Updated: 10 November 1998
This is a selection of notes from over two years of behavioral intervention sessions with a young child who ultimately recovered completely from autism. It includes many curricula ("drill sheets"), therapists' notes, and parents' notes, covering (in part) his development from no pretend play skills all the way to fully independent, spontaneous, creative play.
The notes are by the parents, Megan and Jim Sumlin (pseudonyms), who feel strongly that this information should be freely available to all who might benefit from it. They ask only that these drills belong in the public domain, and are not to be claimed or copywritten by any person who is or will in the future be seeking monetary gain for wide distribution of same. Feel free to re-distribute this document, but please include this entire preface.
These notes are just one part of a comprehensive program guided by a behavior analyst; there were other parts of the total program, not included here, that were necessary to the child's development and eventual recovery. They are specific to one individual child. Use them as a resource to help you plan your child or student's curriculum. What works for one child will not work for all. While much of the material here addresses problems common to many or most children with an autism spectrum disorder, you will want to select carefully based on individual needs, learning style, and personality.
A few notes on terminology:
Proper reinforcement is the key to learning. Much more common in these notes is DRO, which stands for "differential reinforcement of other behavior." In addition to reinforcement for "getting the right answer," the child was frequently praised for unprompted appropriate behaviors (in place of undesirable, 'stereotypical' behaviors). For example, when playing with dolls, the therapist may say, "I'm glad you're not banging the characters together," or as the notes say in many places, "DRO'd flexibility"--unprompted spontenaity. Remembering to "catch 'em being good" takes a lot of practice, but it is essential to the development of a truly natural repertoire of age-appropriate skills.
[ Animal pretend | Appropriate play | Listen to a conversation I | Listen to a conversation II | Listen to a conversation III | Listen to a story I | Listen to a story II | Listen to a story III | Parallel play | Play with narration | Pretend | Therapist and parent notes ]
See also: Sumlin Program Notes and
Sumlin Social Stories and
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SD: "Pretend you're [drill list items]......Do this." [model for child]
Discrete Trial Style: No-No-Prompt or No/Equivalent-No/Equivalent-Prompt if child is ready for that (i.e., by the time of this drill our son was ready for simple "no equivalents" such as "say it better", "almost", or "pretty good" when he was closest) used in the place of "no"s in a NNP sequence. We were using differential reinforcement (especially once items were mastered...although we were ALWAYS using diff reinf for better responses) to shape down stims and non-compliance and to shape up eye contact. It wasn't until later that we used NNP to directly attack stims, noncompliance and poor eye contact, although we may have already been using NNP for these things sometimes.
Physically prompt child re: list items. Eventually fade "do this" (only use "do this" if child needs it).
Later vary SDs to: "Act like....."
"Make like...."
["Make like" was an SD we hardly used...rubbed us the wrong way grammatically, but it does say this on our drill over sheet]
After all the list items below were mastered, we continued working on this drill for many, MANY months (randomly doing them and working harder on some than others at times).
we probably did some of the following (again) because he WASN'T eating food or drinking out of a cup yet, wasn't washing himself, etc.
Some examples of therapists' notes (other than the usual, which were therapists' initials and date and either "intro'd #4, still not at 90", "#6 at 90%, needs 2nd person to master", "mastered #5, intro'd #6..now at 90%, needs 2nd to master", etc., many longer (i.e., two or three line) descriptions of what went on in session came when we randomized these in the last few months of the drill's life:
"spoon...nice job, just needs a little more practice; wash hair - first prompted him by having him squeeze socks to get the hand movements & eventually did his head correctly, but w/the prompt of "squeeze" which now needs to be faded. Also, don't let him jump up and down while shampooing (stim)"
"Getting there with riding a bike. As he begins say "no arms" and he won't move them"
"Did well (eating) using one hand, but still turning the spoon upside down"
"When pretending to be a penguin he always says "say, 'Come back penguin boy' "
"Randomized. Drying hands needs to be reviewed!"
"Reviewed drying hands. He's perseverating on penguin. Leaves the room and insists on returning as a penguin."
"Washing hair: I poured shampoo in his palm, he rubbed palms together, palmed his hair (to spread shampoo) and then squeezed his hair (to lather) ...palmed again (to rinse). Watch out for: - he can't cover head and face with towel (like a ghost). Should look more like a nun (but DON'T use words "ghost" or "nun"). - has to look at body part as he dries. - for his back, it should be like a shimmy move. - he might start perseverating on "armpit" and "belly button".
"Great job eating raisins with a spoon. Did it quickly and easily. Shampooed well."
"For Cleaning with Soap and Drying, point to (for ex.) the top of his arm to the bottom of it to encourage using broad strokes. Make sure he uses the flat part of the soap and stands during the drill (no chair in bathroom)."
"Talking nonsense while using the soap. Getting broader strokes."
"Did entire shower routine in bathroom (in tub and at sink for Wash Hands). He pumps the soap well but needs to be reminded to wash the back of his hands."
"Shower looking good, but still perseverating on talking about different body parts."
"Worked on getting him to dry himself without talking about what body part he's drying."
"Beware of talk about turning water on/off, temperature of water, bouncing up and down, body part talk, closing shower door when he'd finished."
"Used a Lego for soap and he did a nice job. Persev a bit on washing his legs (but no talking!). Still bouncing. Asked if we were dancing or shampooing and he stopped."
"Outside - pretended to be a baby, various animals, a teapot. Did well."
"Car was a little sloppy (being silly). Other pretends were good, especially animals."
PARENT'S NOTES: - Ask him to do same movements for rinsing AND washing hair. Moving fingers harder in circles all over head. Rounded part of soap on body in broader strokes - "how about your legs?" "did you forget your neck?", etc.
- Work hard on #22-25 only!
- Pretend you're taking an entire shower
- Pay attention to details on there. See [therapist name] entry on 8/22 for an example.
- For washing hands use empty soap pump (see us) and teach him to push pump w/hands underneath; scrub hands and dry w/towel.
- Do this drill in the bathroom for now on
- Be sure to use a different towel than the hand towel so he can learn that there are hand AND face towels hanging in many bathrooms.
- Don't use "legs quiet"...dangerous if he ever says this in school (therapist must have said s/he used this phrase as a prompt)
- Have him go through item list once or twice and then back to shower within a few days
when we were 3/4 way through with the above drill, we began......
SD: "My animal is [action]" prompt child
R: "My animal is [different action]"
Each has a toy animal picked by you (this instruction to the therapist is probably because he would perseverate otherwise and insist on some animal he may be "stuck" on)
Using furniture (chair, etc.) as props and demonstrate by acting out the actions with the animal...therapist says, "My animal is......
Examples: climbing up the mountain, falling off a cliff, swimming in a lake, jumping on a mountain, rolling down a _____, running, dancing, etc. in the grass, eating on the beach, sleeping in the desert, singing in the rain forest, etc.
Prompt child to say "My animal is......" and it must be something different but a similar nature-wise. Child will get ideas for later from the therapist. Remember that there was lots of prompting in this drill because I really don't think he had any idea what the places meant (except perhaps from some category cards or colorforms in another drill), although he did know the actions and was getting some idea about what cooperative play was.
For us the first early drill that worked on not only on pronouns and sequencing, but also comprehension and recall. For our son, the third part alone (LISTEN III) lasted for over a half year (and he was a quick learner!)
Therapists tells short, one line story and child answers "Wh- questions about it.
We used a large flannel board with people, places and began with stories like, e.g.:
"The girl left her house and went to the bakery"
(On flannel board picture of house and a bakery. Have figure of girl "walk" o/o house and toward the bakery.)
SD1: "Where did the girl go?"
R1: "to the bakery"
[I'm not sure if we looked for "She went to the bakery" from the start, although I'm sure that we would have prompted fuller sentences soon after, especially because we were doing pronouns/pronoun labels at the same time. We apparently began ONLY with "the boy" and "the girl" because there's a note approx one month into the drill that says "put Man and Woman into the mix".]
We did many like this and once we were getting 90% across a few therapists, we began to add an ACTION to the story:
"...and then s/he [something incredible or wild that he would remember]"
Example: "The girl left her house, went to the factory and she JUMPED ONTO the roof!"
[I'd remember that we would say JUMPED ONTO to the roof w/a vocal prompt, especially at the beginning when we first added the extra information]
SD1: "Where did she go?"
R1: "She went to the factory"
SD2: "What did she do?"
R2: "She jumped"
[I'm sure that we may eventually leave out the word "she" in our story example i.e., "the girl left her house, went to the factory and jumped onto the roof" and would differentially reinforce if he'd say "she jumped to the roof" (we'd have been thrilled)...we would always shape w/diff reinforcement towards better, fuller answers and our SDs also would work toward this.
We continued "and she climbed the tree" and other wild stuff (to help him remember and make him laugh--we were lucky that he had a sweet sense of humor) for a while and then there's a note that says to begin making our stories "more contextual" once he was getting the wilder ones. This was a drill where we were able worked very hard on his pronouns and sequencing skills.]
Unfortunately, I couldn't find any notes on the early parts of this teaching program (Listen to a Story I or II) but we do recall that we would sometimes give him a chance to tell US a story and then prompted him to ask US wh- questions! This was great fun for him (we were doing CHILD AS TEACHER drill by this time so it was easy for him to understand turn-taking with therapists).
We did this for a couple of months and then it changed slightly to....
Also using the flannel board (although I'm sure that different things can be used...perhaps colorforms or just dolls. Whatever is used, the same props probably should be consistently used....but I suppose we might have changed it if he was perseverating or seemed inflexible. We had lots of problems like that later on in therapy and tried to be more varied with our props)
Tell the story w/ACTION (as before), but add a second destination after the action. This time there are three SDs (story should reflect this, some examples are in our actual therapists' notes below LISTEN III as well).
SD1: "Where did the [pronoun label] go?"
SD2: "What did [pronoun] do?"
SD3: "What happened next?" or "And THEN what happened?"
Story example: "The man went to the library and yelled 'Hooray!" AND THEN he went to the newsstand."
SD1: "Where did the man go?"
R1: "He went to the library."
SD2: "What did he do?"
R2: "He yelled 'HOORAY!'
SD3: "AND THEN what happened?"
R3: "He went to the newsstand"
Be sure you use "AND THEN" during the story when you introduce the third part. Make it contextual until he's getting it well and then get "wild" gain. [Now this seems like the opposite of what we did in LISTEN I... my guess is that this just keeps the drill interesting to him going from contextual: "The girl went to the bakery and then ate a cupcake" to WILD: "The girl went to the bakery and drove the car onto the roof!"]
Once we began these multi-part/multi-SD drills, we used No-No-Prompt (or simpler "no equiv/no equiv/prompt", i.e. NO = "almost", "say it better", "try harder", "pretty good"....) in the middle of our delivery. i.e., If he was unable to get R1 correctly (or even if he DID get R1 correctly but messed up on R2 or R3), we would "no" it and re-enact the same story with the flannel board from the beginning, NOT just repeat the SD sequence. This was important. If he could not complete the three responses twice in a row (w/full flannel board re-enactment by us), then we would fully prompt all responses. Although this may seem tedious, we feel it was necessary.
We seemed to have done LISTEN II for a short time (some may want to do this longer to help with pronouns and to keep it interesting...because of the flannel board), when we began....
As above in LISTEN II, pronoun goes to TWO places and does ONE action but without a flannel board (or props). Actual note on drill cover sheet says: Include some "Why When and How" but BEGIN WITH MOSTLY WHERE? WHO? and WHAT?
[There's a note that says "begin Why When and How six weeks after the start of this drill"...i.e., we were still in the thick of our Why When and How (separate) drills when this one began so I suppose he needed more experience with these first]
Get him to use WHY during his turns (when we give him any [he definitely perseverated on getting all the turns!]) by saying "Ask me "why?" [He would tell us a story and obviously forget that he's supposed to follow it up with SDs to us asking WH questions]
[Some yellow post-its that remained on the cover sheet: "WHEN" and "HOW" are OK again" (as if we began them too soon and he had problems with them) and also "TELL FULL STORY AND ASK ONLY ONE WH- OR HOW QUESTION AND THEN TELL ANOTHER STORY, ETC."].
In these drills, we often had to scale back and work forward again.
The following are some notes taken during this drill (notes were found for LISTEN III only). PN=parents note. All are notes on loose-leaf paper following the drill sheet. Please note that every one of these is a full entry preceded by therapists' initials and date.
"I had a hard time w/him in this drill. Insistent on how I asked questions and who my subject was. I worked through breaking the rigidity -- he cried, etc. & overall became quite upset. Did get through it though on my terms."
"Did very well."
"Did well. Two places, one action. Also able to do two places, one action and one 'why?' e.g., left school and went to pizzeria and bought pizza - Why? because he was hungry."
"Did well w/recalling places & actions. He attempted to come up w/answers to WHY but they didn't make sense so I had to prompt."
"He is recalling excellently."
"Impossible to get any answers -- total non-compliance"
"Did well recalling stories. Able to answer WHY questions."
"Not bad."
"I did one past tense and one future tense. He had difficulty w/WHEN questions."
"Did well. Also asked him past & future tense -- conditional as well."
"Did well. Worked on WHY questions. Story: 'Man went to subway because he needed to ride to work." Independently asking WHY questions!"
"Did fine on first two, but then had trouble w/concentration. Some difficulty with HOW questions."
"Did very well. Answered easy HOW and WHY questions. e.g., Woman went to shoe store and bought shoes but had to bring them back because they didn't fit. He answered WHY she had to bring them back correctly."
"Great attention. Able to answer WHY questions to emotion stories."
"Attention was fair, but he was able to get himself together when I picked up the pace."
"Refused to answer questions; NNP got him to know the answers. Then he began getting them."
"Tried hard --- need to remove WHEN and HOW."
"His attention was great, getting all answers, so I focused on eliminating finger/hand perseverative stuff w/NNP."
"Major compliance problems due to glue on his hands [from glue drill, a constant problem throughout therapy]. Once [mom] straightened him out he did very well."
"Major compliance problems. Began imitating what I was doing (physical gestures). Told him to stop and when he wouldn't, told him that I would stay all night, sleep over, etc. never go home. He stopped."
"Really nice work. After initial struggle where he didn't listen to two stories. Told him we will keep this going until he can listen to four stories and then he could take a break."
"He was being awful, covering his ears, etc. Told him I would work with him until he was good even if [next therapist] was here. Big improvement."
"When he gave a purposeful wrong answer, I let him have a turn and I gave HIM the wrong answer. He didn't like this, but he still continued to give me wrong answers. I then gave him an easy one (my mom gave me a sandwich and I ate it. What did I do with the sandwich?). He answered correctly and I let him go and did NOT return to the drill. At no time when he got the wrong answer did I 'uh-uh' him. I just said, 'OK, do you want to go?' After I let him go, I didn't call him back to the same drill. I felt this would show that he got to me. This entire drill lasted no more than about four minutes."
"Did ok. Listened carefully and answered well. Told him stories about a little boy who went to the park and had adventures. He seemed interested."
"Very good attention. I told a story about a little boy at the amusement park."
"This was the first verbal drill of the day. He was doing lots of stimming and had problem answering WHEN questions. Told him that if he acts like this in school, kids may laugh at him. He quickly got himself together." P.N. - Great!
"Nice job. Good on WHEN and WHY."
"Very well. Did well w/HOW and WHEN."
[Entry below is by same therapist who did short drill earlier....she was the only therapist who was asked to leave throughout our son's therapy] "Immediately gave a purposeful wrong answer to WHERE instead of answering '....to school', he said '....to the farm' and....' I left the rest of the story the same and this time asked him a WHAT question. He answered appropriately throughout the rest of the drill, incl. HOW and WHEN."
"When I let him know he's misbehaving, he has been continuing the behavior and saying 'like this...I go like this'. So far my making a face and looking away has sufficed."
"Problem with WHEN questions."
P.N. - If WHEN remains weak, do a few isolated ONE sentence WHEN stories with a WHEN question. e.g., Johnny bought ice cream after dinner; when did Johnny buy ice cream?
"WHEN and HOW questions still weak when they're in the context of a larger story. I switched to WHEN and HOW 1 liners and he did fine w/them."
"Did well with HOW in more complex stories, but WHEN was a problem, even in simple one-liners."
"Still having trouble with HOW. WHEN was fine only after we went over it 2x."
P.N. - Keep one-liners for a while and then go back to fuller once he gets it (on same day, in this drill).
"Answered difficult HOWs and WHENs after a few one-liners. Did well!"
"Excellent!"
"Complex stories. He did very well."
"Was very distracted and much more interested in playing with the glue on his hands."
"Excellent listening to a story."
"Good listening and answering."
"WHEN questions were problematic at 1st in complex stories. Told him some one-liners and then WHEN improved. At 1st he was confusing WHEN and HOW."
"Worked on WHEN, HOW, WHERE. Did not get them on 1st try but did on second. Probably because he knew at that point (2nd time) what to listen for. Otherwise he was not able to recall the info and dissect it for the correct answer."
"Answered perfectly HOW and WHEN. 1st story. Confused HOW and WHEN three times."
"At 1st asked him a WHEN question. He got this wrong and then for the next stories was listening for WHEN information and could not answer OTHER kinds of questions."
"He did the same thing as he did w/[above therapist]. First asked HOW and then kept answering HOW when I asked other things. Had to repeat myself several times to get a correct answer."
P.N. - Vary the placement of the KEY statement in your story before you ask the question. e.g., sometimes beginning/middle/end.
"Unable to answer HOW questions, but was able to answer others when key statement was in beginning and middle."
"Answered some basic questions in simple stories: HOW WHEN and WHERE. But when I made the stories a little more complex, he wasn't able to answer the question and usually gave an answer that had 'context' at the end of the story."
"WHEN was still difficult for him. All the rest he did well on. Compliance not too good."
"Answered WHEN well. Had trouble with more difficult HOW and WHY questions, not necessarily using last line of story to answer, just various inappropriate parts."
"Difficulty w/WHEN questions embedded in larger story."
"Nice job on all."
"Great with everything."
"Good again. Told story about a boy who saw a grownup who was his friend and went with her. Why did he go with her? He didn't know why. I told him because she was his friend and he knew her well. I asked him if he would go with the grownup if he didn't know her and he said 'yes'. I explained that we NEVER go anywhere with grownups who we don't know."
P.N. - Start being more consistent working w/NNP on eye contact when he's getting correct answers [this drill was much later than PRETEND...where we still would have used more differential reinf re: eye contact Here we were already very purposefully targeting eye contact and shaping it w/NNP, something we had probably started doing across many drills at this time.]
"Did well. Answered all ?s appropriately. Good eye contact"
"Lots of problems answering questions. Especially WHEN."
"We did this outside. He kept talking about other things, the park, etc. and couldn't answer any ?s, particularly WHEN."
"Outside. He did very well. Answered all ?s incl. WHEN and HOW. Worked on better eye contact w/NNP."
"Missed the first WHEN, but got the second (different stories). Correctly got HOW. Was being non-compliant with his arms and legs. Fixed the arms and then announced that his legs were wrong. I told him "yes, I know, but I don't care" and he stopped."
"WHEN ?s were a problem in the beginning of sentences. Answered WHERE WHO and WHAT nicely (worked on eye contact during these)."
"WHEN still pretty poor. Nice eye contact"
"Had great eye contact Loved story about a boy whose nose fell off because he never blew it!"
"Major non-compliance. Lots of stuff w/hands, not looking, and "I don't know"s/"don't remember"s. I told him if he doesn't know, then guess. After I told a story he started asking me all types of questions: "What did they sing?" "Who did you see?" "Why did you see them?" "When did you see them?" I let him go play even though it wasn't a sustaining conversation drill. Very impressive." [this was w/the therapist who he often had lots of non-compliance with] P.N - Good judgement!
"Listening wasn't great. He had a hard time answering questions. He wanted to talk a lot (I think he thought this was sustaining conversation drill). I told him I like talking to him but now it was time for him to listen. He got himself together and he realized what we were supposed to be doing." P.N. - Great!
"Not sitting where I wanted him to; worked through this, labeled him 'rigid' and he finally quickly to the correct place. He was attentive and answered all ?s. Lots of DRO because he had been inappropriate early in the drill and he really got himself together nicely."
"Listening seemed good but he had hard time answering WHEN questions. Couldn't answer even two line stories. Able to answer HOW, WHY and WHERE. Worked on eye contact through these."
"Did great! Even with WHEN. Lots of DRO."
"Mostly wonderful. Had a little confusion with WHAT and WHEN, but I worked him through it. Great eye contact."
"Really good. Worked on WHEN, HOW, WHERE. HOW was good. WHEN still a bit weak, usually getting it on second shot."
"Needed prompt on HOW. Great with WHO and WHERE. DRO'd great eye contact"
P.N. - TO ALL - Thanks for all the info re: eye contact
"Said 'I don't know' two times at first on WHERE ?, then did better but kept trying to tell me stories. Got WHEN ?s right away. Huge DRO."
"'I don't know's at first. Worked on WHEN ?s until he got one. DRO. Moved onto HOW, WHO, WHERE and another WHEN. Got them all right. Big DRO. Good eye contact"
"Tried to talk back like conversation. I let this go on for a while & then got to work. Still weak on WHEN; better w/more concrete questions -- tomorrow. Harder time with stuff like -- in two weeks, over the weekend, etc."
"Did easy stories with WHEN. Got them. I tried a harder one and he still had to have it told twice."
P.N. - Focus a little more on WHEN (tomorrow, two weeks, next week, etc.). and definitely prompt and explain. Let's hammer the concept home!
"Concentrated on WHEN. Got about 50% right. I prompted and explained."
"More WHEN. Missed first ones but then got them all after that. I mixed up when the answer was presented within the story. He still does better when the answer is at the end of the story. The closer to the end the better he does."
"Still really weak on WHEN. Forgets to give answer at beginning of story if story is more than one line. Worked on WHEN in two line stories after he got it in one line stories. HOW was fine."
"Lots of trouble with WHEN. Seemed to have WHEN w/simple sentences but as soon as I threw in other WH- questions, especially WHERE, he began guessing a lot. Needs work."
"Wasn't paying attention at first. Then started listening more carefully and answered WHO, WHAT, WHEN, WHY, WHERE with simple stories and then started not paying attention again. I stopped and told him I'm going to write a note to dad about what he did. He said I couldn't do this, please don't and I told him I have to because he's not listening. We tried again. Got two out of three stories correct and I let him go on a positive note."
"Guessing WHENs....got last one correct so I let him go."
P.N. - Keep the focus on WHEN (tomorrow, two weeks, next week, after, soon, etc.) and add HOW MANY in as well where you can....notes.
"Some problems attending to stories. Got him to attend by telling him he needed to listen carefully and give the right answers if he wanted to go see [family friend he likes]. He listened, even with [brother] walking around him. Answered HOW MANY questions. Answered 2 out of 4 WHEN questions."
"Answered nicely. WHEN confused with WHAT a bit. He sat nicely, concentrated well with a lot of people in the room, all talking. Great eye contact."
P.N. - Always add in a few HOW MANYS (notes please). If prompt is needed, hold up # of fingers as you say the # in your story.
"He wasn't listening; had his own agenda. Got a huge T.O. Extremely effective. He finally answered one HOW question. Lots of DRO for sitting nicely. He was staring off a bit too!"
"T.O. immediately for sitting and feet. Wouldn't answer my questions so [dad] worked with him. Did well w/him on WHEN questions. This was a marathon drill with [dad] working and then myself. Wasn't able to answer my ?s but it was apparent that he was listening and knew the answers but just didn't want to give them. He was able to answer [dad's] questions very quickly and when he would ask him what I said, he was able to answer."
P.N. - If he doesn't answer, rapid fire your statements and questions and challenge him (e.g.: you: "did I say Tuesday?" child: "no" you: "Well then, what DID I say?"). This works!!!!
"Listening was good after I did the above. Asked "did I say she rode in a pizza?" .... he said "no, in a pumpkin". Then he listened nicely and answered HOW MANY, WHEN without problems."
"Got a T.O. for talking back. Then answered WHEN (DRO) and then didn't answer WHEN. Did rapid fire and then he answered HOW MANY, WHEN, WHO and WHY perfectly. DRO'd."
"HOW MANY, great! WHERE, WHEN, wonderful! Then he stopped listening and started making weird mouth gestures. Worked through this until he got better again."
"Didn't pay attention at first. I used rapid fire statements and questions and he did better. Towards the end he was much more focused and answered questions quickly, inc. HOW MANY and WHEN. DRO'd a lot towards the end."
"HOW MANY and WHEN got good at end after I changed my speed of delivery."
"Weak on HOW. Didn't seem to be listening well even with rapid questions and giving wrong choices. T.O. for continually biting cheeks."
"Excellent job! Answered all ?s correctly on first tries and he even interspersed some spontaneous questions. For example, I told a story about my kitten and he asked me how old he was! I think he was good because he was interested in the stories."
"Wasn't listening during drill and got a T.O. for various hand and foot stims. The T.O. really bothered him and he straightened out when he came back. Answered HOW LONG, HOW MUCH, WHEN and HOW perfectly!"
"Did great! Told him about Martin Luther King. Answered all questions? Great eye contact DRO'd."
"More on MLK Jr. Great job. Answered questions WHEN, WHY, HOW and then he asked for story about my cat. He did fantastic job listening. I told him my cat jumped on my leg and he got stuck. He asked if I put tape on my cat. Really cute."
"Great job. Answered WHEN, WHY, HOW MANY, WHAT. Sat nicely and very good eye contact I told story about a boy who wasn't well behaved at the playground who didn't listen, shoved things in his peer's face, etc. Asked him WHY the child's parents were upset at the little boy and he gave detailed answers. Wonderful job!" P.N. - Great story and notes!
Avoiding answers, not looking, changing subject. Last story he got some of the HOW MANY questions b/c the story had to do with a boy who had three T.O.s for not listening to three stories I told him."
This seems to have been one of the more important prerequisites to the Conversation - Dolls/Puppets drills we sent over the past few days. Seems that it changed into the "Dolls" drill after a while.
First have only person speak and ask child questions Then have two people ("Listen to us...."; "Listen to both of us...", etc.) speak and have him answer each. [Once he was able to do this well enough, we continued doing a form of this with dolls and animals.]
SD examples: "Listen...."
"Listen to a conversation...."
"Listen to us....Ó
Therapist and parents:
Therapist: "Yesterday I [action]; then I [action]"
Parent: " " " " " " " "
Therapist: "What did I do yesterday?"
R1: Child: "You [action]"
SD2: Therapist: "(Then) What did I do (next)?"
R2: Child: "(Next) you [action]
Once other grown up begins telling a story too (only after child has mastered remembering two things one grown-up has done) - this would be followed by (as SD1, R1, SD2 & R2 above) SD3, R3, SD4 and R4. We shaped additions of "first", "then", and "next".....
Yellow post-its on drill cover sheet:
DO THINGS HE WOULD LIKE SUCH AS "PLAYED WITH _______", "WATCHED [VIDEO TITLE], "LISTENED TO [MUSIC HE LIKES]", ETC.
ANSWER HIS "I DON'T KNOW"S WITH "LISTEN AGAIN...." AND RETELL
Therapist's and Parents' Notes (P.N.):
[Only found one page of notes, however these notes began after we were doing this drill for almost two months (we know that prob more exist but weren't able to find them). We obviously started telling stories so that we could ask more than "WHAT....?" Used all other WHs too.]
Used more future tense and conditional phrases...."if it's hot, I will wear shorts", etc. "After I talk to you I will say 'hi' to your brother"
Worked on WHY. Put on A/C because it's hot outside.
Worked on WHYs. He's doing well.
Worked with animals. He really liked this. Only problem is that he was imitating the voices of the animals in his responses.
P.N. - Please tell him not to, but we'd like to continue using voices. He will see puppets with funny voices in life and he'll need to deal with it without acting bizarre.
I used pig and penguin puppets. He answered well and I didn't allow him to imitate. P.N. - GREAT! [we always reinforced our therapists in the notes this way, although I'm not going to add them here]
Used rat and frog. Could NOT answer WHEN questions (as in most drills). Tried putting on various hats and having conversations with myself but it was too hard for him.
Chicken and frog; frog and skunk. Poor attention.
[After a couple of months, there was a NEW drill cover sheet for this....]
Include WHY sometimes... (e.g., "Yesterday I put a jacket on...it was cold. What did I do yesterday? WHY did I do it?")
Insist on eye contact with person who speaks.
Do ONLY things he would like or things we've [parents & him] done together. Very relevant stuff to him.
He doesn't always get turns--none on contingencies especially.
YELLOW POST-ITS:
DO WHY ONLY ONCE and PLEASE keep it obvious! [this was prob added when he was having a very hard time w/WHY]
Use Puppets Instead and have puppets ask the questions (in the first person - e.g., "Where did I go?") [This began about a month in ]
He gets a puppet and you get another - Stimulate appropriate social interactions and conversations.
Selected Therapists' Notes [many "positive" ones omitted] and Parent's Notes [P.N.] for LISTEN CONV II
Very poor attn at 1st. Switched drills. Then much better attention.
Great job! Answered WHY appropriately but still couldn't answer WHEN.
Answered WHY questions well, as long as they answers were given in context.
P.N. - Stick with WHY. NO work on other WH- questions.
Not good. I pretended the first two puppets were mad because he wasn't paying attention and left. He was upset by this and paid better attn.
Concentration not great (glue on his hands was more interesting) but eventually he did ok. I'm sorry but I asked WHAT questions to get him back. Only did a few WHY questions.
Did a pretty good job. Asked WHERE, WHAT and WHY.
Very nice job with only ONE question asked per story.
Only two stories with one question (WHEN AND WHAT) each. Answered both correctly so I let him go.
P.N. - Keep it this way because in REAL life we're requiring him to stop asking five questions about the same thing. [he'd ask the same question in five different ways..."verbal" stuff like this (all things being relative) as great as it might seem to many, was a new perseveration that lasted a very long time.]
Great job. Still one question per story.
I combined this with DOLL PLAY/SCHOOL. He had large problem staying focused.
Did nicely. Even had puppets ask me if I like chocolate ice cream (after I told story about eating choc ice cream).
Got confused on 1 story and answered questions on one character w/info about another character.
I had him choose the puppets he wanted me to use. Did a pretty good job. At break be careful of his using rat and telling story about going to the basement to eat cheese.
I let him pick too...rat and pig. He tried to dictate how the pig would talk. He did an excellent job.
Used Ses St characters from one of brother's toys. He was very interested in stories and did wonderfully. Even able to answer WHEN & HOW MUCH questions. WHY too.
[The following therapist constantly got into power struggles with him.... ] Awful. He could not answer any questions. Could be because he had glue on his hands. I finally made him sit on his hands and gave him some simple ones which he answered.
Great. He answered WHEN WHY & HOW ?s amazingly well. P.N. - [Ther], what did you do/use? Let us know if you think you can pinpoint why he did so well.
I used the chicken and the chick. Once in a while he didn't look at the characters so the chick said to his mom that [name] was being rude by not looking at the chick when he talked. He then looked and did nicely.
[obviously began using dolls after this] In context of SCHOOL, classmates (dolls) talking to each other and he had to listen and "Frankie" didn't want to be his friend. Answered WHEN, WHY, HOW pretty well.
I used the mouse and elephant puppets. I think he did well again (not first questions so well) with Ernie and Honker dolls.
I used Mickey and Buddy doll in a School context. M & B talked about their weekend and what they did. He answered WHO WHAT WHERE and WHEN nicely. WHEN was a little wobbly but overall he was attentive and engaged in the conversation.
[Other therapist] and I did a puppet show w/the chick and the turtle. He was unfocused at first...then the animals complained that it made them feel bad when he didn't listen. He improved.
Used the bear and caterpillar. We glued with pompoms. Didn't answer WHEN HOW WHY well. WHERE was ok. (glue problem)
Not very good. He was too busy looking at the new doll to do well.
Monkey and Chick. Did ok. Making conversation with some prompting and ans WH questions. However he was tactile s on the puppet too much.
I drew faces on my hands. He was TOO into it. We conversed. He did well; needed some prompting. Began getting silly. When I asked him what his father's name was, he said "[all the other therapists' names]."
Nice job. He was Big Bird and I was Bert. Look out however for his touching doll in S way [S = stimming...it was our school book code that transferred into our home drill book].
Saying things out of context. Not responding accordingly. Needs lots of practice.
Had conversation about trick or treating. What did you get [I said Milky Ways, he said water]. Kept talking about "brothers" and "sisters" EVEN WHEN THE CONVERSATION SHIFTED. We definitely need to stop talking about brothers and sisters for a while.
Squirrel and elephant. Worked on having him ans my questions and then ask me the same question back. He did fine answering various WH- ?s.
Working on HIS having PUPPETS maintain eye contact.
He put a fireman hat on and a cowboy hat on me so I decided to just go w/the flow and turn it into a conversation. He maintained good eye contact and proper distance. Ans questions appropriately. He needed prompting for asking questions.
We used the Barbie and Ken dolls. He carried on a decent conversation but had to be reminded to keep his doll still and facing mine.
[After another few months passed by, the drill sheet changed as follows....]
STAY IN CHARACTER!!!!
i.e., Animals are animals! People are people!
STAY IN CHARACTER
- Animals are ANIMALS!
- People are PEOPLE!
Stay in character ... he has to get into the mind set of the puppet and NOT assign human attributes if it's an animal.
e.g. - You: I'm a rabbit; I live in the garden
Prompt: I'm a monkey, I live in [state]
You: [Name], you're a monkey! Monkeys live in the jungle!
KEEP THIS DRILL SHORT! DON'T ALLOW IT TO DETERIORATE!
[Later, probably when "Sustaining Conversation" started, the drill cover sheet changed]
Use Puppets/Dolls AND props, etc. and have the kind of conversation outlined in: Sustaining Conversation, Snack Time, etc.
YELLOW POST-IT: Use blocks in this drill. Build house/place for them first.
[An additional related drill cover sheet, not used until much later, has no title but you can see it's an example of one of the ways to use Social Stories.]
1. Have two dolls/puppets/figurines (not in character...e.g., call Curious George "Alex", call Dopey "Murphy", etc.) act out appropriate and inappropriate behaviors based on the Social Stories themes above (improvise please...do not use word-for-word Social Stories).
2. Ask him questions about your Puppet (or whatever) Show. Ask the questions from both the positive AND negative side ("What would happen: if he kept doing that/if he stopped?, etc.)
3. If working on inappropriate behavior, re-enact it appropriately after asking him the questions.
4. He is NOT allowed to act it out himself -- just observe -- unless he is PERFECT (i.e., not zoney, answers all questions, does not stim on or grab puppets, etc.).
If he asks for a puppet, use it as ULTIMATE reinforcer for PERFECT behavior: e.g., "it might be a really long time because you have to be sitting perfecting and looking in the right direction", etc., etc.
5. If he's zoney, cut it short and go back to it later.
6. DO NOT re-enact incidents from his real life...only imaginary/novel situations.
THERAPISTS & PARENT'S NOTES (P.N.):
Rooster and Barney - We talked about my friend's birthday party that I'm going to tomorrow. He did an excellent job. Really tried to respond correctly and even added in a few "That's great!"s and "really excellent" when they were appropriate!
Barbie & Snow White - He asked too many WHY questions. Asked a WHO ? unprompted. Barbie (me) told Snow that she reminded her of somebody. He (Snow) said "who?" and Barbie said "Sleeping Beauty". Then he called Barbie a "bubble head". P.N - Let's slow this down too...Careful also of perseverative "reminds me of".
Still too many WHYs but did nicely and asked a few unprompted ?s.
Rooster and Bug - He did well with WHAT but incorrectly asked WHY to everything else. Told him once that his rooster wasn't looking at me.
Oscar and Elmo - Good job sustained - Too many WHYs still. Prob with HOW. WHAT is fine. At end Elmo (he) was not looking at Oscar. Oscar walked away from Elmo and said he wouldn't be his friend.
Did well. Had to be told 2x to look at my doll but asked WHY only 1 inappropriate WHY, a couple of WHATs and a WHERE and a WHO. WHEN is a problem.
Did this with Legos. Visited a Tinker Toy zoo. Boy and Girl talked. He initiated conversation at some points. Appropriate use of WHY. Looked at doll with his doll the entire time!
Asked too many WHs. Asked me a WHAT for a WHO. I said "Not something...SOMEONE, and he got it.
He was playing w/a doll and doll furniture during a break (inappropriately) so I took a doll and joined him. His conversation was good. He was climbing on the dog house so I asked him if he had a dog. Said "no..I live in this house". I told him that house was too small. Then he said to my doll "let's play hide and seek" and he hid in the house. Conversation was good.
Used dolls - He was too focused on the doll and not on the conversation. Had to comment many times that his doll was not looking at me. Used [other ther's] prompt for WHO -- "I said someBODY." It worked.
Big brother (him) and little brother (me) went to amusement park and barber shop. Conv started out good and then his doll started doing weird stuff on little brother doll so little bro went home and told his mom he doesn't want to stay with big bro anymore.
My doll and his doll were friends playing...Talking about zoo. He asked good ?s but walked away from my doll 3x so my doll didn't want to play w/him anymore. He still had his doll and I told him to give it to me. He threw it so I made him give it to me again nicely and he did.
He was chicky and I was froggy. Went to the ice-cream parlor to buy ice cream and had a good time. We picked out flavors. Vanilla for me; green choc mint for froggy. Good eye contact
He was rat and I was kangaroo. We met at a desert. I told him I saw a great big snake. Used this to arouse his curiosity for sust conv. He had good eye contact but still tends to utter choices when a WHAT ? is presented -- i.e., "what did you see in the desert..a rat or a bug?" Then we went to find food at a garbage can...he was creative! stiffed the shape sorter!
Again his doll wasn't looking at me. He had trouble asking most ?s and kept interrupting me to ask things that didn't make sense.
***Don't allow him to ask if the dolls can say "hi" to each other. He's perseverating on this.
P.N. - GIVE THE DOLL A TIME OUT!
His doll didn't look at me and got a t.o. He said "what isn't the rat (his doll) looking at the kangaroo?" i.e., he's VERY aware of what he's doing wrong.
His doll not looking at mine. [Child] got t.o. this time. Being rigid also when I took doll. Said "I have to hold doll." Before that needed prompts to sustain conv properly (WHEN WHO, etc.) Asked WHEN on his own. DRO'd.
P.N. - Better to T.O. him if he's doing it on purpose.
Played Barbie with [playdate]. At first it was hard to get their dolls to talk to ea other because she was so excited about all his stuff [toys]. At the end the dolls went to the movies. She took two other dolls and put on a puppet show. She just hummed...no words for show, but he didn't get stuck on this! (-: By end their dolls were talking more.
Our dolls talked to each other. Needed prompting. Good WHERE by himself. DRO'd dolls. Emphasis was on dolls looking at ea other. Did well DRO.
Was frog at first. Not holding puppet approp so I took it away after two chances. Then I gave him kangaroo puppet. Did well for a while and puppet looked at me and asked good ?s. Then started doing really weird arm movements with puppet. Told him to stop..he didn't so I took it away and stopped drill.
GAK puppets. We put GAK on our hands and had conv. His started to run after mine but my puppet was losing his hair so he had to stop running. Conv. was good. Lots of DRO (in puppet voice - for looking).
Blue dino and Cookie Monster. He needed prompt for WHEN only (got all others incl WHICH). His doll only maintained good eye contact when he was answering but while I was talking it was fleeting. I let this go...should I have targeted? Also, he kept trying to change topic..it was very rude.
W/Legos. Built hopscotch course. At first was ok. Asked Barbie to play w/her (Snow White) but then stopped looking and began talking weird and looking at dolls clothes and hands. 1st doll got T.O. and another doll came to play but he still didn't look so we had to stop.
He had puppets and said they were going to bite me so I put them away in toy chest and told him why. He ans ?s really well. Not WHEN first time, but answered two well. DRO.
Terrible w/WHEN and HOW. Good on other ?s.
He was chicky and I was bear. Talked about bear going to the movie "Beauty and the Beast". We planned on going together and inviting friends so that we can all be together. He tended to start talking about how he wanted to go too... He forgets that it's "chicky" who is supposed to be talking and not him. I responded by only acknowledging chicky and asking chicky "who's [child's name]? what are you talking about?" He got idea and tried to focus more on chicky and not himself. Needed prompts for WHICH.
Nice vocal animation. Prompt for him to volunteer things about his doll and ask other doll.
He was Clifford and I was Beany-Bear. We had nice conv about going to the store together. Good doll eye contact, but needed to be reminded (a little) to talk about the doll and not himself. Asked lots of good ?s, "what will we buy?", etc.
I was lamb and said something scared me. He said something scared him too. A bug bit him on the tongue and then he went to the doctor and got a shot in his tongue! Then brought the cow back to me and said "what bit you?" -- I corrected "what scared you?" VERY GOOD!!!!
Did nicely at beg. Took Dopey doll and started talking to me indep. Then when we started talking about school pictures tomorrow I tried to prompt Dopey w/concrete statement and ?s but Dopey wasn't paying attn to me so I stopped talking to him. [Child] was really affected by this and said "not me...I was listening. Will you still talk to me?" !!!
P.N./T.N -We played with Barbie and Snow White dolls. He wasn't too good at pretending b/c he had trouble being only that character. He tends to bring himself of others (family, therapists, etc.) into the immediate pretend situation. The boundaries of pretend and reality are blurred in this program. Megan & Jim recommend that we should just state to him that we are pretending NOW and can't talk about anyone else except the dolls.
Did well. Stayed in pretend mode. Held man doll & I held little boy doll. Little boy was worried b/c he got in trouble in school. Father told him not to worry b/c he does good things in school. Boy was upset 'cause father didn't listen to him. He was not good in school and he wanted help to be better. Voice was appropriate. No high talk. Mild DRO.
Good voice. He had a prob w/giving the "man" a name. Kept calling it Daddy. I told him he had to give man a real name, i.e. Mike, Alex, etc. Fooled around and said "Susan". I said I'm serious and that this would be his last chance. He finally named him "Joe". Once he did we had a nice conv about work. He worked at an office. I worked at MacDonalds. Told him I had great idea "why don't we go to eat?" He had asked what idea do you have. Did this to get him to eat. It worked.
He was Doc & I was Barney. I was sick and Doc prescribed OJ (in the bottle from toy chest). I had to prompt approp ?s - Doc just shoved the bottle in Barney's face. Doc even sort of got a joke and we both laughed. Doc said something about his glasses and Barney said "yeah, they're crooked. Oh wait...it's just your face".
Used Sleepy and Doc. Had very good eye contact I had to prompt him in places where he needed to ask WH ?s b/c I didn't give leading statements. Otherwise, the other reciprocal statement were very good and were said without prompting.
He was brown horse and I was white horse. He was very animated. Voice and affect were good. I told him my name is "Giraffe". He said "Why don't they call you 'Horse'?" It was really cute. He helped me find something I lost. Changed topic of conversation once but I stayed in character and steered him back.
He was man in car, I was a chicken he run over (my foot so I was ready to start a lawsuit..just kidding). I said OUCH, you ran over me. Had the police come and reprimand him. He explained that he had a prob w/his car and that was why he was speeding. He said he needed to take it (the car) to the car dealer! Police told him he can't speed and he must help the chicken go to the doctor to fix his leg. Lots of DRO for being creative.
We were Santa Claus (he was skinny one--used tree ornaments). Said he was going to order in...I said is it b/c you're so skinny? Conversation was downhill from there. He perseverated on banging on the piano with Santa and repeating nonsense words so I told him if Santa did this again, I'd blame it on [name]. He stopped.
I was Dr. (Barbie) and he was the other Barbie. Right away he told me I have to say "What's wrong?" and stuck his finger in Barbie's face (T.O. for this and doing strange tactile s w/Barbie's stethoscope). Conv required a lot of prompting but instead of telling him exactly what to say verbatim, I instead gave him open-ended choices. e.g., say "I have a cough or cold" or say "I caught the cold from..." and he would fill in the rest.
Selected from subsequent Ther Notes:
- No changing topic. DRO'd
- Used the Octopus we made in Arts & Crafts for conv. Was animated & motivated to go on even after drill ended
- Changed subject 2x & had trouble w/Big Bird keeping contact w/Cat, etc.
P.N. - THE DRILL HAS CHANGED...See new cover page. Extensive notes please.
He was whale; I was seal. He did pretty good job staying in chair. Prompted answ & he elaborated on them. Started talking about something unrelated (but related to his own life) so I said "good-bye" and told him he can't come out of water b/c he's a whale. Had hard time saying good-bye. Needed prompts.
Did this w/Math. Two Barbies asking for food; sharing beads. He had easier time staying in character because they were people. I worked on liking things and WHY.
Nice. He was a rhino; I was a whale (bad choice) (hah). I stuck to conversation about the animals- i.e., habitat, where they eat, drink, etc. I had to prompt a few answers for him. He did nicely afterwards -- prompts were accepted.
Good. He was squirrel. I was a dog. He immediately asked what I ate, initiating conv. DRO. Good imaginative answers. Said he lived in a stone house in the park. Told me that most dogs say "ruff ruff"--asked ?s about what my owner fed me and what I liked!
He was groundhog and I was giraffe. Asked him about what he would do and why. Prompted answers where he hesitated or was moving off character.
He was pig and I was dog w/puppies. We used puppies for a conv about giving birth, being pregnant and the names of baby animals. Towards end he started doing weird things w/the pig (talking w/his nose and tail). My dog told him he didn't want to talk to him anymore b/c he was weird. Then dog told all the other animals in toy chest not to play w/or talk to the pig. He did not care.
At lunch the onion ring spoke to the french fry. This was really cute and he got into it, elaborating on prompted statements. DRO'd and stopped on a very positive exchange (leaving him wanting more...maybe).
Demanded his eye contact for asides, prefacing these w/ him, otherwise if he was looking at doll that was acceptable. Hot dog man and witch. At first he wasn't really engaged in task but got into it. Told him hot dog man has to look at witch. Prompted conver - then he initiated some on his own.
P.N. - For this drill his eyes should be FOCUSED on the doll/puppet UNLESS you are talking directly to him. In other words if you said, "[name], rabbits don't drive cars", he MUST look at you since you addressed HIM and not the rabbits.
Nice job. He looked at me whenever I directed comments towards him, otherwise he focused attn on the animals' convers. Very appropro. He stuck to the topic. He was the kitty; I was a pig. Asked appropro ?s. At one point he used a remark about the kitty working. I told him "[Name] (he looked at me)..cats don't work. Only people do" He accepted this and had no complaints.
Used two cats. Prompted most of his answers. He stayed in character nicely and looked at me when I addressed him.
Horse and teddy bear. Often needed prompts repeated before he said them. Needed prompts not to bounce horse up and down.
He stayed in character well. He was cow, I was camel. Looked at me only when appropriate.
He was sandal and I was snowboot. He was anxious to say his own stuff. I tried to prevent this by prompting all the answers but occasionally he managed to slip them in. Two of those times he went out of character and said something about eating and growing. I reminded him that shoes don't eat and grow and had him say it.
He was blue crayon and I was a red crayon. Full prompted answ -- he elaborated. He went out of character once. I prompted with a quest and had him repeat "when I go out of character I'm not pretending anymore and the game ends."
I blew up balloons and drew faces on them -- we discussed ?s and answers [See Qs & As post] that are on the wall. My balloon did the wrong thing and I prompted his to correct mine. Stayed in character (DRO) and looked at me when appropriate. Elaborated appropriately on his answers.
Needed prompt for eye contact two times. He was pig and I was bunny. He went off topic 1x. I corrected this and he looked -- DRO. Full prompted convers except when he jumped it with something of his own. This only happened once and it was not successful.
Man and woman...married couple of dolls. All was prompted. I had him mostly answer (prompted) my ?s rather than having him ask me ?s. As usual, he elaborated on the prompts -- they were all appropro. The only prob was he kept playing w/the man doll's arms -- I used physical intervention.
Played students in class. Girl (me) was not following rules (ones on wall - calling out, touching other kids). He was boy she was playing with. He kept correcting her bad behaviors and then told her he couldn't play w/her until she learned to control herself. At end he got T.O. for rigidity (he didn't want to stop playing and was stuck on moving doll's arms).
Played with two girl dolls - good friends on way to school. We forgot to do our homework and were worried about what the teacher would say. I prompted him w/?s and answers -- he also spontaneously added some phrases. Needed a couple of prompts to look at doll when he talked to my doll and to look -- when dolls didn't talk and I gave him instructions. Accepted prompts nicely. DRO.
In classroom three kids and 1 teacher. Went over various situations where kids were either rude or were able to control themselves. His doll was behaving beautifully (he said "I controlled myself") and teacher really DRO'd him and other kids said they wanted to be just like him. No prob accepting prompts. Glanced up during breaks when I gave him instructions. Lots of DRO.
Mom and little girl went out food shopping (#13, 11 & 10) [these refer to our Q & A sheet--a precursor to Social Judgement/Social Stories]. He was the mommy and I prompted him to ask girl ?s. Good eye contact One phys intervention for laying doll on the floor.
I was the teacher doll and he was the student doll. We were having a private conversation while a little girl was riding a donkey across the table. We covered Q & As #7 and #9.
Dr. Barbie talked to Aerobic Barbie. He was Dr. He was great. Aerobic Barbie (#3, #18) asked Dr. B how she did so well in school (by controlling herself). Also for beh in schl #5,6,7,9. He needed prompt not to bounce doll up and down. Otherwise ok.
School with dolls. Hit Q&A #s5,6,7,9,18. He stayed in character. eye contact w/me was poor. Needed lots of physical intervention. Distracted by Q&A signs on wall! Prompted control questions and then self pride questions about it. This worked!
P.N. - Sometimes do unusual stay in character stuff, but keep up school situations (for Qs and As).
He was gorilla and I was giraffe. Gorilla came to visit at giraffe's home. He touched things w/o asking. Did Q & A for this. E.C. was ok...needed physical prompt once.
He was a kid at magic show and I was magician. Performed tricks, etc. worked in Q&A #12,13,15. Then his doll wasn't looking at mine so he made her go back in the audience and picked another kid. This upset his doll. What could you have done to stay on stage --- Looked at you when I talked to you.
Two adult sisters (dolls) discussing day. Set it up to make his doll do things that would cause Qs and As. His doll took the prompts very well and even corrected itself after saying the answer!
He was [girl playmate he really sometimes had] and I was him. Dolls talked to ea other. He was good. DRO'd self for looking. Lots of reinf.
Great --- he was hen, I was bear. He looked at bear nicely. HAD A LOT OF SPONTANEOUS COMMENTS AND ideas. BIG DRO (i.e., he sat on the couch with him and bear went to foot of couch and said, "Hey bear...come down, I can't see you" His hen said "Well, why don't you come up here?" !!! Really smart! Big DRO. Did Q&A #13,10,2. Wonderful!
Q & As #s 3,2,7. He was elephant, I was alligator. Stayed in character. "You swim in the water - Can I swim with you?" BIG DRO for these appropro statements. Played with elephant and stopped talking for a second. Otherwise great. Prompted positive self-control statements.
He was baby doll and I was variety of other kid dolls. Had my dolls do the wrong thing and he corrected them with Qs & As. He was resistant to correcting my dolls. Instead would say things like "...but you didn't try to guess what would happen. Good job." When he did this 2x in row (not taking my prompt), I said, "I'm giving you a warning." Then he straightened out. I hope that was ok.
He was boy doll & I was whale. I wanted to go to school and asked him if I could. Even though I knew how to behave, I couldn't 'cause I had to stay in water. He couldn't control self - kept playing with boy's shirt. Being R [rigid] about touching boy's clothes so we had to stop. Got him in control w/statements, prompts re: control & forgetting about obj stuck on.
I was little sister and he was big brother. He told little girl rules. He needed some prompting to keep hands still. Controlled self. Praise.
We were two best friends. He was Nico and I was Josh. Josh invited Nico over to his house to play w/his toys. Did lots of Qs & As (4, 2, 13). He needed some prompts to look at who he talked to. Was pretty good otherwise. Lots of DRO & self-praise, esp when he caught his own mistakes (i.e., not looking at the doll, etc....he accepted prompts nicely and generated a few spontaneous conversations following the prompts.
He was man and I was frog. I had lots of ?s for him b/c I wanted to be a human. He was really cute. In end we made a compromise. I could go to school but I had to stay in the tank. Needed prompts & control statements to stop moving doll. Did this .... praise & "proud I'm in-control" statements.
I was new student in class. Teacher appointed his doll to show me around and teach me the rules. I did everything wrong and he had to correct me. Only one reminder for not looking at my doll. DRO & self-praise from teacher.
He was Sara and I was Samantha. Basic classroom stuff except Sara didn't stand still when she was talking to Sam and Sam didn't want to be her friend. Full prompts through control statements. Then Sara controlled herself. Lots of DRO.
He was Mr. & Mrs. Piggy; I was gorilla. Talked about where these animals live and like to eat. He was great. Looked at animals & me appropriately. He was really up w/the verbal descriptions of animals. VERY into it. Lots of DRO for eye contact -- not too bad with the shoulders either.
[fem playdate] was Snow White & he was Dr. Barbie, but he couldn't control himself so we had to stop. Then we played with family. He was Daddy, she was Mommy and I was little daughter. He needed to be refocused on interaction occasionally, but basically did good job. Needed prompts to not move figure's arms and look at other dolls. She was good at prompting.
He was Tophat and I was various trains from Thomas puzzle. Pieces were lost & not behaving properly & needed to get back to their resting places. He held piece appropriately & was very involved in play. A noticeable improvement from last time. DRO holding man still.
He was Josh and I was Julie. Had a conv about visit to the zoo. Talked about when & with who we went to zoo, what type of animals we saw, etc. Excellent eye contact & control. He self-praised himself for not talking w/his mouth full of oranges. Big DRO since this occurred after a major battle & T.O.
He was daddy & I was little boy doll. He praised me for controlling myself & standing still w/arms down. DRO. He needed lots of control statements to hold doll still when he talked to his son. Talked about school day & little boy told daddy how good he was (following various rules) & daddy was very proud and boy felt happy & proud of self.
I was lizard & he was frog. Talked about what he liked to eat & where we lived. He touched frog funny & squeezed him to make noise. Scripting took care of this. DRO for looking at my doll. Calling lizard a hermit crab! Lizard told frog we better not say that anymore
P.N. - Thanks for letting us know that scripting is working. ["Scripting" often consists of large amts of long, full prompts]
Kids at bus stop waiting to go to school. Talked about Qs & As re: school to see if JoJo [therapists' real-life dog] could go to school. Even though "Joey" answered all questions right and other kid said he thought JoJo could behave in school, at end "Joey" said "April Fools" because dogs can't go to school. Lots of praise for doll staying still when he talked to people. Control & self-praise for his great control over doll & attn to what other doll was saying.
I was Fluffy the cat; he was Ford the chicken. Talked about laying eggs and where the chicken lives on the farm (chicken coup). He was great. I asked him how many eggs a chicken lays ea day and he first said 100 and then said "Nah, that's too many. She really lays two a day." AMAZING! He held animals very nicely. Needed a little reminder to look at the other animal when talking, otherwise great job. Lots of praise and self-praise.
Man and woman w/doll house furniture. He had a hard time staying in character when asked to go to diff rooms or get stuff. Couldn't negotiate doll & accessories. With intensive prompting was getting a little better (phys prompting of how to hold doll, etc. too).
He was monkey and I was Barney -- not too good. He needed scripting to look at Barney & phys prompts to stop touching the eyes on his monkey & also Barney. I did Q & A re: interpersonal space. Prompted lots of answers and scripted T.O. warnings. He gained better control at end. DRO'd his control over not touching eyes on dolls & accepting scripting.
Needed scripting/control statements to hold doll still. He was teacher (at first resisted b/c I gave him man doll & he said I'm not a teacher; I'm a man but understood after explan. that men are teachers too) and I was student. His doll got in control. DRO'd him for holding doll still. Accepted prompts well. DRO & kept it relatively short so I could DRO holding doll still w/lots of praise & self-pride statements at end.
[At some point, this drill might have had more in it about building a doll house and putting it away w/o being rigid than conversing (though that was always in it as well)]
His doll worked for mine and had to get things and bring to "me". Needed to follow directions & manipulate doll. If doll didn't look at mine/answer, he could be fired (this worked to keep doll still also). He responded well & had his doll carry things to mine and kick ball to it. DRO'd following instructions. We worked in office. He told me about his other job where he worked with [names of dad's co-workers he's visited]. DRO'd for great job.
Playmobile playground & doll stuff out, so I joined him. Needed occasional prompting for doll to look at other doll & once used babbling instead of real words (did Q&A), but otherwise good job. DRO looking & holding doll still. Played many games. Self-pride for learning how to play nicely w/dolls.
Used bunnies we made from Play Doh. Bunny stood still & looked at other bunny. DRO. They used crayons as carrots. He needed some prompting to follow along in the game, but scripting worked. Praise & self-pride. Thinking/feeling scripting worked when he wasn't participating.
My doll wanted to buy his doll's Lego house. They made friends. I prompted him to make his doll give mine flowers, then they went swimming. His doll wanted to go inside -- talked about how my doll felt that he didn't want to be w/her. Then he started dancing w/her in pool (scripted this & it worked). He needed two verbal prompts to keep his doll looking at mine. Repeated -- scripted about this. He stopped.
It was a little hard to get him & [playdate] to interact b/c they both wanted to do their own thing. I scripted [name] to listen and look at whoever was talking & DRO'd great sitting/setting up dolls. [Playdate] had to be reminded to be quieter a few xs. Q&A about interpersonal space. DRO'd [name] about his remembering not to get into anyone's face. Also had him repeat answers to questions [playdate] responded to first. Good listening on his part.
Two kids met in park. Sat under trees (bean bags). He needed prompting & scripting to look at doll - w/feeling scripting. Otherwise nice job. Good attn. DRO. At first had hard time w/bean bags for trees but got through it relatively quickly with scripting. DRO'd control & listening to directions.
P.N. - Be sure the dolls/puppets do some IMAGINARY things (stuff where there are no CONCRETE props or where the props have another identity). Notes please!
We were two camels on the beach. Blue bucket was water...we were thirsty and almost drowned. He had NO problem pretending carpet was sand & bucket was w/water. Great participation and creativity. DRO'd.
I was tiger, he was gorilla. I pretended my pen was a tree. Did a few perspective-taking roles about friends I have that he doesn't know. Also things like what I see & what he sees from the position our animals were sitting at. Good listening & interacting.
P.N. - Be sure to integrate lots of social stories.
Enveloped was our dolls' school. Did lots of Q&A social stories & perspective-taking concerning feelings. Also kids discussed summer vacation -- if they weren't there, did they have a good time (there)? etc. He did great. Even made doll kiss & hug mine! Then suggested we dance. Did well until I tried social scripting & he kept singing. This led to a T.O. b/c he couldn't stop singing.
He was playing w/musician dolls so I joined him. Had his doll teach mine how to play drums. Used bucket for seat at drums (he resisted at 1st but then did it w/talk -- social story -- about pretending & rules & learning how to pretend). My doll walked away from his. Social story. Then his doll was paying more attn to drum than to my doll - perspective taking/emotion. DRO'd sitting still & eye contact Observ. learning at beg for eye contact -- self-pride. I can do it, etc.
Dentist office (Playmobile). He was patient, I was dentist. Needed only one prompt for doll to look in right place (non phys-gesture). Otherwise participated very well. At end girl was good so she got a lollipop (dental instrument). Lots of DRO for paying attn & being very polite.
Schoolhouse - he was teacher & I was kids. Asked various ?s in soc stories & he (prompted) answ. His teacher doll stood still & looked at people when she talked to them so the children would learn how to behave. Stayed in chat w/lots of DRO for paying attn.
Concen. on social stories & persp taking. Great imagination & very appropro responding. Needs prompts on most persp taking but accepts them. Great ideas. His doll wasn't facing mine at one pt. Used story about walking away from convers.
He got stuck on doing weird stuff w/elephant puppet so I took it away & made him be monkey. He resisted. Did control stmts. & soc story about rules. He finally settled down & did a nice convers. about where monkey lives & eats. Kept it brief & to the point. DRO'd getting into control.
P.N. - Make him work w/o STIM to earn elephant back as reward....lay this type of contingency out to him 1st.
He was lizard & I was dots all over. Piece of paper was lake w/area around as grass. At 1st he said "grass" w/double s sound at end b/c it has a "lot of ss" in it. Corrected this. He was great. Animated & involved in play. Finished on a positive note. Lizard had good eye contact & he received reward at end.
He was boy; I was girl & we played game where he asked me ?s & I only gave him the right answ when his doll was standing still when he talked to me. Great participation & his doll learned to stand still. Lots of DRO.
It was his doll's b-day party. Threw in some soc stories. His doll was jumping all over the place. I warned a T.O. & then he did great. Held doll still & convers was great. DRO.
Convers was really good. He was Curious George; I was a dog. Talked about where we live, what we eat, etc. Did persp-taking about feelings - e.g., Curious G had big ears -- I asked if people laugh at them and he said no. I as puppy said I was sad b/c little boys are afraid of me. Got him to ask why. He also said they shouldn't be afraid b/c dogs are nice. They don't bark at little boys.
Talked about my doll's prob of walking away from people when they talked to me & what I could do about it. Then used "camera" (crepe paper) to take pictures of ea other. He did nice job. DRO.
Used clay figures we made (snake & fish). Snake lost collar - clay & fish jumped into lake (Play Doh canister) to find it. Persp- taking & partic. were great. DRO.
P.N. - First set up a scene...always declare the dolls to be in a certain location. e.g., the kitchen, living room, school, museum, etc. & be sure the play is consistent with the setting -- Lots of notes on this pls.
From Parallel Play - He helped me set up kitchen in doll house & then he was the daddy & I was the little girl. He gave me hot cereal for b'fast (used button as dish). Then bought dishes to sink & washed them. Then we went to Snow White's house (puzzle) to visit her & her pets. great participation. DRO.
We were at the airport. I had to catch a plane. He worked at airport. Partic. well. Play consistent w/airport setting. DRO.
[When we realized he couldn't do this w/o stimming, we decided to teach him how to set up a house and then play with dolls in it -- we mostly used Playmobile 1-2-3 playhouse for this -- very Lego-like. We were able to use this as a visual tool to show him some of his own problems doing persp-taking as far as space, behaviors, etc. This drill was being done much earlier than our more systematic, general role play drill re: his behaviors. We also used drill to target ritualistic play behaviors (putting things away, banging toys together, etc.) Usually I don't include all the tedious therapist notes we had, but I've included many of these here to show how hard we worked stuff over & over until we got rid of perseverations & rigidities and made what we thought was a lot of progress in a specific area of play or whatever.]
P.N. - Build a KITCHEN on top of the small doll house (see us). Have him:
1. Pick what belongs in a kitchen (mix kitchen furniture w/non-kitchen furniture in a pile and have him pick) 2. Make a kitchen (he can't add characters until all the furniture is in place; vary the position of the furniture ea time you do it 3. Play w/the dolls appropriately in the kitchen.
*Do not let dolls/characters out of the room/scene.
*Be sure he applies proper pressure when attaching pieces to the doll house (also be sure he uses his hands appropriately)
*He must put things away when he's done with NO RITUALS. Have him practice (overcorrection) until he gets it right.
Built kitchen with small doll house. He got rigid about moving table so that doll had room to sit down on the chair. I modeled how the doll was stuck & wouldn't fit -- how it would have no place to move. Worked on problem solving the chair arrangement. He moved the chair to the other side of the doll table to make things fit. Nice strategy. DRO'd the prob solve technique. Putting things away --- he had to do it several times b/c he used weird rituals like putting baby in chair and THEN putting it away. He finally shaped up towards the end.
Kitchen - left some LR & BR furniture to choose from among pink refrigerator (didn't call it a bookshelf -- DRO'd that). Put doll house under the table. He had to move it out. Did it on his own - DRO. A little rigid about having all FOUR kitchen chairs and baby in baby chair. I talked him through. Put stuff away quickly. While playing w/dolls he figured out strategies to make room for them e.g., taking table away from refrig so doll could get through. No rituals when putting things away. BIG DRO.
Set up kitchen. I put out a few extra pieces of furniture that didn't belong. He sorted all the appropo pieces of kitchen furn & set it up nicely w/fridge, oven, cabinets, etc. Lined up on one side. Provided enough room for people to move. DRO'd his use of pressure when putting pcs on board. He had to put away toys 2x b/c he did some hand stuff the 1st time. Overall he was pretty good. Convers was excellent. He pretended to be a step mom & I was a girl, Jessica. Came home from school & wanted dinner. He was creative w/content of convers. He made a pasta sandwich. We talked about trying new foods.
Put out stuff to set up kitchen, mixed w/other stuff & baby with NO baby chair. Reminder to use two hands setting up -- DRO'd two hands. Needed prompt to look at what he was doing. DRO'd for this after. Set up house against table [his table in room]. Needed to prompt him to move it out so he could work better. Tried to make "grandma" come in house through roof window. Talked about how impossible this was & she went in through door & up the pretend stairs. Then made her go up the side of the house. Had him make her come in through front door. Resistant -- Told him I would put it away if I had to (going up the house & in through the roof window becoming a "thing" --- WATCH OUT for this). Talked about rules. When putting away first "walked" stuff in but had him do over & he did it right. DRO'd.
Kitchen - He sorted appropriate appliances for the kitchen. Set up nicely. Fridge, oven, sink in a row. DRO'd for leaving space so people can pass. We had a dinner convers. Had him go get dessert from fridge. He tended to pick up the characters and fly them through the air. Prompted to stay on floor. Putting away - got a t.o. b/c of wiping. Jim took grapes he was eating away. He gained control pretty quickly & put the rest of the toys away nicely after that. DRO'd quickness. [Wiping was something that came out of phys interventions -- e.g., if you touched the "offending" body part, usually foot or hand -- sometimes face for a grimace, to let him know he was stimming, he would "wipe" where you'd touch to negate what you were trying to tell him.]
P.N. - Have him set the kitchen up on one of the sides of the house. Be sure furniture is against the walls and table is out on the flap. Begin setting up a living room on top.'
Set up kitchen inside house against wall. Chose pieces approp. (table on flap). No problems walking dolls around inside house. Stayed away from doors & windows, except when pizza man came & it was appropriate. Still needed prompts to keep dolls on floor. Set up living room on top. Picked out correct pcs but had trouble pointing them in correct direction. Prompted that furniture usually faces middle of rm. Put pcs away nicely. Beautiful behavior. DRO.
Did kitchen on top. Tried to use the miniature pieces [I think this means the tiny forks, knives, cups, etc.] but he was rigid and didn't deserve it. He wanted them badly though. Every time he lifted people off the kitchen floor I took them away. Told him people do not fly & they have to stay on the floor. He set up kitchen nicely -- matched colors. DRO'd facing. Putting away was a prob - He had little rituals i.e., putting in the [can't read handwriting] before putting it away & walking all the people in the door first. Made him do it over & said he was acting like a baby & that's why he couldn't get the miniature stuff.
Kitchen inside house; living room on top. Needed prompts to keep dolls on the floor. Set LR up with couch in front of coffee table. Used square cabinet as a TV. Put chair at 90 degree angle to couch. Had a hard time w/plates & cups. He wanted to put them in sink instead of doll, but he listened when I told him that the doll has to do it. DRO'd. When we were putting stuff away he put dolls in through door. I used overcorrection & he finally did it right way.
Kitchen inside; LR on top. Kept dolls on floor w/o prompt. DRO'd great job. When putting away again tried to put doll through door. Wouldn't let him; otherwise good job. Then was moving fingers strangely & making noises w/furniture. Had him do it over until he got it right and then reinforcements.
Kitchen - Pretty good job. He started out by asking to build a LR. I said "no, we can only do the kitchen and only if you're good can we do the LR" -- I hurried to engage him in kitchen only so that he wouldn't talk about doing the LR anymore. This worked & he didn't persev on the idea, although he did ask at end to do it. Play & convers were good. He set kitchen up & some pieces didn't fit well so I had him problem solve it by throwing out ?s like "Can you open the refrig door if the fridge is over there?" He finally set up nicely. People moved off the ground a couple of times. I took away person & he didn't pose any arguments. I DRO'd this heavily & gave it back as soon as he started to play appropriately. Put away things nicely. DRO'd eye contact throughout.
Nice kitchen. Was a little rigid about LR. Wanted to line couch & chairs up in a row. I suggested L style. He was flexible so he could set up other furniture. Bathroom -- walked person through house w/o going near door. Kept person on floor. DRO'd. At end almost tried to stuff person through door but controlled himself. DRO and scripted pride statements.
We built kitchen on top of house. Did this well. No prob picking out furniture. Set it up nicely. LR - good. Tried to set up seats in one line -- put chair at a diagonal & said "I like to be flexible" BIG DRO. Put together bathroom. Needed some direction putting toilet next to sink & not in front of it. Good job otherwise. DRO. He was so well behaved & listened so well that he got to make the bedroom. Played very appropriately w/dolls when house was complete. Great job cleaning up. Natural Reinf -- got to play w/miniatures.
Started out nicely w/an agreement that he would get to build other rooms if he did nice kitchen. He became very rigid about arrangement & fridge color [there was a yellow & pink piece that looked the same]. I told him to use the same colors for the appliances b/c kitchens usually match. He started w/weird grimacing & hand stuff as well as head shaking. Threatened to take away whole thing if he didn't stop. This turned into an argument on his part -- I remained neutral & put away the house. He hit me & pushed. I cont'd being neutral & told him to sit down, be quiet & calm down for his T.O. He finally sat quietly. When he was done I went over T.O. in detail. Why it began, why it lasted long, what could have happened if he hit me again (i.e., he almost pulled my chain off -- I said I would have been very upset). He listened nicely. DRO'd good listening & calming down.
Worked on kitchen. He had to teach [playdate] how to build kitchen. Did a pretty good job so I let him use miniature utensils but he got stuck on putting little spoon between the edges of the kitchen floor. I gave him a T.O. - Took away toy. He pushed. Told him to calm down or T.O. would last longer. I remained neutral. He finally calmed. Said he wanted kitchen again...said please, but I didn't give in. Said that sometimes even though T.O. is quick & short, you can't always have what you want. Got angry; started to argue. I ignored this time & just turned to [playdate] and asked (in animated voice) "What should we do next?" -- [name] popped up and said "Let's play!" I DRO'd him for forgetting about the kitchen, etc. Nice job.
P.N. - Please don't use miniatures! [re: forks knives, etc.]. Each room can be a reinforcer for the previous room. If he does all the rooms well he can play with the dolls.
Did kitchen 1st & then LR. Couldn't do BR b/c he didn't do nice job w/other rms. Was stuck on steps & door. Was flexible w/door. Able to leave it open. Lots of DRO. We played w/dolls in house. Nice job. No prob cleaning up. DRO. Sorry - we played w/dolls even though he didn't do all rms. I didn't look at directions carefully & told him if he does LR and kitchen he could do BR & gave him doll play for being flexible about door & forgetting about steps.
Beautiful job - He worked for stairs. He build the kitchen, bathroom & BR and then got the stairs. Wasn't rigid about anything. Gave him a lot of freedom w/the people he chose. We had a great doll conversation. Mom, dad, baby. Dad woke up, cooked b'fast for baby. Mom did dishes and drove baby to school and drove Dad off at work. Heavy DRO in the beg....then he was amazing during play. DRO'd a lot at end also. While I wrote notes, I let him play. Excellent job. No babbling! Used characters very nicely. Little weird stuff. Great job!
He built rooms by himself. I sat at a distance & told him that when the entire house was built, if he did a quick, good job, we could play w/dolls. He did an amazing job building LR, BR, bathroom, kitchen. Then great playing w/dolls, mommy, grandma and grandpa. DRO.
P.N. - All read [therapist/date] notes. We like the idea of having him do this independently!
Followed [ther's] idea about sitting back & letting him build rooms independently. Did amazing job. Quick. All the rooms done in 2 to 5 min. BR, LR, bathroom, kitch. Nice & neat. I don't think he did any weird stuff b/c he probably didn't have time. He got stairs & people as a nat. reinf. This was nice & funny. At one point I decided my person had to go use the bathroom. He watched the lady go downstairs to the bathroom. He said "Why are you going to the br?" I said, "I have to urinate". I sat the doll on the toilet and he said, "no silly, you have to stand up." Of course I was rolling w/laughter. I explained simply that girls sit & boys stand. Nice job.
P.N. - Please stop giving the stairs as a NR [natural reinforcer]...it will make him rigid.
First thing he requested was stairs. Told him he can't have it today b/c we were going to make the house w/o stairs. He didn't argue. DRO'd. Waited nicely until I brought the doll house in. DRO'd flexibility & patience when he was finished. I let him construct rooms on his own. LR was on top. He did nice job. Doll convers was very good. After we were done, I let him play on his own until I wrote notes. I noticed nothing bizarre. He was having very nice convers with the dolls! Lots of DRO when putting it away. He tried to set up some conditions about getting to play w/ the house later, but I ignored his comments & redirected him to put on socks to go out for Ball Play drill.
He didn't request stairs. Lots of DRO for getting into activity quickly. Set up rooms quickly & independently. There was some humming. I didn't interfere but I did DRO quiet working when I could but not directly after he stopped humming. Doll play was nice. I even told him he could walk his character through the door and he controlled himself. Lots of DRO. I was grandpa & I brought a TV so I moved some furniture in the LR around to make rm. He was flexible about this -- DRO. Some difficulty during clean-up but overcorrection / redirection worked.
P.N. - Good! Always use overcorrection and re-direction for cleaning up.
Requested stairs but accepted "no". DRO'd flexibility. Set clock at 12:50. I made the doll change it and he was fine about it. Lots of singing but I didn't interfere so I let it go. I will DRO its absence later (if it ever ends 0-:) He built all the rooms on his own & interacted beautifully in doll play. When I asked him to feed the cat he said he didn't like food (interesting). Cleaning up was difficult. Overcorrection & redirection worked though it took a long time. He hit me earlier in the drill w/a piece of doll furniture. We put it away (I was neutral) & I told him we'd do it again when he controlled himself. He apologized & calmed down so we started again.
I took the stairs away before we started. He asked about them but accepted that we couldn't find them. DRO'd flexibility. Stuck on making clock [doll clock] 10 to 1 again. Jim talked about how time changes. He stopped being rigid. Getting stuck then on having people talk through upstairs window. Put away nicely at first and then singing a little. Responded when Jim told him to do it quietly.
Before I brought house in, I told him I was doing so. He immediately said OK, I'm going to build all the rooms AND STAIRS too! I just neutrally said that I think the stairs are missing. He didn't bring it up again. DRO. Just gave him the condition that kitchen has to be on the top today. He didn't resist. DRO. Absolutely no weird thing occurred while building. No twisting, turning furniture, etc. Worked quickly & quietly. DRO'd this heavily since singing was a problem today with other breaks and drills. Very nice convers too. Told him he can play on his own until I finished writing notes but then he'd have to put them away.
Did a beautiful job setting up rms. We put bedroom on top. No probs with clock. He asked me what time it was (7:30) & he put hands on the 7 and 3. Didn't ask about stairs. Played appropriately with me using grandma & grandpa doll & put things away nicely. Only problem was clicking lamp into dresser which straightened out quickly w/overcorrection.
Excellent work - Beautiful set up w/rms. I asked if I can do some and he was flexible and allowed me to do bathroom & kitchen. Lots of DRO. Asked about stairs once but didn't mind that they were still "missing". Convers was beautiful. He was grandma. DRO'd that he didn't take both grandma & grandpa like last time. He did something "different" for a change. BR was on top. I let him play until notes were finished.
Doing lots of beh that interfered w/putting dollhse together so I neutrally said we'll do it later. Had a fit. Told him we could do it after he does a good job w/something else. Interfering beh were twirling objects in fingers & getting up to put lamp under blanket. He sat down and we went to expr. categories. Went back to dolls. NR - Oh the Places You'll Go. Putting lamp under fireplace before and asked me time to put on clock. So when we went back to this asked for those right away. Took them away on break. Then was piling furniture on top of ea other on floor. Gave SD - Put the kitchen in the house. He listened and I DRO'd. Lots of singing had to be ignored but tried to redirect by having convers. This worked. Refused to do LR so I said OK and started putting dolls away. Changed his mind quickly. Talked about doing house calmly in beg b/c he was body jerking. As I thought, didn't want to do LR b/c clock wasn't there. Taking long time & hiding bathtub so I put away the house. All this was done neutrally -- he got upset so I said next time he'll do a better job.
I told him to do three rooms & surprise me. He did LR, BR, bathroom, quickly & relatively quietly. There was some quiet humming that stopped quickly w/redirection. He was the daddy & I was the girl. Great job playing & putting things away quietly & quickly. DRO'd.
Let him do this independently. A bit slow at first but I told him I was really excited to see what it would look like when he finished and that I wanted to play dolls w/him. Worked quickly and COMPLETELY quietly! Lots of DRO. Was sticking stuff in the fireplace. Redirected. When I talked about why he was doing so well (being quiet), he started making mouth noises, so I pretended to go to BR & watched him. The mouth stuff gradually stopped, he quickly finished the house & came after me to tell me he was done. Then we played dolls. He was grandpa and I was granddaughter. Let him continue playing until I finished the notes. Putting stuff away was resistant. Didn't want it to be put away at all. Explained that he got to play w/it for a while & that now it was time to do something else. He put it away w/some noises.
Set up rooms quietly (LR on side-outside, BR on top) & quickly w/ [little bro] in the room playing with Play Doh. Lots of DRO w/statements about how little brother is learning to play nicely from [name] to which he said "I know" and DRO'd his brother! Beautiful job w/ rooms -- Didn't put away anything in fireplace. Accepted absence of suitcase w/o a prob. Played w/dolls. He was mommy & I was daddy. In the middle of playing he left situations & went to get grandfather doll. Game stopped. Reminder about walking away from friends. Put objects away nicely & quietly. DRO.
Set up rooms. LR was on top. Did a few weird things w/the fireplace. Put lamp under it. I took it away & asked him if he wanted to play w/it. He said yes. Told him he can only play w/ it nicely. Told him he was an angel all along & hope he could continue this behavior. He played well afterwards. DRO'd appropro play & quick set up of rms. At end was a little rigid about putting things away -- redirected by telling him he can read his Madeline book & he went for it. DRO'd flexibility later. Nice work.
P.N. - Careful -- no N.R. mid-drill [N.R. = natural reinforcers]
Set up house indep. Bookended no silly stuff with furniture, w/lots of DRO for putting items down quickly. I had to intervene as he was doing the 2nd room & he was going through box of furniture & making cat noises & playing w/cat. This interfered with his ability to set up rms. Redirected by asking him what room he was doing next. This worked. (He has no prob w/setting up this dollhse -- should we move on to something else...i.e., extra items or cooperative setting up of the dollhse?) Two young girls (friends) played together. He was very hesitant not to use adults but went along w/it
P.N. - Start doing cooperative setting up and get him to ask you to join him.
Built it w/him. I arranged things quite differently on my part (e.g., two sep bedrooms, LR & BR on same floor, bathroom & kitchen on same part). He was very rigid, esp about my putting clock in BR. Redirected by making him ask ?s -- e.g., can there be more than one BR? This worked. Prior to that he was trying to move the furniture I laid out. We talked about how people get angry when you mess up things they make. Then he played nicely. DRO'd flexibility. Putting away was awful.
Lots of rituals. Used overcorrection. He screamed each time I did. I told him to do it right & I won't take them out. Didn't listen so I neutrally put them away. Let [little bro] play w/it b/c he wouldn't let me put it away. He tantrummed & said he was younger and [little bro] was older & he couldn't play w/his toys. I ignored him.
P.N. - Get him to INVITE YOU TO PLAY
You: "Would you like me to join you?"
Him: "Yes"
You: "Ask me..."
- Sometimes say "yes" and sometimes say "no"
- Do cooperative play with each of you being a different character.
Notes please.
We worked on this for about 15 min. Very nice throughout except for when we got to end. He put away dollhse pcs very ritualistically. I had to overcorrect & this escalated to grabbing, pushing & ultimately a t.o. Tried to redirect when he came back, but still did the same behaviors when putting away. At beginning I prompted him to ask me to play w/him by saying that I was bored w/my toy. Asked him if I can help him build. He refused & said you can play w/the people when I'm done. This gave me opportunity to tell him NOT to forget to ASK ME! He did remember -- lots of DRO. Played beautifully w/dolls. Lots of DRO.
At 1st he told me he would set up rooms & I would play w/dolls w/him. I told him that's no fun. If he wants me to play with him he has to invite me for the entire thing. He did. DRO. We cooperatively built house & I prompted him that he couldn't touch other people's furniture & move it. He balked at 1st when I placed things in diff places but he complied & participated wonderfully. Tons of DRO & really good play. We finished on a positive note & he put things away nicely with constant DRO.
At first things were great -- played cooperatively, compromised, ignored [little bro], etc. DRO for all these things. We built together & he was flexible. Then when I asked him to clean up he refused and then was ritualistic (banging pieces, etc.). Stayed in clear discrete trials -- n/e, n/e, prompt [n/e = "no" equivalent] -- he hit me & Jim gave him a t.o. -- then put away Barbie dr.'s office.
P.N. - Keep using new doll house furniture, castles, etc.
While TV was on new channel...very nice setting up. Np persev on any particular toy. Lots of DRO for quick setup of all rms. Got right into a doll convers that was nice & coherent. Lots of talk about school & what he did at the firehouse he visited. Pretended to drive him to school & Drove him off with grandma & mommy. Very flexible about toys -- lots of DRO. While I wrote notes, no weird behs, except for singing "This Old Man" & trying to rhyme very strangely. Tried to redirect by conversing w/him. TV didn't seem to interfere w/his performance.
Used Barbie kitchen. We were husband & wife. Cooked dinner, put away the food from shopping, washed dishes, used the blender & food processor. He stayed in character & did overall great job. DRO'd.
Dollhse. Set it up together (TV on news channel). He had some difficulty leaving my pcs where I put them but no equivs & redirection worked. Play was OK; needed redirection away from windows & doors, but it was OK.
Dollhse. Set up. Had some prob w/lamp & fireplace. I spotted him putting lamp under fireplace. I let him do it & then, when it was time to have a convers., I made believe a fire had started b/c of it & burned down the entire house. Had the fire dept. look for the arsonist/culprit. He of course got very into this & wanted to make "excuses" about why the lamp was under the fireplace. I had detectives reprimand him by throwing away all the burned furniture & apologizing. Good lesson -- he said he learned to put things where they belong. Let's see if he remembers. I DRO'd good attn, play & construction.
P.N. - Great -- let him fail. He could handle this now & we can find good opportunities for teaching lessons.
Nice job. Cooperatively put house together. Needed prompt at beg to not move my pieces but otherwise no probs. Played nicely w/DRO for following my lead.
He & I both built the rms. Very nice job - no weird stuff w/toys. We sort of contracted in the beg that he would have a surprise for me -- i.e., move bowels -- He kept it at the end. Convers was great. Did whole skit on little Joey defecating on his own in bathroom w/o telling parents. He was very into this. A little rigid ending the "show" but redirection worked. I just started putting away things that I built. He was OK. DRO'd flexibility.
Some really bad grimacing & toy tapping as he built the kitchen & also opening & closing the window non-stop. I took off the window & the kitchen & redirected to having him build another rm. This caused a tantrum. I tried to ignore a lot of the behaviors. He was very upset. Almost hit me but managed to only squeeze himself on me. Megan told me to open & close his window. I did this and asked "what's wrong with this?" and he said "it's weird - you shouldn't do it." I told him he was right & that this was why I took his window away. He denied this -- I neutrally moved on. DRO'd being quiet & flexible as he started to build a new rm. Convers was good & so was play when we got into it.
Big dollhse. Wow! Really nice. We were both very absorbed in the details. he was good w/playing, setting up & convers. He wanted to open & close doors a bit too often, but redirection worked nicely. He was flexible w/the furniture & it's placement in rooms & with the characters. Lots of DRO. Needed a little n/e, n/e, p for eye contact [no equiv, no equiv, prompt for eye contact] and switching attn. (not too bad). All else was very good.
P.N. - This is DOLLHOUSE ONLY (which he perseverates on in school) to desensitize him. While you can include some of the themes we're working on in Play With Narration, remember you're restricted to the doll house, it's rooms and furniture. P.S. - Barbie extras OK here too; NEVER USE Victorian giant doll house...if he asks. tell him we said he's "not allowed".
Used schoolhouse. He did great job. We did show & tell and my doll asked his for pointers on how to do well. Nice job. Stayed in character, but after drill, in play, he acted crazy. No interventions worked. Kept playing w/him but he'd immediately go back to stims & babbling. Other kid's statements went ignored. Narration worked only for a moment & he didn't respond to switching attn ?s Got a T.O. from Megan.
Used schoolhouse. I tried to work on concept of sharing/asking instead of telling & grabbing. Worked in context of school situations i.e., in playground, outside, classroom, etc. Asked him to comment on all that was appropro & why. He understood that sharing & asking is better b/c kids will like you more. If he grabs or acts like a bully, kids will leave him.
Dollhse. Played beautifully! Assembled rooms w/me. Needed one n/e not to move my pieces but then did a great job. Was not bossy. DRO'd his not telling me but asking me things. Dolls conversed well & went to movies. He was great - stayed in character & did not get stuck on any pcs. Lots of DRO. WE played for a long time & ended on a positive note.
Used some old playground figures. Told him to help me set up. He could barely move b/c he had to go to the bathroom but wouldn't. I just pretended everything was OK & went about conversing w/ dolls. Did a whole story on the kid in the playground having to go to the bathroom to make. She didn't want to make in pants b/c other kids may laugh & not play w/her. The outcome was she went to bathroom on her own & was proud of herself for not making in pants. He listened w/intensity.
Dollhse - Nice setting up. I purposely did things to see his reaction, e.g., put cat in LR before all furniture was in the house. He moved it & we talked about bossing around, etc. He was flexible & not bossy. DRO. I moved his things & had to prompt a reaction. Played nicely for most part, ignored me at times so I told him he made me feel like he didn't want to play w/me. After some nonsense about being disappointed in me & other kids statements, he stopped ignoring. DRO. Made dolls do weird things. I used "other kids" & he told me it was b/c they had magic so I had him narrate his play so I'd know he wasn't doing weird things. Cleaned up nicely. Natural Reinf - keeping out the dollhse.
Great play. Beautiful convers. Nothing weird. Ans. irrelevant ?s on the side (should we be doing this -- sort of like switching attn?) P.N. - YES!!! That's great. No weird play. DRO. He did get rigid about ending dollhse & yelled at me. I played it out like a kid & pretended my feelings were hurt & started to cry. This caught his attn. Debriefed on what happened & what would or could happen in real school. He was attentive & cooperated w/putting things away finally.
P.N. - All read [therapist/entry date]. She brought in extra switching attn. as well as letting a rigidity play out, acting like a kid and then de-briefing.
Again, as w/[above therapist], he got rigid, but this time b/c I started playing before he finished setting up his rms. I also let it play out & debriefed. It worked well (I did this another time too - but results weren't as good. See [date/section].)
Used dollhse. Great job. Setting up was great. I did lots of switching attn. w/him while we did drill. Great w/both. Doll convers was amazing. Focused on one major theme throughout the drill (sick kid eats good food, feels better next day). eye contact was also very good. Gave him regular DRO. Nice.
Used school house. He got rigid about having "King Arthur" in the school. It was hard to redirect at first b/c he was banging on the door & asking for his servants. I picked up the teachers & asked the class to line up. Started talking about how kids shouldn't be wearing costumes to class & about how only on Halloween can they do this. He was rigid about accepting this but I remained neutral & persistent until he submitted. He finally did nice job. Defended "Jerry" (King Arthur) by saying it was only a "pretend sword" he had. Teacher gave lecture on school rules. Finished up nicely. Had a hard time looking up when name was called.
Used school again b/c I wanted to work on listening to adults. He was rigid & doing lots of tapping w/dolls. Wouldn't stop. Tried to have [playdate] redirect but he had little effect on it. He got into "a little quarrel with [playdate] over a toy." They started to "fight" just like kids -- e.g., I had it first -- I took the opportunity to act like a disciplinarian teacher. Took away the school (& castle b/c he started to drift towards it) and "yelled" saying no sharing or playing. I made it look as if it was [playdate's] fault so that he couldn't act up, but then I generalized to the "whole class". He became VERY cooperative. Almost scared! Did everything I asked him to & listened, paid attn. & gave very good eye contact! Kept this going as long as I could.
Used dollhse. He was letting out a lot of S behaviors [s = stimmy]. I remained very neutral about it. He banged toys, made lots of weird sounds, etc. Convers was hard b/c of his beh. He did help to set up (even though he was rigid about where the BR went & how many beds there had to be). Helped to clean up. Complimented him on this.
Joined him in wild play -- tried to redirect (stop fighting at the castle). Worked well. I asked him why they're always doing this (fighting) and he said it's their last day. I said "Hallelujah!" Let's fight until everyone is dead (reverse psych). This got his attn. BIG time. He obeyed the rules that those soldiers who died cannot be woken w/any magic sword & they can only become alive tomorrow morning. Also - there will never be any more fighting in the castle (let's see how long this lasts). He totally stuck to this & continually responded when I called [name]. Gave natural praise.
P.N. - [therapist name]...He can fight (kids his age do); just make sure the fighting isn't stimmy.
Used dollhse. We made some compromises & we ea got to place some furniture. No fighting - DRO for respecting my choices. Played appropriately & stayed in character. Able to use narration when character asked what he was doing. Put everything away w/o a prob. Great job. DRO'd.
Worked w/castle soldiers but I sort of moved away from the castle, He was very flexible. Got him to change all his characters' names. We did Hamlet w/major script changes. He was really getting into it. eye contact & attn was good & he was excellent on following leads. Nice job. No wild or weird play. Gave him lots of compliments.
Played w/schoolhouse & dolls. He was flexible about set-up & played nicely. Stayed in character. No strange voices. Good job.
We used dolls & Lego airport he built. What a disaster! He completely ignored me & began stimming on elephants right in the middle of our dolls talking to ea other. He was stimming on Dr. Barbie's stethoscope so my doll walked away & Dr. B got bossy & hit her, so another Barbie, who was a police officer, put her in jail for assault & resisting arrest. He was upset b/c Barbie was in jail. [we had some fun therapists, we did]
Dollhse - good; worked through silly rules, etc. compromised, gave him what he wanted & didn't. When I wanted to stop playing, he walked away & ignored me. He picked up a brush & got crazy, roughly putting it through my hair (= hit). Told him to "take time for himself" [P.N. - Don't label it "taking time for himself" pls. Just do it.] - he refused. I ignored him. Asked me later if I was ready. Told him to let me know when HE was by showing me he'll stop w/silly stuff (hitting brush on things, etc.). I waited neutrally until he did.
[This drill went on for another FULL YEAR!!!!!! after the last entry.]
This drill lasted with different names for over two years. The descriptions on the cover sheet for the first part of this drill were as follows:
Bring [little bro's name] in and have him play with a toy while [name] watches (if brother isn't available, you play with the toy). Do not let [name] interrupt for a long time. Create your own SDs like:
"You can't grab...but you can watch." "Let me do it." "Hey, I'm/[bro's name]'s playing with that", etc.
Eventually, allow him a turn and share; sometimes grab it from him and prompt him to express displeasure with you (get him to say "don't grab it", etc.) Ask how he feels about you interrupting his turn (and prompt appropriately), etc.
LATER ADDED TO THIS DRILL COVER SHEET:
Work on Parallel Play here and in other drills, but report it not only here (or other specific drills parallel play occurred in), but in "GENERAL" so we never get into the situation where he's parallel played in too many drills too often!
A NEW COVER SHEET APPEARED APPROX 2 MONTHS AFTER THE ABOVE BEGAN (WE SUPPOSE THIS DRILL IS ONE OF THE FIRST THAT SOME MAY CALL A "PEER IMITATION" DRILL--THOUGH WE'RE NOT SURE...)
THE NAME SEEMS TO HAVE THEN CHANGED TO PLAIN OLD.....
...PARALLEL PLAY
Description: You do one thing while he does another. Prompt comments from him about what YOU'RE doing. He must show an interest in what you do.
Therapist and Parent Notes [P.N.]:
Nice sharing with brother. After some time I let him ask for turn.
Did well w/brother and reacted appropriately when I grabbed the toy from him. Needs work on letting me have a turn. I asked him if I can have turn and he said "no".
Played with Mr. Potato Head with brother.
Played Bang a Ball with brother, daddy and me (Megan) and did fine.
Played Mr. Potato Head again (sorry - had to come up with something quickly to end stimming on break).
Hammering wooden pegs. He was not watching brother play. I had to prompt him to watch brother. He still didn't watch. Finally, I told him he would have to stop playing with brother b/c he was being rude. He finally said he would stop being rude. Then played nicely.
Both boys were good at sharing and taking turns [In addition we had a turn-taking drill that began with building with blocks and progressed to playing board games...this drill went on across all three years of therapy]. He even invited me to play. At one time he didn't give bro a turn & then admitted that he was being SELFISH. When I grabbed toy away, he acted appropriately and said "You're being selfish [therapist name]; don't grab!"
Roly Poly w/brother. Brother not really interested. We then watched brother hammering some stuff. [Name] didn't get a turn b/c he wasn't watching brother play.
Brother again not too interested. [Name] was patient and attentive and offered me a turn. When I grabbed toy from him he said "that's not nice".
Brother sleeping so I did this drill with a book. He did well.
We took turns drawing. He was attentive and responded well.
Played with memory game. Excellent attention.
Brothers played w/schoolhouse. He was distracted and spacy. He pushed the toy at me too hard and I had him hand it to me again nicely.
He wouldn't share his toy w/me after I shared mine w/him so I took mine back and told him I did this b/c he wouldn't share. He was very unhappy.
Used one of his old toys that is now brother's. Brother didn't know how to use it so I showed [name] how to show brother. [Name] had to take brother's hand and place it on toy. Nice job.
He was non-compliant w/me in the beginning. It took a while for me to reel him in (w/Jim's help of course). After he was under control and I actually started to move around and being a distractor, he put a toy car in a specific place and told me not to touch it! I let him sit down then I picked it up. He was obviously upset but I got him under control. It was great after that...Switching attention [something we were working on within drills now].
Sharing was great. We played with the shape sorter. He understood when I was selfish and rude and v.v.
Sesame Street toy. Brother played and he watched. He was attentive and even commented on what brother was doing.
Brought him into the living room to play Magna Doodle with brother. He didn't want to share and when he was told to give toy to brother, he threw it at him. The drill was interrupted with a t.o. due to his tongue clicking.
P.N. - Switch rooms if possible.
[Playdate], [name] and me took turns blowing bubbles in the living room. Good job.
P.N. - Let's tone down the talk and get into more quiet play and sharing (try to let the talk be more natural...less structured). Also parallel play with him -- while he plays, play w/something else w/ the object. i.e., both peacefully co-exist. Notes please.
Played with cars on mat with brother. Working on getting him to tolerate brother playing with stuff in his own way.
Parallel Play combined with Arts & Crafts drill. He's busy looking at my work and not at his own. Began babbling so he got a t.o.
P.N. - Work on sharing with brother as much as possible!
(In "School"). He needed to be prompted when [other therapist] grabbed his checkers from Connect 4.
Brothers played with doll house. He was restless while watching but didn't touch. They read together too, but he kept trying to stim on brother.
Played stacking rings w/brother. I had him hand his brother the rings in the correct order but did not allow him to place the rings on the stand. His job was to help his brother only.
With [other therapist] we took turns playing Perfection game. He had to be prompted to tell [other therapist] not to grab. He tried to grab a piece from me and lost his turn. Didn't do it again.
Brothers and I played shape sorter. He explained to brother how to play. Tried to grab out of brother's hands once.
We played Squiggly Worms. We took turns. He cheated a couple of times b/c he wound up the apple twice, so I told him that he lost his turn. He understood and played nicely. We both took turns.
Animal puzzle - waited patiently. When I was finished asked me if he could go now. Didn't let me put piece in and I cried because he didn't share with me.
Very nice playing with brother. Helped brother fix his animal puzzles. Brother really cooperated. [Name] did nice job and didn't stim on brother.
He built a house of blocks. I handed him blocks and he built. Did nicely. Waited patiently for me to give him blocks and didn't grab. Good cooperation.
We played with a puzzle. He did well. Needed a prompt to say "share with me".
Brothers played with shape sorter and a car. Brother took the car and [name] ran after him. He had to be reminded to let him share. Showed him how to use shape sorter and gave him pieces. Shared his food w/brother. Asked brother if he "wanted one"? (Chinese noodles).
Played with bubble gun. He really wanted it and I wouldn't let him. He asked why and I told him b/c "I'm selfish". Then we shared.
P.N. - Add in Sustaining Conversation (see Sheet).
Shared Tinker Toys. He played appropriately. Conversation about my friend Patti and when we went on vacation together. I made Patti out of Tinker Toys.
Brothers and I played w/Lincoln Logs. He didn't play appropo; kept knocking down what we built and putting roof on his face. I put them away and he got VERY upset.
We played with a cash register. I was buying pumpkin. Incorporated the Sustaining Convers drill. Did nicely. I talked about Halloween events. He asked appropro ?s. He needed some prompting but it stopped at a minimum. Good work.
Played Perfection game. Very good. He played and shared nicely. Great eye contact
Parallel Play - with Play Doh. Talked about what we were making, etc. He did ok with some prompting.
Played with puzzles. I had him carry them over to me from on top of the dresser. We talked about my dog and the boo boo on her eye. He needed prompts...w/o them either asked "why?" or was silent.
Watched brother play w/shape sorter. We talked about what brother should be for Halloween. He had a hard time watching brother w/o touching him. He would either try to touch him or not pay attn. Had hard time sitting still.
We played w/spaceship we built from Tinker Toys. I ignored him, rolled over toys and broke them to show him how it feels when he does that. [Other therapist] was selfish. Then she shared and had to go home and even took "her" toy with her. He was upset. Said "could you give me that toy...please?" She explained that she had to go home.
Sharing and play was great. We played house and I visited him at home. We watched TV and then went to the park. I grabbed a lot of toys from him. He kept saying "Hey you're being selfish, you're not sharing." I kept pushing him for more comments. Prompted him to say "please, let's share....it's better that way. I want to play also". "That's mine...you can't take it away", etc. He caught on and he did great with this and had very good eye contact [THIS IS THE THERPIST ENTRY REFERRED TO IN ****PN A LITTLE FURTHER ON....]
Tinker Toys with [playdate]. Parallel play. Nice talking about what they were making. Then helped her with shape sorter. He needed prompts to watch her.
P.N. - Do this a lot with other "kid" in joint therapist School drill. He needs it badly in school.
Brothers shared dolls; at first played well. Brother sat on [name's] doll set-up. I asked him how he felt about that and he said he "didn't like it". I reminded him that he did this in school himself. Gave him a T.O. for not looking 3x during this drill while I was talking. He made no attempt to look at me when he answered.
P.N. **** Everyone look at [therapist note/date]. We have to generalize his comments out more. Prompt him [script him] through this kind of thing often. Thanks!
We watched a little girl playing Tic Tac Toe in the park. Then we played. I took his turn and we worked on saying "you're skipping me; don't take my turn." Needed prompts.
Played Tinker Toys w/brother. Nice parallel play for some time. He pulled toy from brother. Worked on having him watch what brother was doing. We talked about what he was doing. Sust Conv was not bad. Went to park and he sang rock-a-bye baby w/me while swinging the baby to sleep on the swing.
We played w/the doll set. I played in the "living room"; he played in the "kitchen". He watched a lot of what I was doing and seemed curious. Asked spontaneously "What are you doing?"!! He then started to play with his kitchen set. I threw in a little of the sharing stuff. He was good at this, esp when I started grabbing. He's gotten better at expressing his thoughts in such situations. Good eye contact
P.N. - THIS DRILL HAS CHANGED -- Please read NEW first page. The focus is on conversation and getting him to comment on what you're doing.
He played with blocks and so did I. I made a big tower, used a lot of blocks. Had to prompt him to ask me about what I was making. He was a bit curious but seemed more engaged w/his own work. I prompted him by slowly taking his blocks sort of inadvertently so that he can at least look at what I was doing. This stimulated him to look but I think he got the impression that I was being selfish. I started talking about what I was making. This got his interest a little but he still didn't really care to ask what I was making.
I did shape sorter while he played w/Legos. At one point I started to hit block on shape sorter. I kept doing this for a long time until he said "you're putting that in the wrong place", so I asked him to help me. Then he kept watching me and didn't go back to his work so I had to tell him to. Then I walked away while we were playing; he didn't notice, so I prompted him to say "where are you going? come back and play with me".
P.N. - Be creative. Try to engage his curiosity in your work [refer to therapist note/date]. Make what you're doing something you know he'd be into.
He made a train out of Thistle Blocks and I used Legos. My Lego animals were talking to ea other. He was looking intently and when he started asking one of the Lego animals ?s, I prompted him to ask ME about what I was playing, doing, etc. and then he went back to his work and I asked him ?s and then prompted more ?s and asked him for help.
He played with med-sized Legos and I played w/smaller Legos. He was interested in small Legos and indep asked me what I was making so I told him and invited him to play w/small Legos too. I asked him what he was going to make and he said an airplane just like you. Then I told him my airplane is going to [state]. He told me (w/o prompt) his is going to [another state].
I took out blocks, built a house w/Lincoln Logs and asked if I could use the fireman doll he was playing with. He gave it to me & played w/the blocks. Asked if he could have it back b/c I share so nicely. I told him as soon as I was done...my log cabin went on fire & the fireman came & put it out & knocked the house down. He was very interested. I had to prompt "what are you doin?" when I was building the house, but was very interested in the fire. Asked good ?s e.g. "why are you destroying the house?" DRO.
Good cooperation, eye contact and symbolic play. I asked him what he was doing as he played. He spoke appropriately about what he was doing. Good playing with figures. He asked me what I was doing also. Asked to play w/my characters too. Good reciprocal stuff happening.
Tinker Toys with [playdate]. They each built something to climb. Then prompted for him to look at hers. She looked at his w/o prompting.
Blocks. I started out building a tower. He didn't seem too interested in it. I prompted him to look at me and ask ?s. He didn't engage in any of these activities. He also wasn't too interesting in playing with the blocks.
I played with Lite Brite, which he loves. Had no problem gaining his interest. What was great was that he listened when I told him to play with his Lincoln Logs and was really into making a bldg. Needed prompts to ask me ?s, but asked right away and answered my ?s immediately. DRO.
I played with Thistle Blocks; he played with shape sorter. I yelled "oh no" -- Megan prompted him to ask "what's wrong?" - I told him that I needed a piece but I couldn't find it. Megan prompted him to ask if he could "help" me. I said "yes". Then he helped me and found piece.
I played with maze toy; he w/train tracks. Prompted him to ask me about what I was doing. Then prompted to ask me to play trains w/him and I built by myself and he built by himself. Prompted a conversation.
Played with the Musical Band toys. We had a little concert. School children came to see us. He named the band "Guitaro". He sang a little -- pretty good. In general this scene was a little bit slow and lacking in enthusiasm. He seemed a little too concerned with detail i.e., school bags in school audience. I ignored his comments and moved on [our Playmobile school characters had school bags and he always persev on them]. Also told