Reminder Boards! A Type of Visual Schedule

Besides the wall schedule Samuel uses, we also make use of "Reminder boards"  These are 6" X 3" laminated pieces of poster board that we use in order to help keep him on task, while minimizing verbal prompting. (Two psychologists, Lynn McClannhan, Ph.D., and Patricia J. Krantz, Ph.D., of the Princeton Child Development Institute, did a 10 year study regarding the teaching of independent behavior in children with autism.   I highly recommend their book Activity Schedules for Children with Autism.  This is a great book to help parents understand why acitivy schedules are helpful and the importance of correct prompting.  If you look this book up you'll notice there is a more recent edition as well.)

These first two reminder boards help him during his school work. They sit on the table along with the third board showing what subjects he will work on at that current "session" of work.

(This "reminder board) prompts him to get his pencil box, and then put it away when we are finished.)

(This reminder board is to help him remember what his physical demeanor should be during "work time.")

(This shows what tasks he will complete during that session of "work time."  There is space for 5 activities, but I learned early on that trying 5 at a time is not optimal, even though the amount of work he does is quite minimal.)

It can be cumbersome to work with all 3 of these reminder boards at one time, and this does not even include the maneuvering of his papers and books on the table as he does his work.  Also, I had forgotten that initially I was maneuvering not only all of this, but also a token board and small edible rewards!  I haven't needed those in a LONG time!  I try to stack these boards one on top of the other so that not as much space is taken on the table.  It took weeks and weeks for me to figure out how to manage it all.  It took months after that for me to see the benefit of using these. If his attention wanders during school work now, all I have to do is remove his papers or books.  That action seems to serve as a prompt to draw his attention back to his work.

This next board is one I made up to use at church.  We have been using it for almost four years now.  I have found it difficult to use because of its large size, but have kept it as is.  In the coming months I may try to change it.  He has recently taken interest in a "sensory story" about going to church that we got from one of his past Occupational Therapists.  I have done several posts about Samuel's church behavior.  I'll post more about it in the future.  I am doing my best to juggle my desire for him to attend church with us, the reality of his ability to participate, while minimizing the disruption that his behavior might be to others sitting around us. 

 

This last reminder board is for when we eat at the table.  Teaching Samuel to chew with his mouth shut has been very difficult.  After watching him for a while, I realized that he seems to not be able to breathe through his nose while he is chewing food.  A speech therapist we saw for a while was starting to help me work on this, but we had to stop seeing her because of his behavior difficulties.  The therapist recommended that I take him to an ear/nose/throat specialist, which I will do one of these days!  In the meantime, the reminder board is effective for short amounts of time. 

You may notice in the photos that these reminder boards are well used and worn.  Some of them have been around for 3 or 4 years now!  I am in the process of re-doing some of these, and am finally getting around to making "reminder strips" to break down some of Samuel's self-care tasks.  In trying to answer another mom's questions about getting a visual schedule started for her son, I came across this website that has given me some ideas.  I'll post about these as soon as I can!

In recent weeks Samuel has taken a lot of interest in these reminder boards.  He gathers them all together and talks about them.  He even put together his own board about what he should do when he goes shopping!  (Long ago I had made a "fill in the blank" schedule piece.."When I _____________ I should ___________."  It has sat unused in his schedule binder, but now it's there to work with!) I'm trying to take advantage of this interest he has!

I would love to hear comments and suggestions from others about these, and about what kinds of visual aids you use to teach your children.  The development of visual schedules is time consuming and the progress can be very slow.  However, I have found them to be very helpful. Some challenges we still face regarding them:  moving forward to the point where Samuel is more independent in following/creating them and getting the school to use what we use.  (They use visual aids, but not like mine, and I don't think he has his own.. he uses what the entire class uses.  Also, I'm not sure if teaching staff understands the importance of minimizing verbal prompting..)

The end of this past January marked three years since I started this blog. It's hard to remember now, but I started it due to my frustration with the whole "defeat autism" attitude that I seemed to be encountering everywhere. It was very refreshing to come across people on the internet who were more accepting of autism, though who still faced incredible challenges in raising their children "on the spectrum". I also found it very therapeutic to share what I was going through at the time with my son.

I don't post on here so much anymore. It's not that I don't want to. I DO, but spare time is very rare for me these days. I'm not going to complain and lament too much, this is just where I am at right now thanks to what is going on in my family.

Samuel is growing up. It hasn't been easy and I think our "fun" is just beginning! Life for him has changed quite a bit since this past winter. He turned 11 just after the new year. He is almost as tall as I am now and has surpassed even his older brother in weight. He can be quite a force to contend with! He is now taking Risperdal to help moderate his temper. That's not by any means where it is ending, that is just the beginning of what has become a new road for us to journey on in helping Samuel to grow and develop. Amazingly, a new social group formed in our area and Samuel was able to attend that for thirteen weeks this past winter and spring, along with 3 other children close to his age. How terrific that something like this came along to help him recognize and learn how to deal with social situations. There are times he is quite vocal about his feelings ("Mommy, I'm so sad!" or "Mommy, I'm very very angry!"). I am so happy that he is able to verbalize these things and I am trying to figure out how to take him to the next step.. getting past those sad and angry feelings. In the coming weeks we will be starting new in-home behavior treatment services for him. I still use his visual schedule but we are definitely at a point where we need some fresh ideas and strategies to teach him how to get through his day with appropriate behaviors.

Well, the "free" time I had to work on this post is about over. Samuel is behind me telling me (thankfully, with a smile on his face) how "angry" he is with me! I promised him a snack a while ago and I suppose I should go make good on it!

Worth Celebrating!

Due to my oldest son's racing activities, every now and then I find myself without my husband around Sunday mornings when it is time to go to church. I am happy to say that this morning Samuel, his sister, and I all successfully made it through mass, on our first attempt! I made sure to give Samuel advance notice about how things would happen. I usually have to sit with him separately from the rest of the family; he gets distracted and agitated with his siblings around. The only other time I tried this was when I had one of his brothers with us, Samuel did not care for it. We had some close calls this morning: he loves to tease his sister and one time he started getting agitated when I asked him to change the position he was sitting in. I tackled these challenges by giving Samuel some words of encouragement and a few hugs and thankfully it helped.

To celebrate our success we went out for breakfast, with more good results! That was no small feat either, with a very tempting gift shop to maneuver through as we entered and exited! (Can you guess what restaurant I might be talking about!?)

The Tough Reality of Consequences

I wrote this back on August 26, but forgot to post it!


Samuel has had a tough time at his last two Occupational Therapy sessions. Last week he would not cooperate with his therapist when it was time for him to use Wii. All Samuel wanted to do was go into the "settings" menu. (At home he erased all the data we had accumulated the first month we owned it while he played around in the "settings" menu.. so it's not a good thing for him to be there!) His therapist had already endured several sessions of this, so last week she decided that no more would be tolerated, his opportunity to play Wii would be lost once he did not comply with her request to stay out of "settings." Their session ended early. Samuel was upset, but he was over it by the time I picked him up at the scheduled ending time.

Yesterday, Samuel never even got together with the therapist to start the session. Over several days prior to the session and on the way in the car, I had talked with Samuel about how it was important to play Wii as his therapist requested, by staying out of the "settings" menu. This caused him to become a bit agitated. Then, as we were waiting in the reception area, he tried getting on to the computer located there. He has learned how to get into the DOS menu on computers (thanks You Tube!) and has already wrought havoc on the entire office's computer system. Stopping him from getting to the computer caused further agitation. He began to yell and throw toys so I told him we would have to leave the office until he could be calm. A few minutes later the therapist joined us outside, where Samuel was still upset. I gave him a few minutes to calm down and his therapist brought a container of rice for him to play with. He still didn't calm down and then he started throwing the rice on the ground.

The next step was to take him to the car to calm down. I gave him five minutes to become calm. I tried giving him some "sensory toys" that I had stashed in my purse, but they were not helpful. Ultimately, we had to call it a day and had to agree that we would try again next week. He was then upset because not partipating in Occupational Therapy meant that the soda I usually get for him afterwards was not available. It took about another 10 minutes for Samuel to calm down enough that I felt safe driving home with him. He apologized within an hour after getting home and has done so again several times today.

What will I do differently next time? I am thinking about setting up some kind of sticker chart or token system that he will have to fill in in order to "earn" his soda after OT next week. I am going to call the therapist and see how many activities we should place on the chart, and determine within what parameters he will "earn" the sticker for each activity. I will also make up a social story for him to read. It seems the "verbal only" method of talking to him about the problem isn't working very well! I am also going to offer him more verbal encouragement ("I know that you can earn all of your stickers!" "Won't if feel great to show Miss M____ how well you can do your Wii exercises?")

Since then we have had two successful therapy sessions! The sticker chart is helping out and his therapist really likes having it. Samuel is happy that he is earning and able to get something he really likes.

The Absent Blogger

It has been quite a while since I posted regularly. Several things have contributed to this. One reason is that I have had an extraordinarily difficult time keeping up with the activity in my daily life. I enrolled two of my sons in a rather demanding homeschool curriculum this past fall. It proved to be very difficult to keep up with while having to continually customize Samuel's school work. In addition to that, last September I became Vice Chairman of our county's Special Education Advisory Committee. Granted, the demands of this position are not very great, but it did involve a monthly meeting, along with a few informal meetings or discussions with other members around that. Also, due to some activity that came up during the year I also served as the committee secretary. A new secretary had to be named and I came to realize that was really the position I wanted to serve in. So, now that's what I do. Again, it isn't all that involved but there is the responsibility of typing meeting minutes each month.

In addition to that, a good predictable bedtime for the kids has become a thing of the past in our household! Bedtime has always been a bit on the late side for our children because of Samuel's natural tendency to stay up late. Well, now his two younger siblings are used to that.. and my youngest has a hard time falling asleep on her own! On top of that, even though Samuel has finally mastered the required skills to change from his clothes to his pajamas, that doesn't always mean he is motivated to do so. I have come up with checklists, etc.. to take care of getting the school work done. Now I have to work on the same thing for the night-time routine! I would love to have my free time in the evening back, at an early enough time that I can stay awake to enjoy it!

Probably one of the biggest reasons for my lack of posting, however, is the advent of Facebook in my life. It is so difficult for me to sit down and write even just a few short paragraphs when I have gotten used to doing posts in two and three sentence blurbs! I went through a Facebook overload when I first joined it over the winter, but now I'm finding that my activity on it has leveled off a bit and I am hoping to post on this blog a little more regularly!

The Flip Side

My last post was about the great time I had with Samuel while we were out one evening recently. I hope I did not give the impression that every single trip out with Samuel is a breeze, that certainly is not the case. A good example of this occurred just a few days after my last post, at Special Olympics Basketball practise.

Samuel started playing basketball this winter for the first time. We did not attend practises consistently, but we did make it to 4 or 5 of them. A few times I took a helper along. By the last week of practise I was able to convince Samuel to stay in the gym (he had made a game out of running away at our first practise). The coaches had also developed a bit of a rapport with Samuel and were able to convince him, on occasion, to join in the drills. Samuel was the youngest player and he was definitely more interested in running up and down the courts than he was in participating. (I'm hoping that track will hold Samuel's interest better. We're planning to participate in that this coming summer)

That last week of practise was going along quite well. Samuel had been alternating between participating in drills and taking breaks by running around the court, when all of a sudden I caught view of him across the court bursting into tears. I honestly have no idea what triggered this. I went up to him and started asking him what he was thinking about, but he had no interest in talking to me. He screamed, "I'm running away!" and he sped down the hallway out of the gym. My two youngest children were with me so I situated them in the gym and proceeded to chase Samuel. He had gone into a room, turned on the lights, and then proceeded further down the hall. I was able to get him back in the gym, but we had to leave practise. Samuel grudgingly came along out to the car, but he still wasn't very happy. Somehow, over the course of the next 10 minutes his mood improved. We were set to go spend the rest of the day with friends and he was fine after the incident at the gym. He was amongst 14 other children and had a great time.

I never figured out why he was upset at the gym. All I know is that I was caught off guard. I had scheduled a helper but due to a miscommunication she did not meet us there. I had thought we would be okay because Samuel was in such a good mood, but I was reminded that day that things can take a turn for the worst mighty quickly!

A Nice Evening Out with Samuel

Last week I started participating in an autism support group that is being held in a nearby town. The group is called Essential Pieces and has existed for a few years now. They hold support group meetings in 8 week sessions. I first found out about this group some time last year but this is the first session that I have been able to participate in. As a preview to attending this group, I attended a conference they held last October about Sensory Stories. I found it to be a very professionally run conference and thought the topic was terrific. I'll talk more about Sensory Stories later..

During the parent meetings, some interns from a local university conduct a social group for children with autism and their siblings. I decided to take along Samuel and his younger brother to participate in this. The first meeting Samuel was not able to go because he had an eye infection. Then, this past week his younger brother was ill, so I took Samuel alone.

I was so impressed by Samuel's behavior the entire evening! We had to park in a parking garage and walk about a block to the meeting location. He stayed with me nicely, no having to worry about him running away! He also left his videos that he had brought along in the car without a problem, even after he had asked if he could bring them and I said, "I think it will be better to keep them in the car, then you won't lose them." I had told him ahead of time in the car where he would be and where I would be, and about how long I would be at my meeting. He seemed excited and interested and did not have any problem saying goodbye. Even though he is a bit older than the other social group participants (most of them look to be somewhere between 4-6 years old), he seemed happy to be there.

Our walk back to the car went great. He asked for a treat on the way, which was fine because we had to stop at a pharmacy to pick up some Pedialyte for his younger brother. Samuel was even well behaved at the pharmacy! He likes to look around stores and I had been worried about him getting into the DVD display. He found it and was able to look at it as I paid for my purchases and accepted the time limit I gave him very nicely! I let him listen to the "Cars" soundtrack on the way home.

Later that evening I thought about how nice it can be to take Samuel out now, after all the years of practising and using visual aids. We had been in a part of town that night where, about 7 years ago (when Samuel was 3 and I was pregnant with his little brother), he ran away from me and out into a road. What a scary event that was. Even though we can have tough moments out in public, it is nice to have more and more successes with him!

Happy 2009!!!

Well, Christmas is over and another new year begins! We returned to school work this week. I was without one of Samuel's helpers while she was on vacation with her family. In spite of that we got by okay. Samuel had much fewer outbursts, even with the demands of school work being put upon him. We'll see how next week goes, when I try to get more work in.

I think Samuel may have FINALLY learned how to zip his jacket! We have been working on that for so long. I realized that the kind of jacket we had him wear was too difficult for him to work with. We usually get Land's End jackets, which are wonderful, but the way the zippers are covered makes it way too difficult for Samuel to maneuver it. He has a very hard time getting the separate parts of the zipper together. I bought a cheap jacket at a local discount store that doesn't have a covered zipper and it's much easier for him to work with that.

I have started using Saxon Math with Samuel. His younger brother has been working in it. I was reminded that Samuel's teacher had used it with him when he was younger. So, we're repeating first grade math again, but I am much more confident he will be successful in this. I was having to make too many alterations to the other workbook curriculum I was using for him.

Seton Home Study curriculum is what I am using for my youngest and oldest sons. While we are provided with a daily schedule for each subject, I did find this statement in the curriculum materials, which I take great comfort in given that we deviated from the schedule after about Day 2 of the school year:

There is no "getting behind" in homeschooling; the pace should be according to
the needs of the student.

Granted, I could be a little more organized, but I don't think I'm doing too bad given all the preparation that has to go into getting Samuel's lessons together and all the chaos our days sometimes holds because of his behavior.

More Challenges and I'm Overwhelmed!

Life with Samuel has been a bit of a wild ride lately! He started private Occupational Therapy services earlier this summer and I told his therapist that he was having 2 or 3 behavioral outbursts per month. Beginning about 3 weeks ago this number seemed to go up so I started keeping a log of his outbursts and the frequency had increased to more like 2 to 3 PER WEEK. In fact, this past week he had an outburst almost every day.


I'm carefully looking at our daily schedule to determine how we might be able to get things done without the outbursts. Among the culprits I blame this increase on are a change in routine as the summer ended and school was started up and my husband's and oldest son's frequent travelling for racing. At the recommendation of our occupational therapist I am trying to work more sensory activities into Samuel's schedule. They are so easy for me to overlook or brush aside as I try to get things done.

Another challenge we are facing with Samuel is the using of some very bad expletives. I strongly suspect he picked them up from watching things on You Tube, so I'm severely limiting his time on the computer and try to stay in the vicinity as he is on it so I can monitor what he is watching. He knows exactly what I'm doing and doesn't like it one bit! I'm considering moving the computer down to our family room, where it can be monitored more easily than up in my out-of-the-way office.

I am in over my head with keeping up with school work for three children. One thing I like about the new curriculum materials I am using is that I am given lots of guidance in constructing lessons. Samuel has actually had some fun doing his math work with some manipulatives, and my youngest son seems to be getting a lot more out of our time together when I have some kind of lesson planned. I'm just having a hard time adjusting to the amount of time I'm having to put in to the lesson preparation.

Samuel will be participating in a Challenger Soccer league (a league for those with special needs and different abilities) beginning in a few weeks. We would be going this week, but he has an EEG scheduled, for which he'll have to be put under general anesthesia. I have no idea how on earth he'll be able to tolerate the wearing of all the electrodes once he comes out of the anesthesia. He'll be monitored for 23 hours! I'm already talking to him about what is coming up, and am stashing away all kinds of special goodies and activities (like DVDs and videos - what else?!) Any ideas for preparing him, anyone?

Two yahoo groups I belong to have been embroiled in some very nasty discussions lately. It's very disheartening, why do people get so opinionated and so intolerant of each other!? I find I have to just let go of these kinds of things so that I can focus more on what really matters - taking care of my own children's needs!

I have greatly missed posting and visiting all my usual "blog friends," but I suspect it will be a while before I can return to it the way that I'd really like to.

Time to Polish the Social Skills a Bit!

Just when I think it is not possible to feel any busier than I already have been, I reach a new pinnacle! Recently this has come about because two of my sons started playing soccer and I actually have had a few social events to attend (after a rather sparse past year of socializing). I suppose the water pouring out of my living room ceiling (from a poorly built shower above it) and the resulting needed repairs have contributed to this as well.

Anyways, my 10 year old and 5 year old sons are playing soccer. They participate in a league of children educated at home and, thankfully, they only have practise once a week, both at the same time, and there are only a minimal number of games that involve travel. For the first time, well, ever (!!!), I have been able to take Samuel along to the practise field where I hang around for the 2 hours his brothers practise. I had to do this a few weeks ago because my in-home helper was not able to make it that afternoon and my husband could not take the boys because of obligations at work.

I made up a visual schedule of what we would do during practise. It wasn't really anything all that special, I just made sure we moved to a new location every 30 to 45 minutes. Part of the time we walked down to see his older brother play, we spent some time in the car and had a snack, and then we spent some time on a playset (swings, slide, "fort"). Yes, nine year old Samuel stood out a bit on the playset, but he was content so I didn't mind! While we walked from field to field Samuel kicked around his own soccer ball and tried talking to EVERYONE!

On the subject of talking to EVERYONE, I realize that we need take a step forward in conversation social skills! Here is one example: People that Samuel does not know come sit behind us at church, Samuel turns around and says, "Hello, are you old?" Or, "Hello, are you a man? " (This to a woman with short hair!) Does anyone have any suggestions for social skills lessons that are just a bit beyond the basics? I have a Carol Gray book about Social Stories (pictured here )and will look at her site to see if she might have anything more advanced, but I want to see if there is anything else.

Too Many Errands in One Trip!

Samuel is eager to get out of the house these days. Now that he is not going out to school every day, he looks forward to his trips to the library, occasional trips to Target, and even going to church. After his vision exam last Thursday Samuel begged me to go to a small shop that he found out sells videos. Since he did so well at the eye doctor I wanted to let him do something he enjoys. My other children were still at my friend's house. I had to go to the grocery store near that shop anyways, so I agreed to take him.

I clearly outlined the conditions of our shopping trip: we were only in there to look, no buying videos. After all, he had a new video on the way in the mail. Samuel likes to e-mail his Dad with requests for new videos (with my help) and my husband had just ordered a Cyberchase video a few days before that.

For ten minutes, Samuel enjoyed looking at the videos and DVDs. He was particularly happy to find a display of Nickelodeon and Nick Jr. videos. It wasn't easy for him to leave these behind without a purchase. After I counted down our remaining time in the store he wasn't at all willing to leave. He grabbed a video and ran to the cashier counter with it. I had to gently but firmly help him take the video back to the display. He yelled and screamed as I escorted him out of the store.

I wish that we could have left the shopping center then but I had to pick up some milk at the grocery store. I knew it wouldn't be an easy venture with Samuel being in the mood he was in. He expects "treats" while we are out. I got him by the donut display without a problem but as we started for the aisle with milk he veered over to some bakery rolls, grabbed one and put it in his mouth. I reached for a bag, put it in and just bought it to save any further trouble that moment. I let him help me put the gallon jugs of milk in the cart. He needs practise carrying heavier items, he practically threw them into the cart! He had several other outbursts before we left the store, but thankfully I was able to pay without too much difficulty.

I am pretty familiar with Samuel's limits in running errands and I admit that I stretched them in this instance! I won't let this take away from my happiness at how well he did at the eye doctor's office!