Monday, February 28, 2011

Michael's goal is to be a Librarian's Assistant

Throughout his 17+ years in school, Michael has been instructed to complete the same type of first grade level worksheets over and over again.  It's not unusal for people who don't speak to be thought of as lacking intelligence.  Michael has said people don’t realize he is smart – especially people at school (he calls them “the people who raise you”).  Since he’s been typing to talk over the last year, he’s revealed he has an intellect that none us realized.  His mom said she would have never believed her son would be practicing job skills to become a librarian’s assistant.  She astonished, as we all are, as Michael, now 20 years old, shows us he can learn to alphabetize books.  The great thing is rather than get stuck in being frustrated, Michael can tell us - by typing - when he doesn’t understand a concept.  It’s our responsibility to be creative at accessing Michael’s way of thinking so he can put the pieces together for himself.  Learning how to alphabetize library books is not done by rote memory.  Michael understands he has to think.

S:  how's it going practicing with grand mom?
M:  I think that I understand the alphabet better

S:  ok. Let's practice the letters A B C D E F G.

I handed Michael the lettered cards and he quickly and correctly sorted them A - G. 

S:  That is perfect!  Let's practice with library books. I brought some that have these letters A B C D E F on their spines.  Put them in the right order on the shelf.

I handed Michael one book at a time in random order.  He put the books on the shelf in the order I gave them to him.

S: We need you to put them in alphabetical order.

I handed Michael one book at a time in random order, and this time he shelved them correctly A - F.

S:  Perfect!  So you know the alphabet rule. are you ready to learn the next rule?
M:  ready to learn the next rule

S:  The letters on the spine are the first letter of the authors last name. What is the first letter of your last name?
M:  H

S:  Yes, great.  In this book, G is for Garrison. When there are books with the same last name, use the first letter of the first word of the title. The first letter of the first word of the book by Paul Garrison is
M:   (no answer)

S:  The title of the book is Red Sky at Morning. so the first word of this title is red. What's the first letter of the first word?
M:  R

S:  Great… just like h is the first letter your last name is h
Get it?
M:  yes

S:  What's the first word in this title (Paul Garrison’s other book)?
M:  sea

S: And the first letter of sea is
M:  S

S:  I’m going to use the letter cards to help you understand the rule. 

I put the letter cards R and S in front of Michael. 

S:  R comes before S when the author has two or more books, alphabetize the first letter of the first word in the title.

Michael sorted the books incorrectly.  He put the S book in front of the R book.

S:  Tell me what is hard to understand?
M:  you don't easy to understand

I realized I had given him too much information at one time.  I placed the R and S letter cards on the table and handed Mike one book at a time.  I showed him how the title with Red as the first word went “on top” on the R letter card and the title with Sea as the first word went on the S letter card.  I gave him lots of opportunities to put these two books in their right places making sure to hand him the books in different orders.  He soon began sorting the books correctly: R before S.

S:  Is this helping?
M:  I think so

S:  You will understand this rule soon... maybe today maybe tomorrow just like you did with the A B C D E F books.  Now add the two Garrison “G” books to the shelf with the other (A B C E D E F) books on it.

Michael put the Garrison’s “Red” Sky first on the shelf next to the F book and then shelved Garrison’s “Sea” book

S: Perfect!  Excellent!  You shelved two Garrison “G” books! The R in Red comes before S in Sea.  You did it.  Fantastic!

We repeated the process 4 times and I handed Michael a different book each time.  He sorted the books correctly – the first letter of the first word on the title.  Michael was gleeful.  He rocked, and laughed, and maintained huge smile. He was very pleased with his accomplishment.

S:  Now shelve two more books.  The author of these two books is Lehrer.  L in Lehrer goes after the G in Garrison.  Two Lehrer books means go to the first letter of the first word in the title. The first letter in the first word (I held the book up to him and was careful not to point to the first word or its first letter so as not to give him the answer)
M:  p (for purple)

S:  Yes, great.  The first letter of the first word in this other book by Lehrer is
M:  m (for Mack)

S:  Wow!  Now put them on the shelf in the right order.

Michael put the two Lehrer books in the correct order immediately after the Garrison books.

S:  Michael this is amazing!  Look how much you learned in one day.  How do you feel?
M:  I easy do it and I feel terrific

S:  Excellent. Ok grand mom will help you practice this week.
M:  ok that sounds great cool,

S:  We are very proud of you!!

Thursday, February 24, 2011

A Job Skill For Michael

Michael is a 20 year old young man with autism who doesn’t speak but who types on an iPad to talk.  Because he needs physical support from another person to use his fingers to translate his thoughts into words on a keyboard, people have questioned whether the words he types are his own.  When he was 8 years old, professionals at his school refused to allow him to receive physical support to type.  Ten years later, after seeing the video: Kayla’s Voice, empowering people with autism, Michael started to type again.

Michael will graduate from school at age 21 in June of this year – 2011.  He has talked to various transition coordinators as well as his family and support staff to help him decide how he wants to spend his days as an adult.  He wants to take courses in psychology to understand why people do the things they do.  He wants be a volunteer but hasn’t determined exactly in what way.  His main goal, though, is to work in a library shelving books.  If you saw the 1000 or so video tapes and DVD’s in his room perfectly shelved – and always in their right place, it would be clear to you, too, that shelving books would be a fantastic job for Michael. 

The challenge is that no one ever thought to teach Michael how to alphabetize.  Many of the people in Michael’s school don’t know he can read – let alone believe he knows the alphabet.  Michael can put books labeled with numbers in order without a problem, but if he is to work in a library, he’ll have to know how to sequence letters.  Michael is extremely motivated to learn, though.  He has often said over the last 6 months that getting a job would allow him to be normal.

S: can we work on the job training and alphabet?
M:  yes

I tired to illustrate the concept of “this letter comes before that letter” by using a Thomas and Friends DVD cover.

S: Thomas comes before Annie (the passenger car) A comes before B

Michael got confused and frustrated – unable to make the connection of the concept.  I decided to make small flash cards with each letter on the alphabet on them and spread them across in a long row across the table. Every time I showed Michael a letter, He wanted to type the letter on the iPad.  I didn’t want him to need to fulfill another habit.

S: The keyboard is to talk the cards are for practice right now.
When you put the books in order on the library shelves the letters won't always be in a row like A B C D E. That means you have to think about sections of the alphabet not just letters that are right after each other.
So we need to help you understand where letters go in the alphabet. What do you think will help you?
M:  I think in stead in and need to understand the alphabet

S: I agree! yes you need to know the alphabet well enough so we can say to you here is the letter G does J come before or after G do you see what I mean?
M:  talk to me more

S:  ok

I used sections of the alphabet to help Michael “see” what letters are next to each other.  I started with A B C D E.  I gave him each caard to place in order in front of him in what I called the practice are.  Then I removed the cards.  I randomly gave him one card at time (either the A B C D or E) saying the books starts with the letter D.  He placed the D in the practice area.  I gave him the letter E, and I was surprised to see him place the E after the D.  I gave him the rest of the cards in random order and he placed them all in their right place. 

We moved to the next letter of the alphabet including the “chunk” of letters he just mastered: B C D E F.  He was able to place the cards in the correct order as I gave them to him randomly.  We continued with the next letter and mastered “chunk”: C D E F G until we got to the middle of the alphabet.  He expressed more happiness by giving lots of smiles and making “happy grunts”.  It was clear that he was pleased with himself that he was learning.

S: is this helping you understand the alphabet?
M:  I think I am getting the hang of it

S: cool. do you want to keep going or work with grand mom later
M:  I want to easy now.

Michael completed the entire alphabet and smiled through the process as he placed every letter card in the correct order all the way to the letter Z.

S: that was absolutely fantastic mike. let's let grand mom practice with you and I'll come back on Friday to learn the next step together.
M:  yes

Monday, January 31, 2011

The Lights Went Out

The whole family gets nervous when the lights go out.  Without electricity, Michael can't spend his time watching DVD's or YouTube.  The family has to endure Michael's anger and Michael has to endure being without his primary way of keeping himself "happy".  Because Michael's anger has been extreme in the past, the family bought a portable generator for the garage, and they send electrical cords from it through the house to Michael's room. 

Since he can speak to us through typing, my approach has been to help him understand how to handle his feelings more effectively.  What if we let him experience the difficulty and then teach him the sequence of steps involved to deal with the situation?  After all, he wants to be employed.  He has said, "I want to have a job and be normal."  He's thinking about shelving books with the help of a one-one-aide.  Realistically, he can only have a few meltdowns in the middle of a library if he plans to keep his job.

S: when it snowed the lights went out you were afraid because
M: I could not watch you tube

S: did you worry they would not come on again
M: yes

S: was it easy to fall asleep knowing the lights were out
M: no

S: how did you manage the worried feeling
M: I think you me

S: what
M: happy thoughts

S: happy thoughts like
M: think I them

S: them what
M: friends

S: friends such as
M: thomas the tank engine

S: so when you are worried and sad you can think of Thomas right
M: yes

S: what is Thomas doing in your thoughts
M: he says nice things to me

S: we are happy that you have a way of feeling good. what kinds of things does Thomas say to you ... describe a nice thing he says
M: he says that I am very useful

S: we totally agree! does he say other nice things
M: he says that everything the really really really ok

S: we are very glad you have a friend like that. he helped you get through being afraid when the lights went out. what would you have done if the lights were still out when you got up in the morning?
M: ok

S: I don’t think you would just be ok
M: I would angry

S: and how would you handle your angry
M: I want the lights on

S: I understand but if the lights could not come when you wanted them to and you were angry what could you have done?
M: easy set I have waited just waited until the lights came back on alright.

S: so mom and grand mom will help you remember that you know you will wait until the lights come back on.  so is it ok if they say... Michael, you know you have to sit and wait until the lights come.  is this okay?
M: easy they need to be kind

S: I understand

Sunday, January 30, 2011

Using Michael's Interest in Thomas the Tank Engine

I've been writing stories using Thomas the Tank Engine as the main character to help Michael talk about what he is thinking and feeling...

Thomas the Tank Engine moves on his track and the track takes him to different adventures.  When Thomas travels on the track, he meets other trains along the way.  He is always curious about what is happening.  During every adventure, Thomas has a certain feeling.  Most of adventures Thomas has make him feel happy, and some adventures make him feel sad.  Some adventures make him feel really really really angry.   No matter what happens, Thomas always knows the other engines are his friends. 

S: tell us the things that make you scared
M: really really really fear when the storm comes thunder and lightening that fear happens

S: tell us the afraid fear part of thunder and lightening
M: fear the thunder and lightening the storm and the thunder and lightening and the rain the rain gets me wet and the thunder and lightening put the lights out and the computer out and the tv out and I can not watch what I want to I get afraid because I can not easy feel happy without the Thomas and friends treat me to be happy I easy they the friends that in

S: that makes sense to me. tell us your back up plan if the lights and the tv and the computer go out. what do you do to pass the time until they come on again?
M: say to mom to get lights on again

S: this is one of those adventures just like Thomas has on his track. your track is I need the lights back on.
M: the lights back on the track I do not like to be on.

S: I understand. you are on a track that makes you feel afraid and angry because the lights won't come back on when you want them to. in that case, your backup has to be to get on a different track. any ideas?
M: easy not to be on a different track

S: I understand. one idea I have is that I remember that the lights will come on again sooner or later. the light track will always be there. in the meantime since I want to feel happy at least a little I need to get on a different track... unless I want to keep feeling afraid and angry.
M: the really really really angry the feeling not easy to have and go to different track

S: you are absolutely correct. just because it's not easy, it still is possible. it means that you have to be okay with being afraid and angry for awhile until the lights come back on. in the meantime you can go on a different track. like mom just said. you might can go on the nap track or sit on your recycler on some other hobby.
M: I feel the anger too much to the different

S: ok. like we talked about before... sometimes you can switch tracks easy and sometimes there are days when it's a lot harder for you And ME to switch. we just have to remember it's possible so it will always be an option for us in our brains.
M: that sounds better get really really really angry lot of the time

S: do you think you can notice when you can easy switch tracks? that's all that any of us can do.
M: typing the words is easy yes

S: I totally agree. all we can do is do our best as best as we can. ok
M: really really really thank you that was help and easy to think about the day comes when thunder and lightening here I will try to remember this

Friday, December 31, 2010

Applying the Back Up Plan to Another Situation

Michael got angry yesterday when a DVD wouldn’t work and his mom couldn’t fix it.  Michael’s mom told me that Michael accepted her suggestion to watch a different DVD.  That was good news.  People with autism, in particular Michael, aren’t easily redirected away from what they demand.  We call this “having trouble with transitions”. 

Michael got angry today, though, for a different reason.  The “Marty Stouffer’s Wild America” DVD set hadn’t arrived in the mail yet.  It wasn’t that a DVD couldn’t be fixed.  This time, the DVD wasn’t in the house for him, and it wouldn’t be until next week.  Now we had to explain that he could use a back up plan in this situation, too, not only when a DVD couldn’t be fixed.  We had to help his brain make the leap... or at least consider it.

S: You heard your grandmom and mom talking about you getting so angry today?
M: I think I was that way because I can not have that DVD that the funny think that the DVD has not get that time I need so I get angry

S: Grandmom and mom told you it will come either tomorrow or Monday or Tuesday.
M: Yes

S: So why stay angry?
M: That is that truth byes that is the truth but I can not stop being that way fit yes I have I have fit that I get that way I get very very very angry

S: I understand you have a fit of anger. The problem is that you make everyone else angry too and get them upset.
M: I think I am help them to understand me that I am angry

S: Yes I understand that you want to help them know that you are angry but you can let them know in just a short few minutes. instead you let your anger out for a very long time.
M: I think I really really really think that no body care in the first first place

S: They do care. It may not seem that way at the time. Mom ordered the Marty Stouffer Wild America DVD seasons one through twelve. You have to wait. If mom didn't care she wouldn't have ordered it.
M: I think that you think that the DVD is coming good to hear that but I want it really really really a lot you understand how I think right

S: Why not watch the Marty Stouffer VHS tapes you have until the DVD comes?
Can you go get the Marty Stouffer and his Wild America VHS tapes?  Mom doesn’t know where they are in your big collection of tapes and DVD’s.
M: Yes

He went into his room, looked around for a minute or two, and then walked back to the iPad with two Marty Stouffer VHS tapes.  He put them on the table and sat down to type again.

S:  Thank you Michael.  Here you had the ability to watch the Marty VHS tapes and instead you let yourself feel really really really angry and let your mom and grandmom be upset for all that time.
M: I think that you are you that know then I feeling get the DVD

S: And in the meantime while you wait for the DVD to come what will you do.
M: I watch the VHS tapes

S: That's what's called a back up plan. You are doing something else so you won't have to stay angry and you won't upset mom and grand mom.
M: That is a back up plan

S: But what happens if grand mom or mom says what's your back up plan while you are angry? you can just get more angry at them.
M: I think that happens the I that you get that the way to handle that is to tell me to the room so I can get calm.

S: So do you think this idea will help you?
M: think it will

Thursday, December 30, 2010

Michael Agrees to Have a Back Up Plan

Maybe it’s the change in seasons or maybe Michael needs an adjustment in his medication, but for whatever reason, Michael is experiencing another cycle of destructive and aggressive “episodes”.  That means his family has to endure his cycle, too.  This time around though, we can help him type to talk about his anger in ways he couldn’t express before.  Our intention during our conversations has been to help him develop a greater awareness of his beliefs, feelings, and behaviors and to support him to come up with ways that he can handle difficult situations using his more productive thoughts and strategies. 

One of his major stressors happens when his mom can’t get a DVD to play.  He’ll hit the wall, throw his computer monitor or computer, and as a last resort, he’ll hit his mom.

S. So do you understand that sometimes mom and grandmom do not have the ability to give you what you want?  They can’t always fix a DVD to make it play.
M: yes

S. What can we do to help you to understand that before you get out of control?
M: I think they get want that I need I that will get calm

S. I see that you think you need the DVD to be fixed in order to calm.  You are going to need a backup plan.  Do you know what I mean?
M: I think so

S. A back up plan is when you can't get what you really really really want so you agree to get something else in its place.
M: Right then I will have a back up plan
S. When mom can't get a DVD to work what is your back up plan?


S. Let me see if I can help you understand.
M: ok

S. If the DVD won't work what will you do?
M: Then I ask mom to fix it you I play the DVD

S. If mom can't fix the DVD what will you do?
M: I think I will much angry

S. Ok that is true.  Remember, though, you can be angry but you need to keep your hands to yourself and off the monitor and computer and TV.
M: That I easy if the DVD get fix get easy calm

S. I understand that you swear you need the DVD to be fixed in order to be calm but if you always depend on the DVD to be fixed and it can't be fixed you will be stuck feeling angry and lousy.  Would you like to be calm even if the DVD can't be fixed?
M: yes

I believe Michael may have made somewhat of a breakthrough.  I believe it has never occurred to him that he didn’t absolutely have to have the DVD fixed in order to get calm. 

S. What if mom reminded you that you want to be calm even if the DVD can't be fixed?
M: I think that sounds all right good have that feeling even when the DVD can’t be fixed

S. So if the DVD can’t be fixed and since you want to get calm you need to let mom and grand mom remind you to do something else to stay calm. That is a back up plan.
Examples of back up plan choices are go on YouTube, watch TV, play x box, play a different DVD, eat a pretzel, drink some milk, rest for a while in your recliner.  These are choices of a back up plan. Doing one of these choices will help you get the calm feeling if things don't go exactly the way you want. The lights might go off or the DVD might not get fixed... but you can stay calm.  What do you think?

M: I think that sounds have to really really really get back up plan you understand I you really really really trying to help me

Thursday, December 23, 2010

Michael’s typing is inconsistent but informative.

November 9, 2010

S:  do you know that you have a dermatologist appointment tomorrow?
M:  I want to and really really really to right not go.

S:  I know you don't want to go but the doctor needs to look at your face and your chest. you really really really have to go.
M:  type this that I do not want to be at the doctor tomorrow I want home you understand.

S:  it's really not an option. you have to go. why not take your squeeze ball and squeeze the whole time?
M:  I want to talk the palm look have you your house.

S:  my house isn't really that interesting trust me. let's just figure out a way for you to feel comfortable going to the face doctor tomorrow. we know that going to the doctors is not fun for you. tell us where you would like to go after the doctors so you can look forward to something fun.
M:  I easy gets have remember the thomas the tank engine that I want today them I can have the one I want. Thomas the tank engine.  the title is help me get he's you the Thomas the tank engine.

S:  unless you can give us the title you are going to have to give us another idea... like why not go out for lunch with mom maybe macdonalds.
M:  ok

S:  the plan is you'll go to the doctors and then to macdonalds with mom. ok?
M:  ok

Mom emailed me the next day.  Michael went to the dermatologist.  He was much more relaxed while he was there.  He let the doctor examine him without being restrained in any way.  He and his mom and grandmother went to MacDonald’s afterward.

December 2, 2010

S: elephants noses are like straws. they suck up water or milk. what do you know about straws.
M:  straws are for drinking

S: do you know how to use a straw?
M:  yes

S:  which do you like better? drinking milk from a straw or just drinking with your mouth?
M:  I like drinking milk with mouth

S: do you use a straw or your mouth when you drink soda at friendly’s.
M:  straw

S:  I hear you love to drink milk.  do you like the taste or something else about milk?
M:  I like the taste.

S:  you certainly are talkative today. what makes today different than the last couple times we typed when you didn't seem to want to type clearly?
M:  I am more aware of my thoughts and so I can type what I want to type you understand what I am saying Steve

S:  so if am I hearing you right, somedays your brain is cloudy so it's harder for you to concentrate. can you tell me more about what it's like when your brain is cloudy?
M:  yes talking is harder when I can not think as in the way I am doing now

S:  wow. I understand. is there anything we can do to help your brain get unclouded when its cloudy?
M:  the is and in that I can stay that way for about three days and the clouds go away for a while and I can think for a while that is what I can tell you for now