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Wednesday, January 14, 2009

Autism – tip of the day [Head, shoulders, knees and toes]

Here is a quick tip that we still use with the children to help sequence them through those early morning steps in readiness for school.

Quite often, there are not many words available first thing in the morning but there are also a great many tasks that need to be performed in a timely manner. My boys are visual learners but also respond very well to kinesthetic cues, it’s almost as if that first movement kick starts their executive function into action. It’s another layer of scaffolding or support to help them achieve and experience success.

We have four hurdles to overcome:- brush hair, clean teeth, put on shoes and socks.

1. Gain your child’s attention, preferably with body orientation rather than eye contact.
2. Ask that they join in and copy your body movements.
3. Ask them to confirm that they’re going to play along, this need only be a nod or gesture to indicate willingness to participate
4. Exaggerate each gesture but keep the movements simple.
5. Say, ‘look at your body’:- self awareness is often a challenge. It is as if their bodies are separate entities from the self. Sometimes by actually looking at themselves, they will also notice something else amiss, such as back to front T-shirts or trousers. If not, this is an ideal time to draw their attention to the glitch.
6. Place both your hands on your head and say the word hair or head depending upon which word they are familiar with.
7. Then point to your mouth, smile and bare your teeth to say ‘teeth.’
8. Bend down and touch your feet to say ‘shoes’ or ‘shoes and socks.’
9. Repeat all the gestures but this time link the word to a number, 1,2,3 and 4.
10. Ask your child which one he wants to do first, 1,2,3 or 4, or hair/teeth/ shoes or socks. [or a,b,c and d for those alpha fans]
11. The element of choice to these ‘chores,’ gives control back to your child and may help encourage co-operation or at the very least, a willingness to have a go.
12. As they move off to start the first chore, be sure to praise verbally, or with a gesture such as a high five, or whatever physical confirmation they prefer. In our case, one cannot be touched and the other cannot be praised, but we all adapt to our own individual requirements.

Obviously this could be adapted to your particular morning hic-cups, the bits where they get stuck. Although we still use the PECs boards to help sequence, somehow the physical movements are yet another shortcut to smooth those transitions. This is a further step forward than a couple of years ago when they needed individual sequencing charts for each separate chore / task which were broken down into their own sequential steps. These can prove helpful with task completion. E.g. once they have brushed their teeth they move a tooth brush icon from one side of the chart [to do side] to the other side of the chart, [done side] These can be individually tailored to your child’s area of interest such as Pokemon, Thomas or dinosaur icons. Icons are particularly handy for those children who do not like to hold pencils to mark completion or have other fine motor issues.

I'm all for encouraging independence but some children need the scaffolding to remain in place for those difficult moments.

Lastly, a note to anyone struggling with the basics.

If you believe that such simple prompts are well out of your league, I can assure you that I would have felt similarly a few years ago. Back then, we too were struggling with the basics of dressing, toileting and feeding. If I had read a post similar to this, I would have thrown up my hands in horror. However, I wanted to share this to encourage and reassure, that all our children keep growing and changing in tiny huge ways.

We will all get there in the end.

This site “Do2Learn” may help, I hope.

 
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