Wednesday, August 31, 2011

What I Did This Summer

My summer began late in May when my parents came back from their annual winter trip to California.  They stayed longer this year because my dad was not feeling well enough to drive back across the country.  He and Mom visited with all of their grandchildren in California but it was hard for him and he rested more than he visited at each home.  Finally, my parents decided to come back to Minnesota despite his illness, but Mom, who does not drive ordinarily, did almost all the driving.  I saw my father, the first day that he returned, and I knew he was seriously ill.  When he finally agreed to go to the doctor, a few days later, I went with him to the Veteran's Clinic.  After few minutes, the doctor told my father that he was dying.  No tests needed.  Just a look.  A week and a half later, my father was gone.

An event like having a parent die, becomes a catalyst for change for many people, I suspect.  I don't think it is just me.  When I took time to reflect on my own life, I knew it was time to do something different.  I decided it was time to practice my profession in a different setting.

I have had kind of a personal mission for about the last fifteen years.  I remember the exact weekend that I suddenly felt compelled to try to make things better for children with autism.  I had seen a child with autism in a very unhappy situation and I saw that the people responsible for him, even the people who loved him, did not know what to do.  I had lots of ideas on how things could be better for him.  So, I set out to be a source of inspiration and practical knowledge, and to advocate with bulldog persistence on behalf of children with autism.  The clinic where I worked, The Scottish Rite Clinic for Childhood Language Disorders, supported me in every possible way.  I might have long since given up without that support.  Happily, the world of knowledge and skill related to autism has changed dramatically.  I think I helped to make this so, but plenty happened beyond my reach and influence.  There are still so many needs, of course.  There is no real end point on a mission like "making things better", but sitting next to my dad in what suddenly became our hospice living room, I reflected on the possibility that I had actually done what I set out to do.

So, I resigned from a job that I have loved at the beginning of the summer.  (I want you to know that that is really a hard thing to do.)  I took the summer off.  As fall begins, I will start a new job and see what else I can accomplish.  I am not finished with my service to children with autism, by any means.  I took a position in a school where there are many students who have this diagnosis.  But, I took a job as the school Speech Language Pathologist, not as an autism specialist.  I don't know yet if I will continue to write Autism Games blog posts.  It feels like I aught to either say goodbye here or say I will be back with more.  But, I really don't know.  So, that was my summer.

Tuesday, May 24, 2011

Making Choices with Interactive Musical Video

   The underlying principle for how I choose or create games and activities is:
I pick/create some activity that has a lot of predictability about it (this is the hook that snags the attention of a child with autism) and then teach a single concept by varying some aspect of the activity.  
In addition, I am always looking for a sensory payoff for the child to make the activity interesting--some cool experience involving one or more of the senses:  visual, auditory, tactile, balance, pressure (think Temple Grandin's Squeeze Machine), taste, smell (theoretical since I don't use this).

So here is an interactive music video which has a great auditory and visual payoff but varies depending upon the choice that the audience makes.  How cool is that?

Keep Your Head Up Interactive Video

Use it to teach:
  1. making different choices (cognitive flexibility)
  2. story telling
  3. predicting
  4. reading
  5. writing (make your own script with different branches)

Thursday, May 5, 2011

Playing in the Dirt

I am a gardener now but I began a happy relationship with dirt as a child of dirt tolerant parents. This week I watched children playing in a park sandbox and thought "this is a pale imitation of the experience a child can have while playing in good rich black dirt".   I was transported back several decades to the yard where I grew up and to the summer when my dad bought a big mound of rich black garden soil.  My brother and I  quickly claimed it for our own, spending hours each day on the hill moving dirt around.

We played alone much of the time, engaged directly with the dirt and whatever imaginary world we were creating so it is odd that I clearly remember that I was playing close by my brother.  We were companions.  He was very involved with trucks and transporting dirt from place to place while I was more involved in building cities.   I packed the earth into buildings, fences, tunnels and roads.  I imagined details that I could never have created.  At some point, together, my brother and I decided to make a gully for transporting water.  We tried to make a route for water that ran from the top of our hill of dirt to the bottom in a zig-zag pattern that we thought looked like  a river.  One of us was trying to keep the water running where it belonged while one of us poured the buckets of water carefully into the gully.  We could never get it to work as planned and ended up with nothing but a mud puddle, much to our disappointment.  Failed projects on the dirt hill never deterred us from trying the next thing rather through our successes and our failures we learn important things about dirt and about life.

We did not know it but we were actually studying art and design, physics, chemistry, architecture, and social skills.  There was a lot of constructive play where we were building our worlds and just as much pretend play where we were creating imaginary people and their imaginary lives.  Within these two frameworks, there was constant investigation, observation, and discovery.    We studied how the mud dried overnight and how it broke up when we walked on it the next day.  We studied the properties of different kinds of dirt--the rich earth on our hill as compared to the paler dirt that was already in the yard.  We studied how water soaked down into the garden soil and how it traveled across the top of the hard packed dirt in the yard where we walked every day.  We thought about town planning including transportation routes,  location options for schools and police departments--especially the jail which we needed because we created a lot of bad guys who needed to be locked up.  We created social conflict and then managed it. Our dirt houses were reinforced with straw, sticks and rocks--rather like the Three Little Pig homes.  We studied systems for adding mud to almost everything.  Even if I could not remember that summer of playing on a hill of dirt (and I can remember it remarkably well) it was a summer of intense learning that I now believe far outpaces any classroom summer program we might have been attending instead.

I am also aware, now, that not all children would love playing in the dirt.  I can't remember my introduction to dirt but I have seen some children fall into dirt from the beginning with gleeful enthusiasm and I have seen other children who work hard to avoid any contact with dirt at all. It is easy to understand why it is a sensory challenge for some children. It sticks to the hands, the toes, the knees and the clothes. Still, I think all children aught to have the opportunity to develop a happy relationship with dirt--even the reluctant children.  Most children can learn to enjoy playing in the dirt with no more encouragement than a good pile of the stuff and a shovel.  Other children might need a little more encouragement.  I grew up with my grandmother gardening vegetables in our yard and she was never happier than when her hands were in the earth. It was a form of play for her although she called it "working in the garden" but as I think about it now,  she provided me with a positive role model for enjoying the creative possibilities of dirt.  In my childhood, grown-ups did not play much with children.  I don't remember any grown-ups playing with me, period.  But, as a child my brother and I were both told every day, weather permitting, to "go outside and play."  All that was out there was my grandma's vegetable garden, a few "outside toys" like trucks and balls, a swing set and a big yard that was not landscaped. There were plenty of bare spots of dirt.  Well, actually there were more things out there but when the truckload of rich brown earth arrived, we really noticed it.  Luckily, whatever they intended to do with that black dirt did not happen for a long time. I think the key to getting most children to play in the dirt is pretty much what happened to me-- opportunity and not too many alternatives.

I forgot to mention that playing in the dirt  or doing anything for hours outside is a lesson in biology.   Just think for  a minute about all the living things that one can find in a yard.  There might be mushrooms, earthworms, beetles and bugs, seeds and sprouts, roots and tubers, sticks and leaves, snakes and moles.  The birds are apt to be close and and smaller winged creatures are everywhere.  The dog is liable to be rolling in the dirt.  The squirrels may be digging and hiding things in the dirt.  Chipmunks are curious and likely to come investigate whatever changes are made to the dirt--sometimes while you are still making the changes.  Plants and trees are likely to be sticking out of the dirt in endless interesting configurations, textures, smells, and size.  Every living thing that is associated with earth is a world to be observed and studied for a minute or an hour or a lifetime.

Time, in fact, passes differently while one is playing in the dirt or investigating the worlds in a backyard.  I notice this now while gardening and I experienced it as a child creating worlds on a mound of garden soil.  Time can almost stand still.  Moments can stretch into hours.   Watching a ladybug  stumble and tumble while trying to climb a little mound of loose dirt is theater on a different scale and the play may last seconds but those seconds stretch out and stay in the memory forever.  Seeing a bird pull an earthworm out of the earth and then feed it to one of her new born chicks provides an momentous experience of wonder.  This kind of timeless time calms the mind and eases anxiety.  Perhaps it is this state of well-being that makes learning so easy.  Playing in the dirt allows children to experience life in a way that is hard to replicate in any other way.

Cross Posted on FunDaMental Play

Saturday, April 23, 2011

Dirty Fruit and Naked Babies: The Dark Side of Toys

I once heard that the pretend play area in most daycare centers was a collection of "dirty plastic fruit and naked baby dolls".  This description brought to mind the toy basket in my living room when my children were young.  We had a large plastic laundry basket filled with toys.  That basket always caused me discontent.  My children spread them around the house daily but rarely played with this collection of toys that ranged from cartoon-like stuffed critters to disassembled Fisher-Price-Primary-Colored-Plastic-Everything. I liked those toys less and less over time as they seemed to cause a lot of trouble but provided little joy and were ugly to boot.

I don't remember having plastic toy fruit but I remember the naked babies.  Some were scribbled on with magic marker pens and at least one had hacked off synthetic yellow hair. They miraculously procreated at night I think because the collection continually grew and I don't remember buying any of them.  They all had clothes that were easy to remove but it was nearly impossible to dress those stiff little plastic bodies.  My children often fought over who had beheaded a doll or scribbled on one.   When they were little the laundry basket where the dolls lived with assorted other toys was more popular than the toys. My kids loved to climb in the laundry basket and getting a grown-up to push them around was as much fun as a carnival ride apparently.

I thought of the naked babies and many other toys as The Useless Toys.   If I tried to get rid of any of The Useless Toys, my children protested vigorously but I could sneak one or two into the Goodwill bag when they were not looking and these toys were never missed, but still the collection grew.  The Useless Toys were a seemingly insurmountable problem.

One day, in preparation for moving to the other side of the world, we sold most of my children's toys in a massive garage sale and they got to keep the money.   We kept and hand carried a collection of Lego blocks in a suitcase when we moved.   We shipped books and art supplies.  If I remember right, that was all.  I played often with my children on the other side of the world where I did not know anyone else and it was a lovely time in our lives.  We often played outdoors but I also loved building with them on the floor of our new, furnitureless house and we became a Lego obsessed family for years after that.

If my children and I had loved dolls, as some people do, we would have kept the babies and I would have dressed them.  A pretend kitchen with plastic food, even fruit,  would have been a good toy if they were younger at the time and if I had liked pretending in a small kitchen. We made choices based upon what we enjoyed as a family and the satisfying success of the new, drastically reduced toy collection was due to both a new orderliness and to my involvment.  After the toy purge, I bought new art supplies often to entice them to do art because I thought I should but I did not draw with them and so art supplies were the least used part of their toy collection. They played on their own with things that I taught them to play by example.  Books were central to our family play life because I loved books.  I read to my children often and we went to the public library every week.  I used the skills that I had learned in my one High School drama class (minimal skills, in other words) as I read books aloud and they appreciated my theatrics enough to make me feel like a movie star.  Over time, we just enjoyed the companionship of reading together in the same room. I came to believe that less really is more when it comes to toys.  It is probably true for grown-ups too.

New useless toys crept into our house over the years, but I treated them like the weeds that grew in my vegetable garden and removed them quickly.  I should have been more ruthless at times than I was but generous grandparents and moments of parental weakness created new toy problems from time to time.  Generally, though, I was successful to the extent that I kept the purpose of toys clearly in mind:  Toys are meant to promote play and should only live in a home if they honestly contribute to family happiness.

Cross Posted on FunDaMental Play

Thursday, April 14, 2011

Alison Hietala Lee

My heart is shattered by the news that Alison Hietala Lee, a beautiful, bright, capable, curious, loving, unique young woman has slipped away from this world as she gave birth to her daughter. What a loss. What a loss.

I can't find words to describe the grief that I feel and my time with Alison was brief. A few short years. Just long enough for me to fall in love with her lovely spirit and bright mind. Just time enough for me to imagine what a gift she would be as she began her professional career as a Speech Language Pathologist. I was so proud of her and so certain that she would bring joy to all the children she would serve and to their parents and to the other professionals who worked beside her. As I think about her husband and family...I can hardly let myself think about them because it is too painful.

In all the worlds of God, Alison I will try to trust that there is an important place for you because right now, here, there is a terrible hole. You are so loved.

Alison helping me create a video model for children with autism in a game that has been posted on You Tube since 2007 and watched by several thousand people on Autism Games.

Thursday, March 31, 2011

Video Modeling New and Strange Activities

A video model is a video clip made to show a child what is going to happen or what the child should do.  One of the best reasons to make a video model is to help a child through new and strange situations. Many of the things we do with and to children must seem very strange.  We talk most children through these new things, offering encouragement, reassurance, and explanations verbally.  

The doctor is looking at your throat to see if it is red.  A red throat hurts.  The doctor can make it better.  Open your mouth for the doctor.  It will just be for a minute and then it will be all done.  The doctor will be very careful.  She won't hurt you.

All this language helps most young children get through such new and strange activities.  A child with autism does not understand all that language though, so instead, we can find ways to show the child what will happen and reassure the child as best we can by making the activity familiar at least.  This is when it is helpful to pull out your video camera and take a few pictures or make a short video clip.

Below is a video clip made for a little boy who will be asked next week to allow a Speech-Language Pathologist to touch his face in a new way as he plays a game that is already familiar to him. For most Autism Games readers, this activity will seem strange as well.  Try to imagine how many times you might need to watch it, given no explanation, before you would feel that the activity was safe and acceptable.

For a young child with autism, many common activities are just as strange--hair cuts, dentists, walking a dog on a leash, eating outside at a picnic table.  This video model provides some important information but probably will not provide all the information that he would like to have. 1)  The child can see the sequence of things that will happen.  2) The child can see that the activity does not appear to cause his father any pain.  3) The child can see when the activity will end when all the rings are on the ring sorter.  After watching this video, you may wish to read more about this strange activity below.  One the other hand, you can skip the explanation and experience it more like a child with autism would.


In this video, Speech-Language Pathologist, Tamara Pogin is touching the face in a way that provides some information about how sounds in the word "on" are produced.  This is a system that is used to help children who have a speech disorder called Apraxia.  Deborah Hayden developed PROMPT (PROMPTs for Restructuring Oral Muscular Phonetic Targets) in the late 1970's. It has continued to develop and the system incorporates new research and evolving clinical perspectives.  PROMPT focuses on tactile-kinesthetic input to oral motor structures for changing and shaping speech sounds.  This is an alternative or additional method to typical speech treatment that relies mostly on auditory and visual input. For more information, see visit the PROMPT Institute Website.

Tamara Pogin, M.A. received training in an introductory PROMPT course.  She is not a certified PROMPT therapist, however, she is allowed to practice PROMPT with this introductory training.  For some children seen in our clinic, we have found this intervention to be helpful.  The little boy for whom this video was made, in fact, seems very curious and motivated by these tactile cues, however, as you might imagine, it also feels quite strange to him and we hope that he will be able to tolerate having his face touched more easily if he watches this video.

Friday, March 25, 2011

My Child Has Autism, Now What?

My friend and colleague, Dr. Susan Larson Kidd, published her first book recently!  My Child Has Autism, Now What?  Ten Steps to Get You Started.  At the clinic, where I work, we were all happy for her and so we hosted a book signing event at a local art museum.  I had the opportunity to introduce Dr. Kidd and this meant thinking about her, her work, and our relationship.  I will say a few words on these three topics here--because all of these things are important to me.  
Let me tell you about Dr. Susan Larson Kidd.  First, don't you think she has a great last name?  I know that the kids she works with love calling her Doctor Kidd.  She is an Educational and Behavioral Consultant who works in private practice and lectures around the nation.  She is good at practically everything that I find difficult.  Like singing.  That is something that I admire that she is good at and I am not.  In addition, she organizes and plans and documents and remembers the details like what various parts of the brain are called and the names of various intervention strategies and who the important researchers are and what they have contributed to the field of autism. So, when she writes a guide book for parents of newly diagnosed children, you can be sure that it will be practical, organized, well-researched and useful. It is a shame you can't hear her sing in this book, though.

We do have some things in common, Dr. Kidd and I.  We both find great pleasure in spending time with children who have autism. We share a passion for educating parents.  We both believe in the capacity of parents to learn and grow well into the fascinating journey that they begin the moment they start to parent a child with autism.  We sincerely believe that with good information and the acquisition of some new parenting skills, it is realistic and possible for parents of children with autism to create happy family lives.  The book Dr. Kidd has written reflects one of our shared goals in life which is to guide children with autism and their families toward happy lives.

 I will take this opportunity to reflect on my friendship with Dr. Susan Larson Kidd as well and give you an insider scoop, because we have a meet every week at least once if we possibly can kind of friendship. Every way that she and I are different and each way that we are the same contributes to the richness of our friendship.  We cover more territory in life through our friendship because of our differences and yet it always feels like we are moving in the same direction.  Professionally, in the same way that parents of children with autism must seek out support, in order to parent their best, those of us who work in this field also need support.  We need to be able to talk about our successes, which might seem insignificant to someone unfamiliar with autism.  We need to be able to talk about our dreams for children and get a second opinion on whether these dreams are too small, too grandiose or reasonably ambitious. We need someone safe with whom we can share failures and insecurities. We need someone to remind us of things we used to know but have forgotten.  We need someone to motivate us to keep seeking out new knowledge even though learning about autism can feel like trying to drink out of a fire hose.   Susan is all these things for me and more.  I hope you will buy and read her book and share a little in the joy of knowing Dr. Susan Larson Kidd.

Lexi, who is pictured in the book, is signing books too.