Monday, January 4, 2010

AV Therapy (aka banging my head against a wall)

Overheard in AV Therapy today...

Therapist: "Look at all these hats for Mr. Potato head." [lets Noah hold each hat and then puts them just out of reach] "Mommy, which hat do you want?"

Mommy: "I want the red hat with the flower."

Therapist: "Noah, which hat would you like?"

Noah: "The blue cowboy hat"

Therapist: "Tell me in a sentence please."

Noah: "Do you want the blue cowboy hat?"

Therapist: "No thank you. Which hat do you want?"

Noah: "You [points to self] wants the blue cowboy hat. That one. [points to blue cowboy hat]

Mommy (modeling): "I want the blue cowboy hat, Miss Sarah." [Miss Sarah hands the correct hat to Mommy and then Sarah/Mommy takes turns modeling the expected script for a few minutes]

Therapist: "Which hat do you want, Noah?"

Noah: "Do you want the blue cowboy hat?"

Therapist: "No, thank you."

Noah (obviously frustrated): "Noah [points to self] wants the blue cowboy hat on Mommy's potato [points to blue cowboy hat that Mommy's potato is wearing] on Noah's potato." [points to still empty spot on his potato]

Therapist: "Noah, why don't you try to start your sentence with 'I want...'

Noah: "...the blue cowboy hat"

Therapist: "Use a complete sentence. 'I want...'"

Noah: "...the blue cowboy hat."

Therapist: "Say the whole thing. 'I want the blue cowboy hat.'"

Noah. "Yes! That one!" [points to hat]

Mommy: "Noah, if you want the blue cowboy hat, what do you need to say?"

Noah: "I want the blue cowboy hat."

(A similar conversation occured for each item that Mr. Potato head wears)

Getting this child to speak correctly is going to be the death of me.


Acey said...

how about some carrier phrase cues for a while...
start "building" sentences with different colored or textured strips. so the blue strip cues him for the "I want..."
I would think he'd pick that up pretty quickly and you could phase it right back out...
what exactly were the goals of that btw?

Emily said...

He was supposed to be initiating a conversation (like in play with friends). He's getting really good at responding if people talk to him, but not so good at starting up a conversation. So when we started the activity Sarah and I were playing Mr. Potato Head and basically ignoring him and he was supposed to say "I want to play too." or "Give me some shoes too." or something like that. Which he did initiate (with the shoes) but he said "you" instead of "I", so then with the rest she was bringing him into the play but correcting his pronoun use/sentence structure. She wants him to overhear the correct structure modeled and then supply it himself, but thus far that's just not happening. He's soooo frustrated and he's gotten to where he is hesitating to speak in sentences lest he choose the wrong one. With Karen she would offer 3-4 options of a correct response and he got to be pretty consistent with picking the one with the right structure & content, but pulling it out of thin air is proving to be a challenge. I KNOW it's important that he learn the right way, but it's just so frustrating to him to have to say the same thing 50x. When Noah was having trouble answering questions she had us write down some sample Q&As with blanks for the subjects and choices of answers: "Where is the _______?" "The _________ is
- "under the _________."
- "next to the ________."
- "behind the _________."

He could refer to the strips if he got stuck and after a week or two we'd do the same thing with a new sentence. We did that most of the summer and by fall he was getting really good at asking/answering questions (not just the ones we wrote, but questions in general). Is that kind of what you're talking about?

leah said...

Oh, I feel your frustration. Only with us, it is with the use of "yes." Nolan has a lot of echolalia, though it is getting a little better. Still, if you ask him something like,

"Do you want candy?"

Nolan will answer,

"Do you want candy."

This means "yes" in Nolan-land. So now we've been doing a lot of modeling and head-nodding, trying to get him to use the idea (he doesn't nod his head, either- one of those weird things he's missing). He's a good little parrot, but has trouble with formulating original responses. We get the same thing with open-ended questions (like "what is the bear doing?"). For a simpler question (like "what color is the hat?") we get the correct answer.

I hope he doesn't get too frustrated and starts to get the idea soon!

Acey said...

Yep, the strips idea is just what I was thinking...
my usual argument against sentence strips is that it doesn't allow/teach the child to use audition. But that's not as much a concern with Noah...
he's doing great with Braille, right?
Maybe even just have some "you" and "I" pronoun braille cards or something...
gotcha about the goal...although, that's a tough one in a one on one setting, even with you as a model...difficult for kids to generalize that over to a classroom setting...

also, it's completely understandable that you two are frustrated by the repetition...again, that should be a focus for audition. the modeling should be for *conversation* for him...not basic language structures . all this of course, is my opinion, not having seen him for almost a year! :(

Emily said...

That's one of the reasons I'm really looking forward to the JTC this summer. I feel like a lot of the things we still need to work on are pragmatic in nature, which it's kind of hard to work on without other kids. If I can see how they handle him in CA, I can then (hopefully) bring it back to the people at school. I'm all for repitition. If I could handle the stupid jack in the box starting and stopping for the months it took Noah to realize that when he made a sound we made the toy work I can do anything. I just see that when Noah gets corrected too often he tends to revert back to earlier/easier speech patterns (like saying just "blue cowboy hat" instead of risking the wrong sentence structure/pronoun being rejected). Anyway, overall I feel like we're still progressing with therapy up there - that particular lesson was just too much for me.