When the Same is Different 2

September 23, 2015

During our weekend trip to City and State of New York we ate at two Diners. In both of them, Robert ordered the same dish: cheeseburger and fries. However, he hardly touched his meal  in the first diner while he clearly enjoyed every bite of the food served in the second diner.

Two weeks ago, Robert refused two small band-aids offered by phlebotomist to cover puncture wound caused by blood test in case the one Robert already had on will fell off.  Robert protested with very loud, “No, no, no”, and was very agitated.  When he is in such a state, there is not much for me to do. I manage to persuade him, to at least replace the band-aid that was already slipping of his arm with a new one (which didn’t hold either as his arm was covered with lotion earlier on) and exit leaving another band-aid in the lab.

A week ago, as a conclusion of a visit to his allergy and asthma doctor, Robert was given a spacer with a mask, a medicated shampoo, and pockets of special face cream. For a few second he hesitated if he should accept any of those items. His hesitation, however expressed itself mildly as slight movements of his hands toward himself and toward the nurse.  There was, no loud protests, no effort to leave everything on the physician desk.  After a few second of silent deliberation, Robert handed me each item expecting me to place them in my purse.  Which I did.

Robert’s opposite reactions to two hamburger plates and to getting things from two medical establishments forced me to realize obvious fact.  Robert doesn’t take anything at face value. He differentiates between things and event based on their qualities.

There was nothing wrong with the fries and hamburger in the diner in New York City.  They were not poisonous or undercooked.  Still, they were thick, yellow, and bland. I tried one fry. It was not appalling, but it was not tasty either. Even dipping it in ketchup or Robert’s favorite honey mustard sauce wouldn’t enhance the taste. I am not sure how the hamburger tasted, but even the cheese on top of it didn’t convince Robert to try it. Maybe that was something about the smell of the oil they were cooked in, maybe there was something added to the meet.  I don’t have any idea.

But, the fries in Hudson’s diner were thin and orange.  They were made from unpeeled potatoes.  They smell as they should.  At least as they should smell for Robert. It might be that diner’s insistence on using only organic products resulted in better outcome.  Maybe the chef who only used organic product treated the food with higher regard and thus put more thoughts and efforts into preparing his dishes even the simple ones.

There was nothing wrong with the way phlebotomist treated Robert.  She really tried to accommodate him. She took his blood in a professional way.  Robert remained calm throughout the procedure although he was slightly tense.

I do have difficulties trying to understand Robert’s varied reactions to getting extra items from both places. The only difference I could notice was the ease Robert was treated by his allergy doctor, her nurse, and her assistant.  He met each of them separately, but all of them were relaxed while working with him, be it weighing him, listening to his lungs, checking his throat, or practicing with him breathing through the spacer with a mask. They not only knew Robert from previous visits, but they probably already met many children and adolescents with special needs. They were at ease, so Robert was at ease too.  When Robert is relaxed he is more open to new things and to  persuasions.  It is a two-way process.

As wonderful as the phlebotomist was, it was clear that she was tense.  She became concerned as soon as I told her that Robert had special needs. She immediately warned me that she might not be able to take Robert’s blood if he would act up. I told her that in the previous year he had his blood drawn twice without any problems and I hoped that she would relax. She probably did… to some degree.

She was calm on the outside but she felt uneasy.  I sensed her anxiety, so Robert had to feel it too. When he senses another person’s anxiety he responds with his own. As a result he stops listening to the person and is directed by the environment of things and his own rigid rules.

 

Advertisements

Climbing Boulders, Tripping on Pebbles

September 11, 2015

This morning Robert had a blood test at Quest Diagnostic.  Nobody was in the waiting room when we arrived.  Robert waited patiently until I registered him.  He bravely stretched his arm and watched attentively as the phlebotomist prepared the syringe and two vials.  The muscles on Robert’s face were tense, and they bulged slightly when the needle pierced his skin. Nothing else. Robert  waited calmly until two vials filled with the  dark red substance. Everything went so well.

I was so proud! It is true that the last two blood drawing went equally smoothly. I remember, however, the times when three people had to keep Robert to prevent  his limbs from kicking, twisting, hitting, and moving in all possible directions so the blood could be drawn or allergy shots could be given.  I knew how scared he was then, years ago.  So I also knew how brave he tried to be this morning. It was an achievement. No doubt about that.

So I was proud.

Until I heard  Robert’s loud protests, “NO, NO! NO!! NO!!!! The event that induced such strong objections was simple. The phlebotomist tried to give Robert two extra Band-Aids, because the one he had already became loose. It was my fault as in the morning I put lotion on Robert’s arm making his  skin was too slippery for the glue to stick to it.  That was a reason the thoughtful phlebotomist offered two extra for later.   Unfortunately,  Robert has very strict rules about NOT taking anything from one place to another. Taking two extra band aids was out of the question.  They were, after all,  the property of the lab and they could leave the lab only as a part of the complete procedure – attached to the pierced vain.

The “No, no, no” was loud, sudden, and thus very scary.  I apologized and explained, but it was clear that Robert’s protests left some aftertaste on everybody in the lab.

It was not the first time that Robert was able to handle the  painful situation with  great maturity and understanding, but fell apart when small things were out-of-place.

A few years ago, while the dentist was fixing his teeth, Robert used the first moment when the drill was out of his mouth to jump out of the dentist chair. We all – dentist, dental assistant, and I -were in shock convinced that Robert would run out of the building in state of great animation.  He, however,  in a fraction of the second,  reached the drawer next to the sink. It was slightly open.  Maybe quarter of inch. Robert closed it and then calmly returned to the dentist chair ready for the next phase of drilling.

 

 

Not Your Typical Curriculum Words

September 9, 2015

A few months ago, I purchased a workbook 100%Curriculum Vocabulary for grades 6-12. Robert knows more or less 10% of those words but he is not using independently any of them. So why then I decided to introduce to Robert  words related to community, government, health, and keyboard?

Well,  Robert lives in the community.  He has checking account, he is involved in taking care of his own health, he uses his  computer skills, and he has to understand, at least to some degree, the role the government plays in his life and the lives of others. Those are very hard lessons for me to plan.  I did not know where to begin.  So although starting with vocabulary might not be the best way for Robert to learn, but it is  the easiest way for me to teach.  The words offer the starting point. They are like primary colors from which all other colors and all other pictures can be created.

Of course there are limits to what I can create, what I can teach.

For the whole week, we practiced words related to money – gross pay, net pay, withholding, interest, balance.  First almost mechanically using word search puzzle and a crossword, then practically with the help of Robert’s paycheck, and his bank account.  Robert found out that he was paid biweekly, that one of his gross pay was $8, his withholding was $0.69 which left him with net pay of $7.31. He also found the balance of his checking account but couldn’t find the interest.

For next few months, every two weeks,  with each new pay check, we will practice these words again and again. That is not as terrible as it sounds. It won’t take more than a few minutes each time.

 

Moving Forward, Turning Back

September 9, 2015

A few days ago, Robert completed Geometry section from Level F Momentum Math.  That was the only part of the curriculum we skipped previously mainly because I wasn’t sure if I was capable of teaching Robert the  Pythagorean Theorem.  I probably wasn’t.  Nonetheless, I had to try. All other sections were much easier to teach.  It helped that over the past few years, Robert had a few other opportunities to learn about polygons and circles. He also practiced calculating their perimeters (or circumferences) and areas by mechanically applying proper formulas.

So I didn’t present Robert with something entirely new.  I mainly opted for refreshing former skills, better organizing the facts, and applying formula in different contexts.  So Robert was finding areas of rectangles, triangles, parallelograms, and circles.  There was no formula for area of trapezoid. Instead, Robert had ample opportunities to practice counting areas of shapes made of a few simple polygons or circles.  With my help he noticed that the trapezoid was made of parallelogram and a triangle thus he could add the area of both shape to come with an answer.

He followed the algorithm

  1. Divide the shape into two or more polygons (or circles).
  2. Write a formula for area of each of the simple shape.
  3. Plug in the measurements into formula and do all the arithmetic operations.
  4. Add all the areas.

Although, Robert still hesitates while following those directions he seems to grasp the idea.  Now it is time to go back to the previous chapter and relearn Pythagorean Theorem.

 

 

 

Stumbling on the Road to Independence

September 8, 2015

One of Robert’s achievements I heralded on those pages was his ability to use men’s locker room while going to the swimming pool.  For many years we used family locker room so I could assist Robert when needed.  Later, he was using it alone, while I waited outside by the door. Still, I could enter any minute.  That was not the case with the men’s locker room.  It was Robert’s dad who assisted him there preparing him for doing everything independently. At some point, he kept leaving Robert by the door and waiting for him in the pool.  After the lesson, Robert met his dad in the waiting room upstairs.

So I dared to do the same. I left Robert at the door to the changing room and waited for him upstairs.  Well, not exactly.  The first time, I decided to wait outside the door afraid that Robert might look for me where he left me.  I was right.  Soon enough, Robert in his swimming pants opened the door on the side of the hall not the pool.  I directed him back, telling him to go to the pool. He went.

One time (as I wrote in another post) I made a mistake of telling him that he put his white T-shirt backwards and Robert attempted to change it in the middle of the waiting room. Luckily, he allowed me to convince him to do the same in the restroom.

One time, when he was not leaving the changing room for extended period of time, I asked Robert’s cousin who visited us during vacation to check on Robert. He told me that he found Robert half-naked, contemplating his clothes. A few words from the cousin sufficed to make Robert dress quickly.

And then there was that:

I waited for Robert upstairs in the waiting room. Somehow, I felt anxious.  I wasn’t sure what could happen, after all Robert never bothers other people.  He can take shower, he can dress, he can dry his hair.  Still, the anxiety forced me to go downstairs and wait by the doors to men’s locker room.  I felt pretty silly staying there, so I kept reading over and over the same ads on the bulletin board.  suddenly, I heard a very loud “No, no, no!!!!” Very loud.  Robert was protesting something.  Very loud! Such protests have the power of intimidating almost anybody.

Well, I opened the door to the small hallway (not to the locker room, which was behind the side wall) and called on Robert to come to me immediately. Robert didn’t come.  Instead a man with a little boy hurried to the door.  He seemed very confused.  He held glasses in his hand. He told me that the glasses were laying on the bench.  Robert picked the glasses and when he saw the man moving to the exit, he followed him to give him the glasses.  When the man tried to put the glasses back, Robert protested strongly, “No, no, no!!!”  At first I didn’t know what to do.  The man gave me the glasses and told me that nobody but Robert was in the locker room.  Still, I didn’t want to go in.  After the man left, I opened the door again and called on Robert.  This time, Robert came.  I told him to put glasses back on the bench.  Since Robert didn’t see anybody else to whom he could give the glasses, he complied with my request.

I know, I know.  Robert meant well. Since nobody was in the locker room, he assumed that the glasses belonged to the man and thus tried to force him to take them.  He didn’t understand that someone else who was not there could leave the glasses.  maybe that is one of the example of “Theory of mind.” Unfortunately, Robert puts so much energy in his vocal protests that one might be scared of him.  That is not something I take lightly.

I wonder, how many other unforeseeable problems will trip Robert over in the future.  How many?

As Simple as That

September 6, 2015

I, probably, wrote about those “techniques” before in a few of my posts. Helas, I won’t find them now among 300+ other pieces of writing. I realized today, that our family’s life became so much more pleasant because of a few very simple tools that manage Robert’s behavior …and ours.

  1. Giving choices.  “Do you want to do A or B?” I ask Robert. He answers.  He might not really voice his preference, but I kept sticking with his answer as a way to install clear understanding of what choice is.  Sometimes the choices are of the same nature or value to Robert. “Do you want poblano or eggplant for dinner?” It is important to provide alternatives specially to someone who has difficulties expressing his or her wishes independently. Robert won’t come and tell us that he wants to go for a walk, or to the movies, or anywhere else.  But he is capable of making a choice when he has the list of options.                                                                                                                                                                                                   Often, I give Robert “unbalanced” choices knowing perfectly well, which one he prefers. “Do you want to study or watch TV?” I ask when I want Robert to, well, leave me alone for a short while.  He chooses watching TV and that allows me to have a calm conversation with a friend who stopped by or talk on Skype with my daughter.
  2.  Five more minutes. Interrupting Robert when he is watching Netflix,  folding laundry, or eating  by calling him to do something else is not a good idea.  Robert needs time to prepare himself for the next activity. When I say, “Robert, we will study in five minutes,” Robert  doesn’t have to jump and come over immediately. He has time to prepare myself mentally for the next activity.  Not once, he surprised me by coming to the table and waiting for me patiently as it is I who forgot about asking Robert to learn with me.                                                                                                 Five more minutes   also gives Robert a toll not to refuse my request straight forward but to delay the compliance. Although, there are times when Robert overuses that phrase, it is a nonetheless one of the most important language tools he has.
  3. First, then tells Robert the order of activities.  That construction, later augmented by the whole list of activities following each other, has resulted in Robert patiently assisting me in doing chores: bank, post office, stores.  At the beginning,  I included McDonald at the end of the list.    I don’t do that anymore.                                                                                                                                                                                                               First, then also encourages Robert to finish the  less preferable activity before the  one he likes more.  “First we finish folding laundry, then we go for a walk.
  4. IF is not exactly the same as, “First, then” although they are closely related and sometimes interchangeable.  When I tell Robert in the morning, “If you want to go to Lifeworks, you have to get up now, ” I both give him a choice and the condition. Of course, when I say that I know that Robert wants to go to Lifeworks.  Although, he wants to sleep longer, he wants much more to go to Lifeworks.  Only when Robert felt very sick, he chose “sleeping longer”.  The IF has been invaluable tool to managing Robert’s behavior specially in those cases when the change in routine was called for or something new was introduced. “If you want to go to Outback restaurant, you have to put on new shoes.”  “Only if we buy you a new shirt, we can go to the Applebee’s restaurant.”

There are other tools which have helped me to deal with some of the excesses of Robert’s behavior. Very rarely now, I have to use, for instance “extinction and redirection” , although that still happens.  (For instance during recent blackout when explanation didn’t help ignoring and redirecting did calm Robert down significantly.) I would still use over-correction, I that were necessary.  It is not, because Robert keep his environment in place without being ask to.

I don’t interrupt when Robert is in the middle of closing the doors that were supposed to remain open.  But as soon as he closes the door, I tell him, ” It is important for me that the door is open.  Please, open the door.” Robert complies 99% of times.  If he doesn’t, I pretend I don’t notice that.  Half an hour later I ask again.  So far, it worked.

https://krymarh.wordpress.com/2013/05/13/discovering-the-path-of-microsteps/

https://krymarh.wordpress.com/2012/07/16/overcorrection/

https://krymarh.wordpress.com/2012/03/24/while-i-was-teaching-him-to-glue-stickers-he-was-learning-whats-important/

 

Hard Task of Teaching “Easy” Things

September 2, 2015

What could be easier to teach and to learn than the fact that the length of the diameter is twice the length of the radius and thus the length of the radius equals half of the length of the diameter. You could see this relation clearly in the picture of a circle.  To switch from one to another you could simply multiply or divide by 2.  Nothing to it.  So obvious. And yet, the link between radius and diameter seems to be the source of great confusion for Robert.  And thus for me.  It is very hard to teach obvious facts and  apparent connections.  There is really nothing to explain and not much to memorize.

It is much easier to teach and to learn other, more complex formulas. How to calculate areas of rectangles, triangles, and even trapezoids, not to mention areas of circles.

Today, Robert was dividing circles into six, eight, or twelve congruent sectors, cutting them out, and using them to build figures that resembled rectangles.

Judging by his sly smile, Robert noticed the fact that as the parts of the circle decreased in size but increased in the number, they could be arranged in a shape that more and more looked like a rectangle. (To illustrate the concept you can look at  http://www.mathsteacher.com.au/year8/ch12_area/07_circle/circle.htm )

I am not sure if he just guessed or sort of understood that the length of the rectangle was approaching half of the circumference while the width was moving toward  the length of the radius.  Nonetheless, we both arrived to the formula for area of the circle, which Robert later applied a few times.

Robert almost automatically calculated areas of the circles when he was given their radii.

When, however, the problem demanded that Robert find the area of the circle with known diameter, Robert hesitated for quite a while, then closed his workbook and said, “Tomorrow.”

Just to put this post in the context of our studying together, I need to add, that we devoted most of the time today not to areas of the circles, but to the clearer pronunciation of CVC words.  That is a real struggle.