Sunday, August 28, 2011

Autism and Collaborative Problem solving

Scenario : kid with language difficulties has been hitting, spitting and swearing at his speech therapist.

The following is a list of interventions that parents try to solve the problem

A Time out and Reflection -  if a kid perceives  TO as a consequence or punishment , reflective questions  -   how do you think your teacher feels ?  can you think of a better way to tell her how you are feeling ?   will have no impact.

The best time for kids to reflect on their behavior is when they feel unconditionally loved and have a good  connection - then they feel safe. It is important to find the right time for your discussion. Kids are generally motivated to act appropriately and adaptively. ' Kids do well if they can '  - they lack the skills to do so. The acting out –being on the looking bad spectrum happens when the demands placed on the kid outstrip his skills.

B.  calming techniques -  teaching him calming procedures ,techniques – breathing,  meditation , crouch like a tortoise – calm down then ask for help ,remember the  traffic light  red =stop, yellow = reflect and choose what to do , green = act , having something ' sensory to touch ' that distracts him, give him the language or sign language that communicates  he is stuck or frustrated and needs help  , role play etc

C .  give the kid a feelings vocabulary  -   I am angry, frustrated, upset, anxious , etc
Calming techniques and feelings vocabulary might help to stop the hitting, spitting or swearing but they still deal with the symptom and not the cause.  The cause is the unsolved problem and the lagging skills which he needs to solve that problem.

D. Out of the moment  Collaborative Problem solving -  We need to solve the outstanding problem so the kid has no longer a need to hit , spit, swear, calm himself down or express frustration appropriately. By engaging in the CPS process , the kid is indirectly acquiring skills –using hindsight  reflecting on the past, anticipation-forethought in predicting the viability of solutions, articulating concerns and solutions, taking perspectives etc  and we are solving the problem which is reliably and predictably occurring in a durable way.

D1 identifying and articulating concerns or triggers  – we can help kids by offering tentative educated guesses/hypothesis  of their concerns or unmet needs usually based on our observation or intuition.  To help with the process , we can make a list of the predictable concerns that cause him to become frustrated  -  clothing bulky or itchy, food does not taste good, peer /sibling bothering him , hungry, hot, tired, thinking someone mad at him that we both can refer to. If the kid is non-verbal or has serious difficulty in articulating concerns we can depict the kid's common, predictable triggers or concerns in pictures so he can point to the concern that is causing the problem.  Over time we can pair specific words with pictures so we become less reliant on the pictures.

D2 Teaching directly the language of concerns.  Teaching feelings vocabulary like sad, mad, frustrated is useful but it is more important for him to let us know what concerns or unmet needs  causing him to be mad, sad or frustrated.  

D3 Generic concerns – teaching '  general problem vocabulary'  that can be applied across many situations  - Something's the matter, I can't talk about it right now, I need help, I don't know what to do, I need a break , I need time to think is helpful.

D4 Taking time -  it is useful to tell kids who may have the language but still find it difficult to express their concerns to take their time and think first about what they want to say. Kids are rarely asked about their concerns and don't have them on the tip of their tongues.

Ross Greene in his CPS book for schools ' Lost at School ' talks about CPS as opposed to ABA as an more appropriate intervention for autistic kids . 

Ross Greene -

'It’s often assumed that the CPS model has no application to these autistic kids, and that well-known applied behavior analysis methodology is really the only option. I beg to differ. “Autism spectrum” doesn’t say anything about the kid’s general cognitive functioning, and unless you’re ready to throw in the towel on teaching the kid lagging skills or helping him learn to solve problems – and hopefully, you’re not – then CPS may well have a role to play. The most common obstacle is communication/linguistic skills. As described above, you’ll want to focus first on helping the kid develop the skills to communicate his concerns (often through pictures or hand signals) in a very rudimentary manner , and if your kid is unable to provide much information about his concerns, then your powers of observation and intuition will be crucial . Of course , because your powers of observation and intuition aren't infallible , you will need to continue observing and intuiting so you can recognize you have hit the nail on its head with your hypotheses about your kid's concerns. Then, if possible, you’ll want to focus (if it’s feasible) on helping the kid express these same concerns verbally. Along the way, you’ll be watching closely to see if there is some mechanism for the kid to participate in generating solutions.'

No comments:

Post a Comment