A day in the life of Speech Language Therapy:
November 21, 2005
Estee,
I pressed Adam today as I increased my expectations (moving towards joint attention), and introduced some new activities into our repertoire (e.g. Elefun, pretend play with the picnic/food). Adam was not interested in the picture schedule I showed him. If I had to venture a guess as to why he moved the blue card away it would be because I chose all of the activities without asking for his input.
The first game was the Elefun game. Adam and I shared in the excitement of the ‘butterflies’ flying around and he watched me as I caught them with the net. With encouragement and direction, Adam helped me re-load the butterflies into the machine. He was determined to figure out the on/off button by himself. At one point he got up, walked around the toy house and then came back to try again, this time with success.
Next, we worked on a puzzle, a new puzzle. Adam was not interested in this at all! He inserted one of the four pieces I left for him and then refused to do any more. He walked away from the puzzle and headed for the spare bedroom. He stood there he said, “open door”, “I want open door”. I followed him to the door but hesitated before opening it for him. When he looked at me I opened it and told him, “It’s good to talk and look”. Once inside the spare room, we played our favorite Pillow Plop game for a bit of a break.
After that, I began to set the table for the stuffed bear and the toy person. I used a lot of self talk as I put the items on the table. Adam wandered about the room, occasionally looking towards me and what I was doing. Eventually he came close enough to the table to signal interest in the activity. I invited him to join in and he helped set the table and distribute food to the toys (e.g. “Bear needs a spoon. Give Bear a spoon” or “What does bear want to eat? Corn or spaghetti?). Adam fed the Bear ‘pizza with peppers’ with a hand over hand prompt.
Finally, we played with bubbles. I used this activity to target joint attention and cued Adam to look at me after looking at the bubbles (I pointed back and forth between the bubbles and my eyes and told him to “say and look”). This worked well while I was holding the bubble container. Adam complied and went for a walk around his toy house before returning to me for more of the same. I moved the house away from its corner location and Adam stayed with me for two consecutive turns, whining before each one. Eventually I placed the bubble container in front of me. He picked it up and placed it in my hand!
Some things I noticed:
1) Adam had a fascination with round objects today. He picked up the net, the stepping stones, and the pizza pan to wave or to turn them around, like a steering wheel, watching the objects closely. He was deep in thought during these moments and did not connect with me at all, even if I imitated the action.
2) Adam’s walk around the toy house may have provided him with additional time to process changes, re-group, and self-regulate his emotions. He used this walk twice throughout our session, both after the puzzle and during the bubbles. When I moved the house he did not modify his path, and thus did not have the opportunity to reduce his anxiety. Sorry Adam.
Alisa
November 21, 2005
Estee,
I pressed Adam today as I increased my expectations (moving towards joint attention), and introduced some new activities into our repertoire (e.g. Elefun, pretend play with the picnic/food). Adam was not interested in the picture schedule I showed him. If I had to venture a guess as to why he moved the blue card away it would be because I chose all of the activities without asking for his input.
The first game was the Elefun game. Adam and I shared in the excitement of the ‘butterflies’ flying around and he watched me as I caught them with the net. With encouragement and direction, Adam helped me re-load the butterflies into the machine. He was determined to figure out the on/off button by himself. At one point he got up, walked around the toy house and then came back to try again, this time with success.
Next, we worked on a puzzle, a new puzzle. Adam was not interested in this at all! He inserted one of the four pieces I left for him and then refused to do any more. He walked away from the puzzle and headed for the spare bedroom. He stood there he said, “open door”, “I want open door”. I followed him to the door but hesitated before opening it for him. When he looked at me I opened it and told him, “It’s good to talk and look”. Once inside the spare room, we played our favorite Pillow Plop game for a bit of a break.
After that, I began to set the table for the stuffed bear and the toy person. I used a lot of self talk as I put the items on the table. Adam wandered about the room, occasionally looking towards me and what I was doing. Eventually he came close enough to the table to signal interest in the activity. I invited him to join in and he helped set the table and distribute food to the toys (e.g. “Bear needs a spoon. Give Bear a spoon” or “What does bear want to eat? Corn or spaghetti?). Adam fed the Bear ‘pizza with peppers’ with a hand over hand prompt.
Finally, we played with bubbles. I used this activity to target joint attention and cued Adam to look at me after looking at the bubbles (I pointed back and forth between the bubbles and my eyes and told him to “say and look”). This worked well while I was holding the bubble container. Adam complied and went for a walk around his toy house before returning to me for more of the same. I moved the house away from its corner location and Adam stayed with me for two consecutive turns, whining before each one. Eventually I placed the bubble container in front of me. He picked it up and placed it in my hand!
Some things I noticed:
1) Adam had a fascination with round objects today. He picked up the net, the stepping stones, and the pizza pan to wave or to turn them around, like a steering wheel, watching the objects closely. He was deep in thought during these moments and did not connect with me at all, even if I imitated the action.
2) Adam’s walk around the toy house may have provided him with additional time to process changes, re-group, and self-regulate his emotions. He used this walk twice throughout our session, both after the puzzle and during the bubbles. When I moved the house he did not modify his path, and thus did not have the opportunity to reduce his anxiety. Sorry Adam.
Alisa
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