There are many self-care skills that my case study student needs to learn. Zipping her coat is a big one, but we are starting to move out of the coat-wearing weather and I may not have much more time to work on this skill. Toothbrushing, on the other hand, is something we do everyday after lunch. And not only will my case study student benefit from a visual task analysis of the procedure, but all my students will benefit. I have a visual sequence of the hand washing steps on the mirror over the sink, and all my students like to comment on those pictures. We may have just as much interest in a toothbrushing sequence.
Steps for brushing teeth - along with visuals for each step:
1. get toothbrush wet
2. put a spot of toothpaste on toothbrush
3. brush bottom teeth on both sides
4. brush top teeth on both sides
5. close teeth and brush front of teeth
6. brush tongue
7. rinse toothbrush
There are many smaller steps in-between such as opening/closing the toothpaste and turning on/off the water, but when there are too many written or visual steps, it becomes confusing and cumbersome. My student may need more detailed verbal instructions as she learns to brush by herself, but for the purpose of posting picture cues, I'll use these 7 steps to see how they work. I don't know yet how I'll get pictures of the steps. Maybe my case study student will be accommodating enough to let me take pictures while I help her brush her teeth....?
Tuesday, March 29, 2011
Wednesday, March 23, 2011
Communication Skills of my case study student
Sally is 4 1/2 years old, but her communication skills are at a much younger age level. She had a multidisciplinary evaluation prior to starting preschool when she was 2 years, 11 months old. At that time her auditory communication skills were at the 3rd percentile, and her expressive communication skills were at the 1st percentile. She is delayed in all areas of development: cognitive, adaptive behaviors, social/emotional, motor, language and educational. She attends a full-day developmentally delayed pre-k class with 11 other developmentally delayed students. Although she is not identified as having autism, she demonstrates many autistic characteristics.
Sally is an interesting child. I chose her for my case study because she intrigues me, perplexes me and frustrates me all at the same time. She expresses interested in her environment and in interacting with her teachers, though she is not particularly interested in her peers. However, she is inconsistent in her desire to respond to her teachers' directions and participate in the classroom activities. She likes music, but she struggles to attend and even tolerate circle-time activities. Sally has some sensory integration differences and needs to chew on a "chew-toy" during circle time and table-top activities. She quickly becomes frustrated or loses interest and will run away from her chair, or cry/fuss, or become aggressive.
Sally has some surprisingly clear language at times, though it does not seem that she always has full control of when and how she uses her language. Sometimes she is very responsive to our efforts to talk to her. We may ask her simple "what, where, who" questions, or ask her to "tell me about...." and she can answer in simple 4-5 word sentences. At other times, she sucks her thumb and stares at us blankly. We use a variety of communication strategies to encourage Sally to use language. We engage her in a dialogue about the toys she is playing with or the food she is eating (she loves food). We prompt her with verbal and visual cues, responding to any of her attempts to communicate. We provide a very consistent daily schedule and routine procedures. The classroom daily schedule is presented as a picture schedule with photographs which we review throughout the day and remove as we complete each activity. Sally has her own picture schedule on her table with Boardmaker drawings. She is not particularly interested in this schedule, and we need to replace or supplement it with photographs of her doing the activities.
When we speak to Sally and all the students in the class, we speak in simple sentences. We try to make our point with just the key words. I'm just sure that our students hear the Charlie Brown adult-speak "Whaah-Whaah-Whaah" when we talk too much. We also use sign language to supplement some of our frequent commands such as "no, yes, stop, wait, listen, eat, drink, more, toilet, finished, play, work, clean up, talk, sing, read, sad, angry, happy, hungry, thirsty."
The text book suggests the use of PECS with children with autism. I'm not sure this system is appropriate for Sally because she has some language skills already. She has a functional vocabulary and functional sentence construction. The trick is to get her to use them consistently. The text also stresses the need to control the amount of extra auditory stimulation in the room. It helps all the students when the room is quieter and less chaotic. We use visual and auditory cues when we have 2 minutes left to play, and when it is time to stop playing. We have a visual/verbal transition cue we use routinely. Our day is very predictable. These are all helpful strategies for students with delays of any kind.
I want to help Sally communicate her wants and needs better in the hopes that she will stop fussing/shouting, running and hitting/throwing. I would like to make a choice book for her. It can have appropriate choices for the various times of the day. She may not get to do exactly what she wants when she wants, but she will have some choices that I can live with, and hopefully she can live with too.
Source: Cook, Ruth E., Klein, Diane M., Tessier, Annette. Adapting Early Childhood Curricula for Children with Special Needs. (7th ed.). Upper Saddle Rive, New Jersey, Columbus, Ohio: Pearson Merrill Prentice Hall, 2008.
Sally is an interesting child. I chose her for my case study because she intrigues me, perplexes me and frustrates me all at the same time. She expresses interested in her environment and in interacting with her teachers, though she is not particularly interested in her peers. However, she is inconsistent in her desire to respond to her teachers' directions and participate in the classroom activities. She likes music, but she struggles to attend and even tolerate circle-time activities. Sally has some sensory integration differences and needs to chew on a "chew-toy" during circle time and table-top activities. She quickly becomes frustrated or loses interest and will run away from her chair, or cry/fuss, or become aggressive.
Sally has some surprisingly clear language at times, though it does not seem that she always has full control of when and how she uses her language. Sometimes she is very responsive to our efforts to talk to her. We may ask her simple "what, where, who" questions, or ask her to "tell me about...." and she can answer in simple 4-5 word sentences. At other times, she sucks her thumb and stares at us blankly. We use a variety of communication strategies to encourage Sally to use language. We engage her in a dialogue about the toys she is playing with or the food she is eating (she loves food). We prompt her with verbal and visual cues, responding to any of her attempts to communicate. We provide a very consistent daily schedule and routine procedures. The classroom daily schedule is presented as a picture schedule with photographs which we review throughout the day and remove as we complete each activity. Sally has her own picture schedule on her table with Boardmaker drawings. She is not particularly interested in this schedule, and we need to replace or supplement it with photographs of her doing the activities.
When we speak to Sally and all the students in the class, we speak in simple sentences. We try to make our point with just the key words. I'm just sure that our students hear the Charlie Brown adult-speak "Whaah-Whaah-Whaah" when we talk too much. We also use sign language to supplement some of our frequent commands such as "no, yes, stop, wait, listen, eat, drink, more, toilet, finished, play, work, clean up, talk, sing, read, sad, angry, happy, hungry, thirsty."
The text book suggests the use of PECS with children with autism. I'm not sure this system is appropriate for Sally because she has some language skills already. She has a functional vocabulary and functional sentence construction. The trick is to get her to use them consistently. The text also stresses the need to control the amount of extra auditory stimulation in the room. It helps all the students when the room is quieter and less chaotic. We use visual and auditory cues when we have 2 minutes left to play, and when it is time to stop playing. We have a visual/verbal transition cue we use routinely. Our day is very predictable. These are all helpful strategies for students with delays of any kind.
I want to help Sally communicate her wants and needs better in the hopes that she will stop fussing/shouting, running and hitting/throwing. I would like to make a choice book for her. It can have appropriate choices for the various times of the day. She may not get to do exactly what she wants when she wants, but she will have some choices that I can live with, and hopefully she can live with too.
Source: Cook, Ruth E., Klein, Diane M., Tessier, Annette. Adapting Early Childhood Curricula for Children with Special Needs. (7th ed.). Upper Saddle Rive, New Jersey, Columbus, Ohio: Pearson Merrill Prentice Hall, 2008.
Saturday, March 19, 2011
Motor and Self Help Skills
My case study student is a 4 1/2 year old girl named Sally. She has some interesting motor delays. Her Preschool Multidisciplinary Assessment reported that her gross motor skills were at "average skill acquisition for her age level." Even though she has "average" gross motor skills, she is unbalanced and walks with a clumsy gait. She walks on her toes. She stumbles often, especially on uneven terrain. Her fine motor skills were rated at 70 on a scale of 100 = average. This puts her in the significantly delayed range. She needs help establishing a tripod grip on a marker, getting her fingers in the scissors and cutting along a line, and fastening zippers, buttons and snaps on her clothing. Her IEP fine motor goals include imitating prewriting strokes (vertical line, horizontal line, circle), using scissors in the "thumbs up" position to make 10 snips along the edge of the paper and then cut along a 3-4 inch piece of paper, using a functional grasp on a writing utensil to color in 80% of a shape, and manipulating preschool materials. Everyday after hanging her coat and backpack in her cubby, Sally signs-in. We help her grip her marker appropriately and trace the letters of her name. Everyday she puts on her own coat to go outside and we help her fasten the zipper. During table-top activities, Sally uses a variety of preschool materials such as: scissors, crayons, play dough, puzzles, beads, pegs, lacing cards, shape sorter, tongs and paintbrush. She holds a small cup to drink her milk or water. She uses a spoon and fork to eat her food. She holds the toothbrush while I help her brush in and out, up and down. Sally is able to pull her pants up and down when using the toilet. She washes her own hands adequately. She needs help getting her socks on, but she is able to put on her own shoes. We tie the laces. Sally enjoys jumping on a mini trampoline, pushing a baby buggy, and riding a tricycle (she pushes the ground with her feet, does not use the pedals). She likes to run in the grass, but she stumbles and falls often.
When assessing Sally using the Creative Curriculum Developmental Continuum, I found her to be at the "Foundational 2 or 3" level for all gross motor skills, and at "Level 1" for all fine motor skills. I find it interesting that she scored higher for fine motor skills considering her rating of "average" for gross motor and significant delay for fine motor.
Sally does not yet show a preference for using her left or right hand. According to Cook, Klein, Tessier (2008), a preference for handedness is not expected until 6 years. old.
According to Cook, Klein, Tessier (2008), a child at 36 - 48 months should be able to pour from a small pitcher, spread soft butter, button large buttons, and blow her nose when reminded. Sally is 53 months old and is unable to do these things. At 36 - 48 months she should be able to walk on a line, balance on one foot, hop on one foot, pedal a tricycle, jump over a 6 inch high object and catch a bounced ball. She is unable to do these things.
Sally has definite delays in both gross and fine motor skills. These motor delays effect her self-help skills. Motor and self-help skills are very interconnected.
Resources:
Creative Curriculum for Preschool. 2001. Teaching Strategies, Inc. Printed in the United States.
Cook, Ruth E., Klein, Diane M., Tessier, Annette. Adapting Early Childhood Curricula for Children with Special Needs. (7th ed.). Upper Saddle River, New Jersey, Columbus, Ohio: Pearson Merrill Prentice Hall, 2008.
When assessing Sally using the Creative Curriculum Developmental Continuum, I found her to be at the "Foundational 2 or 3" level for all gross motor skills, and at "Level 1" for all fine motor skills. I find it interesting that she scored higher for fine motor skills considering her rating of "average" for gross motor and significant delay for fine motor.
Sally does not yet show a preference for using her left or right hand. According to Cook, Klein, Tessier (2008), a preference for handedness is not expected until 6 years. old.
According to Cook, Klein, Tessier (2008), a child at 36 - 48 months should be able to pour from a small pitcher, spread soft butter, button large buttons, and blow her nose when reminded. Sally is 53 months old and is unable to do these things. At 36 - 48 months she should be able to walk on a line, balance on one foot, hop on one foot, pedal a tricycle, jump over a 6 inch high object and catch a bounced ball. She is unable to do these things.
Sally has definite delays in both gross and fine motor skills. These motor delays effect her self-help skills. Motor and self-help skills are very interconnected.
Resources:
Creative Curriculum for Preschool. 2001. Teaching Strategies, Inc. Printed in the United States.
Cook, Ruth E., Klein, Diane M., Tessier, Annette. Adapting Early Childhood Curricula for Children with Special Needs. (7th ed.). Upper Saddle River, New Jersey, Columbus, Ohio: Pearson Merrill Prentice Hall, 2008.
Saturday, March 5, 2011
Social Story for case study student
Social stories are a great way to help students understand social norms and expectations. They are little stories that teach social skills, daily living skills or behavior management skills. According to The Interactive Collaborative Autism Network (ICAN), the purpose of a social story is to:
1. describe social situations and appropriate responses
2. correct student responses to a social situation
3. personalize instruction for each student
4. break goals into easy steps
5. teach routines for better retention and generalization
6. help the student cope with both expected and unexpected transitions
7. address a wide variety of problem behaviors
(from http://www.autismnetwork.org/modules/social/sstory/index.html)
Social stories are written in the "first person" so the children can identify with the character in the story. They can be general enough so that anyone can relate to the story. Or, they can be specific to a child, using that child's name, picture, and personal associations.
I use several general social stories in my classroom. For example, "I Can Be Calm." and "My Hands Are Gentle." and "I Want To Play." and "I Can Be Quiet." My students are interested in these stories because the characters have strong emotions that the students can relate to. For example, in the social story "I Can Be Calm" the character sometimes feels angry, or sad, or frustrated. I use board maker pictures to illustrate the text. The students love to see pictures of strong emotions. In this story, the character shares some things he can do when he has these feelings: breath in and blow out like a balloon, go to a safe place to be alone, tell a teacher or a friend.
My case study student has a hard time with transitions. She does not want to move from the tables to the circle rug, or from play to clean up, or from the playground to the classroom, or from her cot to the bathroom, etc. Even though we use a two-minute shaker (rain stick) to give advance notice of an upcoming change, AND we tell her personally that we are about to change to the next activity, AND we give her a reward when she comes to the next activity without teacher assistance, she still resists almost every transition. So perhaps a social story telling how she can stop one activity and move to the next activity will help her. It will have pictures of her doing the things she is supposed to do. It will have text that says how she likes to play and she does not like to stop. But when the bell rings she can go with her friends to the next activity. When the teacher calls her name, she can say "OK" and get up and go.
We have a picture schedule for this student, but they are not photos of her. They are board maker pictures (icons). I think she will respond better to photos of herself and a little story of how she, Sally, can make choices that will help her have fun in the classroom.
source: Social Stories: Introduction from http://www.autismnetwork.org/modules/social/sstory/index.html
1. describe social situations and appropriate responses
2. correct student responses to a social situation
3. personalize instruction for each student
4. break goals into easy steps
5. teach routines for better retention and generalization
6. help the student cope with both expected and unexpected transitions
7. address a wide variety of problem behaviors
(from http://www.autismnetwork.org/modules/social/sstory/index.html)
Social stories are written in the "first person" so the children can identify with the character in the story. They can be general enough so that anyone can relate to the story. Or, they can be specific to a child, using that child's name, picture, and personal associations.
I use several general social stories in my classroom. For example, "I Can Be Calm." and "My Hands Are Gentle." and "I Want To Play." and "I Can Be Quiet." My students are interested in these stories because the characters have strong emotions that the students can relate to. For example, in the social story "I Can Be Calm" the character sometimes feels angry, or sad, or frustrated. I use board maker pictures to illustrate the text. The students love to see pictures of strong emotions. In this story, the character shares some things he can do when he has these feelings: breath in and blow out like a balloon, go to a safe place to be alone, tell a teacher or a friend.
My case study student has a hard time with transitions. She does not want to move from the tables to the circle rug, or from play to clean up, or from the playground to the classroom, or from her cot to the bathroom, etc. Even though we use a two-minute shaker (rain stick) to give advance notice of an upcoming change, AND we tell her personally that we are about to change to the next activity, AND we give her a reward when she comes to the next activity without teacher assistance, she still resists almost every transition. So perhaps a social story telling how she can stop one activity and move to the next activity will help her. It will have pictures of her doing the things she is supposed to do. It will have text that says how she likes to play and she does not like to stop. But when the bell rings she can go with her friends to the next activity. When the teacher calls her name, she can say "OK" and get up and go.
We have a picture schedule for this student, but they are not photos of her. They are board maker pictures (icons). I think she will respond better to photos of herself and a little story of how she, Sally, can make choices that will help her have fun in the classroom.
source: Social Stories: Introduction from http://www.autismnetwork.org/modules/social/sstory/index.html
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