Simon Says Teach Conditional Directions

On August 23 New York Times published an article Simon Says Don’t Use Flash Cards.  The article reported on a research which claimed the superiority of specific games over flash cards in teaching young children. The games, need to be said, required the children,  more or less explicitly,  to follow conditional directions.  Since I didn’t find in the article any referral to children with disabilities I had to assume that the research did not include participants with autism. Despite that I believe that the teachers and therapists of children with autism should read the article carefully and supplement their students’ IEPs with some of the mentioned games or their variations.

Sadly, only once ( in 2006)  I was told by the speech therapist of the importance of teaching the concept of  “First….then” .  That was not exactly,”If….then” but it was pretty close.  Short of formal teaching, I used “First… then” a lot during those errands I did with Robert. I would say, ” First we will go to the grocery store, to buy X, Y, and Z  then to McDonald” . In 2006 Robert was at home for four and a half month, so we did a lot of errands together and a lot of practicing of  “First…then.”construction.  Soon from “First…then” we moved forward in two directions.  One lead to making longer list of errands that would include bank, post office, store, and McDonald at the end. Second direction lead toward understanding  cause and effect relations as they applied to Robert’s actions.  “If you do this, then we  do that.” I do believe that I used this phrase a lot, but  don’t remember the circumstances or Robert’s reactions.

I do remember that with the help of this construction I was able to “convince” Robert in 2011 to buy a shirt. Previously, Robert never let us leave the store with a piece of clothing purchased for him.  Never.  With the help of the sentence, “Only if we buy a shirt in Wal-Mart and take it out of the store (Very important distinction, as on one occasion Robert let me pay for a shirt, and then grabbed it and ran to put it back on the same rack he took it from.), we can go to Applebee’s for lunch.”

By that day in 2011 when Robert with mixed emotions carried a bag with a new shirt to the car, we had already completed two trainings related to conditional sentences and directions.

One involved a book Comprehending “Conditional Directions”  That Begin with “IF”.  Robert understood such directions , for instance “If the giraffe can fly, touch your nose” with the help of a simple algorithm. I placed the first part “If the giraffe can fly” in a box at the top center of the page. Two lines lead from this box to either “yes” or “no”.  From “yes” the line went toward second part of the clause (“Touch your nose”), from “no” the line went to the expression, “Do nothing”. Later we simplified the presentation of such algorithms hoping that Robert would apply the concept with reduced support.  He never get fluent but he seemed to grasp the concept.

Second training come in the summer of 2010 when I started using level A of SRA program Reasoning and Writing”.  In a simple graphic method involving  pictures of two people doing different things (one person representing a teacher, second a student)  and an arrow the program introduced the novel for Robert concept: “If the teacher do this, I do that.”

That was a revolution! Robert went through years of discrete trails in which the emphasis was on doing what the teacher did, or what the teacher asked him to do.  Robert became all too good in imitating other people gestures and following simple commands to be suddenly forced to do something different, or even worse: Not to do what he was told or rather shown in the picture above the arrow. The teacher in the picture was touching her nose, the student in the picture was tapping his head.  If I touched my nose, Robert was supposed to tap his head. But how could he?  For 8 years he was taught to do the same! Moreover, when he finally  grasped that he should do something different, I confused him even more by touching my ear (instead of nose) and NOT ALLOWING HIM TO TAP HIS HEAD!

It took a few weeks of practice before Robert understood the concept and even found it entertaining. Still, he forgets it quickly as imitation was strongly imprinted in his brain by eight years of practice.
The same applies to conditional sentences.  After longer break he is unsure what to do.  But surprisingly he became pretty good at understanding “IFs” as they relate to his own life’s activities.  That,in turn, increased his ability to adjust to new situations and novel conditions.                                                                                                                                                                                                                                                               Sadly, Robert never played “Simon Says” which requires similar skills to those we practiced with Reasoning and Writing. He was unable to play it when he was younger.

He doesn’t have anybody to play it with  now, when he, probably, can.

Walking a Crooked Timeline

During July and August, I stopped using our regular curricula:  Momentum Math, 6th Grade level,  Saxon Math 4thGrade,  Reasoning and Writing Level C,  Horizon Reading C-D and instead I returned to  the old workbooks, which I bought over the years.. Some of these materials I used before once or twice.  I had made copies of all the pages and left the originals intact knowing, all too well, that Robert would need to either review, practice, or relearn the same concepts in the future.

This summer, we finally completed work on the  set of four  Fisher Price  workbooks.  Each workbook emphasized one question: Who, What, Where, and When.  Published and purchased in 1999, those preschool level workbooks  waited long to be completed. A few times, in the past we opened them, read a few questions, and practiced answering them. It didn’t go well despite different approaches. So, every time, I stopped for one reason or another.  This summer, we followed through to the end of each book.    Robert still doesn’t know some of the answers, but he knows most of them.  So it is a relatively easy task. Its simplicity  takes the pressure out of talking. Reducing the pressure became more important lately as Robert became more self-conscious about his speech and thus more stressed.

We have worked on a few Math workbooks levels 3-5.  I bought them during the last four years in Barnes and Noble, Local Teacher’s Supply Store, or Costco.  Some of the problems and math games we did before. Now we just finished what we omitted.  Although Robert knows most of the required arithmetic, he has problems with following directions when they are presented in a way he was not accustomed to. So presenting the same math operations in a new context or using them for a new purpose demands that Robert pays attention to language and  flexibly  switches from one set of tasks to another.

We returned to the same  four vocabulary workbooks for grades 1-2, we worked on during the last  school year. Over the previous few months I used and overused some of the new words wherever and whenever they seemed suitable.  Now, I stressed independence while working on  some of the exercises.  I left Robert alone with  short quizzes. He reluctantly  filled the blanks with proper words. Very reluctantly.  It is possible that he will never use many of the words we practiced. I think that he, nonetheless,  should at least be exposed to them so when he hears them he can connect them to the concepts they represent or at least recognize them as something familiar.

We are still working on a second grade reading skills.  This year I bought two nonfiction workbooks from Top Readers series.  The texts are much easier, and definitely shorter than the stories from workbooks we used previous summers. Because the texts are short, but accompanied by pictures they are like postcards sent from all over the world. Its past and present.  This is an ideal summer reading.  It is simple, and clear.  No decoding the meanings of new words, no excessive search for answers to the questions, no making inferences, no  memorizing of any important facts, and no following a story map. We did all of that before with all kinds of fiction.  This year we relax. We read the greetings from ancient Greece, from a jungle, a coral reef, or a moon with a growing admiration for the world.

We finished the World Geography workbook written with 6th graders in mind.  Again and again we went over oceans, continents, lines of longitude and latitude and time zones.  Time zones we encountered before while following  Saxon Math curriculum.  Coordinates didn’t seem hard, because Robert knew how to find coordinates of numbers on the plane.  Remembering oceans and continents proved to be a challenge.  Luckily, we worked on copies of the pages and we still have originals to go back and relearn. Besides we can always look at the  globe or a map of the world and review the names.  When I think about that, I realize that I didn’t utilize the map sufficiently. We worked mostly with a globe, but he globe is much harder to learn from.  It moves and it is tilted..

Another example of turbulence on a  timeline, relates to the cards for apraxia.  As I was practicing with cards designed for adults,  I felt that something was missing. After some searches through catalogues  I decided that what was missing was a box of preschool level apraxia cards as it offered slightly different approach to practicing speech.  So for the last few weeks Robert and I were using both sets – the one for adults and one for preschoolers.

The main reason I am using all that supplemental materials is that it allows me to find the holes in Robert’s knowledge  and fill those voids.  I don’t have another way of finding out what Robert knows or what he doesn’t know.  More precisely,  HOW he knows things. He cannot tell me.  Many of my questions would be impossible for him to understand.  Those materials help Robert and help me.  Even the best curriculum cannot cover every aspect of every concept.  So-called typical children, who have language that matches their age, can fill those gaps all on their own.

Robert cannot.

Not So Lazy Summer

I didn’t write much during these  summer months that come to unfulfilled end. There were reasons  why I couldn’t focus on writing.  Many of them are not related to the main theme of that blog. But one certainly is.  Robert was attending a  summer program.  It was a so-called “collaborative” with 14 or 15 children and 6 or 7 teachers or teachers’ aides.  The speech therapist was in the classroom 4 days a week.  The children seemed a little higher functioning than Robert. I am not sure if that could be clearly assessed as Robert’s extremely poor expressive communication clearly taints the picture.  In my opinion, Robert has relatively (RELATIVELY!!) advanced skills, but because they cannot be easily accessed, they -sort of- don’t exist.  Still, Robert was not treated as a special case in a special education classroom, which had been, has been and probably will be the case in his regular program.  Robert  felt he belonged.  He longed to go to the program.  He jumped and skipped joyfully when I assured him he was going there the next day.  It did help that there was a swimming pool included in a daily lesson plan but the pool  alone wouldn’t make a difference.  After all, in the past, Robert had attended  summer camps that included daily splashes in the pool, and those camps, good as they were, didn’t evoke the same feeling in Robert.

So what exactly made Robert so deeply happy in this program?  He doesn’t explain himself, and my conversations with teachers were rather brief, although frequent. Nonetheless, I am guessing…

1. For a part of a daily routine Robert sat at the desk placed among 14 other desks. He sat among other children.  He observed the children. That allowed Robert to discover who he was and where he belonged.  I am not sure if in any of the  previous classroom settings,  Robert could  come close to understanding himself and create his own image of himself. (Maybe with one exception.) As he was watching other children, he also noticed differences.  Maybe that was a reason why, during the time he was going to this program, he was extremely eager to learn more.  Maybe he noticed similarity between what we were doing at home and what the children were doing at the class.  Maybe he wanted to learn more to catch up with his peers.  I don’t know what were his reasons, but every day Robert wanted to study for hours. Every day this summer we studied together for 2-4 hours a day.  I was exhausted.  Robert was not.

2. He did not have 1:1 aide, so he had to rely more on what other children were doing and not on constant directions from an assigned to him teacher’s aide. There is no doubt that changing from his regular class where three students had help of three teachers or teacher aides, to this collaborative program required a lot of adjusting on part of Robert and on part of his teachers.  It would be helpful if Robert had a part-time aide whom he would share with other student or with the whole class.  But being relieved of constant shadow was an experience in growing up.

3. For a short part of the school day he was sitting around the table with very talkative students and was immersed in the verbal exchanges among those children even though he probably didn’t participate. Being exposed to “chatty” peers was one of the most motivating experienced.  He couldn’t join the “chat” but he certainly had a chance to understand the social function of speech and its importance.

4.He worked one on one with speech pathologist on issues related to his apraxia and application of language concepts in simple conversation. I suspect that he was in one way or another practicing speech – concepts and articulation almost every day. It was important, as I understand from learning more about apraxia therapy, that he worked one on one, because that allowed the therapist to set the proper pace and  increase the frequency of responses.  At home, Robert wanted to work with me.  In the past, I tried to use, for instance, the time in the car to encourage Robert to talk more.  He didn’t want to talk. He  asked to turn on the radio. He wanted to listen to music, not talk.   Now, he wants to talk.

5.His  notes home were not sanitized by close teacher’s supervision but were results of Robert’s independent efforts, his real struggles to come up with words that would carry the information.  I got a few notes written by Robert.  I had difficulties understanding them, but I figured them out.   They were clumsy and not without errors. However, the fact that Robert wrote them without help or with a very little help had an important benefit.  He remembered the written message so well, that he could tell me what the note was about without reading.  One note, for instance,stated that he said he should bring chips to cookout, and that was the thing he told me, repeating message a few times to make sure that I understood. I did.
Never before, he carried any message from school.
Many times I asked him what happened at school and he didn’t know what to say.  With the help from his teachers he made a list of daily activities, which I read and used it to  force conversation about the school. But he has never carried even one message home in his brain. Always on paper.  He had never told me what the teacher did or asked him to do. This was the first and the only time he carried home the message from school.

6.  I also wonder if the number of students and varied activities were not  factors in Robert showing less OCD’s (Obsessive compulsive disorder) behaviors.  As if being exposed to richness and complexities of other students, their varied behaviors, different personalities  resulted in more tolerance for changes.  This is something which had already struck me the previous summer, but I dismissed that as a coincidence.  Now, I think there is a connection….

Robert had a busy summer.  I had a busy summer as well.  Robert wanted to learn more, to know more, to talk better.  He was the force behind our studies together, not me.  So we did a lot of work.  Robert kept me busy and so I didn’t write much.

Every day, Robert puts some of the worksheets in the red folder. He places the folder in his backpack.  He expects to go to the collaborative again.  The red folder is getting ticker and ticker.  I am telling Robert that the program is over.  He doesn’t want to believe me.    He found a place for himself.  How can he not go there again?

Tricking the Mind to Use Itself

In many posts written before this one, I indicated that Robert gets a lot of cues  from his environment.  He believes it is his responsibility to maintain the environment as unchanged as possible.  In the last few years, however, he began accepting the fact that the words, when introduced  clearly and with advanced notice, have the power to alter the order in space around. Still, in his actions,  Robert relies heavily on what he sees and only slightly on what he hears. When he sees that the roll of toilet paper ran out, he immediately replaces it with a new one.  When I tell him to replace the roll, he takes time to process my request.  I have to repeat  it a few times, before he checks the bathroom to confirm that he understood me properly, and only then he fetches a new roll.

When we practice language skills, this problem presents itself in a dichotomy: written versus oral. I noticed, more than six years ago, that when Robert had to fill blanks in written sentences he couldn’t retrieve proper words from his mind.  When, however, he had a bank of words in front of him, he could fill the gaps by choosing properly with only occasional error.  We worked on his ability to make free associations by drawing webs of words associated with the main word.

It was very difficult for Robert.  We were sitting in the dinning room and Robert tried to name a few objects that could be found in the kitchen.  We got up and looked inside the kitchen, named a few objects, and came back to the worksheet.  Robert still had difficulties. As if he could not carry those words in his mind from the kitchen to the dining room table – seven steps altogether.  In the end, I wanted Robert to just memorize names of four objects found in the kitchen.  Except, he couldn’t memorize them.

I made a list. He read it a few times but did not retain any words.  I read with Robert all four words: sink, oven, table,and  spoon touching each word as we read.  Then, I covered the words with my hand, but proceeded to touch this part of my hand under which the word was hidden.  Surprise, surprise! Robert named all four words.  He didn’t see them! Still, he knew they were there.  I don’t understand this mechanism, but it seemed that as long as the words were somewhere on the outside of his brain (on the paper, under my hand), he could refer to them and remember them even when he didn’t see them. Just knowing their location sufficed to recall them all.

After we practiced this way many times, he was able to remember these words (and other) without any additional support.

Yesterday, I encountered another problem.  As we were practicing with No Glamour Vocabulary Card, Robert had difficulties choosing from four words the one which didn’t belong in the set.  I gave the verbal direction, “Which one is not a furniture: table, chair, pencil, or sofa?” Robert was lost.  He clearly couldn’t follow such a long chain of words and analyze their relationship at the same time.  Similar difficulties he exhibited with other sequences. This  and the following example are consistent with defective working memory, I believe.

I asked him to write down all the words as I was saying them.  When he did that, he was able without any difficulties to choose the correct word.  We did that again with a few other sets of words.  He was always right. When he saw the words, he was able to perform well.

In next step while I was reading the words I drew one horizontal line for each word but left all of them empty.  As I asked, ” Which one is not a vegetable: carrot, apple, spinach, onion”,  I touched each line as if I suggested the place where each word was supposed to be.

With slight delay, Robert touched the line assigned to “apple” and said ” an apple”.

I am not really sure what I was doing there.  I hope that  as I was drawing these empty lines, or was covering the list of words I tricked Robert to use his brain in a new way, as if I was helping to create  some new templates for thinking.

In one of my early post, I wrote how I used the fact that Robert knew how to add double numbers (8+8 for instance) to teach him add doubles plus one (8+9).  I got the idea from Saxon Math, but I went a step farther than the authors of the curriculum did and I used empty squares as the last step.   Those empty squares, just like empty lines might have helped Robert organize his abstract thinking and form concepts.


Life Is a Therapy

During almost all ABA workshops I attended when Robert was younger, I heard the same message,” One should invest time, effort , and money in those therapies that have scientific backing of a double blinded research.”  Only ABA therapy withstood such criterion. Other therapies did not. There is in doubt that those  first months if not years of Applied Behavior Analysis therapy changed my son’s life, by providing some sort of clarity and orientation in the chaotically unapproachable world. There is no doubt about that. On the other hand all the complexities, variations, tastes, shapes, and forms of life cannot be addressed in even thousand discrete trails. Providing enriching activities outside the discrete trail format is even more important for children who, like my son, are more developmentally impacted as it is harder from them to “feel” the world without more or less systematic introduction to it.

Except, the world is not widely open to children/young people like Robert.  Robert,too, is not ready to jump into any program designed with “typical” children in mind.  We had to find adaptive programs, that would match Robert’s needs.  Moreover, just placing adjective “adaptive” in front of the name of the activity, doesn’t  make it suitable for Robert.

Not without problems we found adaptive skiing, adaptive swimming, and therapeutic horseback riding….

Did I say, “Therapeutic?”

Well, yes, because I  call an activity therapeutic if during its duration Robert’s behavior seems undistinguishable from that of his typical peers. I don’t look for the lasting effect as I wouldn’t be able to asses it correctly. I am only interested in the immediate outcome.

Because every activity that reduces or eliminates Robert’s self – stimulatory behaviors is already therapeutic.  Every activity that results in gaining new perspective and learning new skills has to be considered therapeutic for Robert.  The more often he does “typical things” in “typical” manner the more “typical” he becomes.  So for Robert not only horseback riding is therapeutic.  Swimming, skiing, biking, hiking, and many other activities are therapeutic as well.

King Sisyphus? Rather Not.

Last Sunday, I took from the shelf, filled with  used and overused teaching materials, the workbook Developing Receptive & Expressive Language Skills in Young Learners. Robert and I went through all the pages of that book 4 or 5 times in the past six years.  Every time we reached the end of the book,  Robert seemed to master  four types of language tasks:  answering “yes” or “no” questions, choosing one of the two words to answer simple question about the picture, finishing the sentence with the missing word, and answering “wh” questions. When, however,  some time later, we started again from the page one, Robert was lost.  Surprisingly,the task he had most problems with was related to  “yes” and “no” answers.  He also made many errors when he had to choose one of two words from the questions as in: “Is the boy pushing a tractor or a lawn mower?”  Having two options already specified in the question didn’t help him but confused him instead. Finishing sentences and answering “wh” questions went much better.

Still, the regress was clear and heartbreaking.  Robert’s  work and my work seemed to be in vain. For the fifth or sixth time we followed the same pattern:

1.Robert has difficulties with exercises at the beginning of the book.

2. As we continue going forward, the number of errors is  decreasing.

3. When we reach last page, Robert seems to pass all the verbal tests.

4.I put the workbook away convinced that Robert mastered the required skills.

5. When I  return to the book a few months or a year later believing it would be an easy exercise related to fluency and maintenance of the skills Robert was supposed to have, I  discover that Robert lost those skills.

6.We start re-teaching and/or re-learning.

This recurrent sequence of learning skills and loosing them is rather depressing.  For the fraction of a  second I perceived myself as Sisyphus, who despite many attempts, failed  to place a rock on the top of the mountain.  Only for a fraction of a second.  But although I dismissed that comparison quickly, I realized that my work with Robert might be perceived as completely pointless. One might think that since Robert kept loosing what he had learned, then there was no point in teaching him.

Such conclusion is not only morally reprehensible but also  utterly wrong.

Morally reprehensible, as it both reduces Robert’s status   from the conscientious participant in the process to the passive object of one’s educational efforts and, simultaneously, demotes a teacher from a person in charge of instruction to a helpless victim of a senseless job. Well, the teacher is NEVER HELPLESS. The teacher can observe, define patterns, learn from them, and adjust learning methods.  Presenting a teacher as a victim of his job damages him and his pupils.

Utterly wrong, as it misdiagnoses the causes of the problem.  It is not that Robert cannot learn.  Four or five times he has proven  that he could. It is the way he is /was taught that leads to loosing the skill.  Robert cannot maintain his skills for the same reasons an average  high school graduate, who never went to French-speaking country, is doomed to quickly forget his French.

Robert never had any opportunity to intensively and frequently practice his newly acquired (or reacquired) language skills outside the dinning room table where he was learning  them with me. I couldn’t assure that others – teachers, peers, community workers would help him practice his language across different settings.

Since Robert has never traveled to “France”  how could he retain his “French”?

Besides, Robert always remembers at least a part of what he was previously taught.