|
[To view recent updates, click on the REFRESH button of
your browser]
Preschool Shadow Aide
How to shadow my child with
autism at a typical preschool
Preschool Shadow Aide
How to shadow my child with autism at a typical preschool
Y.S. Brobst, M.A. – a parent. Copyright 2001- 2009. All Rights Reserved.
Please do not print,
reproduce or transfer this written work by any means. Refer the reader to the
website (http://home.san.rr.com/autismnet/preshadow.html) because this paper is updated occasionally.
Autism is a lifelong neuro-developmental
disorder that presents itself with a triad of behaviors: impaired
communication, impaired socialization, and repetitive or stereotyped
behaviors.
A typical preschool is probably the best
place for a 4 year-old child with autism to model the behaviors of typical
peers. However, each child with
autism presents a unique array of symptoms that fall within the autistic
spectrum. The higher-functioning child
with autism who presents no major disruptive behaviors will have the best
outcome in the typical preschool setting, however with the help of a
qualified shadow aide.
Choosing a shadow aide for my child was
hard. Our qualifications for the
shadow aide included:
1)
At least a bachelors
degree in psychology, speech, education, or special education.
2)
Knowledge, experience, and skilled
in behavior modification or applied behavior analysis
3)
Experience working with children
with autism
4)
Ability to pretend to be a peer
5)
Ability to pretend to be a class
aide
6)
Ability to implement the techniques
used by the speech/language therapist, occupational therapist, vision
therapist, psychologist, and other specialists involved in providing special
education supplemental services.
With the above qualifications, the parent
or supervisor, nonetheless needs to train and
communicate frequently with the shadow aide. A less qualified individual is
acceptable but may require high self-motivation for this person to learn the
behavior modification techniques and about autism. Otherwise, the parent will simply be
wasting their child’s precious time with a less qualified and unmotivated
shadow aide.
The Interview
1)
The parent or supervisor provides
the individual with materials to read in order to be successful at being a
shadow aide for a child with autism.
2)
The goals and objectives are set up
based on the needs and overall functioning of the child.
3)
The data sheets are provided to
track progress and behaviors.
4)
There is a discussion of what the
child is like - the current behaviors and functioning.
5)
There is also a discussion of what
is being done outside of the school (ABA Therapy) and the plans to generalize
at the typical preschool setting the skills learned during the home therapy.
First 2 Days on the Job
1)
Get a notebook, observe the child’s
behaviors, and record everything – behaviors, actions, verbatim language,
interactions, etc.
2)
Also, observe the typical children,
record what is typical behavior, typical social interaction, typical verbal and non-verbal communication. Observe the extroverted and introverted
children and record observations.
3)
After 2 days, analyze the behavior
of the child with autism and do a plan of action.
Summary from the 2 days of observations:
1)
This child has the ability to
parallel play.
2)
This child has immediate echolalia
and some delayed echolalia.
3)
This child can interact with adults
better than his peers.
4)
This child cannot respond to
questions asked of him by adults. He has to be prompted for answers
5)
When peers attempt to interact with
this child, he looks at the peer briefly, attempts to say something but
instead walks away.
6)
He perseverates on activities such
as puzzles.
7)
He does not communicate his
needs. He attempts to do things
himself.
8)
He talks to himself often.
9)
He mouths his shoelaces, pencil
erasers, etc.
10)
He chooses not to run around with
his peers.
11)
He has fleeting eye contact.
12)
He sometimes refuses to join his
peers at circle time.
13)
He does not like to share toys with
anyone.
Analysis from observations
1)
This child needs intensive language
therapy.
2)
This child needs to learn
turn-taking
3)
This child needs to learn social
play with peers
4)
This child has a lot of problems,
let’s handle them one-at-a-time.
The definition of “shadow” from the Random
House Dictionary is “to follow (a person) about secretly in order to keep
watch over his or her movements.”
Likewise, the definition of “aide” from the same dictionary is “an
official assistant.” From the above
definition, one can surmise that a shadow aide is a person who follows
another child about secretly in order to keep watch over his or her behavior
and assist this child in achieving age-appropriate behavior. With this in mind, the author defines the
"shadowing process" as an iteration of behavior analysis, planning,
implementation, and review of results.
Repeat this process again and again until you reach favorable results
in behavior. This definition follows
the “Y.S. Brobst Principles of Being a Preschool
Shadow Aide” which is a unique way of approaching shadowing. Many shadow aides are there to merely
assist children with autism when they run into trouble. This shadowing process requires a lot more
work, analysis, trials, staging of real-life scenarios and achieving
realistic goals.
Sometimes before a shadow aide can deal
with the core of the shadowing program (communication and socialization), she
has to deal with disruptive behaviors (or some stereotyped behaviors) such
as:
1)
Hitting, screaming, crying, running
away
2)
Making odd and inappropriate noises
3)
Making inappropriate body movements
4)
Not following directions
5)
Lack of self-help skills such as
using the restroom
6)
Impulsive behavior such as running
into the street, leaving without telling anyone
7)
Not being able to sit still in
circle or during class
8)
Non-compliance, melt-down
If this is the
case, it will benefit the child to start out in a very structured and
disciplined program to make him aware of these disruptive behaviors and
replace these behaviors with acceptable ones such as use of appropriate
language, etc. It is unfair to the
typical class of children, if a child is always disrupting learning in class. However, bear in mind that even though the
child has mastered appropriate behavior in a structured setting, the
beginning days of typical preschool inclusion may invoke disruptive
behaviors. This is where the shadow aide needs to analyze
what is causing the disruptive behavior, determine what happens after the
behavior took place, and do a plan of action. Action may include some sensory integration
therapy, occupation therapy, behavior modification therapy, etc.
Once the
disruptive behavior is brought down to a minimum, start the communication and
socialization shadowing program at the typical preschool. Please note that the role of the shadow
aide at the typical preschool is to teach the child with autism to
independently socialize, communicate, behave and perform in class at an
age-appropriate level. Typical peers
have disruptive behaviors. What will
differentiate the child with autism from the typical peers are the behaviors
due to the child’s disability. The
role of shadow aide is not an easy job.
If the sole role of the shadow aide is to make the child behave, sit
quietly in class, and complete all the school work, then the aide’s work is
completed in a few days. There is more
to sitting quietly, doing the school work, and behaving nicely at a typical preschool. The child with autism needs intervention
for his impairment in socialization and communication, and
stereotyped/repetitive behaviors.
BEHAVIOR
ANALYSIS #1
My child’s first behaviors included sitting
on the carpet alone at the preschool classroom and playing with the same
puzzles over and
over again. There was no interaction
with peers. A peer attempted
interaction with him but he ignored the peer.
Based on the above behaviors, devise a plan
of action and implement. For example,
PLAN A- Have a peer sit with the child with
autism and play the puzzles with him.
Results of implementation: The child with autism screams obviously
protesting to not want to share the puzzles with the peer. (FAILED implementation)
Based on the above behaviors, devise
another plan of action and implement.
PLAN B – Practice parallel play first with
a peer
Results – A typical peer is prompted to
parallel play with the child with autism.
This child with autism stands up and walks away. (FAILED implementation)
Based on the above behaviors, devise a plan
of action and implement.
PLAN C – Shadow aide sits with the child
with autism and parallel plays.
Results – The child with autism stands up
and walks away. (FAILED implementation)
PLAN D – Shadow walks around the child with
autism who is playing by himself. She
sits down with him for 5 seconds and parallel plays, after which the shadow
stands up and walks away.
Results – The child with autism parallel
plays with the shadow for 5 seconds. (SUCCESSFUL implementation)
PLAN E – Shadow walks around the child with
autism who is playing by himself. She sits down with him for 10 seconds and
parallel plays, after which the shadow stands up and walks away.
Results – The child with autism parallel
plays with the shadow for 10 seconds. (SUCCESSFUL implementation)
PLAN F – Shadow walks around the child with
autism who is playing by himself. She
sits down with him for 15 seconds and parallel plays, after which the shadow
stands up and walks away.
Results – The child with autism parallel
plays with the shadow for 15 seconds. (SUCCESSFUL implementation)
PLAN G – Shadow walks around the child with
autism who is playing by himself. She
sits down with him indefinitely and parallel plays.
Results – The child with autism parallel
plays with the shadow indefinitely. (SUCCESSFUL implementation)
SOCIALIZATION and PLAYING ALONE ANALYSIS:
Many people will argue as to why one would
“force” a child who would rather be alone to play or socialize with
others. At what point will the shadow
aide determine that this child with autism wants to be left alone or that his
lack of socialization and play with peers is a result of his disability. Shadow aide analyzes the situation. The child with autism above prefers to play
with the puzzles over and over again because this is what his body and brain
can do comfortably. The child with
autism prefers to be alone because this is what his body and senses can
handle. Why not “teach” this child to
do something else? Socialization does
not come easy to this child with autism.
All the very basic aspects of socialization have to be taught
step-by-step. Just as math may come
easy to some children, others may have trouble with it and need to be tutored
step-by-step.
BLIND SHADOW AIDE
OR NOT:
The question arises as to whether or not
the shadow aide should be blind to the child with autism. Choosing an aide who is blind to the child
may be a good approach for this child with autism. This means that the child will not know
that he has a personal aide. The aide
will pretend to assist the other children in class while keeping an eye on
the child with autism. The only reason
why his home therapists would act as shadows at school is to give him the
motivation and confidence to transfer his newly acquired skills at the school
setting. In this respect, the shadow
aide is acting as the child’s coach.
Once he masters the skill at school, then lean towards switching to a
blind shadow aide for the child to test his independence in using acquired
skills.
BEHAVIOR
ANALYSIS #2
My child can now parallel play with the
shadow aide. The shadow attempts to
touch the puzzle he is building. The child screams and protests “No!” The shadow analyzes this behavior. Why?
She touches the puzzle again which results in the same screaming and
protesting behavior. The shadow says
to the child, “Why? It’s okay, I am just touching
it. See?” Child protests and cannot
verbalize as to why. The shadow puts herself in the child’s position. Why would she not want anybody to touch her
puzzle? Oh, because I am building it
and I don’t want anybody to mess it up.
The child perseverates on the puzzle all day – building the puzzle,
when done, shuffling it, then building it again and
again and again.
PLAN A – Shadow aide makes the puzzles
inaccessible and will observe what the child will do. Please note that many preschool teachers
exercise boundaries on their students.
For free play, they only allow certain activities for children to do
while other activities cannot be accessed.
This teaches the children boundaries and following the rules. Please coordinate with the preschool
teacher if a certain activity will be inaccessible to the class.
Results – The child with autism would not
join the typical peers in building the blocks nor would not play with the typical
peers in the pretend center. He just
stands around. Shadow tells the child
to go play with the blocks. The child
screams, “No! Leave me alone!” The
shadow holds his hand to walk him to the blocks. The child starts screaming and
protesting. Everyone in the preschool
room is disrupted. (FAILED
implementation)
PLAN B – Shadow still has all the puzzles
inaccessible and will observe what the child will do. Then she brings the blocks to the child and
attempts to parallel play with him.
Results – The child plays with the blocks
by himself. The shadow sits by him and
watches, then she starts to play with her own
blocks. The child continues to
parallel play with the shadow aide.
The shadow talks to the child.
The child responds with echolalia and continues to parallel play. (SUCCESSFUL implementation)
BEHAVIOR
ANALYSIS #3
Shadow wants to find out if the child with
autism chooses to parallel play with typical peers. Outside, there is a big sandbox. She directs the child to sandbox and the
child says, “No!” The child chooses to
ride the tricycle.
PLAN A – Shadow tells the teacher to tell
the class or the child with autism next time that the tricycles are not
available outside. They can either go
to the sandbox or play ball.
Results – The child with autism chooses the
sandbox and parallel plays with the typical peers. (SUCCESSFUL implementation)
DATA LOG RECORDING:
Shadow aide reports the following in the
data log.
1)
Non-compliant – says “No!” all the
time. Need additional intervention on
this (i.e. social stories)
2)
Has trouble with cooperative
play. Need to model to him what
cooperative play is all about. This
child seems to have the receptive language skills to understand directions.
3)
Practice on parallel play more. Parallel play with an adult first, then
peer, then group of peers.
PLAY WITH PEERS ANALYSIS:
Shadow aide observes and analyzes the play
skills of the typical peers. Here are
two children. One has a language
barrier and can hardly speak English and the other one is quite shy. But yet, without too much language
exchange, these two children are playing and interacting with each
other. How can they do this? Why is it so easy for those two children to
socialize? Why is it so unattainable
for this child with autism to do what they can do? Shadow aide observes the typical children
social behavior. One thing that she
notices is that these typical children use of their eye contact along with
their facial expressions to communicate messages to each other. Looking somebody in the eye establishes a
connection, an emotional connection.
Many psychologists today who deal with autism argue that eye contact
is not important as it used to be because many adults talk without making eye
contact, anyhow. The author disagrees
because this child with autism needs at least the very basic eye contact to
establish an emotional connection with others. When someone walks by, a typical child
would look up and look at that person’s eyes.
This may mean nothing to typical people but it means a lot for this
child with autism in order to establish the connection with others. What about the children who are blind? How can they establish a connection without
the eye contact? These blind children
have the functional language to socialize.
Their other senses and physical being are functioning properly to want
to be with others. Unfortunately, this
child with autism does not have the functional language to socialize. There are also some sensory integration
issues in which his body cannot properly process the environment around
him. So how do you teach this child
with autism to establish eye contact?
It is more than a “Look at me, look at my eyes” program therapy. It’s about an emotional connection and
non-verbal communications therapy.
BEHAVIOR
ANALYSIS #4
Shadow aide steps back and observes the
behavior of the child with autism from behind the bushes. Is the child able to parallel play without
prompting? It looks miserable. The child stands at the perimeter of the
walls and is contented with walking around while touching the walls.
PLAN A – Shadow walks up to the child with
autism and says, “Hi, do you want to play?”
If he says yes, then great. If he says no, then shadow aide sits next
to child and pretends she is having fun with the toy, while tempting the
child to play with her.
Results – The child continues to walk
around the perimeter of the wall and ignores the shadow. (FAILED implementation)
The shadow aide thinks hard. The wall is more reinforcing for him than
this toy. She has to find something
that is more reinforcing than the wall.
PLAN B – Shadow aide picks up a few of the
playground wood chips, walks up to the child with autism and says, “Look,
these little barks are like puzzles.
Puzzles. I’ll show you.” Shadow sits down and plays with the barks
that looked like little puzzle pieces.
Results – The child hears the word
“puzzles” and becomes curious. He sits
down with the shadow while they play with the barks. (SUCCESSFUL implementation.)
BEHAVIOR
ANALYSIS #5
PLAN A - After a while, other typical peers
are curious as to what is going on and they wish to join in. The shadow aide gives them their own set of
barks to play with after which she stands up, moves away and observes the play.
Results – The child was able to tolerate
the parallel playing with the peers. (SUCCESSFUL implementation.)
The shadow notices that a peer tries to
interact with the child with autism.
The peer says, “I am making a building now, what are you making?” The child with autism looks quickly at the
peer, attempts to say something but decides to stand up and walk away as if
he cannot handle the interaction or does not know how to reply.
The shadow analyzes the situation. Is it sensory or is it the language
deficit? If he has the language, will
he be able to respond to him?
DATA LOG REPORT
1)
The child can parallel play with a
typical peer. When the peer starts
talking, he walks away. What happens
when the typical peer doesn’t talk and just does non-verbal communication
(gestures)? Will this child with
autism walk away?
OVERALL ANALYSIS:
1)
COMPLIANCE: Why is it so hard to
have this child comply with the shadow aide in a typical environment? First off, the regular preschool teacher
actually treats this child like any other typical child – meaning no
“special” treatment which is what we want.
However, this means that he does not get any more attention than any
other child. Is this child asserting
his independence from the aide? Or
does the child with autism feel like this aide is just bugging him all the
time? Just leave him alone? Compliance is never really a problem in a
special class setting or special program setting with special needs kids. For one thing, the special class setting
and the special program setting are much more structured and all the children
given the behavior problems are cited by the teacher and aides at some point.
In the typical setting, he probably feels that he is the only one who is
required to do all these things.
Exercise some informal and fun compliance testing with the child. If the child says no, then that might mean
that he feels he is the only one being required to follow all the
instructions from the shadow aide.
Shadow aide has to pretend that she is aiding everyone.
2)
LANGUAGE: This child obviously has delayed expressive
language. He tries to talk but
can’t. He tries to put words together
but ends up with delayed echolalia or out of context language – language that
does not relate to the situation. When
asked a question, he responds by repeating the last few words of the
question. The ABA therapy home program
needs to increase one-on-one therapy on language development.
3)
PLAY: This child seems to have the ability to
play parallel with another peer as long as there is no conversation (talking)
involved in the play. He does not know
how to initiate play nor join in play.
4)
SOCIALIZATION: This child has no clue on how to initiate socialization nor join in socialization.
5)
STRESS: This child has stress-related behaviors
such as immediate echolalia, mouthing objects, scratching body, and fidgeting
in his seat.
6)
SENSORY: This child has sensory
issues because of poor eye contact. He
chooses to walk around the perimeter of the walls because of sensory
overload. Possible auditory and visual
sensory issues.
The big question is: Is this child ready for typical preschool
inclusion? Examine the ABA (applied behavior analysis) home therapy. This child needs to master skills using
child-to-adult therapy, child-to-peer therapy, child-to-two peers therapy, child-to-small peer group therapy, and
child-to-large peer group therapy. All
peers must be typical in order to model correct social behavior.
NON-COMPLIANCE ANALYSIS:
Frequently, most ABA therapists and shadow
aide therapists will complain that the child with autism has non-compliance
issues while the parents or even the school teacher say otherwise. Most
typical children have non-compliance issues ranging from refusal to brush
their teeth, do homework, sit down to eat dinner,
etc. Another example is when a mother requests (or demands) a typical child
to help clean up the mess. Most often the typical child will either ignore
the first request and it may take a good number of repeating the request (or
demand) for the child to comply. Some typical children are furtive enough to
think up of a number of excuses as to why they could not possibly clean up
the mess. In this light, the role of
the shadow aide in analyzing non-compliance behavior is to determine if this
behavior is merely typical child non-compliance behavior such as refusal to
do the task because of being lazy, putting the task at low priority, etc. or
if non-compliance is the resulting effect of his disability in which the
child with autism may not possess the skill, confidence and motivation to
follow the request. An example of a
non-compliance behavior for a child with autism is as follows. The shadow aide requests the child to “Go
find a friend and play.” The child
either ignores the shadow aide or screams “No!” Before the shadow aide can conclude that
this child is disobedient, the shadow has to analyze why playing alone is
much more motivating for this child than playing with a friend. More often than the author sees, shadow
aides and therapists dismiss the resulting non-compliance as the child being
undisciplined and manipulative. With this, the child’s behavior then progress
into a power struggle with the shadow aide.
Yes, this particular child with autism can recognize the methods of
manipulating himself out of the situation that he cannot carry out. And this is what makes it hard for the
shadow aide to analyze non-compliance behavior. The resulting negative
consequences given to a non-compliant child with autism are usually time-out,
withholding a preferred item, extinction, etc., or yet ignoring that the
non-compliance behavior ever took place. The shadow aide may not realize that
when the parent or teacher requests this child with autism to “Get the pencil
at that table.” “Throw this paper in the trash can.” “Put that book away.”,
this child is remarkably compliant because he can do these things with very
little effort. A better approach is
for the shadow aide to analyze why this child with autism prefers not to play
with a peer. Perhaps, this child has
no skills in initiating play with a peer and needs to be taught. Perhaps,
this child has sensory issues and has difficulty processing the environment
considering the surrounding noise of other children when he approaches a
peer. Perhaps, this child is afraid of
failure because he understands that he can’t keep up with the peer once play
has started. Before dragging this
child by his hand so he can play or before presenting him with negative
consequences, the shadow aide has to determine how to present playing with a
peer to be more motivating than playing by himself. One intervention is to teach this child the
“prerequisite” skills needed to play with a peer after which the learned or
mastered skills are generalized in the school environment. If the child has learned and mastered the
play skills in a controlled environment and is still non-compliant in the
school setting, then this may simply indicate that he may not have the
confidence and motivation to transfer them to this environment or perhaps
there are unknown sensory issues affecting the generalization of skills. In
this light, continue to analyze the child’s behavior. The key is to make each small step towards
play with a peer a success for the child.
Gradual success can propagate into one big success.
MOTIVATION:
Motivation is a problem for this child with
autism. How does the shadow aide give this child the motivation to interact
or socialize with other children? For
most days, the aide may feel like this child with autism is a hopeless case. This child will never socialize and does
not have any “will” to socialize at all. He is in his own world – period and
he wants to be. The last thing that is
needed is a shadow aide who rolls up her eyes and dismisses herself to
whatever the child wishes to do. First
of all, the shadow aide has to study the art of motivating. What motivates a person to do
something? Reinforcement - positive or
negative, prizes, rewards, high-fives, social reinforcers,
etc., no doubt may play as a solution to the problem. The difficult part may be finding the right
reinforcer in order for the child to perform the
requested task. The key again is to
start slow and to reinforce each minute success. For example, if the child with autism said
“Bah!”, the shadow aide should reinforce him by
saying, “Hey, thanks for trying to say something. Tell me more. Give me
five.” instead of “Yes,
what are you trying to say? I can’t understand you.”
LANGUAGE ANALYSIS:
During the home therapy, the child with
autism is able to speak 3-4 word sentences with the ABA therapist. The child is also able to communicate with
his parents. However, he can barely communicate with his siblings, a playdate or playmate.
His language is out of context when he is exposed to a group a
children and echolalic when exposed with
adults. At the typical preschool, this
child with autism is almost mute or non-verbal. Analysis suggests that he has not
generalized his language skills beyond the home nor beyond the
therapists. He needs the
self-confidence and motivation to respond to the adults at the typical
preschool. He is, however able to
respond fairly to his shadow aide at the typical preschool. Shadow aide has to devise some means to
generalize at the typical preschool the learned skills from the home therapy.
ECHOLALIA:
Echolalia is a behavior in which a child with autism
repeats (echoes) what the other person says. For example, this special child
is asked by an adult, “Where should these toys go?” Rather than answering the question, the
child responds with “Where should these toys go?” or he responds by
repeating the last part of the question, “These toys go.” To a parent, this is an extremely baffling
behavior. And as one can see, this
special child often displays echolalic tendencies
at the preschool. The shadow aide
analyzes this behavior as to when it occurs the
most. It appears to occur
the most when the child is under stress of being questioned or during novel
situations. For the most part, the
home therapy is pursuing the child’s goal to achieve “functional” language which will
eventually replace echolalia. At this
point, this special child’s language is mostly declarative such as “You’re a
man.” “Lettuce is a vegetable.”
Functional language is needed to make this child communicate with
others effectively. The role of the
shadow aide is to let the home therapists know that echolalia is a problem in
the school setting at various scenarios.
The child may not exhibit echolalia at home at all,
however the therapists need to employ some interventions to move this new
skill (functional language) beyond the home by exposing the child to novel
environments such as a public playground, etc. Role-modeling and practice in
answering questions outside of the preschool will help the child prepare for
novel situations (questions and iteractions) at the
preschool. Also, stress-management
techniques need to be employed to reduce echolalia. There is one technique that could replace
echolalia temporarily. Taken from Koegel’s method
of saying “I don’t know.” instead of repeating the question is a more
acceptable social response until the child achieves functional language and
stress-management techniques to respond appropriately in novel situations.
TEACHER SURVEY
This PDD School Survey can be administered
to the teacher(s) or teacher aides who work with the child in order to
pinpoint the symptoms of the disorder (from a casual observer’s
point of view) and to prepare a game plan for reducing or possibly
eliminating the autistic tendencies.
This survey must be administered at least after one month of school or
whenever the teacher is comfortable with rating the child with autism.
PDD SCHOOL SURVEY - CONFIDENTIAL –
Survey Adapted from the DSM-IV Criteria, PDD --- Survey Copyright 2000 Y.S. Brobst
STUDENT:
____________________________________ SCHOOL: _________________________
TEACHER:
____________________________________ DATE TODAY: _____________________
Please answer with Y (Yes) or N (No) on the
following survey of this student.
Additional comments can be written at the back of this page. Thank you so much for your time.
______ 1) Qualitative impairment in social
interaction
_____ (a) marked impairment in the use of
multiple nonverbal behaviors
(Please check the
impairment below)
_____ eye-to- eye gaze
_____ facial expression
_____ body postures
_____ gestures to regulate social interaction
_____ (b) failure to develop peer
relationships appropriate to developmental level
_____ (c) a lack of spontaneous seeking to
share enjoyment, interests, or achievements with other people
Please check the following
that applies:
_____ lack of showing objects of interest to you
_____ lack of bringing objects of interest to you
_____ lack of pointing out objects of interest to you
_____ (d) lack of
social or emotional reciprocity
Please check the following that applies:
_____ lack of reciprocating
greetings
_____ lack of reciprocating
joy
_____ lack of reciprocating
other emotions such as ______________
______ (2) Qualitative impairments in communication
______ (a) delay in,
or total lack of, the development of spoken language (not accompanied by an
attempt to compensate through alternative modes of communication such as
gesture or mime) -
Spoken language is estimated at the level of a ________ year old.
______ (b) marked
impairment in the ability to initiate or sustain a conversation with others
______ (c) stereotyped
and repetitive use of language or idiosyncratic language
Please check the following that applies:
_____ Echoing the words of
others (all or last few words of the sentence)
_____ Use of language that
is out of context
______ (d) lack of
varied, spontaneous make-believe play or social imitative play appropriate to
developmental level - (Examples if any
_____________________________________________)
______ (3) restricted, repetitive, and stereotyped
patterns of behavior, interests, and activities
_______ (a)
encompassing preoccupation with one or more stereotyped and restricted
patterns of interest that is abnormal either in intensity or focus
Please check the following that applies:
______ Abnormal intensity of
focus on art projects
______ Abnormal intensity of
focus on other interests such as _____________
_______ (b) apparently inflexible adherence to
specific, nonfunctional routines or rituals
Please check the following that applies:
______ Inflexible to change
in routines (ex. Go this way, etc.,)
______
Inflexible to change in routines (other examples __________________)
_______ (c) stereotyped
and repetitive motor mannerisms (e.g., hand or finger flapping or twisting or
complex whole-body movements)
_______ (d) persistent
precoccupation with parts of objects
Please check the following that applies:
______ Persistent
pre-occupation with parts of cars, etc. ___________
______ Persistent
pre-occupation with parts of other objects such as _________
BASIC ASPECTS OF SOCIALIZATION
One might wonder why it is essential for
the shadow aide to observe typical children and record typical behavior,
typical social interaction, typical verbal and non-verbal communication. This is because it is crucial to have a
basis for coaching socialization and communication.
For example in this first scenario, here
are two typical children sitting next to each other in the sandy playground. No activity nor socialization between the two children are
taking place. A few moments later, Child A starts to scoop up sand and builds
a small hill of sand. Child B looks
over, grabs a shovel, picks up sand with the shovel and pours it over on the
small hill that Child A created. Child
B glances at Child A and vice-versa.
Then Child A proceeds to pour more sand on the same hill after which
Child B takes his turn. They do this
activity without fighting and without words, merely actions. This is called
cooperative play. The two typical
children are turn-taking. It is an
amazing sight to see when these children play cooperatively without
words.
Now, let’s look at the second scenario of
our special child with autism and the typical Child sitting next to each
other in the sandy playground. Typical
child starts to scoop up sand and builds a small hill. This introduces an opportunity for the
special child to join in play by pouring sand over the small hill that
typical child built. After prompting,
special child pours his sand on the small hill exactly like Child B in the
first scenario above. Seconds later,
typical child gets very upset at the special child. Why?
The shadow aide is baffled. The
two groups of children did exactly the same thing- they both poured sand on
the hill with the same amount of sand.
What was different?
As one can see, in the first scenario, when
typical Child A and typical Child B were busy taking turns during the sand
activity, subtle social cues were being communicated with each other. When Child B poured the sand on the small
hill, he quickly glanced at Child A for his reaction, while letting out a shy
smile. Child A smiled back and read
the cues of Child B, after which Child A took his turn to pour his sand on
the shared hill. Afterwards, Child A
paused for a moment and made eye contact with Child B as cue that it was
Child B’s turn to pour sand over the hill.
In the second scenario, special child with
autism poured the sand on the small hill without making eye contact and with
zero social cues. The typical child
was desperately trying to read the cues of the special child to determine his
intentions for pouring the sand on the typical child’s hill. Because the typical child could not read
special child’s intentions as he looked at him, he thought that special child
did not ask for permission first to pour over sand on the hill. The typical
child rightfully became upset. Isn’t it beyond belief that typical children
can ask for permission to join in play using merely their actions and eye
contact?
How do you teach a special child with
autism to do such a complex task?
Luckily, this child with autism responds to modeling and role-playing
techniques of teaching. The same scenario
was recreated over and over again to the child outside of the preschool,
while painstakingly teaching him the very basic aspects of socialization and
relationship development. It is not an
easy task because before one can recreate the scenario, there are several
prerequisites. The very basic eye
contact needs to be taught. The
development of relationships and emotions need to be taught. The awareness of
environment and non-verbal cues need to be taught. This exercise becomes a process of taking
the top level of social activity then breaking it down to several branches,
and those branches are then broken down to other branches, until a number of
discrete activities at the lowest level of the branches are reached. Subsequently, the branches in the lowest
level can no longer be broken down further.
Therefore, the activities at the lowest level are where one can begin
coaching the child. Breaking down
these tasks to their lowest level is also quite complicated. Furthermore,
mastering one discrete task may require different types of exercises that
match the unique needs of the child.
For example, to achieve the very basic eye
contact one may have to perform several exercises to achieve this. Establishing the very basic eye contact
continues to be an ongoing exercise for this child with autism. This is because his hypotonia
or low muscle tone is affecting the ability of the eyes to move, track and
focus. Examples of eye contact drills
are as follows:
1)
Classic “Look at me” program
2)
Peekaboo
program
3)
Follow the picture at the end of the
moving Popsicle stick for eye tracking exercises and other eye tracking
exercises.
4)
Look at my eyes while the child
moves his head from left to right, right to left, up and down, down and up,
etc.
5)
Look at my eyes while I slowly move
around.
6)
“Look at my eyes because you care
where I am at” program
7)
“Look at my eyes because you are
making sure I am paying attention” program
8)
Emotions program, after which look
at my eyes and determine my emotions
9)
Staring contest
10)
“I am being funny and silly, so look
at me” program
11)
And several others
Sample Role-Playing of the sand scenario:
1)
First exercise: Adult pours sand on a hill. Then prompt by asking the child with autism
to pour his sand on the same hill.
After that, the adult takes a turn.
Then child takes his turn.
Repeat this until child masters this type of turn-taking. Note that the child may not make eye
contact or read the cues of the adult.
The only cue that he is reading is that the adult finished pouring the
sand and that it was his turn. In this
exercise, the child is learning turn-taking.
2)
Second exercise. Instruct the child that he needs to watch
the adult pour the sand first on the hill, after which he takes a turn, then adult takes a turn.
In other words, the adult will not prompt the child to take a
turn. In this exercise, the child does
not make eye contact, however concentrates on the cue of the adult pouring
the sand on the hill “for the very first time”. At that time, he joins in and takes a turn.
In this exercise, the child is learning joining in play and taking turns.
3)
Third exercise: Instruct the child that he needs to look at
the adult’s eyes first before he takes a turn to pour the sand on the
hill. In other words, the adult will
pour the sand on the hill, the child will look at the adult, after which she
will allow him to join in.
Role-playing: Adult pours sand on the hill. The child attempts to join
in without eye contact and the adult pretends to get mad. Adult pours sand on the hill again. Child tries again with eye contact after
which the adult lets him join in play and they take turns. The child is learning that he has to make
eye contact as a gesture to ask for permission from adult to join in play.
4)
Fourth exercise: Instruct the child that he needs to read
the face of the adult first before he takes a turn to pour the sand on the
hill. Role-playing 1: Adult pours sand on the hill. Child makes
eye contact with adult. Adult makes a
mad face. Child does not join in. Role-Playing 2: Adult pours sand on the
hill. Child makes eye contact with adult.
Adult smiles. Child joins in
and they take turns. In this exercise,
the child is learning to read emotions as cue to determine if he has
permission to join in play. Reading
social cues is the most difficult part of the exercise and the hardest to
generalize. After successfully
implementing this exercise, the adult and child may role-play several
variations of this scenario by adding other types of social cues.
As one can see, the techniques used here
are practically similar to learning to play a sport or a musical instrument
for the very first time. When an
individual learns to play a sport or a musical instrument for the first time,
the person has to initially learn the basic skills of the sport or playing
the instrument through simple drill exercises and repetition until mastery.
JOINT ATTENTION
Joint attention is the ability of the child
with autism to have shared attention with others. For example, if a typical child riding in a
car sees a tractor out in the road, the normal response would be, “Look, Mom!
A tractor! Look!” This means that the child is seeing
something and that he wants to share what he sees with another person. As one can guess, this child with autism
does not do this at all. He may see a
million interesting things but will never share what he sees with any
person. However, there is one thing
that this child will share with an adult.
His finished art projects and completed desk work are important enough
to warrant some adult’s attention.
This is a good start because this means that this child has the
ability to share attention, he merely needs to be taught how to do it in
various settings.
Interesting enough, when the shadow aide
pretends to be a class aide, she may find that many children come up to her
and say, “Watch me!” or “Look at what I can do!” These typical children are yearning for the
attention of others because of what they can perform physically. They do this with fellow peers almost all
the time. As one can deduce again, the child with autism does not have the
ability to show off his physical abilities.
“Why is that?”, the shadow aide may ask. Perhaps, the child with autism thinks that
nobody cares even though he tried to share his attention with others. Or perhaps, the child with autism never
thought that someone will actually think that it is “neat” to see what he can
see, or see what he can physically do.
And perhaps, the child with autism does not know that people actually
do this – show off.
Consequently, how will the shadow aide
teach this child joint attention. The
techniques are very similar to the one described above for the very basic
aspects of socialization. Joint attention may be modeled, role-played and
taught outside of the preschool first. But one may wonder why this is very
important to teach. This is because
joint attention is part of the emotional connection and the development of
relationships. One technique used to
teach the joint attention drill for “Look at what I can do” is by modeling,
coaching, and role-playing.
Example: Shadow aide kicks her leg up. She says to the child with autism, “Look at
what I can do!” Child with autism
watches the aide. The shadow then
prompts the child, “What can you do? I
bet you can do this, too?” The child
with autism attempts to kick his leg up.
Shadow then prompts him to say, “Watch me!” while he kicks his
leg up. Subsequently, she gives the child a short lecture that whenever he
can do something, it is okay to show it to somebody and say “Hey,
<peer>. Watch me!” Shadow then
proceeds to role-play with him by saying, “Okay, let’s pretend I am standing
here and you want to show me what you can do.
What do you do?” Child with
autism says, “Watch me! I can do this!” then proceeds to jump from the
stool. This is a successful
implementation for the shadow aide.
However, another problem surfaced.
What if the shadow aide is not paying attention. How can the child with autism assure that
the other person is paying attention?
Another modeling, coaching, and role-playing for this drill need to be
implemented. As one can see, each
minute aspect of socialization has to be taught for this child with
autism. This takes a great deal of
effort and time but the results are certainly rewarding even if it takes
years to teach these. Unfortunately
for this child with autism, simply having him around typical children or
having typical children reverse mainstreamed into his environment does not
totally teach him the subtleties of socialization. It may teach him good behavior through modeling, however every aspect of the socialization still
needed to be taught. It is unfortunate
that for this child with autism, there are no short-cuts such as putting him
in a roomful of typical children and letting him go and figure out
socialization by himself with a few pull-outs for speech therapy. However, bear in mind that there are other
techniques such as video scripting, video modeling, even watching himself on
video, comic strips, etc. that can be added to the exercises to help teach
the skills.
ANOTHER EXAMPLE OF JOINT ATTENTION
This happens all the time with this child
with autism. A group of children
adjacent to the child with autism gathers around watching something on the
ground. It’s a moving bug! However, this child with autism merely goes
on with what he is doing and does not congregate with the other children who
are near him. He is not participating
in sharing their attention on the bug.
One might say that this child with autism is definitely not interested
in bugs. But what if this lack of
joint attention happens with every instance?
The whole class gathers around the teacher’s table to watch the
science experiment. However, the child
with autism is away from the group, does not even bother to look up from his
seat and is quite oblivious of his surroundings. Now, this can be a big problem
academically. The author did some
informal tests with this child with autism on several occasions if this type
of joint attention is truly a potential social issue. While in line at school, almost everyday, one child next to him will want the attention
of children nearby by saying something like, “Look! I see John (or some other
person) coming!” or “Hey, that man has a weird hair color!” while pointing at
the person they are referencing.
Immediately, all the typical children near the typical child will look
at the direction he is pointing at, maybe even make
additional comments about John or the other person. Now, this is good joint attention by the
typical children. 100% of the time,
all the typical children will look at the direction of where another child
nearby commented and referenced. Some
of this typical children may not say anything,
however they are still sharing the attention of fellow children. The child
with autism when next to children who are visually attending to something or
someone will never attend with them nor look at the direction that the
typical children are referring or pointing to – as if this child with autism is
deaf to the comments of the other typical children or blind to what is going
on around him. This child with autism
will continue to do what he is doing, even if he is doing absolutely nothing
at the time. In other words, this
child does not have the ability to share attention with the other
children. A solution that the shadow
aide may implement is that whenever a typical child or a group of children
seems to want to get the attention of another, is for the child with autism
to be prompted to observe what the other children nearby are doing and to
respond to their subtle call for attention even if the child with autism is
not specifically invited to attend “with” them. This technique increases attention to
environment and to what the other children are doing and saying. Example:
A typical child while in line called out, “Look at the man with
crutches!” At this point, all the
typical children near the typical child will turn their heads and look at the
man with crutches. Some of the
children may say something and many will not. Prompt the child with autism to
look at the man with crutches because the child nearby said something about
him. Then instruct the child to join
in the group of children looking at the man and pay attention to what these
children are going to do or say next and that he may add to the comments
being made. This is also a joining-in
exercise for this child with autism.
PERSONALITY OR NOT
This shadow aide may find that while
talking to some probably well-meaning people that many will dismiss the
interventions as changing the personality of the child with autism. “Yes, John, a typical child is also very
quiet and plays by himself here. Your child seems happy doing this because
when I ask him to play with others, he says no. I am not going to force
him.” “Yes, children have their ups
and downs. Today is a down day for your child.” “All children do that type of
stuff – he just wants to do it more.” If serious shadow aides encounter this
type of roadblock, the best bet is to observe and analyze what several
typical children do and compare.
Observe how the other children (not how the adults) interact with and
respond to the child with autism. If
the other children don’t respond or interact with the child with autism, or
that they are giving signals that this child seems to be from another planet,
then this is how the future of this child will be like without proper
interventions. True, the author has observed typical children who at times
lack perspective-taking in that they tease other children endlessly. True, the author also has observed many
typical children who are shy, withdrawn, do not play with others, only watch
others play, play in the sandbox all day, or even rock back and forth. It is not about being withdrawn or playing
alone or not socializing that is the highlight of problem. It is more about the way this child with
autism interacts with other children.
In time, the shadow aide like some experts that the author has dealt
with will distinguish what an impairment looks like
versus the true personality of the child with autism, especially this one who
can be unusually inconsistent from day to day.
CONCLUSION
Being a shadow aide is more than helping
the child with autism to be successful in academics. It is also about helping the child
transition to become a healthy and productive member of society. Moreover, a shadow aide has a role of
teaching the child to become independent.
The sooner the shadow aide can transfer the skills needed for the
child with autism to become independent, the better for the child. There is no doubt that appropriate
intensive early intervention is the key to obtaining a better future life for
the child with autism.
Recommended Reading:
1)
How to Be a Para Pro, A
Comprehensive Training Manual for ParaProfessionals
by Diane Twachtman-Cullen
2)
“How An Aide Can Help Your Child Get
the Most Out of His Classroom Experience” pages
424-432, The Child with Special Needs, Greenspan, M.D.
3)
“Play and Social Skills”, Chapter
11, pages 105-117, Behavioral Strategies For Teaching and Improving Behavior
of Autistic Children, A Work in Progress, McEachin,
Ph.D.
4)
“Social Play”, Chapter 12, pages
119-125, Id.
5)
“Play”, pages 175-178, The Autism
Partnership Curriculum for Discrete Trial Teaching with Autistic Children,
Id.
6)
“Peer Interaction”, pages 299-302,
Id.
7)
“Socialization Skills”, pages
317-319, Id.
8)
“School Checklist”, pages 343-344,
Id.
9)
“Incorporating Speech-Language
Therapy into Applied Behavior Analysis Program”, Chapter 13, pages 297-303,
Robin Parker included in Behavioral Intervention For Young Children with
Autism, Maurice
10)
“Language Development Overview”,
page 318, Working with a Speech Pathologist,
Strategies for Promoting Language Acquisition, Id.
11)
“Social Language”, Chapter 2, pages
15-101, Teach Me Language, Freeman, Ph.D.
12)
Teaching Children with Autism, Strategies to
Enhance Commuication and Socializaton,
Quill
13)
Helping the Child Who Doesn’t Fit In,
Nowicki, Jr., Ph.D.
14)
Social Skills Activities for Special
Children, Mannix
15)
Relationship Development Intervention with
Young Children, Gutstein
16)
Teaching Children with Autism, Strategies
for Initiating Positive Interactions and Improving Learning Opportunities,
Koegel
17)
Merging Language Intervention with Classroom
Practices, Eisner
18)
Language Intervention in the Classroom, Merritt
19)
Making School Inclusion Work, Blenk
Web Sites:
1)
“Functions and Responsibilities of
the School Shadow”, http://groups.yahoo.com/group/autismnet/message/2365
2)
“Shadow Aide’s Role”, http://groups.yahoo.com/group/autismnet/message/2341
3)
“One-on-One Shadow Aide”, http://groups.yahoo.com/group/autismnet/message/3345
4)
“Appropriate Shadow Aide”, http://groups.yahoo.com/group/autismnet/message/3344
5)
“Inclusion and Shadow Aide”, http://groups.yahoo.com/group/autismnet/message/2370
6)
“School Shadow and the Science of
Autism”, http://groups.yahoo.com/group/autismnet/message/2368
7)
“Recommendations for Students with
High-Functioning Autism,” http://groups.yahoo.com/group/autismnet/message/2130
Article created December 20, 2001 in San
Diego, CA.
|
