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214 Start at 1:05:17
Nancy: These were some of the things you put down and we are going to come to some consensus of the main ones we are going to work on. That some of the main challenges are tolerating others, interacting communicating with peers, adjusting, with play moving beyond parallel play, interacting. So out of all that what would we target to be the main thing you feel we need to work on with social skills as we break it down into measurable king of things we want to work on.
Teacher: I think actual interaction, communicate with peers, actually asking
Mom- See all of this plays in to that as far as I
Teacher- Cause now at this point tolerating others playing in a circle share a toy, she is doing great.
Right
Teacher: So a lot of it is learned behavior once she becomes comfortable.
Nancy: So do you see with social and some kind of reciprocal interaction with peers?
Teacher: Do I see it?
Lisa: No, no as a goal
All: as a goal
Teacher: Yes
Mom: that would be wonderful
Lisa: Do you want to write on this Nancy
Nancy: sure
Lisa: ok
Nancy: you look in there, there is tape in a box, oh you got it. Ok. Alright.
Teacher: You can just say initiating like a verbal come do this with me some kind of initiating play cause I don’t see her without actually doing the actual play she is going to need but that’s just the first step I guess.
Nancy: We can also look at putting something in if you look but at communication skills we can look at it in a communication skill if she says come play with me shes got to be able to do something with play.
Teacher: right, right
Mom: with the person wants to get there
SLP: a game
Nancy: right, right. Still with AJ we are at the point right now her not particularly caring
Mom: right
Nancy: and so I almost think we are going to need to look at and I’m just looking at the play now and I think it is with a peer some kind of reciprocal back and forth
Mom: and to enjoy it
Nancy: right, right. We hope she will enjoy it.
Teacher: laugh, I’m giving you this because I have to
Mom: So like throwing a ball or book passing back and forth.
Nancy: Right. So that she is engaging in some kind of back and forth activity and we can’t say cause you can’t measure enjoyment but she is looking at the peer
SLP: I cant remember what the activity was, may be dance but it was couple of things where she went and took their hands
Teacher: I think you two were over by the table cause I remember you were so excited by it and you mentioned it.
Mom: She likes ring a round the rosy
SLP: Yea, maybe it was some kind of motor activity.
Teacher: And scarves she gets very motivated if we have that.
Nancy: Alright, of. So we need to figure out on this one how we can word one of those so its very specific cause that is a really good things but its not necessarily going back and forth
Right
Nancy: so it may be that we just want her to engage in an activity for 10 minutes with a peer where she is ummm
SLP: its almost like you would have to do some kind of physical play almost
Teacher: right
SLP: where you just have other kid and you put a toy in there.
Teacher: the attention isn’t going to be on the person anymore
Nancy: right
Lisa: Where’s your little criterian, your little nice IEP thing you made up?
Nancy: oh yea
Lisa: that helps. But shes not doing anything interactive with kids now even when it comes to sharing.
Teacher: we always share supplies
Lisa: right
Teacher: we take turns in circle, but when she has free time she just runs and explores her own thing.
Nancy: She doesn’t do it I think you gave a good example when she really really wanted it but her brother wouldn’t. they have something going
Mom: she can do it
Lisa: yea
Nancy: but her preference, or her way of doing it is by herself really doesn’t look much at the other child so its really to define clearly what exactly we wanted her to do
Lisa: and if you go back to the social those questions that umm about her play. There are two things about her play that you told us about. One was play and how she interacts with objects. I think there was some discrepancy she talked more about more pretend play at home where as I think at school um you saw her doing more of just focusing on the parts of the toy or um no more of the exploratory play
Mom: right like she will take the figurine she is using and set it up on the vcr or help them along
Lisa: right right so there is interaction with objects and when you set them apart what you talked about was interaction with other children and this is where you had more of a difference. At home you see her more doing um more parallel play where she is using more materials, maybe there is some brief interactions but its not really interactive or cooperative. And then focusing at school really unaware of other children on her own activities. So it sounds like you are wanting to get her to be more playing and interactive with other children so its like the way we set this up is developmentally so kids start off focusing on their own actions and then play with toys and other children solitary play and then its more looking and more parallel.
:Mm hmm
Lisa: and you know So what we want her to start to do is move down this way where it is more cooperative
:Oh ok
Lisa: So what we want to think about is where at the end of the school year do we see her
Teacher: right right
Lisa: yea yea, so we will set it there and we will break it down by bench marks. What it will look like for progress. So maybe cooperative is even exceeding where we might expect so maybe its more parallel it sounds like though at home you see her more of doing that with her siblings, they are very familiar
Mom: Then again its more of a different setting
Lisa: right
Mom: where here the kids in her class are having some of the same struggles she is. My ,her siblings they wont as they get a little older I’ve noticed they are starting to pull away a little more from her but I also if I notice it wont last. I say go in there, go do this, go do that. So from whichever angle its coming from at home she is not being given a choice.
Lisa: Right yea this is work for her this is work for her yea
Mom: So I Think the differences there not that they are giving her a choice but the other children are having the same struggles as she is here
Lisa: well And that is an environmental challenge that we will have to talk about in the teaching plan if there is a way for more sociable peers
Nancy: well she is she is in the morning , she is in another class
: well in the morning she is in the other class
That would be kinda be observant in our classroom more socialization
Lisa: She could practice in your classroom and the generalization to other peers
Nancy: right right
: Right right
Nancy: Perfect
Mom: So is that where we should bring Amy Biddinger into?
Teacher: That was my question.
Mom: As far as like uh
Teacher: Is it possible for you to be aware of the other environment because I think
Nancy: Oh absolutely
Teacher: You know taking part, I don’t know if that needs to be noted because a lot of these skills are coming across in where we cant totally do it in this environment or the other one so she needs the dual placement
Nancy: right
Lisa: the other thing you talked about is we all want her to be initiating and initiating social interactions. And we saw a nice little clip of that in the video where you had her initiate asking
Teacher: Yea yea
Lisa: That is such a neat activity I just love that video
Nancy: That was the when the day you were doing with the speech where she was asking so see I see the initiation being almost in the communication but in the social with peers we need to get some reciprocal
Lisa: But it could be stuff like maybe I don’t know I am just guessing just that comes to mind but even if its just the sand table or water table and there is a really neat toy and there is like a ferris wheel you have to fill up and there is just one tool and she has to wait and say my turn or something like that and she is interested in it, she has a reason to be there and she has to ask the peer and then share something
Teacher: And you all did do that. She will do that with guidance, models
Lisa : Hmm mmm
TEacher: Its just on her own she will probably walk away from the table.
Lisa: hmm mmm
Nancy: Well we would like her to do is do it with the peer, the peer doing all the prompting
SLP: Then its got to be in the other environment
Nancy: Then its got to be in the other environment
SLP: Yea
Lisa: But she could practice on it
Nancy: and at home cause she has her peers cause she could practice
SLP: Yea with us being the model
Teacher: right
Lisa: She could practice with the adults then she could generalize with plans to the peer
Nancy: yea
Lisa: That’s just an example that it might actually look like. Im sure you have lots of other ideas.
Nancy: I think playing the ball is also part of with a peer your there doing the prompting
SLP: Right, Yea
Lisa: Right
Nancy: But still she is learning the skill she needs which is to watch and to keep engaged
SLP: And we can do that here easy because
Lisa: Hmmm mm
SLP: we got there is a couple other ones in her class we could but we also have other kids that are pretty verbal and in other classrooms that we can pull from to help
Nancy: Hmm mm
Mom: Is that something that could be beneficial to the other child though too
SLP: sure
Nancy: yes yes
Teacher: doing the same skills
Mom: right, that’s what I am wondering if there is someone like that. And we could sit down and talk to Amy too about and it just might be Nolan. I don’t know about who she might if there might be someone in that setting and maybe we purposefully target someone other than Nolan.
Laugh
Teacher: Right right
SLP: Cause she is comfortable with that
Mom: Very much so
Teacher: I think Nolan gives her what she wants, that’s what they said she has fresh peers in this class that age appropriately will say no it changes her scheme what she is used to and if she asks she will
Mom: So maybe we could ask if there is someone in her class in the other school that we could pull in
Nancy: Ok lets see if we can do that with the conditions given what, what’s the condition that she has sociable peers. This is what we want her to be doing by the end of the year
Lisa: During free play during unstructured time, I mean this is
Nancy: We will have structure, I mean what
Teacher: Well that is one of her goals. We want her to find a friend and request play
SLP: So during a structured activity she will initiate the play with a friend that’s not the end goal probably something in between there
Nancy: See I would, I guess I would like to see her engage in some kind of reciprocal back and forth for a certain amount of time or certain number of exchanges so we are keeping her on target. Like the ball
SLP: Right
Teacher: Yea I keep going back to the ball cause often when she knows we are going outside she will ask for the beach ball or ask for the princess ball she will take it outside and she will kind of kick it somewhere and then she is done. That might be a good start where its something she has been interested in and show her how to keep it up
Nancy: Right and like Lisa said in the other settings where she is going back and forth so we are going to engage in an X number of reciprocal interactions with a peer
Lisa: And she will complete 3 back and forth or whatever
Mom: Exchanges
Lisa: Exchanges,
Nancy: alright
Lisa: and exchanges completely one and back to the other, that’s one
Teacher: is that prompting or a person prompting
Nancy: So its going to have to be structured its not going to
Lisa: Well that’s what we got to decide, yea, so that’s part of the condition the prompting. But again think about the end of the year where you would like to see her so it could be peer prompting with adults out of it.
Mom: Thats what I was going to suggest is it be a peer rather than an adult
Lisa: mmhm
Nancy: Ok, so given a structured play activity AJ will
Lisa: And just to let you know I am going to write this up and we will get you a copy of it so whatever
Nancy: AJ will… what,
SLP: reciprocal exchanges
Nancy: And how many reciprocal
SLP: and is this the end of the year
Nancy: Yes.
Teacher: The ultimate target
Nancy: Play through how many exchanges
Mom: How do you put a number on that
SLP: I mean at least 4
Teacher: Maybe 3 to 4. I was going to say once you hit 3
Nancy: And I mean this is one so
SLP: So it could be a ball activity, some kind of game activity
Nancy: So we are going to play through 4 exchanges and should we say
Mom: That just goes back to her attention span
SLP: Well and that interaction time like the time she stays enjoyably
Nancy: You know if we get to this we just keep going, expect more
Mom: Extend it
Nancy: 4 exchanges and how many play activities. I think we should probably put a number. Cause we could say she has met it if we do it with the ball
Iisa: So how many different play activities
Teacher: It would be nice if she could Transfer that to her own type
Lisa: right
Mom: Is three a good number?
3 or 4
Nancy: 3
Lisa: 3 different structured play activites
Mom: Just trying to think of things she likes, her little people or weebles or a game
Teacher: Games would be easy to share
SLP: Its gotta be where the other kid needed to complete the activity
Nancy: why
SLP: Its like what kind of activity and the other child is needed to complete it whether its roll a ball
Nancy: Or you just set it up you need to exchange it
Lisa: You only have one item and they need to share
SLP: mmhmmm
Lisa: And she is interested in whatever it is
Nancy: And they are working on something together and its just
Teacher: One glue stick, or something like that
Nancy: And I guess, you know we may have to go to what we mean by reciprocal I think we know but we are really looking at trying to get her to look at the child and write something and put a little note in here its like
Teacher: Yea
Teacher: Right And if we
SLP: Its physical or touching the child
Nancy: Right, yea
SLP: Keep that. Showing her to get the other kids engaged too
Nancy: right. Ok how often will we do this?
Lisa: You mean for success or criteria? So
Nancy: How often will we want to see her do that
Lisa: I mean during the week she might have opportunities during the day the question is how many times will she have opportunities to play the 3 different activies during the week
SLP: Do we have to do all three schemes or are we just doing one scheme
Lisa: That’s what we will have to decide
Nancy: You just decide
Mom: Or is 3 like an ultimate goal that’s not 3 daily is it, that seems over whelming
Lisa: Not necessarily
Teacher: I would hope we could give her the opportunity to practice at least two schemes a day
Lisa: Its whatever you want to do or at least twice a day with at least two different objects. Ok
Nancy: I mean we know for her to learn we want her to do as many opportunities as possible so um 2 times a day and you keep data what … weekly?
Teacher: Daily, we try to write down what we have done
Nancy: You do everyday,
Teacher: What the result is
Nancy: ok two times a day. Is that clear enough
Lisa: Well what I wrote
Teacher: Should we say on 80 % on the collection opportunities?
Nancy: Ok, ok
Teacher: We can follow your pattern if you have a different recommendation
Nancy: Just so we are clear. We are still the way this is worded cancelling out the thing where she is doing the dancing kinda thing cause its not really reciprocal
Mm hmm
SLP: Well with one scarf they could take turns with one scarf
Nancy: That’s right
Teacher: That’s true
Nancy: Yea we could make it a reciprocal
SLP: Yea With dance
Nancy: yea
SLP: There are dances where you have to use each other, hold each other hands, or do something with the other child
Nancy: Right right, ok now um I am going go, whats our time
Lisa: 1:30 what did you say
Nancy: We have an hour?
Lisa: About an hour and a half
Nancy: oh! Ok, umm what we are going to do after we get them all is to try to devlop a specific teaching plan like we have been talking about it but we will try to say this is how we are going to do this. Now what we lay out today when we go and try it may need to be fixed
Mom: Sure, trial and error
Nancy: but we are going to come up with a plan
Lisa: Laugh
Nancy: Now lets go to communication. And you have one with initiating to a.. somebody to ask them someone to do something.
Lisa: now Nancy can I ask something though do you want to go on to communication
Nancy: Yes I do
Lisa: instead of working on the
Nancy: Yes I do
Lisa: ok
Nancy: I want to get them all up there. And then we will go back and get them all down
Lisa: Alright
Nancy: So I am so gald you are here to say well what do we want her to do what’s the key
SLP: You know initially it was you know thinking about snack time and that she would typically just sit there, last year. She wouldn’t initiate or ask for anything
Nancy: Even when she really wanted it
SLP: She wasn’t able to tell she really wanted it she might go over and try to get it but she wasn’t verbally able to do it. So you know it was Krista prompting her, call the person’s name, I want a cookie, you know or whatever phrase, a phrase you know she can do the phrases. Now she can do that pretty well. I don’t think she really uses the name
Teacher: Every once and a while she does
SLP: She doesn’t really call attention
Teacher: Sometimes she can not be looking and she will say Dorris I want milk. You know
SLP: Yes, yea, if Dorris is holding the milk
Teacher: Yea, but she won’t gain their attention
SLP: Hmm
Teacher: But she is kinda getting the idea of putting it together
SLP: Hmmm, so do we want to keep it during the snack or is there another time when you want to have her initiate requesting for something else.
Nancy: So some of it is she really doesn’t give the directed to somebody she really doesn’t get anyone’s attention she just says it
SLP: She does at home though
Mom: She does but I am still noticing some like this morning for instance and it is more around meal time and maybe that’s just because I am more focused on it
SLP: Well and it is a big requesting time
Mom: It is and I a there are times where she is sitting there and her cup and her plate are empty and I know she wants more and before I would just go and get it for her but now I wait and I wait and she just wont say anything so I will say AJ is there anything you need? AJ do you need something and sometimes that is enough but sometimes she will just sit there and then I have to give her a choice. You know AJ do you want more French fries or are you all done and at that point she will normally pick one or the other but I am still seeing some of that its not as often but there is still some of that at home.
Nancy: Mmhmm
Mom: So, but then again she will also pip up and say I want more
Nancy: Right
Mom: Bread please
Teacher: Right
Mom: We are working on manners
Laugh yea
Mom: We are making sure we throw those in too
Nancy: With Please in there
Teacher: And sometimes she does use that, sometimes she says please
Mom: That’s just one of my pet peeves
SLP: Yea when she really really wants something she will request it maybe not to a specific person
Nancy: And and some of what you have written down is to be able to communicate her wants and needs in a socially appropriate manner is part of that you know if you just say it
Mom: Just randomly in the air
Nancy: Randomly yea then who’s going to get it
Teacher: Right right
Nancy: All of us are trained to get it but that’s not going to work eventually
SLP: Well even asking for help that’s probably something she really doesn’t do at all right now, does she? I mean I think we are coming along with the requesting as far as getting someone’s attention, I think we got a good we can make that our goal but
Mom: Its emerging
SLP: Its emerging. Asking for help probably isn’t emerging yet. She just gets mad
Mom: So you think that’s more important than requesting?
Nancy: Well well
SLP: I don’t know
Nancy: You can also use that as part of the learning skill we can do that as a learning skill and do another social communication or request up here because yes learning it appears AJ knows when she needs help she rather not ask for help but then she gets to the frustration point and yells it out
Right
Nancy: right
SLP: She doesn’t know how to easily enough
Teacher: She doesn’t know how to get her bookbag on and she will get stuck and she will say My book bag and I need help or you know
SLP: right
Nancy: But rarely its my book bag
Rarely would she say I need help
I don’t think she has that concept of help necessarily
Nancy: Help me
Mom: no
Nancy: That’s what I am wondering about the concept
Mom: She knows what the problem is she doesn’t know how to correct it
SLP: Right
Right
Mom: Or how to have someone help her to correct it
Right
SLP: Right and the same I think that’s kinda the same as gaining someone’s attention
Nancy: Yea it is just yell it out and then something is going to happen so how do we want to um
SLP: yea
Lisa: Well Im kinda still stuck on what you were saying earlier about the darting
Teacher: Yea that could be good to work in
Lisa: if we cause part of this is
Teacher: Follow direction
Lisa: I think its not understanding that we have the information
Nancy: The impulsiveness
Lisa: You know to ask
Nancy: That we dont have the information
Lisa: Well Or right well or
Nancy: Mmhmm
Lisa: She needs to communicate something to us all that initiating communication it seems like both these things can be separated like asking for help but then asking permission asking you know
Teacher: What are the rules so she
Lisa: Or just um um cause you have on here just um you know to be able to express her wants I want to go to chucke cheese and then of course its like no but this is when we are going to go to chuckie cheese to take that information to you and ask you for help or to ask for information
Mom: And there is some of that
Lisa: Mm hmm
Mom: She had asked to go multiple times but she didn’t, I guess accepting the answer maybe
Lisa: Well I think too that sometimes some of these kids think that we didn’t really hear them that we don’t understand you know
SLP: Right cause we didn’t respond the way they want
Lisa: So if I keep repeating it maybe they will understand it cause by understanding they will let me go
Mom: Yea
When I get to go that means that they got my message
Teacher: Right right
Nancy: Well and she just takes it into her own hands its this
Mom: Yea
Nancy: Its this great independence that she desires or whatever
SLP: She doesn’t realize that anybody else gets to do anything
Mom: right
Nancy: I am just going to take care of it and I think what you said you know just you cant really trust that she is going to stand by you and uh that’s at school and that can be a real problem
Lisa: yea
Teacher: Well I feel like sometimes I will just repeat back to her what she said, I know you want to go to chuckie cheese
Lisa: Yea
Teacher: but right now we are at school and sometimes that will take care of it but other times it wont
Lisa: yea
Nancy: does it it
Teacher: sometimes I wonder oh she didn’t hear me so I have to repeat back
Lisa: right
Teacher: AJ, I know you want to go outside but right now we are not
SLP: And the visual is the writen word for that too first play then chuckie cheese
Mom: Right
Teacher: And she is doing very well with notes
Lisa: Yea
Teacher: She gets very turned on by that so that’s something that we
Lisa: yea
Nancy: Its also a good strategy
Teacher: What
Mom: Multi colored post its
Teacher: Ok are you doing post its at home?
Nancy: Laugh
Lisa: Or not chuckie cheese I don’t know these things that you got repeatedly up just letting her know
Mom: And it’s a matter of finding the correct way of getting her to understand
Lisa: Yea
Mom: When she can go
Lisa: yea
Mom: Because I know that you guys have told her no you aren’t going now, but I told her no we aren’t going now we are going tonight or we are going Thursday night or
Nancy: Which and she doesn’t understand
Mom: Well
Lisa: And tonight is kinda abstract
Nancy: Or she doesn’t like the answer
Mom: No I think its more she doesn’t like it
Nancy: I think she understands
Mom: We have a big bulletin board at home and I put I have things up there to yesterday was Monday today is Tuesday tomorrow is Wednesday I have all kinds of visuals and that for all of them not just for her because your right that’s age appropriate for them to not necessarily have the concept of time passage so I am trying to help all of them
Lisa: Sure
She just gets thrown in the mix with the rest of them all of them I expect her to learn the same things that I expect the others to learn
Lisa: yea
Mom: so I don’t know
Lisa: I wonder if it might be a little bit of a compliance thing
Mom: Yea I think so
Nancy: Well its also I have a great desire I have something in my head
Mom: She gets stuck on it
Nancy: And we don’t know whats in her head
Lisa: Yea
Nancy: So
Mom: We might be rich if we did
Lisa: I just brought that up cause I wonder if there is a way to sorda weave that into
SLP: So can we make something
Lisa: Initiation
SLP: Ok, so can we make something following verbal commands you know we are going ok its time for snack we are going in she can follow verbal commands and we change that to a less desired thing. You know what I mean
Lisa: Yea, its just that gets us from her being a responder instead of initiator
SLP: Communication, Yea
Lisa: But definitely I mean she obviously these are things that can be worked on. I was just thinking if there was a way she can initiate communication with her wants and um social acceptable wants and needs cause you both said for her to be able to express her wants
Uh hu
Lisa: And you can make that part of getting her attention like you have been working on
SLP: Well yea cause we do a lot of requesting. what do you want I want we started and sometimes
Lisa: Hmm mm
SLP: She doesn’t seem really I just noticed since the last time of seeing her
Nancy: Well if we get to the concrete and we go back to the help tho, if she we need her to ask for specific help directed at a person and in an appropriate way and I don’t know you know give examples of cause it sounds like now what she does is just yells something out she doesn’t it isn’t til she gets to a frustration point
Right I feel like maybe we have things set up in the classroom so that she is very successful
Uh huh
You know she has gotten to the point this year where she has
We would have to sabotage it
Nancy: You would
Teacher: You know like circle time with her carpet square isn’t there
Right
Right
I need that carpet square
yea
Her awareness isn’t there who cares about the carpet square we would have to try to bring her around uh- huh
What do you do
Or her backpack isn’t on the line or her coat isn’t on the hook
yea
We would have things very predictable so she
Lisa: And what is great is that will help her use her words instead of having a fit you know it will help her in her first grade classroom.
Teacher: What she expects isn’t there
SLP: That could be a goal I mean
Teacher: That would be a good goal
SLP: Getting someones attention
Nancy: Right
SLP: And then asking for an item that’s missing or
Lisa: Or just I need help
SLP: I need help with some situation
Teacher: Yea cause we have repeatedly done that with her straw and her milk, she will be sitting there, AJ what do you want, my milk, ok lets try, open, AJ what do you need. She can tell us she wants the straw but not necessarily get it open
SLP: And if we walked away from her she might yell straw if she is really thirsty.
Mom: Or she might try to just pick it up and drink it herself and end up with milk all over her and that’s another issue I see a lot of this at home too.
Nancy: Ok, let’s work on that one as as the communication one. Well um what is it that we want her to do? Given a so it’s a situation where we clearly know.
Mmhmm
Nancy: Ok um, what do we want her to do?
SLP: Where she gains somebody’s attention by calling their name, or physically touching them, or going to get them.
Lisa: And how, what to gain their attention?
Request
Hey Krista.
Or hand up.
I say anything verbal.
Mom: I will take anything I don’t know about you guys.
Lisa: Ok.
SLP: Verbal, physical, gestural, whatever.
Nancy: I will put gestural because we don’t know quite what it might be.
SLP: I say by the end of the year we want her to call the person’s name.
Or
She might not know the person’s name.
Mom: Well and that’s where holding your hand up, I mean because if we think about where she is going or where we want her to go...
SLP: In school.
Mom: Next year...
Nancy: And maybe raising her hand.
Mom: She is going to have to I mean that’s the rule.
Nancy: And even if she did that and said the name at the same time that would be great but giving a gesture then.
Lisa: Mm hmm.
Nancy: and then what saying I need or I want.
Teacher: Requesting.
SLP: Expressing a need.
Lisa: Oh thank you.
SLP: Socially acceptable manner.
Teacher: And I need a different often said instead of want but I need might be a little.
Nancy: I need or I want.
Uh huh.
And she can say help or.
Help or the item.
Nancy: Umm.
Teacher: I think that’s a reasonable one. She is almost at the point where she is...
Nancy: Yea ok, And set it up so she has a number of these things.
Yes yes.
So.
Teacher: Becky has helped us so we have a lot of different visuals so.
Nancy: And she responds so well. So how many times a day would we like her to be doing this?
Teacher: Trying to do that almost in every activity throughout the day.
But
Teacher: Right maybe four...three or four times a day.
Hmm mmm
SLP: Stick with the three.
Lisa: Uh huh, yea
Nancy: Three times a day.
Mom: And is it this may have nothing to do with anything but can we make sure we here it is me being petty but can we make sure that her manners are involved in this please
Nancy: Yes
Mom: Cause I am trying to teach my other children this
Lisa: And when you say manners what do you mean
Mom: Please thank you
Lisa: Oh oh please
Mom: Please thank you and I know that may not be important
Nancy: Yea yea
Mom: But that’s kinda a goal like a personal goal cause I Am trying to teach my other children the same thing and their
Nancy: Well and and its not I mean some kids cant do that cause they don’t have the
Mom: But she can
Nancy: She can
Mom: She can tho
Nancy: So I want X please
Mom: And like I said I know that may sound petty
Nancy: No
Mom: But if I have aj and if she is only able to say I want this that’s a different story, but my other children hear that and they repeat that and I fully expect them to say please, thank you, may I, and she is capable
Teacher: And she will repeat that back
Mom: Yes yes
Teacher: If they say I want that please
SLP: Especially if we use written cues for her too
Mom: Yes
Nancy: And so we will put in socially appropriate way too cause we don’t want her yelling it out
Right
Right
Teacher: I was going to say the intonation in her voice
So I want instead of I need
sure
So we have I want instead of I need
Mom: I like I need cause often
Nancy: You like I need
Mom: Cause a lot of times her voice is escalating she
SLP: It could be either one say like the carpet square its something that she needs you know and there are other things that you want
Nancy: yeaI need my square
So we will just use the appropriate given the situation
Nancy: So three times a day um, 80% of that same thing
Mom: Thank you for humoring me, laugh
Nancy: That’s why we are here yea and as we are teaching it we want to teach
Mom: I expect all my children to have manners
Nancy: Um ok, so this is what we are working on communication now lets go to the work, um the learning skill. Task completion which I know you have been working on seems like she is doing pretty well with that
Teacher: Yea she is ready to be changed
Nancy: Yea, yea
Teacher: She is even ready you know sometimes we will change in free and play time her skills she wants her reward
Nancy: So so look at the learning and look at the personal management together and and we are the thing highlighted was the impulsiveness
Lisa: Well, I wonder about that that’s kinda staying with the group that’s the skill in kindergarten is staying with the group and not darting out and being a little more aware of rules and all that
Nancy: Walking beside people
Mom: What she does in the community preschool
Teacher: Yea I would have to see what she is up too
Mom: She does it here cause it is structured
Lisa: mmhmm
Teacher: Right
SLP: We don’t give her the chance to not
Lisa: Mm hmm and it’s a real safety issue it just takes that one time darting
SLP: And she may do that at preschool she may try to wander
Mom: Well and see I told that they walk to the library once a month and she stayed with them last month but Amy held her hand the whole way and they have a rope that they hold on to and I did tell Amy please you know depending on how she is acting let her hold on to the rope like the other kids but
Nancy: But be right there
Mom: don’t walk away from her they go to the library on Thursdays so I can talk to Amy then and make sure get a full report, more information this time
Lisa: mmhmm
Teacher: Well and maybe that’s something for one of her skills that she can be walking a distance without holding hands using verbal cues,
Lisa: Right
Teacher: you know verbal reinforcement.
Lisa: Does she fight at all with someone’s hand, I mean is she okay with taking osmeones hand
Teacher: Umm she is very willing to hold adult hands, but sometimes there are kids she wont
SLP: But she will
Mom: She holds her brother and sisters hand, but then again sometimes they don’t want to. But she will hold her borthers and sisters hand. Most of the time I hold her other hand cause I go a lot of places by myself with them and I only have two hands so I will make sure AJ is holding my hand and like have Annie has the other hand. And she will hold Annie’s hand.
Lisa: yea
SLP: What does she do at home with routines like getting dressed? Can she get her socks, shoes,
Mom: I normally lay everything out
SLP: But will she get herself dressed?
Mom: She can, not as well as the others. She can do it.
Nancy: But some of that is a motor difficulty
Mom: Probably, mm probably
Nancy: Along with some attention
Mom: She doesn’t have a lot of Yea I would say its more attention than motor skills
SLP: Yea she is pretty good
Nancy: ok
Mom: But when it gets down to buttoning and things like that and that’s a fine motor skill and no she doesn’t have that and none of my children do which could be bad I know, she can dress herself and this is my fault but I have just recently moved into saying ok, Nolan get dressed, JR get dressed and we all get dressed in the same or they all get dressed in the same room together and the other 3 are much more capable than she
SLP: Im thinking does she understand the routine?
Nancy: Its just staying with it
Mom: She will wonder off
Nancy: yea
Mom: I have to keep redirecting her
SLP: Maybe, is that a good one to finish the routine?
Nancy: I think that we should probably target this impulsiveness for school that she will walk. I think there are several things that we need to and we are not going to get her by the end of the year to know that we can have her holding the rope you cant ever take that chance but we can still what is it that we want her to do we want her to walk by an adult we want her do we want her to walk by a peer by the end of the year in a structured situation.
Teacher: I think that will facilitate her learning as she is in classes down the road if she is able to you know
Nancy: If we go from here to here with the group and whatever they do
Teacher: Right
Mom: We are saying peers with the knowledge that the adult there knowing good and well they cant take their eyes off her
TEacher: Right
But in her mind it would be walking with a peer beside
Nancy: Right
Mom: I would think that would be an ultimate goal, wouldn’t it
Teacher: Yea
Nancy: Peer walk beside
Teacher: Yea, but im thinking is it too complicated to want her to avoid something that’s tempting her to walk beyond the ball pit I feel like its also that she gets distracted she knows she is supposed to go from point a to point b but she sees something she wants to do take that opportunity outdoor play we need to make it all the way in she
Lisa: Is that pretty predictable can you almost predict when she will do that
Teacher: Sometimes but not always sometimes she knows what she is doing she is going for snack she will go right there you know very smoothly
Lisa: Well there was this one little kiddo we worked with last year who would dart around the school
Teacher: Mmhmm
Lisa: And what they realized is he was always looking for the water fountains and
Mom: Mm
Lisa: It became a thing and they just set it up you knew he was going to go there so they taught him he had to come and ask
SLP: Its not always sometimes she would go in to Nancy’s room I think last year Nolan was there
Mom: She probably think
SLP: And other times she will run
Lisa: Oh ok
SLP: For the ball pit
Lisa: What we want her to do is walk beside a peer, to class
TEACHER: Mmhmm
Lisa: Coming in from outside you want her to go to the class
Teacher: Right
Lisa: And you will just set it up that it will be a peer that she is walking with
Mom: Well I don’t think its unreasonable to put in do we have to have some place specific to go to put in there that she should ask to go somewhere else
Lisa: um
Mom: You know like this little boy the water fountain you guys specifically said he has to ask to go to the water fountain is it too much to put in if you want to do something different you have to ask
SLP: Well last year she did that when we would be eating at the table and her brother would be at the table and
Lisa: Uh huh
SLP: her brother would be there that’s ok if you want to go there but you need to ask as soon as that became her routine she did very well
Lisa: oh, on her own?
SLP: Yea
Lisa: So like she would get up and then she knew to come over and ask
SLP: Well after many many times of prompting her
Lisa: Yea
Teacher: What do you do
Nancy: She was getting up though
Lisa: Ok
Teacher: She was just getting up
Lisa: Right
But she was starting to ask
Teacher: Yea I think a lot of times to the cafeteria probably at the other school quit a few times
SLP: Where they
Teacher: Right Yea she could learn
Mom: I know she has been darting out of her classroom too, cause Amy asked me if that was a problem
Lisa: I just think that right now its too much decision making on her part
Teacher: Yea
Mom: Ok that’s what I was asking
Lisa: Its such a safety thing this little guy was probably in 2nd grade
Nnayc: He was
Mom: Oh he was older
Lisa: Yea he was older
Nancy: Yea I think we need to know
Mom: So we go from point a to point b
Lisa: Right now just follow our directions
Nancy: And we know We get that close to 100%
Lisa: Cause of the safety
SLP: I think that is a goal that will lead to the learning part of it
Lisa: Uh huh
Nancy: Ok, so its when moving from and is there we would expect her to be able to do this or not moving from point to point
Lisa: Well, I said during transitions but that’s fine
Nancy: Yea, I was thinking we would go on a field trip or outside
Teacher: Right
Lisa: mmhm
Teacher: That’s a hard one cause basic things that she is used to she does it you know we have
Uh huh
Teacher: Can it be one of the goals she has mastered you know when it’s a routine she does it well its when there is an outside distraction like maybe that day
Nancy: Will she at this point wait beside you
Lisa: Mm mm. She doesn’t trust her at all
Mom: I do not let go of her
Teacher: We keep our door closed its not just aj’s challenge it’s a lot of ours
Lisa: Yea I mean aware that the adult wants you close by them
Teacher: Right its almost like we need to take walks outside the classroom
Nancy: Well its not just moving tho cause we have also had to work with these children on wait and that means right here
Lisa: And that’s what we did with him yea
Mom: And that worked
Lisa: We set it up on purpose other kids would come talk to the teacher and say wait and he had a waiting strategy for that
Wait or walk with me
Lisa: Yea
Teacher: Yea
Lisa: Cause he was darting out of the classroom
Mom: And that just scares me to death
SLP: Maybe its wait
Nancy: So its when given the direction, right of wait or walk with me um .. so we are really doing two things here..
SLP: I can just see her yelling no AJ wait
Mom: Laugh, in that little voice
TEacher: But she really picks things up quickly once she understands them
SLP: mm hm
TEacher: We changed her lunch first few days but now that she knows she needs to wait for a signal which is
Nancy: Alright, Lets define how long we expect her to wait when we do that
Mom: Well try I am trying to think if I am you are going to have to club me over the head to ever let go of her hand in a parking lot but
Nancy: Well that’s not where we are going to start
Mom: But I am just trying to think from a time stand point if I am putting the other three kids in the car buckling them up, whoever it was I would expect them to stand right here
Nancy: Yea
Mom: Oh yea
Lisa: So say a minute
Mom: Yea at least
Lisa: Mmhmm
Mom: That is a fabulous start
Nancy: yea
Mom: I mean I have a short attention span I don’t know if I could stand still that long
Nancy: Now, Walk with me cause I think we expect her any time she is walking
Mom: It will vary
Nancy: Right, So she is there, right
Teacher: Yea I think so
Nancy: Ok, um,
Lisa: And do we want what kind of cuing one verbal cuing wait with me and she might have visual cues
SLP: The end of it I would expect it to just be verbal
Lisa: Right right
Teacher: I was just going to say written is probably going to be your most direct
Nancy: Well I think even if we have it written at the end it will be okay, so we will say with
SLP: yea
Mom: I would love for it to be verbal in the end, is that unrealistic
Lisa: Not as she matures right now we are using her personal strength of that visual capturing her attention
Mom: Right
Lisa: You know cause if her distraction but once she learns the routine and grows I think you know she will be more motivated and better able to follow the verbal
Nancy: Um, how often are we going to do it
Lisa: Once a day
SLP: Twice a day
Lisa: Or twice a day
Mom: How many times do you leave the classroom
Teacher: Well sometimes only once so we are going to have to build that in
Mom: Ok
Teacher: And she is a helper occasionally for lunch so that’s the biggest time when she is outside her routine
Lisa: Mmhmm
Teacher: Cause it seems like such a simple goal
Lisa: Mmhmm
Teacher: But when its outside of her
Nancy: Ok, if we write two times a day for each can some of it be in the other setting
SLP: Yes
Ok
Teacher: Well that’s what I am wondering can we have that carried over
Nancy: Sure
Lisa: Oh we would love that
SLP: Then how would we document that
Teacher: We would have to talk to Amy about that
SLP: right
Lisa: Yea, you can just share that information with her. We don’t really have the data collection
Nancy: Well we didn’t write the procedure either. Ok let me give you what we just wrote. Um
Teacher: Becky, sometimes
SLP: Yea we can build that in
Nancy: What we are going to do is look at um, are these in your packets. I am a little confused
Lisa: Yes they have that in their packet
Mom: Sorry, huh
Lisa: It’s the other one, the training packet
Teacher: The compass
Lisa: The training packet
Nanyc: Do you have one of those
Lisa: Mm hmm ok you should have it
Nancy: Ok this is what we have done here
Lisa: Yea there you are
Nancy: Ok so what we want to do is go back to the social one and a lot of these challenges if we get them for the one they are going to be the same but the personal challenges that AJ has on reaching this the kind of things that we know are going to have to balance out are what? What are the problems?
Motivation
Nancy: Ok
SLP: And interest
Nancy: Ok
Mom: That’s going to apply for everyone of those and distractions will apply to others
SLP: Yea distractions
Mom: You know though I am driving down the road and I go oh shiny so maybe some of that is hereditary
Lisa: We all have some of this
Laugh
Mom: Pretty
Laugh
Nancy: And the eye contact problem here just not looking at the other kids. So the distractions are everything in the environment that happen to be there um the challenges in the classroom in the afternoon the possible sociable, sociable peers
Teacher: That’s what I was thinking to say we don’t have sociable peers they don’t have interest
Nancy: Right
Teacher: We can try to set her up with peers
SLP: Yea I think we can
Mom: Are there other peers, I mean I don’t want to disrupt her class
SLP: In her class there are a couple girls who are verbal who could interact
Nancy: Um, personal supports that she has within her
Teacher: Social
Nancy: Mmhmm
Teacher: That she does enjoy different play options
Nancy: right
Teacher: she has the idea when we say go play she has the idea of that
Mom: She knows what she wants
Teacher: Right and she does act appropriately she wont hit someone
Mom: Mostly
Teacher: I think we have made steps towards this
Nancy: Well and personal supports and her reading there are um and then all the environmental supports she has all of you working together
Lisa: Siblings
Nancy: Siblings the mornings she has visual supports just lots of things in place and we want her to function in everyday enviornment
Mom: Yes
Nancy: So the distractions are just part ok if we look at the communication one any additional challenges
Teacher: Again just her motivation
Nancy: Hmmmm
Teacher: Sometime she is ok
Lisa: Impulsive
SLP: She needs to know the words
Mom: I think some of it is understanding
SLP: Mmhm
Nancy: Probably also is this kinda desire to do it independently or the lack its easier to go do it this way then ask a person
SLP: It’s a lack of awareness to ask permission
Nancy: Yea
Teacher: Sometimes she gets frustrated cause she isn’t getting her requested item
Nancy: Right
Right
Nancy: And then environmental challenges are she can just get things herself
mmhm
Teacher: She is very capable
Nancy: right
Mom: I don’t need you
Nancy: It’s a lot easier to go this way
SLP: I can get the cereal its right there
Teacher: right
Nancy: And I can unlock the door and go where I want to go and possibly someone is going to say no
SLP: Yes
Teacher: right
Mom: yes
Teacher: Well and impulsive probably brothers and sisters and some of us just give her what she needs cause she doesn’t get the practice
Mom: Well that’s what I am talking about
Teacher: Mhm
Mom: I have had to work really really hard not to do that
Teacher: Right cause naturally
SLP: And anticipating what she wants so she doesn’t scream
Mom: And that’s part of why I am making her ride the bus
That ok
That’s good for her
It gets her into a routine for the day
It gives her an opportunity to talk to friends
Mom: There are times when I can bring her but I make her ride the bus
Its ok
Nancy: Yea
Nancy: And I think person supports are still there. There are lots of things she does want and its not like we can set it up and she likes routine
yes
Nancy: so if you sabotage she is going to care she is going to be aware. Um ok. And with the other one when we look at walking beside me and waiting we certainly have to put the impulse
Mom: well and Recognizing danger
Nancy: Yea
Mom: Then again I think her age comes into play
Nancy: It does
Mom: But its not unusual for a 4-5 yr old to not understand danger
Nancy: Yea
right
Mom: No fear
yea
Lisa: And part of that is not understanding the impact that her behavior has on you so when she is running away how scary that is for you and the consequences
Mom: That’s it I might be in the situation where I am alone with the others and how am I going to handle that with the other three
Right
I cant just run away from them
Yea
Its not necessarily her problem
Yea
Its just the reality
I was just going to say that’s something you could practice at home cause you could talk to them about it sometimes AJ might be wanting something and didn’t tell mom we are going to do this
That’s a good idea
You all stay together
Have a plan
Practice and role play with them cause they can understand that
Yea yea
Cause and effect
Right
Your ball goes into the street and gets squished
Yea
Lisa: Does she watch videos
Oh yea she watches videos
Lisa: Im kinda jumping ahead with the teaching plan but yea
Nancy: Ok anything else with the waiting well the environmental distractions or just whatever is there that she wants
For her to be able to even see to know where she is going if she knew where she was going she might be more likely to stay with you
Yea
Mhm
You know walk out around why shouldn’t I just walk
We were thinking when we go with the group sometimes she will just keep going and we could extend that
She just keeps going
Yea so we could extend that following directions all the way down if there are a few other kids going to the office
She would go
Right
Yea that’s the distraction
Maybe go another way
Mmhm
Well if we get to here we just keep going
Oh yea
Lisa: Well it was impressive, were you surprised when she did stop when you said her name?
Mom: Yea, very
So when there is a very strong
She got your voice
Unexpected voice
Yea there was nothing more than the panic in my voice
And she waited for you
Mom: She ran back to me
Nancy: What did you yell
Mom: AJ stop
Yea
Mom: And it wasn’t that calm but it was simply AJ stop
Yea and she turned around and came back she sensed
Yea it wasn’t the words spoken it was my voice
Nancy: Ok, go to the next one and we will start again with the social we talked a lot about this about exactly how we are going to start to teach this what are the steps we want to have in place we talked about first um identifying peers
Lisa: And this will help us too thinking about the teaching plan how to break it down
Nancy: So um we identified the plans the peers and some activities that are going to be motivating to her
Lisa: Nancy, this is one that I do remember you got the yellow sheets there are some nice web sites and there is one that is about how to train peers how to talk to peers to give them information cause they are going to need information about how to be persistent with her how to get her attention if she walks away don’t give up try to get her attention again
And preschoolers are good at this
They are really good at this
Its the one under the social I think its peer mediated so here is the website and then I broke down under each category and then a lot of them over lap same topic
And on each of these there is a list of these and I think depending ok simple way toilet training is under the COMPASS there is stuff on that
Ok
Well and like there is stuff to train peer this would be huge for us at home
You want to get a kiddo who can pay attention for at least 10 minutes
Social skills
Peer mediated instruction
We might have to get 1st graders
Oh yea preschoolers can do it, yea
So there would be training
Oh yea
Um, ok and then we need to what else,
Situations
Social
Maybe one can actually be sharing
So
She loves music
Take turns with musical instruments
They can switch
See I think she can do that but I don’t see her
No this is work for her, play is work
Yea
So this will be like
We have done turn taking
She can
She can with the adult
Like she likes matching wands maybe there is a special wand then I mean we don’t say in here does she say my turn or how does she get the turn
Well no cuase we left it more open if it is ball play or the scarves
Mmhm
Exchange scarves sometimes its easier to do that anything that we are getting her to be reciprocal and aware of the other child.
So since she is capable of turn taking she is very capable of playing the my turn game
Yea
Mmhm
But maybe if we structure it as not necessarily its my turn with the red scarf but this is the way it works so and so dances with the blue scarf
And then switch
We play with taping sticks now hand your sticks to your neighbor
Right
Maybe its easier to start with pass something
Right
So say and then work up to different colors
Yea
Maybe it addresses more this is the way we play the game more than we are going to take turns
Right
Maybe if the presentation is a little different
I think too the activities that worked there is nice engagement between the two there is the reciprocal
Well
Well you cant do row row your boat unless you both do it can you
I don’t really see that as reciprocal
Its not
Its engaging
Its engaging
Yea yea
What about we are playing bob the builder with a peg builder and take turns with the hammer
Lisa: Yep
Until we get them all done
Lisa: Yep
My turn your turn back and forth Lets finish the whole things
Nancy: So we are all working on the same thing
right
Yea
Sometimes its hard to keep doing it
She likes duck duck goose. Does that count as reciprocal
What is it
Duck duck goose
You go around
I know but Whats that
Lisa,
I know I know
Lisa
Are you serious
How do you not know that
You go duck duck duck duck goose
You go around in a circle and you chase
ok
Mom: You have to come to my house, you cant go anywhere else, you come home with me
Reciprocal
Joint attention
mmhm
And that’s really important for her
yea
That’s a group one
That’s what I see is missing right now
Right
She doesn’t do that
She does at home I mean if she wants too
Right right
And its probably here cause we don’t have enough kids for her to engage
Mmhm
And I am sure in the morning program there are multiple kinds of things
Ok
So I just have identified the activites
Ok
So after we do this and we have it all set up then what do we do, what are some ways
Mhm
Strategies we are going to use
Well got to verbal whose turn is it visual my turn where she actually has to get it
Its my turn
Yea
Yea
It goes back and forth between the kids
If you made a video of doing this and showed it to her
Oh that would be good
Video modeling for her
I found even when we try to do the ball exchange
Physically
Yea I mean if we are rolling the ball
Uh huh
If we are just standing there
Yea
She is in space
And seeing her brothers and sisters doing it and watching
Mhm
We always want her to see herself doing it positively
Another activity to go off of would be face painting or something on each other
Mhm
Doing something putting stickers on each other
Mhm
Different body parts
So its more of a natural
Fun
Prinicess stickers
She likes make up
Sticker on her nose
They love face paint
Of AJ and her make up its more like my make up
Does she ever do
No she does her own
Hey
How are you
This looks like a crowd
Looks familiar this is the other student
Oh
Will the time work and I am going to call and remind her and she said so that will work
And then amber said her material was at home do you want her to fax
She can fax it
Ok
She can fax it in the morning
Lauren is going to leave tomorrow afternoon so she will have to fax it in the morning
Well I don’t know if the web version is working
Its completed
Make me feel better I am not alone
Nancy do you have your phone
I am sorry to interrupt
That’s ok we are making some goals
Reciprocal play that’s good
Now some of these are similar to her IEP but some are we haven’t addressed before safety concerns we are adding them
Uh huh
Especially she has a few other siblings in other rooms
Exactly
She just had a birthday how did that go
It went just fine
She had a good time but she did alright with it yea
My son is a senior he is talking about doing his senior project he is talking about having a fundraiser car wash and have the money go to benefit something with autism can I put him in contact with you
I have one right doing power points with kids transitioning so I am all game with that
Well and he wants to keep it local so hopefully it will benefit AJ
Yea right we can use it for training and resources
Thanks
Alright lets get to the next one where um needs something and gains someones attention so our methods for teaching
Would be modeling it to her written
Alright but you set the situation up
She really needs something
That’s where snack would come into snack is a big one there isn’t it
Sometimes she will go to the table and hopelessly
You can tell her go get her folder and put it there
Yea you said it before sabatoge situations
right
Yea take her normal routine and just
Take away something
Nancy: And so you really are going to start with the ones you can identify will motivate her that you know you know she needs help
Mmhm
Nancy: And you think she is going to be motivated to need help
What are some of her favorite items, often she will go to the dress up station and want a certain dress
Nancy: Yes
You know if that’s not there she will
Mmhm
Have to find it or find me and ask
Yea
Will we have to give her a direction for that like go get the pink dress
Yea something
Something we will have to know what she is going after
Right
See how she responds to it
Mmhm
And then you are going to have a written are you
I think we would do written and verbal
Could we start with verbal
Would you add, well what we are trying to do is to not get her to escalate and want her to say it in a certain way so would you ask her
Probably go over there and she would be looking before she gets upset where is it, where is the pink dress, lets go ask
Nancy: What if she comes or you take her square away at circle and she just stands there
Mmhm whats missing
Ok so you give her the verbal cue
Ask her
I will tell her her reaction go get it
Yea
Is that what she will say
Get it
Yea
Sorry if blankie is not on her bed at home see that’s what I can do at home if its not there at night time she will say where is blankie
She will say that
She will and I will say I don’t know. But that’s a specific thing
Well that’s ok
Nancy: That’s ok so she says where is blankie and you say I don’t know
Will she go in the other room and say that
No she wont come to me she will lay in bed
Oh she will lay in bed and She will just keep saying it
So she will keep saying it
Yea And if I come to her she will say where is blankie and I will say I don’t know she will say go get it
There was a time we ran out of paper towels in the bathroom and she could not finally we made sure everything was there
And what was she doing
Need paper towels
Need paper towels
But she was just standing there
So that will be good
Things like that
Oh you need paper towels
But it’s the coming and getting you
Right
Like coming to get me and telling me her blankie is not in her bed
Right
Its almost like a picture exchange system where she has to learn to take the message to you
Yes
Right
And the more you go to her the less she has to do sorda like traveling going this way seeking them out or
Nancy: Well in here she is laying bed or she is in there with the paper towels someone has to go in there she is stuck
Its like that reinforcement
Lisa: So the question is that’s the plan what is exactly how is she going to ask is she going to have or we give her a script that says I need help so you know that’s where it gets tricky
Yea
Cause if you are saying what do you need do you need help then again there is that verbal prompting
Yea
Lisa: So if she has some kind of script even in the bathroom where you purposefully don’t have the towels it’s a cue for her if you need help or I need help find teacher
Mmhm
Lisa: Something that tells her what to do
She does really well with social stories
Ok
um
So she might need
She might need I will ask an adult
Lisa: And she might need to be physically prompted the first couple of times to go
Nancy: Well and you may need to write these social stories real real specific
Uh huh
Like with the
When there are no paper towels I need to ask an adult
And what do you say and put the please on there put the whole script on there.
Well I can do that and I can tape it to her bed I can just put it right there on her bed
Mmhm
The verbal I need
Well but
Be very specific
The whole social story
In bed it may be harder if she cant get out of bed
Well not at that point cause I am upstairs and when this happens I never let it get beyond that
So she would need the cue
And she needs specific we could be in circle and I say please sing and wont do it I say please sing the wheels on the bus and sometimes she will do the whole thing
yea
Do you want to do it like PECS in the bathroom the paper towels aren’t there we have a picture of the paper towels and we have a phrase I need paper towels
She is going to still need the cue to go get somebody
Well that’s where we would non verbally take her the picture take her to the person
So is that a picture you would have on the paper towel dispencer or I don’t know and that’s where I am kinda get at social story taped to her bed
Right
I had a problem with her getting out of bed in the middle of night and I taped on her wall get back in bed it worked I would hear her and she would still get up but read it
Was that last year
It was last year she would say get back in bed and would go get back in bed
That’s great
And that’s what I was asking if I wrote up a social story and tape it to her bed its missing
Right
And what do you want her to do
I want her to come get me at that point
Write what you want her to say cause we want her to get it
Ok
Nancy: Mommy I need my blankie please
But she can do it and she can read it I can break it down
Comprehension I think she
If I break it down so so I am not talking about a four page story
Yea
But I mean if I put a piece of paper in there and I have not necessarily number them but star them and have them defined as steps
Mmhm yea cause she did do that at school so paper towels aren’t there number one go find number two say go get paper towels
And if you do that in a few situations and see how she can respond to it and then you can start cutting it down cause she knows she has it
You think that’s ok to go with the written verbal and not pictures
I think that’s worth a shot
Yea
Cause she can read it
Lisa: Sounds like she’s got it
So carpet square
Yea
Yea
She is looking at another students written she is very curious
So by reviewing social stories with her and and multiple situations you know you so that she is getting it here getting it here then shes got the verbal as to follow
Mmhm
I think she will
So it might be a script if we are talking about a social script so you know what does she call you
Or princess Krista
Ms Krista I need towels cause we are wanting her
We are hoping she will say that
She will have the script with her
Please
Please and what we have here is she is going to initiate this get the persons attention
I think if we go with that and the verbal cueing sometimes the verbal cueing becomes the routine and
Right
Since she is so good with the written
Well this will allow her to use some independence
Sure
Right
Yea
Nancy: When you hear
Mom: She tore it down yes I did yea she wouldn’t have none of it
You have to stay inside
Mom: It said do not go outside without mommy or daddy that was the first one
The reinforcer here is she gets what she wants so that
More things that she really
yea
Mom: Well im thinking I keep something on the refrigerator she wants a drink I mean cause when she wants a drink
Uh huh
She can come ask me
Yea
In our personal setting there are some opportunities for that
Nancy: Ok lets do the same things now with wait and walk with me and we will have to be collecting the data
That’s fine
Yea
Would we use a timer for the wait
Gestures
Yea
Would like to when us say to her so that its visual see it
So she can see it
If all the kids were going that would be too awful if all the kids were going outside and she had to wait that wont work
Becky, that’s not nice laugh wait a minute
Sometimes something that she really likes can be in her pathway you know she needs to follow the directions
Well that’s for walking but for wait
yea
Well I have an egg timer at home too
Right
If she has to practice when she sits on the yellow line or ready to go outside
She does that
Right once she is waiting
I think this is to get her to the point where she could stand by the car
Nancy: Well and it could be in to the walking where the teacher
Right
Nancy: You are practicing and walking and you say have someone come talk to you
Right
Nancy: You need something and
Right
Nancy: you give her the direction and timer you need to wait by me and maybe that’s
I think the sand timer would be a visual to focus
To start with that
Yea
I have
Awe
You know what I mean
I think she may become fixated on that kinda rigid and she will want
Well that could be something else
Right
It’s a start
She gets the practice
Lisa: Well and given her visual I mean her reading that could be something on the back of the wait card to look at while she is waiting and says stuff like
That’s a good idea
Lisa: Princess stuff
We will write down and try wait card on the front and then on the back
Something interesting to her
Yea
All the social stories
Right
Mommy said wait stand here
Yea
Well and even that could be off the back of it
Oh that’s true yea
You know even that could be on the back of it and princess stickers
Maybe the princess is waiting
Well that’s true maybe if we just address her as princess AJ that will be enough
And here too is it possible to use video
Yea
How we wait various strategies and the walking beside
Well she could again a video watching someone else
You made need a written card to cue her and certainly start with the short sentences so she succeeds
Walk beside me and stay with me
Ok
Stay with me
The meaning yea
So you would stay with me
Would she do better if you have stay with me on one and we are wanting her to walk with you I was just thinking earlier if she had something that said classroom and a reminder of where she is going
Oh that’s a good idea
Um
We have tried that with pictures
Uh huh
That didn’t work
So maybe it could be
Yea it could have all the places you go and you circle just thinking about a card that could be used for multiple places you go
And is she going to need any kind of reinforcement for doing this
She usually gets her desired snack
Verbal praise works for her
Mom: She likes high fives
Yea
Mom: If you are talking about a reward we do that a lot at home
Nancy: And then the naturally recurring then will you talk to Amy about
Yes
Nancy: How that’s carried over and what we expect there and you know we haven’t talked a lot about the system
Yea
Nancy: Ok anything else we need to go over.. now since we are a research team
Laugh
Lisa: Warning
Nancy: Fidelity check list the components you can check as many
Lisa: Here is another one
Mom: Do you need it like right now
Nancy: Yea
Mom: Ok