Thursday, December 13, 2012

What Can Change in 2 Months?

Ballerina has a follow-up IEP Meeting coming up next week.  This is a pre-determined meeting to discuss the progress she is making following the changes that we made in October's Review Meeting.  We increased her hours of support, we instituted a behavior modification plan and we worked to ensure consistency across all staff members working with her.  And, outside of the meeting, a new behavior reward system was created for her which has been generally very positive.

First, let me describe this new reward system.  It's a laminated card, with a velcro strip on the bottom of both the front and the back of the card.  On the front are 6 choices of rewards (which I'm sure can be changed if needed), including a hug, read a book, take a walk, drink of water, some kind of game, and do a puzzle.  Ballerina chooses which reward she would like to work towards and then they begin.  On the back of the card are the expectations, including Quiet Mouth, Quiet Hands and Great Working.  There are 5 squares, each containing the picture of a heart. along the velcro strip on the front.  For every 10 minutes Ballerina successfully achieves those objectives, a heart is moved from the front to the back.  After all 5 hearts have been moved from the front to the back, she gets her requested reward.

The introduction of this reward chart is the best move that the school could have EVER made!!!!!!  Because of her ABA success, we know she responds well to periodic rewards.  But they can't be abstract.  They have to be something she can see and something she will receive immediately.  With this system, she is rewarded every 10 minutes with something small (the moving of the hearts which she witnesses [and even contributes to by confirming she's doing the 3 required things]) and then she gets her big reward when the hearts have all been moved.  She's been choosing a hug since they initiated this system, but she has the freedom to choose something different every time she starts again.

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(pictures taken and emailed to me by Mrs. R [Ballerina's classroom teacher])

I spent just over an hour observing her in her classroom on Tuesday.  I was there from the time she returned from specials (Physical Education, in this case) until she left for lunch.  I watched her have a snack (and go over to get a drink from the water fountain), sit with her class on the carpet, answer some questions, return to her desk to complete a worksheet, and then go on to her independent learning center.  She had a paraeducator with her the whole time (they no longer have her do the independent learning center without one as she is unable to complete anything with success without the support).  She listened to the story (If You Give A Moose A Muffin by Laura Numeroff).  She answered the teacher's questions about the story.  And she walked back to her table to do the assignment.

During the time on the carpet, I watched the paraeducator move 2 of the hearts from one side of the card to the other, indicating that she was earning her rewards.  And I watched her complete the assignment.  There were several parts.....she had to write her name (using a "magic C"), color in the pictures, cut the pieces out, and paste them back onto the worksheet in the same order that these items appeared in the story.  It involved using her memory and her comprehension skills, as well as following multi-step instructions.  And she did it ALL!!!!!  Following the sequence of instructions was not a problem.  Determining the correct order for the pieces to be pasted back onto the page was a bit more challenging for her, but she had the book with her (and the para) and they were able to put it together correctly with the book to ensure that things were correct.  And then she was able to go to her center where, once again, she was asked to cut and paste and put together complete and correct sentences.

And through it all, every 10 minutes (or so) they would move another heart.  In the 75 minutes I was there, she received a hug and was about 60% to getting another (which I'm sure happened not long after recess).

The entire time I was there, there were no outbursts.  There were no tantrums.  There was no threat of being sent to Time Out (for her -- others were threatened to move their behavior cards).  She did all of her work, and did it correctly.  She worked well with her para and apologized for accidentally colliding with a classmate after being reminded to do so by the teacher.

She looked just like everyone else.....just a little different because of the support she was getting.

What a moment for this Autism Mom!!!!!!

Wednesday, December 12, 2012

Whose Will Is Strongest?


Over the weekend, we got "serious" about being done with dealing with toileting accidents.  Urine accidents have become rare but poop, well, it's rare that it's NOT an accident.  I mentioned in a post last week that Music Man had an accident at school which really seemed to get the ball rolling, so to speak. But it's not school's responsibility to get this's mine.

We had to find something that would motivate our children to use the bathroom.  The answer to that question really is quite simple.....their phones or the computer.  However, taking this away from them makes things EXTREMELY hard on Dad and I.  But the time had come.  We needed to take that step. So, for the first poopy pants, no iPhone.  For the second, no iPod.  For the third, no computer.  And we were just PRAYING that there wouldn't be a fourth, because there was nothing left to take away.  And this would carry over from day to day (last thing was an accident on Saturday, no phone on Sunday).  However, once there was a success in the toilet, everything would be restored and we would start fresh.

During the week, for Music Man at least, things are relatively easy.  He "poops" shortly after coming home from school.  He's regular.  We can count on this almost every day.  So, when he comes home from school, we have snack, go into the bathroom and he does his thing.  Then he can have his phone.  But on the weekends, things are a bit more difficult.  He's NOT consistent about when he goes.  This (to us) is unsubstantiated proof that he is withholding during the school day because he doesn't want to deal with it at school.  He clearly has the control.

So, on Saturday morning, as soon as they go downstairs to play, Dad takes Music Man to the bathroom.  They try for a few minutes without success, so Dad resolves to take him again 30 minutes later.  By then, too late.  He pooped in his pants.  Oh, well.....bye bye phone!  Was Music Man happy about this.  ABSOLUTELY NOT!!!!!  Despite being warned numerous times, he was VERY angry about this change of events and how his weekend was going to progress.  But he eventually settled down.  Later that morning, once again, there was poop in his underwear.  Bye Bye iPod.  Now he's FURIOUS.  But he's determined to NOT let us win this fight.

For the rest of the weekend, we tried.  And for the rest of the weekend, so did he.  There was no successful potty trips.  And there was no return of the iPod or the iPhone.  And on Sunday night, he woke in the middle of the night and walked into the bathroom.  I was POSITIVE there would be some poop in the underwear, but there wasn't.  He just needed to pee and then went back to sleep (eventually).  And on Monday morning, before heading off to school, the stand off continued.  No poop in the potty, so no phone or pod.

But, come Monday afternoon, I don't think he could hold off anymore.  He pooped in the potty after school.  We did the same thing we did during the week last week.....come home, snack, potty, then play.  And that potty should include poop.  We have been successful on Monday and Tuesday of this week.  Today was very similar -- he came home from school and had his good strong poop after snack.  However, he did poop in his pants at school today.  Since we have established the policy of success means all privileges are returned, he didn't lose time with the phone.  However, if accidents continue at school, we will have to modify that part of our agreement.  I guess we are making progress.

I feel comfortable making this statement:  Music Man is poop-trained during the week.  He is unable (or unwilling) to anticipate the need to go, but he is regular enough that we can anticipate for him.  He is not yet fully trained as we have still not seen any successes during the weekend.  Hopefully, as he realizes that life is much happier when you are FULLY potty trained, he will take this leap soon.

On to the next saga......

Wednesday, December 5, 2012

Time For Drastic Measures

I wrote last week that we were starting to see success with Music Man's potty training.  After an accident at school, we got more serious and started to withhold a reward.  We almost immediately had a success.  But, after once, he realized that there are other things that he gets that are similar that don't require him to use to potty to deposit his BMs.  So, we seem to be back at almost Square One (he'll sit on the toilet and "try", but he won't allow anything to come out).

I know what we need to take away.  I know what would be the BEST motivator for him.  Unfortunately, I don't have the nerve to follow through.  Keeping this from him would be far more of a punishment to me and to Dad than it will likely be to him because WE will remember this for years to come.  For Music Man, despite his long memory, I don't think it'll make that big of a long-term impression.

I'm speaking of course, of his phone.  He spends as much time as he is allowed playing on his inherited iPhone (or iPod if the phone is unavailable).  He calls the phone "Bubble Phone" the iPod has been named "Toca Boca Phone" for reasons of making the distinction.

But I think I came up with a compromise that won't tax my sanity to the point of unendurability and will still bring home the point.  And, if we don't see success, I can take it a step further to really bring home the point.  I think the time has come to take away "Bubble Phone".  If Music Man poops in the potty, he gets it back for the rest of the day.  If he poops in his pants again (while he still has it), it gets taken away again.  He can have "Toca Boca Phone", so there is still something for him to do (which is my compromise).  But, if he poops in the potty, he gets his beloved phone back.  And, if this is unsuccessful, than "Toca Boca Phone" will also be withheld.

Cookies aren't cutting it.  At school, they're seeing success with a Leapfrog product.  I think we need to do this with our own electronic device.

I know he's ready for this.  I'm 100% certain of it.  I just need to make sure that he understands that we've reached the end of our patience and tolerance.  So, tonight, Dad and I will discuss this course of action.  If he agrees, it will come into effect when he arrives home from school tomorrow.

Am I nuts?!?!?!?!?