simple directions
• Can do some simple self-dressing
• Curiosity about, and possibly imitation of, other people’s bathroom activities

What Do I Do Now?

Once you have determined that your child is ready to learn, or if you want to help them along in the process, there are lots of ways to go about it. In The No-Cry Potty Training Solution, Elizabeth Pantley offers suggestions for pre-potty training, such as reading books about toileting to your child, teaching the vocabulary you want to use, and practicing following directions.

Pantley also offers a menu of ideas to choose from as you move into the active training phase. Here are a few that may be particularly helpful with a special needs child:

Make it a routine. Instead of asking if the child needs to go, simply take him at regular times or when you think he may have to go.

Make a custom potty book. Take photos of your child at each part of the process and put them in a book by taping together several pieces of cardstock or poster board and then adhering the pictures to the pages. Include pictures from start to finish so she sees the entire process.

Make a potty poster. Similar to the potty book, this would be another visual representation of the steps in the routine, using either pictures of your child or appropriate drawings/icons. Glue the pictures in sequence on a poster board and number them.

Offer a prize. This could range from stickers to inexpensive items from the discount store or a party store’s small favors. If your child can understand the concept, a bigger prize or a special privilege could be earned with a certain number of stickers.

What If We Aren’t Making Any Progress?

If, like I was, you are faced with a child who is well past the “right age” to potty train but who shows few to none of these signs, you may need to take a different approach.

Maria Wheeler, author of Toilet Training for Individuals with Autism or Other Developmental Issues, offers lots of strategies and tips that take into account issues such as sensory processing difficulties, motor challenges and communication needs. After hearing her speak and then reading her book, we put the following plan into place with our then five year old son:

1. Parent or behavioral support person would take him to the bathroom once every hour. He would be given a five-minute warning with a visual cue and then shown the cue again for the transition.
2. Once he was sitting on the toilet, a timer would be set for 5 minutes. When the timer went off, he could get up even if he hadn’t gone potty. (Of course, he could get up sooner if he went!)
3. He would do the entire routine each time, including hand washing, even if he didn’t go potty.
4. He would be given lots of encouragement and praise for completing each step, with no recriminations for not going potty.

Within a month on this routine, he was consistently staying dry and going potty within a minute or two of sitting down. We were able to gradually lengthen the interval between visits, and he even began wanting to go right away when the five-minute warning was given.

After a few months, he had become independent enough that we could simply tell him to go to the bathroom and he would complete the routine by himself. Eventually, he did start telling us when he needed to go to the bathroom. Although transitioning to him being in control of getting himself to the bathroom felt like a step backward because we were seeing accidents again, it was really a giant step forward in his progress.

A year and a half later, our son is completely trained and independent for daytime, and we are getting ready to tackle nighttime training. Out of everything I have learned from this experience, the best advice I can offer in this whole process is to keep yourself calm and to remember there is always room for hope.

Note: This article appeared originally on Root & Sprout, a parenting ezine which is no longer available online.

For Try This Tuesday at 5MFSN today, I wrote about my introduction to 1-2-3 Magic, which is a parenting/discipline method we are starting to use with Michael. A big part of its success depends on the parent keeping their own emotions and words under control, which can sometimes be difficult when you have a high stress level.

I recently saw an article on our local ASA listserve called Calm, Cool, Collected and Consistent, which goes into quite a bit of detail about how stress affects our bodies and how regular exercise such as walking can help. I tracked down the reference and was able to find it as part of a collection of articles by Susan Crum from Able2Learn. I would definitely recommend checking these out.

Another site that looks like a great resource is Jill Kuzma’s Social Thinking Weblog. Jill is an SLP from Minnesota who offers both information and teaching resources on a variety of social skill related topics. She also has a list of ideas for social language IEP goals and a detailed page about assessing pragmatics/social language skills.

For today’s Try This Tuesday, I’m talking about expected behaviors and perspective-taking. Not too deep for this early in the morning, I hope! This is something that has come out of Michael’s sessions with the psychologist I recently started taking him to. I’m so thrilled to have found her and want to share more of what I am learning and how Michael is doing here, but in the meantime please pop over and read more about it.

So I was catching up with my Google Reader today (since I hadn’t even turned on my computer since Friday and was feeling serious withdrawal pains) and saw that 5 Minutes for Mom had yet another giveaway, this one for a $50.00 gift certificate to Tiny Prints. Just as I was thinking about how many giveaways they have had lately, my eyes landed on another post, this one announcing their newest site, 5 Minutes for Giveaways. And their first item up for grabs is a Kodak Digital Picture Frame!

I know things have been pretty light around here lately. Between us taking turns being sick and decorating/shopping/etc for the holidays, I haven’t had much time to sit and process all the things that have been going on inside of me. My company is also considering layoffs for the first time in its history, and my husband’s job has become quite stressful due to a variety of circumstances, so daily life is definitely taking up more than its fair share of my time!!

But things are good, and even if they aren’t at times, God is good and He will provide. (Okay, rambling over, you may now return to your regularly scheduled programming!)

Following  my comments today about feeding issues, I was asked how many foods my little guy will eat. That made me curious, so I made a list and was pleasantly surprised that the number is much higher than I thought – around 30.

First of all, I had mentioned that we were down to 5 foods around his second birthday. It was something like this:

• Month 1 – mom makes grilled cheese sandwich, son loves it and eats it all up
• Month 2 – mom makes grilled cheese sandwich, son fusses and eats parts that do not have cheese oozing out the side
• Month 3 – mom makes grilled cheese sandwich, son cries and won’t eat any of it

Bad foods would be ice cream or any other very cold food; mushy foods like mashed potatoes, pasta, pudding, applesauce or yogurt; crumbly foods like cake or doughnuts; meat that is not breaded or encased in something; or anything vaguely resembling a fruit or vegetable (other than grapes and bananas).  And God forbid you try to use any type of condiments, except for syrup on pancakes and waffles!

Good foods would be specific GFCF & Michael-approved brands of crunchy cereal, cereal bars, corn chips, veggie chips, chocolate chips – sorry, I was on a “chips” roll , pretzels, crackers, cookies, chicken nuggets, hot dogs, french fries and an occasional fish stick.  As I mentioned above, he will eat grapes and bananas, and he likes waffles and pancakes, both with syrup.

For treats, he also likes raisins, fruit snacks, jelly beans, lollipops and gummi bears (this does not include other shapes of gummies, which are yucky!).  Although for the most part, his diet is gluten-free, casein-free, dye-free, preservative-free, we will occasionally let him have a few M&Ms or Hershey Kisses and have not seen a negative reaction in small quantities.

Warning: If anyone reading this is looking for guidance on what to feed your child, I would not recommend that you use me as an example.  We have chosen not to make this a big issue in our lives, since we have been focusing so much on things like speech, and sleep, and why we are getting yet another new support staff person!