214 Start at 1:05:17

Nancy: These were some of the things you put down and we are going to come to some consensus of the main ones we are going to work on. That some of the main challenges are tolerating others, interacting communicating with peers, adjusting, with play moving beyond parallel play, interacting. So out of all that what would we target to be the main thing you feel we need to work on with social skills as we break it down into measurable king of things we want to work on.

Teacher: I think actual interaction, communicate with peers, actually asking

Mom- See all of this plays in to that as far as I

Teacher- Cause now at this point tolerating others playing in a circle share a toy, she is doing great.

Right

Teacher: So a lot of it is learned behavior once she becomes comfortable.

Nancy: So do you see with social and some kind of reciprocal interaction with peers?

Teacher: Do I see it?

Lisa: No, no as a goal

All: as a goal

Teacher: Yes

Mom: that would be wonderful

Lisa: Do you want to write on this Nancy

Nancy: sure

Lisa: ok

Nancy: you look in there, there is tape in a box, oh you got it. Ok. Alright.

Teacher: You can just say initiating like a verbal come do this with me some kind of initiating play cause I don’t see her without actually doing the actual play she is going to need but that’s just the first step I guess.

Nancy: We can also look at putting something in if you look but at communication skills we can look at it in a communication skill if she says come play with me shes got to be able to do something with play.

Teacher: right, right

Mom: with the person wants to get there

SLP: a game

Nancy: right, right. Still with AJ we are at the point right now her not particularly caring

Mom: right

Nancy: and so I almost think we are going to need to look at and I’m just looking at the play now and I think it is with a peer some kind of reciprocal back and forth

Mom: and to enjoy it

Nancy: right, right. We hope she will enjoy it.

Teacher: laugh, I’m giving you this because I have to

Mom: So like throwing a ball or book passing back and forth.

Nancy: Right. So that she is engaging in some kind of back and forth activity and we can’t say cause you can’t measure enjoyment but she is looking at the peer

SLP: I cant remember what the activity was, may be dance but it was couple of things where she went and took their hands

Teacher: I think you two were over by the table cause I remember you were so excited by it and you mentioned it.

Mom: She likes ring a round the rosy

SLP: Yea, maybe it was some kind of motor activity.

Teacher: And scarves she gets very motivated if we have that.

Nancy: Alright, of. So we need to figure out on this one how we can word one of those so its very specific cause that is a really good things but its not necessarily going back and forth

Right

Nancy: so it may be that we just want her to engage in an activity for 10 minutes with a peer where she is ummm

SLP: its almost like you would have to do some kind of physical play almost

Teacher: right

SLP: where you just have other kid and you put a toy in there.

Teacher: the attention isn’t going to be on the person anymore

Nancy: right

Lisa: Where’s your little criterian, your little nice IEP thing you made up?

Nancy: oh yea

Lisa: that helps. But shes not doing anything interactive with kids now even when it comes to sharing.

Teacher: we always share supplies

Lisa: right

Teacher: we take turns in circle, but when she has free time she just runs and explores her own thing.

Nancy: She doesn’t do it I think you gave a good example when she really really wanted it but her brother wouldn’t. they have something going

Mom: she can do it

Lisa: yea

Nancy: but her preference, or her way of doing it is by herself really doesn’t look much at the other child so its really to define clearly what exactly we wanted her to do

Lisa: and if you go back to the social those questions that umm about her play. There are two things about her play that you told us about. One was play and how she interacts with objects. I think there was some discrepancy she talked more about more pretend play at home where as I think at school um you saw her doing more of just focusing on the parts of the toy or um no more of the exploratory play

Mom: right like she will take the figurine she is using and set it up on the vcr or help them along

Lisa: right right so there is interaction with objects and when you set them apart what you talked about was interaction with other children and this is where you had more of a difference. At home you see her more doing um more parallel play where she is using more materials, maybe there is some brief interactions but its not really interactive or cooperative. And then focusing at school really unaware of other children on her own activities. So it sounds like you are wanting to get her to be more playing and interactive with other children so its like the way we set this up is developmentally so kids start off focusing on their own actions and then play with toys and other children solitary play and then its more looking and more parallel.

:Mm hmm

Lisa: and you know So what we want her to start to do is move down this way where it is more cooperative

:Oh ok

Lisa: So what we want to think about is where at the end of the school year do we see her

Teacher: right right

Lisa: yea yea, so we will set it there and we will break it down by bench marks. What it will look like for progress. So maybe cooperative is even exceeding where we might expect so maybe its more parallel it sounds like though at home you see her more of doing that with her siblings, they are very familiar

Mom: Then again its more of a different setting

Lisa: right

Mom: where here the kids in her class are having some of the same struggles she is. My ,her siblings they wont as they get a little older I’ve noticed they are starting to pull away a little more from her but I also if I notice it wont last. I say go in there, go do this, go do that. So from whichever angle its coming from at home she is not being given a choice.

Lisa: Right yea this is work for her this is work for her yea

Mom: So I Think the differences there not that they are giving her a choice but the other children are having the same struggles as she is here

Lisa: well And that is an environmental challenge that we will have to talk about in the teaching plan if there is a way for more sociable peers

Nancy: well she is she is in the morning , she is in another class

: well in the morning she is in the other class

That would be kinda be observant in our classroom more socialization

Lisa: She could practice in your classroom and the generalization to other peers

Nancy: right right

: Right right

Nancy: Perfect

Mom: So is that where we should bring Amy Biddinger into?

Teacher: That was my question.

Mom: As far as like uh

Teacher: Is it possible for you to be aware of the other environment because I think

Nancy: Oh absolutely

Teacher: You know taking part, I don’t know if that needs to be noted because a lot of these skills are coming across in where we cant totally do it in this environment or the other one so she needs the dual placement

Nancy: right

Lisa: the other thing you talked about is we all want her to be initiating and initiating social interactions. And we saw a nice little clip of that in the video where you had her initiate asking

Teacher: Yea yea

Lisa: That is such a neat activity I just love that video

Nancy: That was the when the day you were doing with the speech where she was asking so see I see the initiation being almost in the communication but in the social with peers we need to get some reciprocal

Lisa: But it could be stuff like maybe I don’t know I am just guessing just that comes to mind but even if its just the sand table or water table and there is a really neat toy and there is like a ferris wheel you have to fill up and there is just one tool and she has to wait and say my turn or something like that and she is interested in it, she has a reason to be there and she has to ask the peer and then share something

Teacher: And you all did do that. She will do that with guidance, models

Lisa : Hmm mmm

TEacher: Its just on her own she will probably walk away from the table.

Lisa: hmm mmm

Nancy: Well we would like her to do is do it with the peer, the peer doing all the prompting

SLP: Then its got to be in the other environment

Nancy: Then its got to be in the other environment

SLP: Yea

Lisa: But she could practice on it

Nancy: and at home cause she has her peers cause she could practice

SLP: Yea with us being the model

Teacher: right

Lisa: She could practice with the adults then she could generalize with plans to the peer

Nancy: yea

Lisa: That’s just an example that it might actually look like. Im sure you have lots of other ideas.

Nancy: I think playing the ball is also part of with a peer your there doing the prompting

SLP: Right, Yea

Lisa: Right

Nancy: But still she is learning the skill she needs which is to watch and to keep engaged

SLP: And we can do that here easy because

Lisa: Hmmm mm

SLP: we got there is a couple other ones in her class we could but we also have other kids that are pretty verbal and in other classrooms that we can pull from to help

Nancy: Hmm mm

Mom: Is that something that could be beneficial to the other child though too

SLP: sure

Nancy: yes yes

Teacher: doing the same skills

Mom: right, that’s what I am wondering if there is someone like that. And we could sit down and talk to Amy too about and it just might be Nolan. I don’t know about who she might if there might be someone in that setting and maybe we purposefully target someone other than Nolan.

Laugh

Teacher: Right right

SLP: Cause she is comfortable with that

Mom: Very much so

Teacher: I think Nolan gives her what she wants, that’s what they said she has fresh peers in this class that age appropriately will say no it changes her scheme what she is used to and if she asks she will

Mom: So maybe we could ask if there is someone in her class in the other school that we could pull in

Nancy: Ok lets see if we can do that with the conditions given what, what’s the condition that she has sociable peers. This is what we want her to be doing by the end of the year

Lisa: During free play during unstructured time, I mean this is

Nancy: We will have structure, I mean what

Teacher: Well that is one of her goals. We want her to find a friend and request play

SLP: So during a structured activity she will initiate the play with a friend that’s not the end goal probably something in between there

Nancy: See I would, I guess I would like to see her engage in some kind of reciprocal back and forth for a certain amount of time or certain number of exchanges so we are keeping her on target. Like the ball

SLP: Right

Teacher: Yea I keep going back to the ball cause often when she knows we are going outside she will ask for the beach ball or ask for the princess ball she will take it outside and she will kind of kick it somewhere and then she is done. That might be a good start where its something she has been interested in and show her how to keep it up

Nancy: Right and like Lisa said in the other settings where she is going back and forth so we are going to engage in an X number of reciprocal interactions with a peer

Lisa: And she will complete 3 back and forth or whatever

Mom: Exchanges

Lisa: Exchanges,

Nancy: alright

Lisa: and exchanges completely one and back to the other, that’s one

Teacher: is that prompting or a person prompting

Nancy: So its going to have to be structured its not going to

Lisa: Well that’s what we got to decide, yea, so that’s part of the condition the prompting. But again think about the end of the year where you would like to see her so it could be peer prompting with adults out of it.

Mom: Thats what I was going to suggest is it be a peer rather than an adult

Lisa: mmhm

Nancy: Ok, so given a structured play activity AJ will

Lisa: And just to let you know I am going to write this up and we will get you a copy of it so whatever

Nancy: AJ will… what,

SLP: reciprocal exchanges

Nancy: And how many reciprocal

SLP: and is this the end of the year

Nancy: Yes.

Teacher: The ultimate target

Nancy: Play through how many exchanges

Mom: How do you put a number on that

SLP: I mean at least 4

Teacher: Maybe 3 to 4. I was going to say once you hit 3

Nancy: And I mean this is one so

SLP: So it could be a ball activity, some kind of game activity

Nancy: So we are going to play through 4 exchanges and should we say

Mom: That just goes back to her attention span

SLP: Well and that interaction time like the time she stays enjoyably

Nancy: You know if we get to this we just keep going, expect more

Mom: Extend it

Nancy: 4 exchanges and how many play activities. I think we should probably put a number. Cause we could say she has met it if we do it with the ball

Iisa: So how many different play activities

Teacher: It would be nice if she could Transfer that to her own type

Lisa: right

Mom: Is three a good number?

3 or 4

Nancy: 3

Lisa: 3 different structured play activites

Mom: Just trying to think of things she likes, her little people or weebles or a game

Teacher: Games would be easy to share

SLP: Its gotta be where the other kid needed to complete the activity

Nancy: why

SLP: Its like what kind of activity and the other child is needed to complete it whether its roll a ball

Nancy: Or you just set it up you need to exchange it

Lisa: You only have one item and they need to share

SLP: mmhmmm

Lisa: And she is interested in whatever it is

Nancy: And they are working on something together and its just

Teacher: One glue stick, or something like that

Nancy: And I guess, you know we may have to go to what we mean by reciprocal I think we know but we are really looking at trying to get her to look at the child and write something and put a little note in here its like

Teacher: Yea

Teacher: Right And if we

SLP: Its physical or touching the child

Nancy: Right, yea

SLP: Keep that. Showing her to get the other kids engaged too

Nancy: right. Ok how often will we do this?

Lisa: You mean for success or criteria? So

Nancy: How often will we want to see her do that

Lisa: I mean during the week she might have opportunities during the day the question is how many times will she have opportunities to play the 3 different activies during the week

SLP: Do we have to do all three schemes or are we just doing one scheme

Lisa: That’s what we will have to decide

Nancy: You just decide

Mom: Or is 3 like an ultimate goal that’s not 3 daily is it, that seems over whelming

Lisa: Not necessarily

Teacher: I would hope we could give her the opportunity to practice at least two schemes a day

Lisa: Its whatever you want to do or at least twice a day with at least two different objects. Ok

Nancy: I mean we know for her to learn we want her to do as many opportunities as possible so um 2 times a day and you keep data what … weekly?

Teacher: Daily, we try to write down what we have done

Nancy: You do everyday,

Teacher: What the result is

Nancy: ok two times a day. Is that clear enough

Lisa: Well what I wrote

Teacher: Should we say on 80 % on the collection opportunities?

Nancy: Ok, ok

Teacher: We can follow your pattern if you have a different recommendation

Nancy: Just so we are clear. We are still the way this is worded cancelling out the thing where she is doing the dancing kinda thing cause its not really reciprocal

Mm hmm

SLP: Well with one scarf they could take turns with one scarf

Nancy: That’s right

Teacher: That’s true

Nancy: Yea we could make it a reciprocal

SLP: Yea With dance

Nancy: yea

SLP: There are dances where you have to use each other, hold each other hands, or do something with the other child

Nancy: Right right, ok now um I am going go, whats our time

Lisa: 1:30 what did you say

Nancy: We have an hour?

Lisa: About an hour and a half

Nancy: oh! Ok, umm what we are going to do after we get them all is to try to devlop a specific teaching plan like we have been talking about it but we will try to say this is how we are going to do this. Now what we lay out today when we go and try it may need to be fixed

Mom: Sure, trial and error

Nancy: but we are going to come up with a plan

Lisa: Laugh

Nancy: Now lets go to communication. And you have one with initiating to a.. somebody to ask them someone to do something.

Lisa: now Nancy can I ask something though do you want to go on to communication

Nancy: Yes I do

Lisa: instead of working on the

Nancy: Yes I do

Lisa: ok

Nancy: I want to get them all up there. And then we will go back and get them all down

Lisa: Alright

Nancy: So I am so gald you are here to say well what do we want her to do what’s the key

SLP: You know initially it was you know thinking about snack time and that she would typically just sit there, last year. She wouldn’t initiate or ask for anything

Nancy: Even when she really wanted it

SLP: She wasn’t able to tell she really wanted it she might go over and try to get it but she wasn’t verbally able to do it. So you know it was Krista prompting her, call the person’s name, I want a cookie, you know or whatever phrase, a phrase you know she can do the phrases. Now she can do that pretty well. I don’t think she really uses the name

Teacher: Every once and a while she does

SLP: She doesn’t really call attention

Teacher: Sometimes she can not be looking and she will say Dorris I want milk. You know

SLP: Yes, yea, if Dorris is holding the milk

Teacher: Yea, but she won’t gain their attention

SLP: Hmm

Teacher: But she is kinda getting the idea of putting it together

SLP: Hmmm, so do we want to keep it during the snack or is there another time when you want to have her initiate requesting for something else.

Nancy: So some of it is she really doesn’t give the directed to somebody she really doesn’t get anyone’s attention she just says it

SLP: She does at home though

Mom: She does but I am still noticing some like this morning for instance and it is more around meal time and maybe that’s just because I am more focused on it

SLP: Well and it is a big requesting time

Mom: It is and I a there are times where she is sitting there and her cup and her plate are empty and I know she wants more and before I would just go and get it for her but now I wait and I wait and she just wont say anything so I will say AJ is there anything you need? AJ do you need something and sometimes that is enough but sometimes she will just sit there and then I have to give her a choice. You know AJ do you want more French fries or are you all done and at that point she will normally pick one or the other but I am still seeing some of that its not as often but there is still some of that at home.

Nancy: Mmhmm

Mom: So, but then again she will also pip up and say I want more

Nancy: Right

Mom: Bread please

Teacher: Right

Mom: We are working on manners

Laugh yea

Mom: We are making sure we throw those in too

Nancy: With Please in there

Teacher: And sometimes she does use that, sometimes she says please

Mom: That’s just one of my pet peeves

SLP: Yea when she really really wants something she will request it maybe not to a specific person

Nancy: And and some of what you have written down is to be able to communicate her wants and needs in a socially appropriate manner is part of that you know if you just say it

Mom: Just randomly in the air

Nancy: Randomly yea then who’s going to get it

Teacher: Right right

Nancy: All of us are trained to get it but that’s not going to work eventually

SLP: Well even asking for help that’s probably something she really doesn’t do at all right now, does she? I mean I think we are coming along with the requesting as far as getting someone’s attention, I think we got a good we can make that our goal but

Mom: Its emerging

SLP: Its emerging. Asking for help probably isn’t emerging yet. She just gets mad

Mom: So you think that’s more important than requesting?

Nancy: Well well

SLP: I don’t know

Nancy: You can also use that as part of the learning skill we can do that as a learning skill and do another social communication or request up here because yes learning it appears AJ knows when she needs help she rather not ask for help but then she gets to the frustration point and yells it out

Right

Nancy: right

SLP: She doesn’t know how to easily enough

Teacher: She doesn’t know how to get her bookbag on and she will get stuck and she will say My book bag and I need help or you know

SLP: right

Nancy: But rarely its my book bag

Rarely would she say I need help

I don’t think she has that concept of help necessarily

Nancy: Help me

Mom: no

Nancy: That’s what I am wondering about the concept

Mom: She knows what the problem is she doesn’t know how to correct it

SLP: Right

Right

Mom: Or how to have someone help her to correct it

Right

SLP: Right and the same I think that’s kinda the same as gaining someone’s attention

Nancy: Yea it is just yell it out and then something is going to happen so how do we want to um

SLP: yea

Lisa: Well Im kinda still stuck on what you were saying earlier about the darting

Teacher: Yea that could be good to work in

Lisa: if we cause part of this is

Teacher: Follow direction

Lisa: I think its not understanding that we have the information

Nancy: The impulsiveness

Lisa: You know to ask

Nancy: That we dont have the information

Lisa: Well Or right well or

Nancy: Mmhmm

Lisa: She needs to communicate something to us all that initiating communication it seems like both these things can be separated like asking for help but then asking permission asking you know

Teacher: What are the rules so she

Lisa: Or just um um cause you have on here just um you know to be able to express her wants I want to go to chucke cheese and then of course its like no but this is when we are going to go to chuckie cheese to take that information to you and ask you for help or to ask for information

Mom: And there is some of that

Lisa: Mm hmm

Mom: She had asked to go multiple times but she didn’t, I guess accepting the answer maybe

Lisa: Well I think too that sometimes some of these kids think that we didn’t really hear them that we don’t understand you know

SLP: Right cause we didn’t respond the way they want

Lisa: So if I keep repeating it maybe they will understand it cause by understanding they will let me go

Mom: Yea

When I get to go that means that they got my message

Teacher: Right right

Nancy: Well and she just takes it into her own hands its this

Mom: Yea

Nancy: Its this great independence that she desires or whatever

SLP: She doesn’t realize that anybody else gets to do anything

Mom: right

Nancy: I am just going to take care of it and I think what you said you know just you cant really trust that she is going to stand by you and uh that’s at school and that can be a real problem

Lisa: yea

Teacher: Well I feel like sometimes I will just repeat back to her what she said, I know you want to go to chuckie cheese

Lisa: Yea

Teacher: but right now we are at school and sometimes that will take care of it but other times it wont

Lisa: yea

Nancy: does it it

Teacher: sometimes I wonder oh she didn’t hear me so I have to repeat back

Lisa: right

Teacher: AJ, I know you want to go outside but right now we are not

SLP: And the visual is the writen word for that too first play then chuckie cheese

Mom: Right

Teacher: And she is doing very well with notes

Lisa: Yea

Teacher: She gets very turned on by that so that’s something that we

Lisa: yea

Nancy: Its also a good strategy

Teacher: What

Mom: Multi colored post its

Teacher: Ok are you doing post its at home?

Nancy: Laugh

Lisa: Or not chuckie cheese I don’t know these things that you got repeatedly up just letting her know

Mom: And it’s a matter of finding the correct way of getting her to understand

Lisa: Yea

Mom: When she can go

Lisa: yea

Mom: Because I know that you guys have told her no you aren’t going now, but I told her no we aren’t going now we are going tonight or we are going Thursday night or

Nancy: Which and she doesn’t understand

Mom: Well

Lisa: And tonight is kinda abstract

Nancy: Or she doesn’t like the answer

Mom: No I think its more she doesn’t like it

Nancy: I think she understands

Mom: We have a big bulletin board at home and I put I have things up there to yesterday was Monday today is Tuesday tomorrow is Wednesday I have all kinds of visuals and that for all of them not just for her because your right that’s age appropriate for them to not necessarily have the concept of time passage so I am trying to help all of them

Lisa: Sure

She just gets thrown in the mix with the rest of them all of them I expect her to learn the same things that I expect the others to learn

Lisa: yea

Mom: so I don’t know

Lisa: I wonder if it might be a little bit of a compliance thing

Mom: Yea I think so

Nancy: Well its also I have a great desire I have something in my head

Mom: She gets stuck on it

Nancy: And we don’t know whats in her head

Lisa: Yea

Nancy: So

Mom: We might be rich if we did

Lisa: I just brought that up cause I wonder if there is a way to sorda weave that into

SLP: So can we make something

Lisa: Initiation

SLP: Ok, so can we make something following verbal commands you know we are going ok its time for snack we are going in she can follow verbal commands and we change that to a less desired thing. You know what I mean

Lisa: Yea, its just that gets us from her being a responder instead of initiator

SLP: Communication, Yea

Lisa: But definitely I mean she obviously these are things that can be worked on. I was just thinking if there was a way she can initiate communication with her wants and um social acceptable wants and needs cause you both said for her to be able to express her wants

Uh hu

Lisa: And you can make that part of getting her attention like you have been working on

SLP: Well yea cause we do a lot of requesting. what do you want I want we started and sometimes

Lisa: Hmm mm

SLP: She doesn’t seem really I just noticed since the last time of seeing her

Nancy: Well if we get to the concrete and we go back to the help tho, if she we need her to ask for specific help directed at a person and in an appropriate way and I don’t know you know give examples of cause it sounds like now what she does is just yells something out she doesn’t it isn’t til she gets to a frustration point

Right I feel like maybe we have things set up in the classroom so that she is very successful

Uh huh

You know she has gotten to the point this year where she has

We would have to sabotage it

Nancy: You would

Teacher: You know like circle time with her carpet square isn’t there

Right

Right

I need that carpet square

yea

Her awareness isn’t there who cares about the carpet square we would have to try to bring her around uh- huh

What do you do

Or her backpack isn’t on the line or her coat isn’t on the hook

yea

We would have things very predictable so she

Lisa: And what is great is that will help her use her words instead of having a fit you know it will help her in her first grade classroom.

Teacher: What she expects isn’t there

SLP: That could be a goal I mean

Teacher: That would be a good goal

SLP: Getting someones attention

Nancy: Right

SLP: And then asking for an item that’s missing or

Lisa: Or just I need help

SLP: I need help with some situation

Teacher: Yea cause we have repeatedly done that with her straw and her milk, she will be sitting there, AJ what do you want, my milk, ok lets try, open, AJ what do you need. She can tell us she wants the straw but not necessarily get it open

SLP: And if we walked away from her she might yell straw if she is really thirsty.

Mom: Or she might try to just pick it up and drink it herself and end up with milk all over her and that’s another issue I see a lot of this at home too.

Nancy: Ok, let’s work on that one as as the communication one. Well um what is it that we want her to do? Given a so it’s a situation where we clearly know.

Mmhmm

Nancy: Ok um, what do we want her to do?

SLP: Where she gains somebody’s attention by calling their name, or physically touching them, or going to get them.

Lisa: And how, what to gain their attention?

Request

Hey Krista.

Or hand up.

I say anything verbal.

Mom: I will take anything I don’t know about you guys.

Lisa: Ok.

SLP: Verbal, physical, gestural, whatever.

Nancy: I will put gestural because we don’t know quite what it might be.

SLP: I say by the end of the year we want her to call the person’s name.

Or

She might not know the person’s name.

Mom: Well and that’s where holding your hand up, I mean because if we think about where she is going or where we want her to go...

SLP: In school.

Mom: Next year...

Nancy: And maybe raising her hand.

Mom: She is going to have to I mean that’s the rule.

Nancy: And even if she did that and said the name at the same time that would be great but giving a gesture then.

Lisa: Mm hmm.

Nancy: and then what saying I need or I want.

Teacher: Requesting.

SLP: Expressing a need.

Lisa: Oh thank you.

SLP: Socially acceptable manner.

Teacher: And I need a different often said instead of want but I need might be a little.

Nancy: I need or I want.

Uh huh.

And she can say help or.

Help or the item.

Nancy: Umm.

Teacher: I think that’s a reasonable one. She is almost at the point where she is...

Nancy: Yea ok, And set it up so she has a number of these things.

Yes yes.

So.

Teacher: Becky has helped us so we have a lot of different visuals so.

Nancy: And she responds so well. So how many times a day would we like her to be doing this?

Teacher: Trying to do that almost in every activity throughout the day.

But

Teacher: Right maybe four...three or four times a day.

Hmm mmm

SLP: Stick with the three.

Lisa: Uh huh, yea

Nancy: Three times a day.

Mom: And is it this may have nothing to do with anything but can we make sure we here it is me being petty but can we make sure that her manners are involved in this please

Nancy: Yes

Mom: Cause I am trying to teach my other children this

Lisa: And when you say manners what do you mean

Mom: Please thank you

Lisa: Oh oh please

Mom: Please thank you and I know that may not be important

Nancy: Yea yea

Mom: But that’s kinda a goal like a personal goal cause I Am trying to teach my other children the same thing and their

Nancy: Well and and its not I mean some kids cant do that cause they don’t have the

Mom: But she can

Nancy: She can

Mom: She can tho

Nancy: So I want X please

Mom: And like I said I know that may sound petty

Nancy: No

Mom: But if I have aj and if she is only able to say I want this that’s a different story, but my other children hear that and they repeat that and I fully expect them to say please, thank you, may I, and she is capable

Teacher: And she will repeat that back

Mom: Yes yes

Teacher: If they say I want that please

SLP: Especially if we use written cues for her too

Mom: Yes

Nancy: And so we will put in socially appropriate way too cause we don’t want her yelling it out

Right

Right

Teacher: I was going to say the intonation in her voice

So I want instead of I need

sure

So we have I want instead of I need

Mom: I like I need cause often

Nancy: You like I need

Mom: Cause a lot of times her voice is escalating she

SLP: It could be either one say like the carpet square its something that she needs you know and there are other things that you want

Nancy: yeaI need my square

So we will just use the appropriate given the situation

Nancy: So three times a day um, 80% of that same thing

Mom: Thank you for humoring me, laugh

Nancy: That’s why we are here yea and as we are teaching it we want to teach

Mom: I expect all my children to have manners

Nancy: Um ok, so this is what we are working on communication now lets go to the work, um the learning skill. Task completion which I know you have been working on seems like she is doing pretty well with that

Teacher: Yea she is ready to be changed

Nancy: Yea, yea

Teacher: She is even ready you know sometimes we will change in free and play time her skills she wants her reward

Nancy: So so look at the learning and look at the personal management together and and we are the thing highlighted was the impulsiveness

Lisa: Well, I wonder about that that’s kinda staying with the group that’s the skill in kindergarten is staying with the group and not darting out and being a little more aware of rules and all that

Nancy: Walking beside people

Mom: What she does in the community preschool

Teacher: Yea I would have to see what she is up too

Mom: She does it here cause it is structured

Lisa: mmhmm

Teacher: Right

SLP: We don’t give her the chance to not

Lisa: Mm hmm and it’s a real safety issue it just takes that one time darting

SLP: And she may do that at preschool she may try to wander

Mom: Well and see I told that they walk to the library once a month and she stayed with them last month but Amy held her hand the whole way and they have a rope that they hold on to and I did tell Amy please you know depending on how she is acting let her hold on to the rope like the other kids but

Nancy: But be right there

Mom: don’t walk away from her they go to the library on Thursdays so I can talk to Amy then and make sure get a full report, more information this time

Lisa: mmhmm

Teacher: Well and maybe that’s something for one of her skills that she can be walking a distance without holding hands using verbal cues,

Lisa: Right

Teacher: you know verbal reinforcement.

Lisa: Does she fight at all with someone’s hand, I mean is she okay with taking osmeones hand

Teacher: Umm she is very willing to hold adult hands, but sometimes there are kids she wont

SLP: But she will

Mom: She holds her brother and sisters hand, but then again sometimes they don’t want to. But she will hold her borthers and sisters hand. Most of the time I hold her other hand cause I go a lot of places by myself with them and I only have two hands so I will make sure AJ is holding my hand and like have Annie has the other hand. And she will hold Annie’s hand.

Lisa: yea

SLP: What does she do at home with routines like getting dressed? Can she get her socks, shoes,

Mom: I normally lay everything out

SLP: But will she get herself dressed?

Mom: She can, not as well as the others. She can do it.

Nancy: But some of that is a motor difficulty

Mom: Probably, mm probably

Nancy: Along with some attention

Mom: She doesn’t have a lot of Yea I would say its more attention than motor skills

SLP: Yea she is pretty good

Nancy: ok

Mom: But when it gets down to buttoning and things like that and that’s a fine motor skill and no she doesn’t have that and none of my children do which could be bad I know, she can dress herself and this is my fault but I have just recently moved into saying ok, Nolan get dressed, JR get dressed and we all get dressed in the same or they all get dressed in the same room together and the other 3 are much more capable than she

SLP: Im thinking does she understand the routine?

Nancy: Its just staying with it

Mom: She will wonder off

Nancy: yea

Mom: I have to keep redirecting her

SLP: Maybe, is that a good one to finish the routine?

Nancy: I think that we should probably target this impulsiveness for school that she will walk. I think there are several things that we need to and we are not going to get her by the end of the year to know that we can have her holding the rope you cant ever take that chance but we can still what is it that we want her to do we want her to walk by an adult we want her do we want her to walk by a peer by the end of the year in a structured situation.

Teacher: I think that will facilitate her learning as she is in classes down the road if she is able to you know

Nancy: If we go from here to here with the group and whatever they do

Teacher: Right

Mom: We are saying peers with the knowledge that the adult there knowing good and well they cant take their eyes off her

TEacher: Right

But in her mind it would be walking with a peer beside

Nancy: Right

Mom: I would think that would be an ultimate goal, wouldn’t it

Teacher: Yea

Nancy: Peer walk beside

Teacher: Yea, but im thinking is it too complicated to want her to avoid something that’s tempting her to walk beyond the ball pit I feel like its also that she gets distracted she knows she is supposed to go from point a to point b but she sees something she wants to do take that opportunity outdoor play we need to make it all the way in she

Lisa: Is that pretty predictable can you almost predict when she will do that

Teacher: Sometimes but not always sometimes she knows what she is doing she is going for snack she will go right there you know very smoothly

Lisa: Well there was this one little kiddo we worked with last year who would dart around the school

Teacher: Mmhmm

Lisa: And what they realized is he was always looking for the water fountains and

Mom: Mm

Lisa: It became a thing and they just set it up you knew he was going to go there so they taught him he had to come and ask

SLP: Its not always sometimes she would go in to Nancy’s room I think last year Nolan was there

Mom: She probably think

SLP: And other times she will run

Lisa: Oh ok

SLP: For the ball pit

Lisa: What we want her to do is walk beside a peer, to class

TEACHER: Mmhmm

Lisa: Coming in from outside you want her to go to the class

Teacher: Right

Lisa: And you will just set it up that it will be a peer that she is walking with

Mom: Well I don’t think its unreasonable to put in do we have to have some place specific to go to put in there that she should ask to go somewhere else

Lisa: um

Mom: You know like this little boy the water fountain you guys specifically said he has to ask to go to the water fountain is it too much to put in if you want to do something different you have to ask

SLP: Well last year she did that when we would be eating at the table and her brother would be at the table and

Lisa: Uh huh

SLP: her brother would be there that’s ok if you want to go there but you need to ask as soon as that became her routine she did very well

Lisa: oh, on her own?

SLP: Yea

Lisa: So like she would get up and then she knew to come over and ask

SLP: Well after many many times of prompting her

Lisa: Yea

Teacher: What do you do

Nancy: She was getting up though

Lisa: Ok

Teacher: She was just getting up

Lisa: Right

But she was starting to ask

Teacher: Yea I think a lot of times to the cafeteria probably at the other school quit a few times

SLP: Where they

Teacher: Right Yea she could learn

Mom: I know she has been darting out of her classroom too, cause Amy asked me if that was a problem

Lisa: I just think that right now its too much decision making on her part

Teacher: Yea

Mom: Ok that’s what I was asking

Lisa: Its such a safety thing this little guy was probably in 2nd grade

Nnayc: He was

Mom: Oh he was older

Lisa: Yea he was older

Nancy: Yea I think we need to know

Mom: So we go from point a to point b

Lisa: Right now just follow our directions

Nancy: And we know We get that close to 100%

Lisa: Cause of the safety

SLP: I think that is a goal that will lead to the learning part of it

Lisa: Uh huh

Nancy: Ok, so its when moving from and is there we would expect her to be able to do this or not moving from point to point

Lisa: Well, I said during transitions but that’s fine

Nancy: Yea, I was thinking we would go on a field trip or outside

Teacher: Right

Lisa: mmhm

Teacher: That’s a hard one cause basic things that she is used to she does it you know we have

Uh huh

Teacher: Can it be one of the goals she has mastered you know when it’s a routine she does it well its when there is an outside distraction like maybe that day

Nancy: Will she at this point wait beside you

Lisa: Mm mm. She doesn’t trust her at all

Mom: I do not let go of her

Teacher: We keep our door closed its not just aj’s challenge it’s a lot of ours

Lisa: Yea I mean aware that the adult wants you close by them

Teacher: Right its almost like we need to take walks outside the classroom

Nancy: Well its not just moving tho cause we have also had to work with these children on wait and that means right here

Lisa: And that’s what we did with him yea

Mom: And that worked

Lisa: We set it up on purpose other kids would come talk to the teacher and say wait and he had a waiting strategy for that

Wait or walk with me

Lisa: Yea

Teacher: Yea

Lisa: Cause he was darting out of the classroom

Mom: And that just scares me to death

SLP: Maybe its wait

Nancy: So its when given the direction, right of wait or walk with me um .. so we are really doing two things here..

SLP: I can just see her yelling no AJ wait

Mom: Laugh, in that little voice

TEacher: But she really picks things up quickly once she understands them

SLP: mm hm

TEacher: We changed her lunch first few days but now that she knows she needs to wait for a signal which is

Nancy: Alright, Lets define how long we expect her to wait when we do that

Mom: Well try I am trying to think if I am you are going to have to club me over the head to ever let go of her hand in a parking lot but

Nancy: Well that’s not where we are going to start

Mom: But I am just trying to think from a time stand point if I am putting the other three kids in the car buckling them up, whoever it was I would expect them to stand right here

Nancy: Yea

Mom: Oh yea

Lisa: So say a minute

Mom: Yea at least

Lisa: Mmhmm

Mom: That is a fabulous start

Nancy: yea

Mom: I mean I have a short attention span I don’t know if I could stand still that long

Nancy: Now, Walk with me cause I think we expect her any time she is walking

Mom: It will vary

Nancy: Right, So she is there, right

Teacher: Yea I think so

Nancy: Ok, um,

Lisa: And do we want what kind of cuing one verbal cuing wait with me and she might have visual cues

SLP: The end of it I would expect it to just be verbal

Lisa: Right right

Teacher: I was just going to say written is probably going to be your most direct

Nancy: Well I think even if we have it written at the end it will be okay, so we will say with

SLP: yea

Mom: I would love for it to be verbal in the end, is that unrealistic

Lisa: Not as she matures right now we are using her personal strength of that visual capturing her attention

Mom: Right

Lisa: You know cause if her distraction but once she learns the routine and grows I think you know she will be more motivated and better able to follow the verbal

Nancy: Um, how often are we going to do it

Lisa: Once a day

SLP: Twice a day

Lisa: Or twice a day

Mom: How many times do you leave the classroom

Teacher: Well sometimes only once so we are going to have to build that in

Mom: Ok

Teacher: And she is a helper occasionally for lunch so that’s the biggest time when she is outside her routine

Lisa: Mmhmm

Teacher: Cause it seems like such a simple goal

Lisa: Mmhmm

Teacher: But when its outside of her

Nancy: Ok, if we write two times a day for each can some of it be in the other setting

SLP: Yes

Ok

Teacher: Well that’s what I am wondering can we have that carried over

Nancy: Sure

Lisa: Oh we would love that

SLP: Then how would we document that

Teacher: We would have to talk to Amy about that

SLP: right

Lisa: Yea, you can just share that information with her. We don’t really have the data collection

Nancy: Well we didn’t write the procedure either. Ok let me give you what we just wrote. Um

Teacher: Becky, sometimes

SLP: Yea we can build that in

Nancy: What we are going to do is look at um, are these in your packets. I am a little confused

Lisa: Yes they have that in their packet

Mom: Sorry, huh

Lisa: It’s the other one, the training packet

Teacher: The compass

Lisa: The training packet

Nanyc: Do you have one of those

Lisa: Mm hmm ok you should have it

Nancy: Ok this is what we have done here

Lisa: Yea there you are

Nancy: Ok so what we want to do is go back to the social one and a lot of these challenges if we get them for the one they are going to be the same but the personal challenges that AJ has on reaching this the kind of things that we know are going to have to balance out are what? What are the problems?

Motivation

Nancy: Ok

SLP: And interest

Nancy: Ok

Mom: That’s going to apply for everyone of those and distractions will apply to others

SLP: Yea distractions

Mom: You know though I am driving down the road and I go oh shiny so maybe some of that is hereditary

Lisa: We all have some of this

Laugh

Mom: Pretty

Laugh

Nancy: And the eye contact problem here just not looking at the other kids. So the distractions are everything in the environment that happen to be there um the challenges in the classroom in the afternoon the possible sociable, sociable peers

Teacher: That’s what I was thinking to say we don’t have sociable peers they don’t have interest

Nancy: Right

Teacher: We can try to set her up with peers

SLP: Yea I think we can

Mom: Are there other peers, I mean I don’t want to disrupt her class

SLP: In her class there are a couple girls who are verbal who could interact

Nancy: Um, personal supports that she has within her

Teacher: Social

Nancy: Mmhmm

Teacher: That she does enjoy different play options

Nancy: right

Teacher: she has the idea when we say go play she has the idea of that

Mom: She knows what she wants

Teacher: Right and she does act appropriately she wont hit someone

Mom: Mostly

Teacher: I think we have made steps towards this

Nancy: Well and personal supports and her reading there are um and then all the environmental supports she has all of you working together

Lisa: Siblings

Nancy: Siblings the mornings she has visual supports just lots of things in place and we want her to function in everyday enviornment

Mom: Yes

Nancy: So the distractions are just part ok if we look at the communication one any additional challenges

Teacher: Again just her motivation

Nancy: Hmmmm

Teacher: Sometime she is ok

Lisa: Impulsive

SLP: She needs to know the words

Mom: I think some of it is understanding

SLP: Mmhm

Nancy: Probably also is this kinda desire to do it independently or the lack its easier to go do it this way then ask a person

SLP: It’s a lack of awareness to ask permission

Nancy: Yea

Teacher: Sometimes she gets frustrated cause she isn’t getting her requested item

Nancy: Right

Right

Nancy: And then environmental challenges are she can just get things herself

mmhm

Teacher: She is very capable

Nancy: right

Mom: I don’t need you

Nancy: It’s a lot easier to go this way

SLP: I can get the cereal its right there

Teacher: right

Nancy: And I can unlock the door and go where I want to go and possibly someone is going to say no

SLP: Yes

Teacher: right

Mom: yes

Teacher: Well and impulsive probably brothers and sisters and some of us just give her what she needs cause she doesn’t get the practice

Mom: Well that’s what I am talking about

Teacher: Mhm

Mom: I have had to work really really hard not to do that

Teacher: Right cause naturally

SLP: And anticipating what she wants so she doesn’t scream

Mom: And that’s part of why I am making her ride the bus

That ok

That’s good for her

It gets her into a routine for the day

It gives her an opportunity to talk to friends

Mom: There are times when I can bring her but I make her ride the bus

Its ok

Nancy: Yea

Nancy: And I think person supports are still there. There are lots of things she does want and its not like we can set it up and she likes routine

yes

Nancy: so if you sabotage she is going to care she is going to be aware. Um ok. And with the other one when we look at walking beside me and waiting we certainly have to put the impulse

Mom: well and Recognizing danger

Nancy: Yea

Mom: Then again I think her age comes into play

Nancy: It does

Mom: But its not unusual for a 4-5 yr old to not understand danger

Nancy: Yea

right

Mom: No fear

yea

Lisa: And part of that is not understanding the impact that her behavior has on you so when she is running away how scary that is for you and the consequences

Mom: That’s it I might be in the situation where I am alone with the others and how am I going to handle that with the other three

Right

I cant just run away from them

Yea

Its not necessarily her problem

Yea

Its just the reality

I was just going to say that’s something you could practice at home cause you could talk to them about it sometimes AJ might be wanting something and didn’t tell mom we are going to do this

That’s a good idea

You all stay together

Have a plan

Practice and role play with them cause they can understand that

Yea yea

Cause and effect

Right

Your ball goes into the street and gets squished

Yea

Lisa: Does she watch videos

Oh yea she watches videos

Lisa: Im kinda jumping ahead with the teaching plan but yea

Nancy: Ok anything else with the waiting well the environmental distractions or just whatever is there that she wants

For her to be able to even see to know where she is going if she knew where she was going she might be more likely to stay with you

Yea

Mhm

You know walk out around why shouldn’t I just walk

We were thinking when we go with the group sometimes she will just keep going and we could extend that

She just keeps going

Yea so we could extend that following directions all the way down if there are a few other kids going to the office

She would go

Right

Yea that’s the distraction

Maybe go another way

Mmhm

Well if we get to here we just keep going

Oh yea

Lisa: Well it was impressive, were you surprised when she did stop when you said her name?

Mom: Yea, very

So when there is a very strong

She got your voice

Unexpected voice

Yea there was nothing more than the panic in my voice

And she waited for you

Mom: She ran back to me

Nancy: What did you yell

Mom: AJ stop

Yea

Mom: And it wasn’t that calm but it was simply AJ stop

Yea and she turned around and came back she sensed

Yea it wasn’t the words spoken it was my voice

Nancy: Ok, go to the next one and we will start again with the social we talked a lot about this about exactly how we are going to start to teach this what are the steps we want to have in place we talked about first um identifying peers

Lisa: And this will help us too thinking about the teaching plan how to break it down

Nancy: So um we identified the plans the peers and some activities that are going to be motivating to her

Lisa: Nancy, this is one that I do remember you got the yellow sheets there are some nice web sites and there is one that is about how to train peers how to talk to peers to give them information cause they are going to need information about how to be persistent with her how to get her attention if she walks away don’t give up try to get her attention again

And preschoolers are good at this

They are really good at this

Its the one under the social I think its peer mediated so here is the website and then I broke down under each category and then a lot of them over lap same topic

And on each of these there is a list of these and I think depending ok simple way toilet training is under the COMPASS there is stuff on that

Ok

Well and like there is stuff to train peer this would be huge for us at home

You want to get a kiddo who can pay attention for at least 10 minutes

Social skills

Peer mediated instruction

We might have to get 1st graders

Oh yea preschoolers can do it, yea

So there would be training

Oh yea

Um, ok and then we need to what else,

Situations

Social

Maybe one can actually be sharing

So

She loves music

Take turns with musical instruments

They can switch

See I think she can do that but I don’t see her

No this is work for her, play is work

Yea

So this will be like

We have done turn taking

She can

She can with the adult

Like she likes matching wands maybe there is a special wand then I mean we don’t say in here does she say my turn or how does she get the turn

Well no cuase we left it more open if it is ball play or the scarves

Mmhm

Exchange scarves sometimes its easier to do that anything that we are getting her to be reciprocal and aware of the other child.

So since she is capable of turn taking she is very capable of playing the my turn game

Yea

Mmhm

But maybe if we structure it as not necessarily its my turn with the red scarf but this is the way it works so and so dances with the blue scarf

And then switch

We play with taping sticks now hand your sticks to your neighbor

Right

Maybe its easier to start with pass something

Right

So say and then work up to different colors

Yea

Maybe it addresses more this is the way we play the game more than we are going to take turns

Right

Maybe if the presentation is a little different

I think too the activities that worked there is nice engagement between the two there is the reciprocal

Well

Well you cant do row row your boat unless you both do it can you

I don’t really see that as reciprocal

Its not

Its engaging

Its engaging

Yea yea

What about we are playing bob the builder with a peg builder and take turns with the hammer

Lisa: Yep

Until we get them all done

Lisa: Yep

My turn your turn back and forth Lets finish the whole things

Nancy: So we are all working on the same thing

right

Yea

Sometimes its hard to keep doing it

She likes duck duck goose. Does that count as reciprocal

What is it

Duck duck goose

You go around

I know but Whats that

Lisa,

I know I know

Lisa

Are you serious

How do you not know that

You go duck duck duck duck goose

You go around in a circle and you chase

ok

Mom: You have to come to my house, you cant go anywhere else, you come home with me

Reciprocal

Joint attention

mmhm

And that’s really important for her

yea

That’s a group one

That’s what I see is missing right now

Right

She doesn’t do that

She does at home I mean if she wants too

Right right

And its probably here cause we don’t have enough kids for her to engage

Mmhm

And I am sure in the morning program there are multiple kinds of things

Ok

So I just have identified the activites

Ok

So after we do this and we have it all set up then what do we do, what are some ways

Mhm

Strategies we are going to use

Well got to verbal whose turn is it visual my turn where she actually has to get it

Its my turn

Yea

Yea

It goes back and forth between the kids

If you made a video of doing this and showed it to her

Oh that would be good

Video modeling for her

I found even when we try to do the ball exchange

Physically

Yea I mean if we are rolling the ball

Uh huh

If we are just standing there

Yea

She is in space

And seeing her brothers and sisters doing it and watching

Mhm

We always want her to see herself doing it positively

Another activity to go off of would be face painting or something on each other

Mhm

Doing something putting stickers on each other

Mhm

Different body parts

So its more of a natural

Fun

Prinicess stickers

She likes make up

Sticker on her nose

They love face paint

Of AJ and her make up its more like my make up

Does she ever do

No she does her own

Hey

How are you

This looks like a crowd

Looks familiar this is the other student

Oh

Will the time work and I am going to call and remind her and she said so that will work

And then amber said her material was at home do you want her to fax

She can fax it

Ok

She can fax it in the morning

Lauren is going to leave tomorrow afternoon so she will have to fax it in the morning

Well I don’t know if the web version is working

Its completed

Make me feel better I am not alone

Nancy do you have your phone

I am sorry to interrupt

That’s ok we are making some goals

Reciprocal play that’s good

Now some of these are similar to her IEP but some are we haven’t addressed before safety concerns we are adding them

Uh huh

Especially she has a few other siblings in other rooms

Exactly

She just had a birthday how did that go

It went just fine

She had a good time but she did alright with it yea

My son is a senior he is talking about doing his senior project he is talking about having a fundraiser car wash and have the money go to benefit something with autism can I put him in contact with you

I have one right doing power points with kids transitioning so I am all game with that

Well and he wants to keep it local so hopefully it will benefit AJ

Yea right we can use it for training and resources

Thanks

Alright lets get to the next one where um needs something and gains someones attention so our methods for teaching

Would be modeling it to her written

Alright but you set the situation up

She really needs something

That’s where snack would come into snack is a big one there isn’t it

Sometimes she will go to the table and hopelessly

You can tell her go get her folder and put it there

Yea you said it before sabatoge situations

right

Yea take her normal routine and just

Take away something

Nancy: And so you really are going to start with the ones you can identify will motivate her that you know you know she needs help

Mmhm

Nancy: And you think she is going to be motivated to need help

What are some of her favorite items, often she will go to the dress up station and want a certain dress

Nancy: Yes

You know if that’s not there she will

Mmhm

Have to find it or find me and ask

Yea

Will we have to give her a direction for that like go get the pink dress

Yea something

Something we will have to know what she is going after

Right

See how she responds to it

Mmhm

And then you are going to have a written are you

I think we would do written and verbal

Could we start with verbal

Would you add, well what we are trying to do is to not get her to escalate and want her to say it in a certain way so would you ask her

Probably go over there and she would be looking before she gets upset where is it, where is the pink dress, lets go ask

Nancy: What if she comes or you take her square away at circle and she just stands there

Mmhm whats missing

Ok so you give her the verbal cue

Ask her

I will tell her her reaction go get it

Yea

Is that what she will say

Get it

Yea

Sorry if blankie is not on her bed at home see that’s what I can do at home if its not there at night time she will say where is blankie

She will say that

She will and I will say I don’t know. But that’s a specific thing

Well that’s ok

Nancy: That’s ok so she says where is blankie and you say I don’t know

Will she go in the other room and say that

No she wont come to me she will lay in bed

Oh she will lay in bed and She will just keep saying it

So she will keep saying it

Yea And if I come to her she will say where is blankie and I will say I don’t know she will say go get it

There was a time we ran out of paper towels in the bathroom and she could not finally we made sure everything was there

And what was she doing

Need paper towels

Need paper towels

But she was just standing there

So that will be good

Things like that

Oh you need paper towels

But it’s the coming and getting you

Right

Like coming to get me and telling me her blankie is not in her bed

Right

Its almost like a picture exchange system where she has to learn to take the message to you

Yes

Right

And the more you go to her the less she has to do sorda like traveling going this way seeking them out or

Nancy: Well in here she is laying bed or she is in there with the paper towels someone has to go in there she is stuck

Its like that reinforcement

Lisa: So the question is that’s the plan what is exactly how is she going to ask is she going to have or we give her a script that says I need help so you know that’s where it gets tricky

Yea

Cause if you are saying what do you need do you need help then again there is that verbal prompting

Yea

Lisa: So if she has some kind of script even in the bathroom where you purposefully don’t have the towels it’s a cue for her if you need help or I need help find teacher

Mmhm

Lisa: Something that tells her what to do

She does really well with social stories

Ok

um

So she might need

She might need I will ask an adult

Lisa: And she might need to be physically prompted the first couple of times to go

Nancy: Well and you may need to write these social stories real real specific

Uh huh

Like with the

When there are no paper towels I need to ask an adult

And what do you say and put the please on there put the whole script on there.

Well I can do that and I can tape it to her bed I can just put it right there on her bed

Mmhm

The verbal I need

Well but

Be very specific

The whole social story

In bed it may be harder if she cant get out of bed

Well not at that point cause I am upstairs and when this happens I never let it get beyond that

So she would need the cue

And she needs specific we could be in circle and I say please sing and wont do it I say please sing the wheels on the bus and sometimes she will do the whole thing

yea

Do you want to do it like PECS in the bathroom the paper towels aren’t there we have a picture of the paper towels and we have a phrase I need paper towels

She is going to still need the cue to go get somebody

Well that’s where we would non verbally take her the picture take her to the person

So is that a picture you would have on the paper towel dispencer or I don’t know and that’s where I am kinda get at social story taped to her bed

Right

I had a problem with her getting out of bed in the middle of night and I taped on her wall get back in bed it worked I would hear her and she would still get up but read it

Was that last year

It was last year she would say get back in bed and would go get back in bed

That’s great

And that’s what I was asking if I wrote up a social story and tape it to her bed its missing

Right

And what do you want her to do

I want her to come get me at that point

Write what you want her to say cause we want her to get it

Ok

Nancy: Mommy I need my blankie please

But she can do it and she can read it I can break it down

Comprehension I think she

If I break it down so so I am not talking about a four page story

Yea

But I mean if I put a piece of paper in there and I have not necessarily number them but star them and have them defined as steps

Mmhm yea cause she did do that at school so paper towels aren’t there number one go find number two say go get paper towels

And if you do that in a few situations and see how she can respond to it and then you can start cutting it down cause she knows she has it

You think that’s ok to go with the written verbal and not pictures

I think that’s worth a shot

Yea

Cause she can read it

Lisa: Sounds like she’s got it

So carpet square

Yea

Yea

She is looking at another students written she is very curious

So by reviewing social stories with her and and multiple situations you know you so that she is getting it here getting it here then shes got the verbal as to follow

Mmhm

I think she will

So it might be a script if we are talking about a social script so you know what does she call you

Or princess Krista

Ms Krista I need towels cause we are wanting her

We are hoping she will say that

She will have the script with her

Please

Please and what we have here is she is going to initiate this get the persons attention

I think if we go with that and the verbal cueing sometimes the verbal cueing becomes the routine and

Right

Since she is so good with the written

Well this will allow her to use some independence

Sure

Right

Yea

Nancy: When you hear

Mom: She tore it down yes I did yea she wouldn’t have none of it

You have to stay inside

Mom: It said do not go outside without mommy or daddy that was the first one

The reinforcer here is she gets what she wants so that

More things that she really

yea

Mom: Well im thinking I keep something on the refrigerator she wants a drink I mean cause when she wants a drink

Uh huh

She can come ask me

Yea

In our personal setting there are some opportunities for that

Nancy: Ok lets do the same things now with wait and walk with me and we will have to be collecting the data

That’s fine

Yea

Would we use a timer for the wait

Gestures

Yea

Would like to when us say to her so that its visual see it

So she can see it

If all the kids were going that would be too awful if all the kids were going outside and she had to wait that wont work

Becky, that’s not nice laugh wait a minute

Sometimes something that she really likes can be in her pathway you know she needs to follow the directions

Well that’s for walking but for wait

yea

Well I have an egg timer at home too

Right

If she has to practice when she sits on the yellow line or ready to go outside

She does that

Right once she is waiting

I think this is to get her to the point where she could stand by the car

Nancy: Well and it could be in to the walking where the teacher

Right

Nancy: You are practicing and walking and you say have someone come talk to you

Right

Nancy: You need something and

Right

Nancy: you give her the direction and timer you need to wait by me and maybe that’s

I think the sand timer would be a visual to focus

To start with that

Yea

I have

Awe

You know what I mean

I think she may become fixated on that kinda rigid and she will want

Well that could be something else

Right

It’s a start

She gets the practice

Lisa: Well and given her visual I mean her reading that could be something on the back of the wait card to look at while she is waiting and says stuff like

That’s a good idea

Lisa: Princess stuff

We will write down and try wait card on the front and then on the back

Something interesting to her

Yea

All the social stories

Right

Mommy said wait stand here

Yea

Well and even that could be off the back of it

Oh that’s true yea

You know even that could be on the back of it and princess stickers

Maybe the princess is waiting

Well that’s true maybe if we just address her as princess AJ that will be enough

And here too is it possible to use video

Yea

How we wait various strategies and the walking beside

Well she could again a video watching someone else

You made need a written card to cue her and certainly start with the short sentences so she succeeds

Walk beside me and stay with me

Ok

Stay with me

The meaning yea

So you would stay with me

Would she do better if you have stay with me on one and we are wanting her to walk with you I was just thinking earlier if she had something that said classroom and a reminder of where she is going

Oh that’s a good idea

Um

We have tried that with pictures

Uh huh

That didn’t work

So maybe it could be

Yea it could have all the places you go and you circle just thinking about a card that could be used for multiple places you go

And is she going to need any kind of reinforcement for doing this

She usually gets her desired snack

Verbal praise works for her

Mom: She likes high fives

Yea

Mom: If you are talking about a reward we do that a lot at home

Nancy: And then the naturally recurring then will you talk to Amy about

Yes

Nancy: How that’s carried over and what we expect there and you know we haven’t talked a lot about the system

Yea

Nancy: Ok anything else we need to go over.. now since we are a research team

Laugh

Lisa: Warning

Nancy: Fidelity check list the components you can check as many

Lisa: Here is another one

Mom: Do you need it like right now

Nancy: Yea

Mom: Ok