Autism – tip of the day [Head, shoulders, knees and toes]
Here is a quick tip that we still use with the children to help sequence them through those early morning steps in readiness for school.
Quite often, there are not many words available first thing in the morning but there are also a great many tasks that need to be performed in a timely manner. My boys are visual learners but also respond very well to kinesthetic cues, it’s almost as if that first movement kick starts their executive function into action. It’s another layer of scaffolding or support to help them achieve and experience success.
We have four hurdles to overcome:- brush hair, clean teeth, put on shoes and socks.
1. Gain your child’s attention, preferably with body orientation rather than eye contact.
2. Ask that they join in and copy your body movements.
3. Ask them to confirm that they’re going to play along, this need only be a nod or gesture to indicate willingness to participate
4. Exaggerate each gesture but keep the movements simple.
5. Say, ‘look at your body’:- self awareness is often a challenge. It is as if their bodies are separate entities from the self. Sometimes by actually looking at themselves, they will also notice something else amiss, such as back to front T-shirts or trousers. If not, this is an ideal time to draw their attention to the glitch.
6. Place both your hands on your head and say the word hair or head depending upon which word they are familiar with.
7. Then point to your mouth, smile and bare your teeth to say ‘teeth.’
8. Bend down and touch your feet to say ‘shoes’ or ‘shoes and socks.’
9. Repeat all the gestures but this time link the word to a number, 1,2,3 and 4.
10. Ask your child which one he wants to do first, 1,2,3 or 4, or hair/teeth/ shoes or socks. [or a,b,c and d for those alpha fans]
11. The element of choice to these ‘chores,’ gives control back to your child and may help encourage co-operation or at the very least, a willingness to have a go.
12. As they move off to start the first chore, be sure to praise verbally, or with a gesture such as a high five, or whatever physical confirmation they prefer. In our case, one cannot be touched and the other cannot be praised, but we all adapt to our own individual requirements.
Obviously this could be adapted to your particular morning hic-cups, the bits where they get stuck. Although we still use the PECs boards to help sequence, somehow the physical movements are yet another shortcut to smooth those transitions. This is a further step forward than a couple of years ago when they needed individual sequencing charts for each separate chore / task which were broken down into their own sequential steps. These can prove helpful with task completion. E.g. once they have brushed their teeth they move a tooth brush icon from one side of the chart [to do side] to the other side of the chart, [done side] These can be individually tailored to your child’s area of interest such as Pokemon, Thomas or dinosaur icons. Icons are particularly handy for those children who do not like to hold pencils to mark completion or have other fine motor issues.
I’m all for encouraging independence but some children need the scaffolding to remain in place for those difficult moments.
Lastly, a note to anyone struggling with the basics.
If you believe that such simple prompts are well out of your league, I can assure you that I would have felt similarly a few years ago. Back then, we too were struggling with the basics of dressing, toileting and feeding. If I had read a post similar to this, I would have thrown up my hands in horror. However, I wanted to share this to encourage and reassure, that all our children keep growing and changing in tiny huge ways.
We will all get there in the end.
This site “Do2Learn” may help, I hope.
January 15th, 2009 at 1:30 am
It’s strange how such a complex stream of procedures can actually make things go better. YOu’re amazing I swear.
January 15th, 2009 at 6:28 am
You read my mind. I was thinking, “Yeah, well of course Maddy can do all this because she is some sort of superhuman-type person. But this is way out of my league.” Your reassurance that you too once found all this overwhelming really helps make it seem possible. You rock!
January 15th, 2009 at 6:50 am
I have found that the element of choice is very important. Thanks for sharing these tips!
)
January 15th, 2009 at 8:25 am
We resorted to a written list of pictures. They check off the pictures with a grease pencil (the list is laminated). There are boxes to check next to the items – trying to write over the pictures wouldn’t go over well, I’m afraid.
They can present a fully-checked list for both praise and a star on a chart that leads to treats. Yes, we’re chart happy. I’ve personally killed several trees. But this works for us most days. There are days, however, when nothing will get us dressed. These tend to be times when the temp is changed, or special clothes are required, or just when things go all screwy. But I find that there are entire weeks where I’m not tempted to hit the bottle immediately after dropping them off at school.
No, it was not always this good!
Working our way up to verbal commands that jog the system slowly, I’m afraid. But as always, Maddie rules!
January 15th, 2009 at 11:12 am
We’ve been doing something similar with my little one. It helps a great deal. I have also found he responds well to songs. The kindergarten has a great song for the kids for their winter gear order, sung to the tune of “head and shoulders”, lol.
Snowpants, boots, jacket and hat
jacket and hat
jacket and hat
Snowpants, boots, jacket and hat,
Mittens always last.
We sing the song and he puts on his outdoor clothes in the right sequence. It was hard cause we would always have a fight about the order.
January 15th, 2009 at 11:18 am
These are great tips! I’ve found as Nigel has gotten older that with chores, if I give him advance notice – “Such-and-such needs to be done today” – and then I give him a little control by asking, “What time are you going to do it?” – he is much more likely to comply because he feels like he had some say in the matter.
January 15th, 2009 at 12:40 pm
Maddy,
I actually try and do this on a daily basis with both kids. When I worked in the classroom years ago before I had Brendan it became actually second nature, which is such an advantage to me and it’s now not an issue. I still have to assist him with tasks though. It’s my older son who is in middle, that I seem to have the scheduling issues with and he isn’t Autistic! Drives me nuts!
January 15th, 2009 at 6:52 pm
We have a written list for one. We are trying a picture list with the other. He needs things broken down into such simple steps, and totally doesn’t get PECS. This is after five years of trying. But now he’s getting signing. I just wish we could get some sort of visual schedule going with him, I really think it would make things easier if I could just get him to understand it.
January 17th, 2009 at 2:03 am
Great idea.
Heidi has just voluntarily put shoes on all by herself for the first time – getting dressed by herself was our goal for this summer holidays and cross fingers I think we might have achieved it.