Special Education, Therapy Tips

How Teachers and Therapists Work Together to Facilitate Self Regulation

It’s back to school time and that means changes in routine for many students with Autism, especially in Early Childhood special education settings. New federal/state regulations and service delivery mandates, budget cuts, and an increasing emphasis on behavior management means that teamwork and collaboration is in, and “pull out” individual therapy in a vacuum is out. New classrooms, new classmates, new teachers, new therapists, and new schedules can all be potential “triggers” that can cause behavioral issues.

"It Takes a Village..."

There’s a saying, “it takes a village to raise a child”. There is truth to this, especially when addressing noncompliance and self regulation in children with social communication deficits. Social communication proficiency is the cornerstone of civilization, characterized by the ability to self regulate i.e. transition from Me to We as needed. This is a hard concept and skill for youngsters with Autism/special needs to grasp and master, due to underdeveloped Self Concept, Theory of Mind, and comprehension of time passing. This results in “meltdowns” due to fluctuating neuro-cognitive disorientation to person/place/time seen in many of these students. To counteract that, it in increasingly important that teachers and therapists collaborate on treatment.

The Three C’s of Behavior Management

Communicating with the child’s inner landscape to establish rapport

1. Get to know the child Get to know the child’s likes and dislikes through play interaction first, to get an unbiased impression. Give the child the run of the room initially, in both class/therapy, for a short time, at regular intervals, to see what he/she is drawn to and what he/she avoids. Keep a list. 2. Gather Information Peruse previous documentation, parental questionnaires (I like to create one to send home to each student’s parents at the end of the first day of school introducing myself, and asking for family photos and a list of favorite toys/snacks/topics of conversation/people etc. 3. Create a Social Story Therapists can assist teachers in using arts & crafts and/or technology to create a visual, customized, cognitively correlated Social Story, “All About Me”,  about the child’s known preferences and proper, more age appropriate responses to unwanted/unanticipated events. This Social Story will  showcase targeted vocabulary and the items the child will likely receive/experience instead,  in various settings. The teacher can create/discuss templates in a group activity. The speech therapist can individualize the templates by taking/showing personalized digital photos and discussing/teaching the vocabulary etc. The OT can facilitate muscle memory, to facilitate episodic memory, by coloring/cutting/pasting those photos and templates. The teacher can then have the therapists “push in” to a Circle Time routine with a Show & Tell component, where each child gets to show off/discuss their uniquely created and collaborative Social Story. A copy (either paper or digital) gets sent home for homework and review, and to keep parents “in the loop”.

Clarifying expectations for that child, with that child:

1. Class Rules, Schedules and Rewards Teachers can use Visual Supports (digital photos, labels, Lesson Pix™ or Mayer- Johnson’s Boardmaker™ software) to create succinct class rules, class schedules (AKA Visual Schedules) , and class rewards charts for good behavior (AKA Reinforcer Rosters). These can be photocopied and sent home with instructions and explanations for review. 2. Reinforcement from therapists Therapists can help the teachers create these materials and teach the meaning behind them, to students on an individual basis.  This can provide an additional “teachable moment”, especially if implemented while using role play with puppets (I recommend the book REPLAYS by Karen Levine and Naomi Chedd) or corresponding iPad Apps featuring those photos/topics/concepts. 3. Use the same materials Both teachers and therapists can use the same photos, target vocabulary, and speech mannerisms for the Visual Supports, to maintain familiarity and help the child retain/generalize.

Consistently positively reinforcing the child’s compliance i.e. performance/completed tasks:

1. Rewards Teachers can create a Reinforcer Roster (rewards chart) of ALL the special things (to be kept out of reach but not out of sight, until ready for use)  in the room available for the child’s use, when he/she earns it (ex: iPod + headphones, favorite snack, skateboard, favorite doll etc.) 2. Mix in the new with the old Therapists can have duplicated items including some new zingers (ex: special straws or horns, playground equipment, iPad with new Apps, remote control airplane etc.) that are visually depicted and up for negotiation as well. For those children who can tolerate delayed gratification, therapists can also create a digital or paper calendar to show how often compliance occurs, and that calendar gets shared with the teacher/class and parents at the end of each month, token economy style, for a bigger reinforcer at a later interval. 3. Get on the same page Both teachers and therapists must agree in advance, in writing (team meeting, IEP Behavior Plan, interoffice Email), HOW to handle the child’s reluctance to comply/complete tasks, in both actions and the language used. Parents must get a copy of the written plan of action, which spells out the designated wording/vocabulary (ex: I like to initially say to the child, “I don’t understand”, or “You don’t seem to be ready” while sometimes showing him/her a mirror to catch his/her expression) and action (ex: setting a timer to ring, removal from others to forestall injury etc.)

Learning to Play Detective

These suggestions, within the framework of the three C’s of behavior management, require both teachers and therapists to play detective and learn about their students’ inner landscapes. They require methodical implementation and documentation of IEP goals within this framework, to facilitate self regulation, and counteract inconsistent, situation specific, splintered performance. Only through careful collaboration, can we really help our students generalize learned skills and learn to more seamlessly transition from being a Me to a We as needed.