Extending his program

After another clinic, we have made more changes to C's program. I really like where it is going. Still working on building skills after working to build more compliance and make therapy more reinforcing. Partly I feel more comfortable because I have a few tricks up my sleeve now that I know him better. The other is because this program varies the way we collect and share data. So the data doesn't get in the way of the teaching. We perform the trials and then tick a box of 0-25%, 25-50%, 50-80%,80-100%, based on our memory. Since we only do a couple of trials at a time it is not too hard to remember. With my other programs I tick a box after each trial, or place a cross. There is actually a little more writing with this program as there is room to clarify each set of data. I can write the materials I used, and the reinforcer that was offered. Also we summarize at the end of each session, with the form covering things like attending, eye contact, stimming, play and behaviour. We also list the reinforcers used and which ones did or didn't work today. Because I can recall the data, I can do a few programs on the trampoline, or in the park without having to carry a notebook to keep score. If feels very natural and doesn't interrupt his focus or mine. We are expanding his play program to include more locations and equipment. So we will be learning to ride a bicycle with training wheels, and braving some more of the playgrounds nearby. The first hour of today's session was walking, skipping, running and stopping on our way to three parks in close walking distance. A piece of climbing equipment, that he had to be carried through yesterday, was not a problem today as we approached in a relaxed manner. He held on to it without reaching out for me, or launching himself towards me as he did yesterday. The whole program was done as an imitation task. Follow the leader style. I go up the ladder, and so does he. I climb down the spiral, so does he. I drum my tummy while I walk, so does he. We are working on "STOP!" also. Very important for safety that he can freeze when we need it. A lot of these tasks have an Occupational therapist bent to it. Making sure he develops the muscle control and awareness of his body to enjoy physical play. He can be a bit floppy and slouchy at times, but he loves the trampoline, and has great control over a bouncy ball, so I really think he will grow to love these other games. Inside, we are taking his good matching skills, and using them to extend his focus. We want him to be able to leave the table to get something and then make his way back and sit nicely. First I am asking him to leave a chair to come to the table to match and then go back and sit down. He is doing well. The other big change to the program is that we have added a negative component. So far ignoring his tantrums, has not been enough to stop the loud outbursts, however he doesn't bite anymore thankfully. The new consequence of screaming is to have to sit in a chair until quiet, and then wait while we colour three circles.(so he has a visual of how long to wait). If he screams, then we start again from circle one. Compared to Supernanny's minute per year of age, I think this is still quite mild, but he sure was pissed this afternoon at being made to stay in the chair each time. Hopefully it will be enough to motivate him to not scream all the time. I am glad I stuck with this program to start seeing some progress, and to get a chance to work with this particular superviser. While I can't mix programs, I can certainly use this experience to mold how I present the tasks given to me. Onwards and upwards.