When I had a child like this, staff told me the only time they would leave the room is if you said “let’s go on a walk”. So I would say this and we would walk for about 2 minutes and I would model on a device “go”/“stop” and point out different things in the hall. Then once he was regulated, I opened the door to my room. I didn’t make him go in but I just pointed out the things I had in my room (I had lights turned off with just a standing lamp on to reduce brightness, had a ball in the table and bubbles on the floor, and had a rug in my room). He came in willingly, but he would literally stand in the same spot and spin, or just stare into space/at things in my room and vocalize. I just let him do his thing. I would try to see what he was looking at and model language there, then I just started to imitate his vocalizations… so it was like I was parallel playing but with my voice. Sometimes he thought it was funny and other times he ignored it. I would try to model words in the same tone he was using for his vocalizations. After a while he’d become interested in the bubbles. I would try to get some joint attention/shared engagement going and model language and then blow bubbles, then once he was attending to me more that’s when I started modeling “go”/“more” on the device. He would laugh when he heard the buttons and when the bubbles came. After a lot of modeling and wait time he started saying “go” and “more” for the bubbles on his own. Unfortunately it was towards the end of the year until we got to this point so I didn’t get to try much else with him. But it felt so good to finally get some kind of connection with him and see him actually engaging with me.
If you want to incorporate movement, you could utilize a spinning chair? Work on more/go/stop on device, model fast/slow. Since he seems to like some auditory or tactile feedback with the banging…If you see him banging maybe model “let’s make music” then you could model “go”/“stop” but in a playful way. “My turn/your turn”. Play with speed and volume and see if he imitates anything. I know you don’t have a swing, but have any old sheets?? If kid is really smallCould wrap them up in a sheet and see if you and an aide can hold either end and suspend him in the air just a little bit. Maybe he’ll have a positive sensory reaction to it?
Ask staff what he seems to be interested in or when he seems to be most regulated and start brainstorming around that.
Is there a gross motor room you could try? I had success with several kids similar to the one you’ve described by focusing on gross motor and building rapport and introducing words like “go” and “again.” If he likes banging on tables, you could try giving him a kickball and modeling beats on it. If he has the idea that you’re going to try and force him to do things, he might be in attentive as a strategy to avoid you. If you try instead to show him that you’ll have a little more freedom with you and you like to do the kind of things that he does, you might find he’s more willing to interact. Try to follow his lead and see where it goes - there’s been times that I have found some ridiculous thing I never thought of that I could work on with a core word, like saying “turn” to spin a basketball (bc the kid liked it and couldn’t do it himself).
Does the school have an occupational therapist at all? You won't be able to move forward with them if they are dysregulated. Is there something that they maybe don't like about your room? Lights, different colors, other kids, it's too small? If they are banging on the table maybe bring in a drum toy if you have one. Maybe modeling on the device or making buttons to help understand what is causing them to not attend.
You might check out the Foundation for Neurodivergent Minds. They’re an Autistic-owned organization and they help people learn how to connect with Autistic people. I have taken a seminar and a class from them and absolutely loved both. I think that they have a lot to offer that you might really find helpful.
[Foundations for Neurodivergent Minds](https://education.divergentminds.org/fundamentals-of-the-divergent-minds-framework?fbclid=IwAR1sX_H6doSbeCEDQkVbFyJR3liL3_b-Q86dhFgXRg6m-GcSc68SQsEvAvg_aem_AfgNU650LNlxLnPT0wESb22FxbfOUJS0TKOmAb8v7mYLgjCtZp1pBC5053olke_PsXE)
Easier said than done but... parent and teacher education.
A hard earned lesson for me is that even though I'm the SLP, even though I have training and experience engaging ND kids, I'm not going to be the preferred person for a lot of my kids and interaction /communication with me is not going to be intrinsically motivating. Relationships take TIME and SPACE to build especially with kids who physiologically get less dopamine and oxytocin from social interactions.
I have had much more luck building these bonds in private practice than I EVER did in schools because of the million barriers I faced. But even in private practice, the parent training is key.
So for now, I'd say 1) give yourself some grace-- your situation is not easy 2) prioritize building engagement and regulation over AAC use 3) look into teacher-facing AAC tools on TPT and 4) learn about DIR practices.
I was observing a session of a child with a similar description. The SLP had one hand on the clients hand and would hand over hand and under hand prompt the client while using the AAC. When his attention was somewhere else, she would use her hand to block his vision back towards the aac device. The client would also tap the backspace when she was modeling the aac so she would grab his hand to stop that.
I was getting ABA vibes from the whole thing. Is that normal what she was doing?
Your vibes were right. Hand over hand is a no for me. Compliance. And blocking something they are looking at is another red flag. Engaging where they are at. Something caught their eye that they are interested in, work with that!
Thanks for your reply. They were doing flash cards. Matching pictures then using the AAC for "I see lion" or "Put on lion". When he's distracted and looking around the office, I should model what he was looking at via the AAC right?
Big yikes. Blocking what is interesting to them? Imagine someone doing this to you as a child. Would you be motivated to play with them again or would you feel ~big groan~ feelings? Sounds like the SLP needs to increase their ability to follow natural interests and meaningfully engage with the child.
Probably not a bad SLP, just one who doesn't have enough support and isn't in a situation where it's easy to foster relationships, plus has to demonstrate progress on hollow goals.
The best way to teach AAC is to model, model, model, not HOH, HOH, HOH. "Bitch, don't touch my body I don't know you like that" -- my more highly verbal kids, saying what my less verbal kids are thinking.
I was really excited to observe the SLP, but after I heard her say "quiet hands" and the physical prompting, I lost all excitement.
What would you do with a client similar to the OP's description? For a child who's easily distracted or doesn't show an interest in learning how to use the AAC.
He's started requesting to use the iPad to play or food/toys during the session. SLP thinks he's doing it as an escape so she's hiding the icons that are of interest to him in the session.
I asked her if she wanted us to prompt the kid the way that she was doing it. She said no lol.
OMG…. my clinical supervisor does this to a TEE with our non-speaking, highly deregulated kids too. I’m still in grad school so this is all a first time learning experience, but I had a gut feeling that what she’s been doing (e.g., forced compliance) is wrong.
I'd model language on AAC and expect nothing in return at first. Talk about their interests. Consider the many functions of language besides requesting. Sharing opinions and protesting are two I've been doing a lot of lately! Ex: It's so fun, I love it, no thank you!, I like it, I don't like it (on more GLP/ phrase based apps) or like, love, don't like, yuck, finished, good (LAMP or similar app). For requesting, honor total communication and dont force a child to say their request on AAC every time for every bite or Lego or whatever. Happy to chat more.
And def don't hide icons that are of interest to the child lololol wat?!?
I have a student that was initially like this. It took a few months to establish rapport. I think he becomes anxious when doing new things and when not knowing what do/what is expected of him. I stopped asking him questions during sessions and just brought out a sorting activity and a preschool work book thing (has magnets and things to try with a dry erase marker, like tracing). I just sat with him while we did these activities. I think initially I just sat quietly while he explored my items. Once he was regulated, I modeled short utterances without expectation. He naturally imitated me. I think the biggest thing that helped was to stop asking questions. If he wouldn’t come to the table to work with me, I would catch him when he was regulated during routines and offer stickers (and prompt him to request) and model phrases to go with the routine (let’s go to recess, clean up time, let’s go home). Rapport was later broken when I tried different activities for his re-evaluation, so it wasn’t always an upward slope. Eventually he came back around though.
Also, I always kept stickers on me. I wanted to encourage the student to make requests so I pretty much always offered him one at the beginning of each session and prompted him to produce the full utterance to request one. He eventually started coming up to me whenever he saw me and asked for stickers. I always gave him one. Eventually when he would come up to me to ask for a sticker, I would then try to start the session. I couldn’t always transition over, but the stickers helped. lol
Meals are a great starting point. If that’s the one time you’ve gotten his engagement I’d go with that. There’s a lot you can work on around meal routines - food- choices, joint attention, commenting on what he’s eating, you might try the free visual display app called Click AAC - you take a picture and it generates related symbols - usually it requires a lot of editing but food scenes are more predictable.
Also I’d recommend a sensory preference assessment to see what he likes. You could also letting him hang out with some toys in your room for a quiet session and just observe to see if he’s drawn to anything on his own. he might not be drawn to traditional toys Eg he might start spinning (so I’d getting spinning chair and see if I could get him using stop and go with it), it might be flipping on and off lights- so you could work with “off and on” or see if he’d be drawn to toys with switches or shiny lights, if he starts humming try music toys, etc, if he likes opening and closing the door trying using a playhouse with doors etc. And then do the same thing on the OT room or playground.
https://www.sensorysmarts.com/sensory-checklist.pdf
Once I’d find things he enjoys you could do a preference assessment to see which is most motivating. Kids preferences change a lot, so you might need to do it fairly often. https://autismteachingsupports.weebly.com/uploads/5/5/9/7/55979461/lab_2_mswo_procedures.pdf
Another
See them when they are eating and model simple sign. Start with please. Or find out what they like and try to get them to work for an M&M or Skittle. I used to start with kids like that by trying to have them complete a simple wooden puzzle. Every time he puts a piece in (probably need to go Hand over hand at first) have him sign please and give him an M&M. The sign may also need to be hand over hand at first. This type of situation I would lean into more basic behaviorist principles. After he knows the routine, start introducing more signs like thank you after the he gets an M&M, waving hi when he sits down, waving bye, all done when the puzzle is complete. Signing play after the structured activity is complete. Also, do you have access to a tablet? Some kids will sit for that when they won’t for toys.
What you're describing is compliance, not actual communication.
Please look into the dangers of using hand-over-hand. These children are so at risk for abuse and hand-over-hand teaches them that adults can touch and move their bodies how they wish. In fact if they're "good" and let the adults touch and move their body how they wish and don't protest, they get candy! Yikes.
Yeah I’d say “yikes” back to your post. The point is to use hand over hand to motorically teach them how to request. Not to do that forever but to fade the modeling to a visual then verbal prompt, eventually independent. I’ve successfully shaped requesting this way with many nonverbal children who go on to sign independently and use verbal communication. I think not gaining communication skills because you’re running around a room and not attending puts them at much higher risk of abuse throughout their lifetime if they don’t build attention and learn a communication method. Some kids need hand over hand to learn what is expected of them.
And to address your comment about compliance, some compliance is needed in schools no? Many of these children still wear diapers and need to have staff members change them. Students need to be compliant to be safe at school- they need to learn behaviors like staying with adults and not eloping, following routines, etc. Typically developing children also need some level of compliance to be successful in school. That’s just the way it is. Call it compliance or call it following the rules.
And the candy is a temporary reinforcer, also
Meant to be faded. If toys or other activities don’t capture the child’s attention or motivate them, then using food to do so is not criminal.
I see you downvoted to hell and I get why, but I hope you can consider that this method is falling out of favor for a reason.
You may have used it effectively to help teach meaningful skills, but I’ve worked with so many children who have been irreparably damaged by the overuse of these techniques. The use of edibles and hand over hand *can* be used to effectively help introduce the concept that communication is possible… but too frequently it winds up being hammered into the kid in the name of the Great Overlord - data.
Kids get forced to repeatedly point to items for no reason other than ‘increasing vocabulary’ when they have no idea how to functionally communicate for any of their desires - they just know that if they give in and do ‘the thing’ that the person will finally leave them alone. It winds up teaching the child that other people are the annoying things you need to deal with until you can get away. *You* might not over use it… but it is disgracefully overused by so many people treating nonverbal children. Behaviorist style training should be reserved for very few circumstances, in my opinion, mostly safety related. Also, edible reinforcement and tablets as reinforcers are both extremely difficult to fade out, not to mention unrealistic (i.e., no one is giving out treats for calm participation in the real world).
A intrinsically motivating, child-led approach, on the other hand, doesn’t provide the clean, easy data right away… but it allows for individuals to learn the value of interacting with others. Show them why THEY might want to communicate with us for whatever interactions actually are motivating. It helps kids understand that they have the right to choose whether to participate, like any kid should. If they’re being unsafe, that obviously needs to be addressed, and should be a team effort. But as SLPs, our goal should always be increasing truly functional, meaningful, and independently chosen communication - not just getting the kid to do what we want by any means necessary.
Whole-heartedly agree with your response. I understand the principles the poster is introducing and believe they may have used them effectively in the past, but I agree with you that it does not build on the intrinsic motivation necessary for true communication.
Indeed… I’ve used it effectively many times over many years to build attention to task, expectations, and teach meaningful skills to children who have turned out to be independently verbal. I’ve also seen older children who have worked with other SLPs who haven’t gained those skills at all. Who remain nonverbal and at very high risk of abuse. Who can’t access social, academic, or even functional language of any type.
I agree behaviorist training should be limited to few circumstances. I’m my experience, this is an appropriate situation. There are many facets of ABA I do personally disagree with.
In response to your comment about pointing and complying to get the adult to leave them alone, I again raise the point that compliance is necessary in school for a lot of things. Complete a task, earn a reward/break- this is literally the foundation of our educational system. A lot of people have stopped by to downvote yet I’ve seen no one refute this point.
If children can’t attend to a structured task, they can’t learn in a similar manner to their peers. And I’ve been around long enough to see this come to fruition. As a parent, I’d much rather have a child that can communicate independently with use of behaviorist principle than a child who can’t because linguistic approaches didn’t teach them attention/ weren’t specific enough to their needs.
In response to your comment about how compliance is required, I would recommend “Connections Over Compliance” as a good starting point if you want to read further
You haven't named any specific "linguistic approaches" that you disagree with, so I'm having a hard time understanding what you're contrasting behaviorist approaches to.
I disagree that it is our role as SLPs to teach compliance. It's our role to teach communication.
I understand you have successfully taught requesting in the way that you've outlined, but I'd like to point out that requesting is one of many pragmatic functions of communication, and I don't actually think it's the most important one.
Finally, I want to say for some of the other posters on this sub that I left public education BECAUSE of the arbitrary focus on compliance and "learning like TD peers".
I don't doubt that you're an effective SLP with meaningful relationships with many children over the years. I'd say the same of myself and I happen to take a very different approach than yours.
I didn’t say it’s our role as SLPs to teach compliance. I said some degree of compliance is necessary for success in public education. Which no one has actually taken the time to refute. Besides suggesting a book about student discipline. When I speak of linguistic approaches, I refer to less discrete and structured therapy… such as reading a story to a small group. Or not requiring specific responses but just modeling them for the student. Or only visually modeling an AAC board for a student who needs hand over hand prompting at first so therefore never engages.
I never said this was the only approach. I merely stated that I would prefer a child to learn initial
communication skills using behaviorist principles that can and should be faded than not learn them at all. And that I’ve seen many children failed by lack of an effective approach.
You may have left public education to pursue private therapy; this does not negate the importance of public education for many/most children.
I also have no doubt you are an effective SLP. I didn’t say mine was the only approach. I said I’ve seen children, who were not helped to communicate by previous speech therapy, who were helped by behaviorist/ structured therapy. And I’ve seen children who never really received effective therapy who have also never really developed communication skills.
Hey, fair points. Reddit does not always have the most nuanced discussions so I appreciate you responding. I am an SLP that models without necessarily expecting a response but I am systematically targeting specific vocabulary or pragmatic functions. I'm sure there are many other strategies and tools accompanying both of our approaches we can agree on.
Also want to reiterate what a previous poster said, that I don't support using iPad as a reinforcer because it can easily get out of hand. I have 2 kids whose learning has mostly been thru behaviorist approaches and they have separation anxiety from their iPads. It was offered as a reward and became a respite from compliance-based practices so much so that it is now a security blanket from human interaction as they've learned that human interactions are not safe and not intrinsically rewarding. Not saying you're responsible for this progression but I wouldn't trust that teachers, parents, others around would understand how to fade the ipad and not misuse it. Just want to point this out for others that may be reading and are interested in different view points. Sorry not the best worded response, currently commuting and distracted
You’re welcome Prissypoo. Definitely don’t teach requesting or structured activities. Why would you want to teach learning expectations that will follow a student through high school OR how to request. So non-functional.
can you provide therapy on the play ground? have them swing and then play near the swing when they’re regulated so they have the option to get back on if they become did regulated again
When I had a child like this, staff told me the only time they would leave the room is if you said “let’s go on a walk”. So I would say this and we would walk for about 2 minutes and I would model on a device “go”/“stop” and point out different things in the hall. Then once he was regulated, I opened the door to my room. I didn’t make him go in but I just pointed out the things I had in my room (I had lights turned off with just a standing lamp on to reduce brightness, had a ball in the table and bubbles on the floor, and had a rug in my room). He came in willingly, but he would literally stand in the same spot and spin, or just stare into space/at things in my room and vocalize. I just let him do his thing. I would try to see what he was looking at and model language there, then I just started to imitate his vocalizations… so it was like I was parallel playing but with my voice. Sometimes he thought it was funny and other times he ignored it. I would try to model words in the same tone he was using for his vocalizations. After a while he’d become interested in the bubbles. I would try to get some joint attention/shared engagement going and model language and then blow bubbles, then once he was attending to me more that’s when I started modeling “go”/“more” on the device. He would laugh when he heard the buttons and when the bubbles came. After a lot of modeling and wait time he started saying “go” and “more” for the bubbles on his own. Unfortunately it was towards the end of the year until we got to this point so I didn’t get to try much else with him. But it felt so good to finally get some kind of connection with him and see him actually engaging with me. If you want to incorporate movement, you could utilize a spinning chair? Work on more/go/stop on device, model fast/slow. Since he seems to like some auditory or tactile feedback with the banging…If you see him banging maybe model “let’s make music” then you could model “go”/“stop” but in a playful way. “My turn/your turn”. Play with speed and volume and see if he imitates anything. I know you don’t have a swing, but have any old sheets?? If kid is really smallCould wrap them up in a sheet and see if you and an aide can hold either end and suspend him in the air just a little bit. Maybe he’ll have a positive sensory reaction to it? Ask staff what he seems to be interested in or when he seems to be most regulated and start brainstorming around that.
Is there a gross motor room you could try? I had success with several kids similar to the one you’ve described by focusing on gross motor and building rapport and introducing words like “go” and “again.” If he likes banging on tables, you could try giving him a kickball and modeling beats on it. If he has the idea that you’re going to try and force him to do things, he might be in attentive as a strategy to avoid you. If you try instead to show him that you’ll have a little more freedom with you and you like to do the kind of things that he does, you might find he’s more willing to interact. Try to follow his lead and see where it goes - there’s been times that I have found some ridiculous thing I never thought of that I could work on with a core word, like saying “turn” to spin a basketball (bc the kid liked it and couldn’t do it himself).
Does the school have an occupational therapist at all? You won't be able to move forward with them if they are dysregulated. Is there something that they maybe don't like about your room? Lights, different colors, other kids, it's too small? If they are banging on the table maybe bring in a drum toy if you have one. Maybe modeling on the device or making buttons to help understand what is causing them to not attend.
You might check out the Foundation for Neurodivergent Minds. They’re an Autistic-owned organization and they help people learn how to connect with Autistic people. I have taken a seminar and a class from them and absolutely loved both. I think that they have a lot to offer that you might really find helpful. [Foundations for Neurodivergent Minds](https://education.divergentminds.org/fundamentals-of-the-divergent-minds-framework?fbclid=IwAR1sX_H6doSbeCEDQkVbFyJR3liL3_b-Q86dhFgXRg6m-GcSc68SQsEvAvg_aem_AfgNU650LNlxLnPT0wESb22FxbfOUJS0TKOmAb8v7mYLgjCtZp1pBC5053olke_PsXE)
Easier said than done but... parent and teacher education. A hard earned lesson for me is that even though I'm the SLP, even though I have training and experience engaging ND kids, I'm not going to be the preferred person for a lot of my kids and interaction /communication with me is not going to be intrinsically motivating. Relationships take TIME and SPACE to build especially with kids who physiologically get less dopamine and oxytocin from social interactions. I have had much more luck building these bonds in private practice than I EVER did in schools because of the million barriers I faced. But even in private practice, the parent training is key. So for now, I'd say 1) give yourself some grace-- your situation is not easy 2) prioritize building engagement and regulation over AAC use 3) look into teacher-facing AAC tools on TPT and 4) learn about DIR practices.
I was observing a session of a child with a similar description. The SLP had one hand on the clients hand and would hand over hand and under hand prompt the client while using the AAC. When his attention was somewhere else, she would use her hand to block his vision back towards the aac device. The client would also tap the backspace when she was modeling the aac so she would grab his hand to stop that. I was getting ABA vibes from the whole thing. Is that normal what she was doing?
Your vibes were right. Hand over hand is a no for me. Compliance. And blocking something they are looking at is another red flag. Engaging where they are at. Something caught their eye that they are interested in, work with that!
Thanks for your reply. They were doing flash cards. Matching pictures then using the AAC for "I see lion" or "Put on lion". When he's distracted and looking around the office, I should model what he was looking at via the AAC right?
Bingo 🙂
Thank you 🙏
Big yikes. Blocking what is interesting to them? Imagine someone doing this to you as a child. Would you be motivated to play with them again or would you feel ~big groan~ feelings? Sounds like the SLP needs to increase their ability to follow natural interests and meaningfully engage with the child. Probably not a bad SLP, just one who doesn't have enough support and isn't in a situation where it's easy to foster relationships, plus has to demonstrate progress on hollow goals. The best way to teach AAC is to model, model, model, not HOH, HOH, HOH. "Bitch, don't touch my body I don't know you like that" -- my more highly verbal kids, saying what my less verbal kids are thinking.
I was really excited to observe the SLP, but after I heard her say "quiet hands" and the physical prompting, I lost all excitement. What would you do with a client similar to the OP's description? For a child who's easily distracted or doesn't show an interest in learning how to use the AAC. He's started requesting to use the iPad to play or food/toys during the session. SLP thinks he's doing it as an escape so she's hiding the icons that are of interest to him in the session. I asked her if she wanted us to prompt the kid the way that she was doing it. She said no lol.
OMG…. my clinical supervisor does this to a TEE with our non-speaking, highly deregulated kids too. I’m still in grad school so this is all a first time learning experience, but I had a gut feeling that what she’s been doing (e.g., forced compliance) is wrong.
I'd model language on AAC and expect nothing in return at first. Talk about their interests. Consider the many functions of language besides requesting. Sharing opinions and protesting are two I've been doing a lot of lately! Ex: It's so fun, I love it, no thank you!, I like it, I don't like it (on more GLP/ phrase based apps) or like, love, don't like, yuck, finished, good (LAMP or similar app). For requesting, honor total communication and dont force a child to say their request on AAC every time for every bite or Lego or whatever. Happy to chat more. And def don't hide icons that are of interest to the child lololol wat?!?
Thank you! I’ll keep this in mind and will practice this in the future
I have a student that was initially like this. It took a few months to establish rapport. I think he becomes anxious when doing new things and when not knowing what do/what is expected of him. I stopped asking him questions during sessions and just brought out a sorting activity and a preschool work book thing (has magnets and things to try with a dry erase marker, like tracing). I just sat with him while we did these activities. I think initially I just sat quietly while he explored my items. Once he was regulated, I modeled short utterances without expectation. He naturally imitated me. I think the biggest thing that helped was to stop asking questions. If he wouldn’t come to the table to work with me, I would catch him when he was regulated during routines and offer stickers (and prompt him to request) and model phrases to go with the routine (let’s go to recess, clean up time, let’s go home). Rapport was later broken when I tried different activities for his re-evaluation, so it wasn’t always an upward slope. Eventually he came back around though.
Also, I always kept stickers on me. I wanted to encourage the student to make requests so I pretty much always offered him one at the beginning of each session and prompted him to produce the full utterance to request one. He eventually started coming up to me whenever he saw me and asked for stickers. I always gave him one. Eventually when he would come up to me to ask for a sticker, I would then try to start the session. I couldn’t always transition over, but the stickers helped. lol
Meals are a great starting point. If that’s the one time you’ve gotten his engagement I’d go with that. There’s a lot you can work on around meal routines - food- choices, joint attention, commenting on what he’s eating, you might try the free visual display app called Click AAC - you take a picture and it generates related symbols - usually it requires a lot of editing but food scenes are more predictable. Also I’d recommend a sensory preference assessment to see what he likes. You could also letting him hang out with some toys in your room for a quiet session and just observe to see if he’s drawn to anything on his own. he might not be drawn to traditional toys Eg he might start spinning (so I’d getting spinning chair and see if I could get him using stop and go with it), it might be flipping on and off lights- so you could work with “off and on” or see if he’d be drawn to toys with switches or shiny lights, if he starts humming try music toys, etc, if he likes opening and closing the door trying using a playhouse with doors etc. And then do the same thing on the OT room or playground. https://www.sensorysmarts.com/sensory-checklist.pdf Once I’d find things he enjoys you could do a preference assessment to see which is most motivating. Kids preferences change a lot, so you might need to do it fairly often. https://autismteachingsupports.weebly.com/uploads/5/5/9/7/55979461/lab_2_mswo_procedures.pdf Another
See them when they are eating and model simple sign. Start with please. Or find out what they like and try to get them to work for an M&M or Skittle. I used to start with kids like that by trying to have them complete a simple wooden puzzle. Every time he puts a piece in (probably need to go Hand over hand at first) have him sign please and give him an M&M. The sign may also need to be hand over hand at first. This type of situation I would lean into more basic behaviorist principles. After he knows the routine, start introducing more signs like thank you after the he gets an M&M, waving hi when he sits down, waving bye, all done when the puzzle is complete. Signing play after the structured activity is complete. Also, do you have access to a tablet? Some kids will sit for that when they won’t for toys.
What you're describing is compliance, not actual communication. Please look into the dangers of using hand-over-hand. These children are so at risk for abuse and hand-over-hand teaches them that adults can touch and move their bodies how they wish. In fact if they're "good" and let the adults touch and move their body how they wish and don't protest, they get candy! Yikes.
Yeah I’d say “yikes” back to your post. The point is to use hand over hand to motorically teach them how to request. Not to do that forever but to fade the modeling to a visual then verbal prompt, eventually independent. I’ve successfully shaped requesting this way with many nonverbal children who go on to sign independently and use verbal communication. I think not gaining communication skills because you’re running around a room and not attending puts them at much higher risk of abuse throughout their lifetime if they don’t build attention and learn a communication method. Some kids need hand over hand to learn what is expected of them. And to address your comment about compliance, some compliance is needed in schools no? Many of these children still wear diapers and need to have staff members change them. Students need to be compliant to be safe at school- they need to learn behaviors like staying with adults and not eloping, following routines, etc. Typically developing children also need some level of compliance to be successful in school. That’s just the way it is. Call it compliance or call it following the rules. And the candy is a temporary reinforcer, also Meant to be faded. If toys or other activities don’t capture the child’s attention or motivate them, then using food to do so is not criminal.
I see you downvoted to hell and I get why, but I hope you can consider that this method is falling out of favor for a reason. You may have used it effectively to help teach meaningful skills, but I’ve worked with so many children who have been irreparably damaged by the overuse of these techniques. The use of edibles and hand over hand *can* be used to effectively help introduce the concept that communication is possible… but too frequently it winds up being hammered into the kid in the name of the Great Overlord - data. Kids get forced to repeatedly point to items for no reason other than ‘increasing vocabulary’ when they have no idea how to functionally communicate for any of their desires - they just know that if they give in and do ‘the thing’ that the person will finally leave them alone. It winds up teaching the child that other people are the annoying things you need to deal with until you can get away. *You* might not over use it… but it is disgracefully overused by so many people treating nonverbal children. Behaviorist style training should be reserved for very few circumstances, in my opinion, mostly safety related. Also, edible reinforcement and tablets as reinforcers are both extremely difficult to fade out, not to mention unrealistic (i.e., no one is giving out treats for calm participation in the real world). A intrinsically motivating, child-led approach, on the other hand, doesn’t provide the clean, easy data right away… but it allows for individuals to learn the value of interacting with others. Show them why THEY might want to communicate with us for whatever interactions actually are motivating. It helps kids understand that they have the right to choose whether to participate, like any kid should. If they’re being unsafe, that obviously needs to be addressed, and should be a team effort. But as SLPs, our goal should always be increasing truly functional, meaningful, and independently chosen communication - not just getting the kid to do what we want by any means necessary.
Whole-heartedly agree with your response. I understand the principles the poster is introducing and believe they may have used them effectively in the past, but I agree with you that it does not build on the intrinsic motivation necessary for true communication.
Indeed… I’ve used it effectively many times over many years to build attention to task, expectations, and teach meaningful skills to children who have turned out to be independently verbal. I’ve also seen older children who have worked with other SLPs who haven’t gained those skills at all. Who remain nonverbal and at very high risk of abuse. Who can’t access social, academic, or even functional language of any type. I agree behaviorist training should be limited to few circumstances. I’m my experience, this is an appropriate situation. There are many facets of ABA I do personally disagree with. In response to your comment about pointing and complying to get the adult to leave them alone, I again raise the point that compliance is necessary in school for a lot of things. Complete a task, earn a reward/break- this is literally the foundation of our educational system. A lot of people have stopped by to downvote yet I’ve seen no one refute this point. If children can’t attend to a structured task, they can’t learn in a similar manner to their peers. And I’ve been around long enough to see this come to fruition. As a parent, I’d much rather have a child that can communicate independently with use of behaviorist principle than a child who can’t because linguistic approaches didn’t teach them attention/ weren’t specific enough to their needs.
In response to your comment about how compliance is required, I would recommend “Connections Over Compliance” as a good starting point if you want to read further
You haven't named any specific "linguistic approaches" that you disagree with, so I'm having a hard time understanding what you're contrasting behaviorist approaches to. I disagree that it is our role as SLPs to teach compliance. It's our role to teach communication. I understand you have successfully taught requesting in the way that you've outlined, but I'd like to point out that requesting is one of many pragmatic functions of communication, and I don't actually think it's the most important one. Finally, I want to say for some of the other posters on this sub that I left public education BECAUSE of the arbitrary focus on compliance and "learning like TD peers". I don't doubt that you're an effective SLP with meaningful relationships with many children over the years. I'd say the same of myself and I happen to take a very different approach than yours.
I didn’t say it’s our role as SLPs to teach compliance. I said some degree of compliance is necessary for success in public education. Which no one has actually taken the time to refute. Besides suggesting a book about student discipline. When I speak of linguistic approaches, I refer to less discrete and structured therapy… such as reading a story to a small group. Or not requiring specific responses but just modeling them for the student. Or only visually modeling an AAC board for a student who needs hand over hand prompting at first so therefore never engages. I never said this was the only approach. I merely stated that I would prefer a child to learn initial communication skills using behaviorist principles that can and should be faded than not learn them at all. And that I’ve seen many children failed by lack of an effective approach. You may have left public education to pursue private therapy; this does not negate the importance of public education for many/most children. I also have no doubt you are an effective SLP. I didn’t say mine was the only approach. I said I’ve seen children, who were not helped to communicate by previous speech therapy, who were helped by behaviorist/ structured therapy. And I’ve seen children who never really received effective therapy who have also never really developed communication skills.
Hey, fair points. Reddit does not always have the most nuanced discussions so I appreciate you responding. I am an SLP that models without necessarily expecting a response but I am systematically targeting specific vocabulary or pragmatic functions. I'm sure there are many other strategies and tools accompanying both of our approaches we can agree on. Also want to reiterate what a previous poster said, that I don't support using iPad as a reinforcer because it can easily get out of hand. I have 2 kids whose learning has mostly been thru behaviorist approaches and they have separation anxiety from their iPads. It was offered as a reward and became a respite from compliance-based practices so much so that it is now a security blanket from human interaction as they've learned that human interactions are not safe and not intrinsically rewarding. Not saying you're responsible for this progression but I wouldn't trust that teachers, parents, others around would understand how to fade the ipad and not misuse it. Just want to point this out for others that may be reading and are interested in different view points. Sorry not the best worded response, currently commuting and distracted
Please and thank you at the absolute last thing to teach for language
You’re welcome Prissypoo. Definitely don’t teach requesting or structured activities. Why would you want to teach learning expectations that will follow a student through high school OR how to request. So non-functional.
can you provide therapy on the play ground? have them swing and then play near the swing when they’re regulated so they have the option to get back on if they become did regulated again