Friday, April 11, 2008

I respect my monkey

Although Bubbles knows that getting his own cup and leading me to the fridge is the fastest path to the juice, it is now the least likely thing to happen. We require more effort from him now, and this? This pisses him off.

We understood him last week! What is wrong with us? Don't we know that:
cup+hand tug+refrigerator=juice?

Of course we do. Maybe if he just screams at us and shows us how frustrated he is, then we will get off our asses and get him the juice. No? Maybe if he jumps up and down with the cup while whining (he is mulit-talented). No? Okay, then maybe if he throws the cup and rolls on the floor. Then we'll really feel bad and get him the juice. No? Okay, maybe he doesn't really want the damn juice anyway.
So he tries something else. How about some ovaltine? Get that and give it to Mama. Whine. Give her another cup. Whine more loudly. She still isn't getting up? OMG THIS IS SO FREAKING HARD!!!!!
Why won't I get up? Because he has not requested it with a(n approximation of a) word. We taught him signs a while back; but he didn't use them until now. Now he tries to recall and use these ancient signs, as his desperate last-ditch attempt at avoiding having to use words.

But in the world of speech therapy, we have goals. And one of them is to use spoken language instead of gestures. Bubbles can hear. Bubbles can make sounds. He can form words. Signing is, for him, using gestures to communicate. I pretend that I don't understand the sign for 'milk'.

Does it break my heart to see him try so hard and not be able to respond with instant gratification? Maybe bruises it a little bit, but I see the bigger picture now; I see the progress he has been able to make, the obstacles through which he has pushed himself and allowed himself to be pushed, I see the benefit of being able to form words which can be understood by more people than the three in his own little family, and I see the pride he has when he has successfully learned something.

When I am daunted by the process (OMG THIS IS SO FREAKING HARD), stumped by the hard or uncomfortable aspects of parenting, I remind myself of what I am really trying to teach here: Life Skills. Which is what we all do as parents. In our vastly different approaches, I think that most of us have similar goals.

Part of our current approach to getting Bubbles to use speech spontaneously, is to use a procedure I mentioned previously called Constant Time Delay (CTD). Initially, it had the efffect of making him dissolve into a heap of screams and flailing limbs. It was too much; we backed off and worked on other procedures which would lead up to success with CTD.
He will now parrot almost any word that we ask him to, merely by prompting him, "Say____"
And he will!
This is where the compliance in the three-step procedure (tell, show, do) is integral to the success of speech therapy. Even with a background in child development and early childhood education, even I had to wrap my brain around the concept of language as behavior. My husband also had a hard time at first; "I thought we were trying to teach him how to talk! What's up with all the 'do this, do that'?"
Have you ever tried to get a resistant two year old to say something just by asking or telling them to? I could ask my daughter to say almost anything at all and she would, but language was easy for her and therefore rewarding and fun. Did I do anything differently with Bubbles? Not consciously. In fact, Bubbles was probably exposed to more language than Supergirl, simply because of the greater number of people in the home talking to him. But Bubbles is not Supergirl, and I respect that this is a struggle for him. I feel it is my job to help him access language. Which is why I sought the help of experts who are willing to share their knowledge.
If you tell a two year old to say 'tree', and they don't say 'tree', or even 'tuh', then how are you going to do speech therapy? But if you can get a child to comply, because he realizes that this is what is expected of him, then there is a far better chance on working on the articulation of 'tree'.
This started with directed play (put the car with car puzzle, put the block on top the block, etc), moved into more specific directions (touch head, touch tummy, pat chair, etc), and then moved pretty quickly into "Say ______".
And he says it.
When we first started using this, he went nuts at the first sign of me saying the word 'Say'! I thought we were doomed. I understood the method behind it, but I still thought we were doomed. They don't know how stubborn he is, I thought.
Oh yes. They did.
Oh yes, I thought, this is why I called in the experts.
We made it through this battle of wills. And when he realized that he wouldn't get juice without saying some approximation of juice, guess what? He said "Juh." (Hope that didn't scar him forever.) And, in addition to him being able to respond to 'Say_____', we get the added benefit of good behavior and excellent listening.

So now that Bubbles has more or less mastered the skills of compliance and imitation, it is time to move on to new skills: Spontaneous use of language, making requests on his own. So, we are back to implemeting CTD. When he comes to ask for juice (or milk, or goldfish, or to go outside, to jump on the trampoline, to go to Hawaii right now, etc...), I will not respond to any non-verbal requests, except with CTD, with the goal of eliciting a verbal request from him.

At first, when Bubbles would want something, we used the traditional first step of

  1. getting in between him and the object of desire, looking questioningly at Bubbles, without saying the words 'what do you want', and raising our hands in a questioning gesture. But Bubbles has become such a good imitator, that he will just look at us questioningly, raise his hands, and copy our expression. So now we just look at him with a more subtle questioning look - but if I cock my head to one side, he will do the exact same thing. So a big part of the first step for us, is to not completely crack up.
  2. After ten (very long) seconds, I would hold up the juice and say, "Say juh", giving him a partial approximation of the word I am looking for, and wait ten more (very longer) seconds for him to offer the correct word.
  3. When he does not say more than 'juh' after ten seconds, I hold up the juice again, and ask him to, "Say juice."
  4. I wait ten seconds more for him to say juice, and if he does not say it,
  5. I prompt him with, "Bubbles, what do you want? SAY JUICE." and wait for ten seconds. If he says it, he gets the juice. If not, he does not get the juice, and we
  6. Start over.

Eventually (and I hope quickly; stay tuned), he will realize that just walking up to me and saying "JUICE" is really going to be far more efficient and satisfying, as well as the most direct route to getting the juice.
For anyone who is concerned that ABA does not show respect for a child, does not allow them input and choices and independence and worth, and essentially creates trained monkeys, you are sadly mistaken and uninformed. As we are newbies to this science, I am going to suggest that the concept is most eloquently explained by this anonymous commenter (to whom I wish I could give credit):

"Quality ABA is all about respect and teaching the child in a way that they are successful by breaking down skills and contriving siutations so they are better able to express themselves. By simply "showing respect" to children in need of this type of intervention, a child would be denied the right to learn..."

See? I couldn't have said it better myself.


Boss of Seattle said...

Puuurrrr-fect Batman. You said it like it is. You are an outstanding mama and woman. Kepp up the good work!

Lin said...

Most impressive progress, G...and results are ahppening quickly, too! YAY!!!!!!

Denise said...

Like I said before. When Danny would come home and do that touch head crap i would go nuts. He is not a dog. Nope try again touch head. But i do see the bigger picture. I.... could not to what he does every day. I asked him doesn't it make you sad if the kid is on a huge tantrum on the floor all because he want's juice. He said yes it is hard but they (the experts) just have to stick it out and work with the Parents to see the bigger picture.
Go Mama! Go bubbles! You are doing great in your quest for Bubbles being all that he can be. Screw what anyone else says. You and only you know what is best for him, and you are the best advocate for him.