An alternative program
- Observation and documentation
- Determination of learning type
- Framework conditions
- Creation of a program on the basis of 1+2+3
- Collaboration with parents and a multiprofessional team
1: Observation and documentation
I documented Joe’s (learning) behavior and identified situations he was struggling in (changes in the daily routine, sleeping problems, sugar as an influencing factor, increased sensory needs, etc.), used this information to change his environment in small steps and gave him instruments that helped him, to deal with the struggle causing situations.
I came to the conclusion that the following aspects led to a positive learning success:
- Reliable and constant relationships to parents, siblings, educators and peers
- Repetition and deepening of learning moments
- Verbal directions combined with pointing and verbal positive reinforcement
- Consideration of sensory needs
Regression and stagnation of his learning success was triggered by the following factors: Sleep deficit, increased sensory needs, altered nutrition.
2: Determination of learning type
Haptic learning type
In order to be able to set up an optimal learning program, it was necessary to determine Joe’s type learning. As I wrote in the last blog post, Joe was a child who explored and discovered the world through touch. He grasped the world by touching his environment.
I used this aspect to make tasks exciting and interesting to him.
I cut small rectangles from different fabrics and cut a hole in the middle. Then I took a string, at one end I made a big knot, at the other end I fastened a button. The goal was to thread the pieces of fabric onto the string.
This task was about three learning elements: Increase fine-motor skills, frustration tolerance, concentration and language development (colors). When he pulled the button through a piece of fabric, I said the color of the fabric and praised him when he managed the task. If he did not, I encouraged him to continue. He loved it and learned quickly!
In addition, after a short time he began to imitate the words yellow, blue, and gray.
Auditory learning type
Also, Joe was an auditory learning type. Verbal instructions in combination with pointing to something, he followed directions well. Of course he had days when he did not listen, but in those situation I often had the impression that he did not WANT to hear. Then he would sneak away with small steps, turn his head to me and check with a brief look if I would react. He then often started laughing and ran away. When I said “Stop. Turn around. Come back “, he turned around and came back.
I loved these situations, because he showed his personality.
His love for music was integrated into everyday life as well as into the behavioral program in the afternoon. He loved the Beatles. Singing “I wanna hold your hand” was the key to hold hands.
Also “Help” when getting dressed led to the fact that, after some time, he tried to imitate the movements of my lips.
When it rained in the forest (and at the beginning of my work with him he still hated to walk in the rain), I sang “Raindrops keep falling on my head” and “I’m singing in the rain”. And Joe would laugh and kept on walking motivated. After a few months the rain did not bother him anymore.
Combination visual and auditory
I also still used a few of the PECS (= Picture Exchange Communication System, visual aids used for non-verbal children). In the ABA program, four song cards were used to match with a lotto board. In the new program I used them to keep working on Joe’s communication skills. I put them in front of him, on the floor or table, pointed to the one card, sang the first line of the song and did the same with the other three cards.
Then I let him choose which song was to be sung. He had a clear favorite: “Row your boat”. He took the card and put it in my hand and I sang the song.
3: Framework conditions
The advantage of the new behavioral program was that time, structure and content of the learning framework were expanded. Previously, with ABA, the exercises were limited to 45-60 minutes and had a previously determined content.
With the changeover and the fact that I worked with him all day, I was able to pick up learning moments from the morning and repeat them in the afternoon. In other words, it was also possible to incorporate afternoon exercises as a natural part of his daily routine. The program therefore extended throughout the day.
4: Creation of a program on the basis of 1 + 2 + 3
The actual success of the program resulted from the fact that Joes’ sensory needs, interests and strengths were integrated into the tasks.
The goals were determined by Joe’s parents, his speech language therapist, occupational therapist, physiotherapist and myself: Increase of language development, motor skills and learning behavior, frustration tolerance, problem solving skills, regulation of sensory needs, and sharing toys with other children.
In the second half of the year, a very important goal was added: the transition from daycare to school (in Canada: Kindergarten). This goal was important as I was pointed out by the other specialists that Joe will be working with ABA and PECS at school.
On days when Joe’s sensory needs were very high, I focused on sensory exercises and adapted the methodological approach to his needs. If he had a strong need to move, we did mainly gross-motor exercises. If he was crying a lot, I read books to him.
It occurred sometimes that because of Joe’s low muscle tone (and overwhelming sensory input), he had the need to lie down quite often. I had an exercise in which a tissue was held in front of my mouth and blew against it (to practice “w”).
When Joe laid on the carpet, I laid down next to him, a tissue on my mouth and blew it in the air. He took his tissue, put it on his mouth and puffed.
Strengthening of intrinsic motivation! If Joe was interested in something, it was easy for him to do the exercise.
Before (with ABA) it was stated that children are (have to be) interested in playing with a ball. But Joe was not interested in throwing, rolling or throwing a ball. Instead, he loved catching a Hula Hoop, and his eye-hand coordination improved.
Even though I chose the tasks for him, I still wanted him to participate in some way. So in the second half of the year, I prepared four small tables, each with one task, and Joe was able to choose the tasks he wanted to work on.
One of the successful factors of the program was to work with what he was already good in and further on easy to improve.
If he quickly reached a learning goal because solving the task was easy for him, it gave him security and self-confidence, and it was easier to present exercises he had not been able to do so far.
One of Joe’s strengths was matching cards. I changed this task after some time and let him match 2D (cards) with 3D (figures). He learned very quickly, and when we did this task at the beginning of the session, he was more willing to participate in the following exercises.
Support and challenge
Every child should not only be supported but also be challenged. If the learning level remains the same, there is hardly any chance of development and improvement. I also applied this basic principle to Joe and addressed him with
“I want you to try, even if you are having trouble with it. If you need me, I am here to help you.”
When I started my job, Joe did not even want to walk from the car to daycare because of his low muscle tone. When going for a walk with the group, he had to be pushed in a stroller. From the beginning, I worked with Joe on using the stroller only for longer walks.
He stumbled and fell, I caught him. When he was ready to hold my hand, he fell less. Holding (touching, gripping) my hand gave him the necessary security he needed.
Five months later, he was able to walk up to 45 minutes – and he had so much fun! When we were outside, he smiled, he laughed and sometimes even ran.
5: Collaboration with parents and a multiprofessional team
Keywords holism: My approach is holistic. In this case it meant, among other things, that I created my program in collaboration with Joe’s parents, speech language therapist, occupational therapist and physiotherapist. His Behavior Consultant had only a minor role in the team at that time, since she spoke exclusively for ABA and disapproved other attempts by the parents to improve Joe’s situation.
In the second half of the year, there was also meeting with the school he would be attending to discuss and plan his transition to school/kindergarten.
The learning method has been changed. Instead of a drill, his needs, interests and strengths were now considered. The program was flexible in terms of content and time frame, and after a while Joe was able to decide which exercises to do. The focus of ABA is the result, the focus now was on process orientation.
In this one year doing the alternative behavior program Joe only cried once…
Part 3 will include a critical review of the ABA program and the statements made by those affected…coming soon!