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I.P. Department 28.10. 05 Specific: In the morning I notice the room is being used for a number of activities unrelated to food, its consumption, or its preparation, e.g. table top activities such as doing jigsaws, peg boards. One at least has a food theme, this has objects such as a wooden knife and cutting board, and wood or plastic 'foods', e.g. 'vegetables', in sections, stuck together with 'Velcro'. The child can easily cut the items into pieces with the wooden knife. One group is having a snack and a drink but there is no choice, and no use of self-help skills such as pouring from a larger container into the child's own cup, and taking pieces of fruit from a serving plate and putting it onto the child's own plate. General: It would be more appropriate to reserve the dining room for activities connected with food, eating a meal, or preparing a meal. This ensures that places are distinct in their function and that the child's action, in t.r.a., of taking an adult to a room has a clearer meaning. It also means that the activity photos on the walls of the room form a more rational category, and organizes the child's life, and thought, in a better way. Procedures in the I.P. Department These form part of the n.r.a. environment, for the child, as long as he is in the hospital. Of course these are, on the whole, very sound. But there are some aspects of this which I believe should be modified. These are as follows:- 1. The area of choice, for the child, should be extended. There is a choice involved in the musical accompaniment to the video activity, in the morning. Here the child may select the musical percussion instrument of his choice. But this might be extended to other areas, e.g. what snack he would like, in the dining room, at around 11 o'clock. At the moment they only seem to be offered one kind of drink and one kind of snack, but they might be offered a choice between water, fruit juice and milk, to drink, and between watermelon, mango, and other fruit, depending on which ones are in season. This then provides another opportunity to represent the objects via photographs and develop the child's skill in using pictorial methods to communicate with, especially expressively. It also allows the child to increase his control over some aspects of his life, an aspect of independence, which is a major desire of the most handicapped of children. 2. A similar point is that there is, in my view, too much of the hands on approach by the mothers with their children. If the child can do something, he should be allowed to do it himself. If he is not very good at it, he should still be given some opportunities to try a skill by himself. If not, all we have is a sort of passive learning, which I do not recall as being a very effective teaching method. Again the issue is one of growing up, and becoming as independent as possible, and taking as much control as possible. Of course this must be monitored and undesirable choices prevented, but this will be reflected in the range of options given by the adult, they will not include undesirable choices. Also, if for example a child always chooses the same snack, this option might be removed and another substituted. On one occasion I observed the teacher briefly alter the arrangement wherein the mother sits behind her child and controls his actions, to one in which the child sits opposite the mother on the other side of the table. In the case of the mother-child pair I was sitting next to the increase in independence and the child's control over his own actions produced great pleasure in the child as witnessed by her broad smiles at escaping, even if only temporarily, from mother's control. 3. Although there is a good deal of relevant teaching of gross motor, fine motor and self-help skills there is still too much emphasis on traditional school content and verbal methods. General: There should be much more use of non-verbal styles of communication, natural gesture, (or t.r.a.), pictures, and sign, as discussed above, since many of the children will never learn to communicate well in speech, certainly not expressively. Denial of the appropriate avenue of communication produces frustration and aggression. 4. The growing over-use of the diagnosis of 'autism', to label cases where the simpler diagnoses of mental retardation, specific brain damage or dysfunction, behavior disorder etc. would be quite adequate and more appropriate. After all it must be observed that 'autism' was originally supposed to be a very rare condition, now it appears that there are as many autistic children as those who are just plain mentally retarded! The photo schemeSpecific:We could have a fraction, at least, of my scheme in the psychology department, as well as in the I. P. (in-patient) wards, in the O.T. department, and so on, as graphic models for schemes to be set up everywhere, and in the home. Of course this must be reinforced by people advising on the setting up of a similar system in the homes of patients and in other hospitals etc. This will include: Destination photos- of places which can be reached via a certain route, e.g. through a certain door. Note the spatial symbolic relative placement of these photos Contents photos- of things which can be found in various containers, e.g. cupboards, drawers, etc Activity photos- of what might, or should, be done in various places, with various objects, e.g. lie on the bed and sleep on the bed in the bedroom, wash the hands in the bathroom after going to the toilet etc. General: Additional on destination photos. Relative spatial arrangement of the photos in the destination/place photo array by a door. In t.r.a./p.c.s. these may inform the child, not only what places one may get to, by going through a door, but also give an idea of where they are relative to the viewer, so that place photos on the left of the array, represent places to the left of the viewer, as he goes through the door, place photos at the top of the array represent places further away from the viewer and so on, as described elsewhere. As usual the system can work in two directions. 1. If the child does not know the way to a place, how to get there, and knows the principles of this sub-system signalling, he can deduce this. 2. If the child does not know the principle of the signalling of this sub-system, his knowledge of the route can give him information about this principle. Note on destination photos Specific: In double doors in the institute, the left door, from the viewpoint of someone going through the door into a room, (or suite of rooms as in the case of a department, e.g. the psychology department, O.P. department etc.), is often kept closed and locked. The door on the right hand side is often kept open, or at least unlocked. This is the natural arrangement for a right handed person going into the place. In this case the best procedure is to have our photo of the place, (or places, in the case of a department etc.) by the outside of the door, and the destination photos by the inside of the door, placed on the fixed left hand door, (looking from outside the place or suite of rooms). This ensures that the photos can always be properly seen, and always be in the proper position, which they may not always be if they were placed on a door which is sometimes open and sometimes shut. General Additional note on destination/place photos The route An additional use of the destination/place photos is achieved by posting copies of a destination at strategic points along the route to the place from some other place. The photos then have the function of informing the child about the route by which he might get from A to B. These will of course be especially important at choice points. For example, say the child comes to a fork in his path with one corridor, C1, going one way and another C2, going another way. We should place a copy of the photo of the place corridor C1 is leading to at a suitable height for the child to see, on the wall of the corridor, after the choice point. We should do similarly for the other corridor. Note that it is clearer if the photo is displayed so that it is orthogonal to the wall, but this might be difficult to manage. General Note on contents photos This classificatory scheme can be used:- A.Child's expressive communication to an adult. (point to a photo on the outside of the container) 1. take object out of store a. child to do so. b. adult to do so 2. put object back into store a. child to do so b. adult to do so. B. Adult's expressive communication to the child (point to the photo on the outside of the container) 1. take object out of store a. child to do so b. adult to do so 2. put object back into store a. child to do so b. adult to do so Just as the point to a destination/place photo by a door is only a fragment of the full communication possible in pictures, which might use pictures of the child, an activity photo of him walking, and of the destination photo, so a more full communication is possible here also. In B, 2, a the adult is asking child to put an object away by signing, gesturing and pointing to the relevant objects, (and the relevant symbols if the child needs help with this). A complete communication in pictures could be an activity picture of child putting object away in a drawer, then a point to the image of the object, and the image of the photo of the object on the image of the drawer, etc. Specific The special education department I noticed on a door into the department the sort of sliding shutter device which can expose either a statement saying that the staff were in the room working with children or a statement saying that the staff were in the room by themselves. This suggested I cue these two situations photographically, just as in the device I had made for the door to the dining room at L.H.S. But there are three possibilities here in fact which are:- (i) we are in the room, you can talk with us, or 'khun khru yu nai hawng------' (ii) we are busy teaching children, or 'khun khru kamlang sorn dek dek' (iii) the room is empty, or 'hawng wan mai mi krai yu'. At first this seemed to prevent using a slide-able shutter device to expose one of the three possibilities, but D. solved the problem immediately in suggesting the use of two sliding shutters rather than one. Then three photos, each representing one of the three possibilities, can be fixed in the strip, and two shutters used to expose one of the three photos. The length of each shutter will be one third of the total length of the strip. The verbal description can be written in small letters just above the photo. I did succeed in making such a device which seemed to find favor with the staff. Note. We might consider these points (a) The photo of a room represents that specific room,no matter whether there are slight changes, e.g. of the position of furniture.(If there are major changes a new up-to-date photo should be taken and should replace the old one). This is similar to the name sign of a person in sign language, which does not change even though the distinguishing personal characteristic referred to does not. For example, a woman who used to wear very large hoop ear-rings stops wearing these but the 'hoop ear-ring' name sign is retained. (b) Similarly, in the device discussed the photos of the two special education staff members refers specifically to these people, not to adults in general. There is some latitude here however because the photo of the lady staff member working with a child could refer to the male staff member also. c) As for the child in one of the photos, this is a photo of a specific child, but we wish to refer to any child. The point also arises in activity photos. A child does some activity in a relatively public place such as a classroom. A photo is taken of this and put up on the wall of the room. This, because it's a photo naturally suggests that this child did, in fact, engage in that activity, in that place at sometime in the past. This meaning we wish to retain. But we also wish this to demonstrate that this activity is acceptable in that place by the fact that we have chosen the photo to put up in that place. And further that it could be acceptable for another child. in the future, to do that activity, and might be desired, by an adult, if the adult shows the photo to a different child. Note here that a child often points to a picture of a different child doing some pleasurable activity, but he does not mean by this that he wants the pictured child to do the activity,(again), he means that he wishes to do it. This is a sort of default interpretation, but at a later stage we will wish to be clear whether a picture of a specific child means just that particular child, or any child. We can do this in a couple of ways. (i) We can use a mixture of t.r.a/p.c.s. and t.r.a./s.c.s. This would involve using a general schematic symbol of a child, and putting this in a photo of a place, and so on. (ii) We can blur the individual facial features of the person, e.g. child. It would then represent an unknown, and unspecified child. Option one has the drawback that it looks rather odd, option two looks somewhat more natural. In a full communication by someone they could specify just who they were referring to by putting a tiny cut-out photo of a specific person over the blurred or fuzzy face-image of the person. This procedure also gets us out of the difficulty posed by a situation where we intend a photo of a specific person to only refer to that particlar person. In a relatively public place such as the school gym, we might have a number of activity photos on the walls, using different children in the photos of the different activities. This helps to convey the idea that various children can do these activities. But in a private place such as a child's bedroom, whether at boarding school or at his home, the relevant activities are, on the whole, only to be done by that particular child. So that specific child is shown in all the activities appropriate to that particular type of room, e.g. sleeping on the bed, making his bed, getting undressed for bed, getting dressed in the morning, and so on. Here the photo of the specific child refers only to that child, and not to any other. Specific Photos concerning the I.P. department The nature of the environment in the I.P department, with lots of glass, and walls at the 'wrong' angles made it necessary to fix photos on the glass of doors It would, as usual help if irrelevant and possibly distracting pictures and writing were removed from the general area where photos are to be placed. The low horizontal metal bar in the huge, (vertically), glass doors may be just at the most inconvenient height for placing our photos. In the classrooms the 4-drawer tower container by the teacher/nurse can of course be labeled with photos on the outside of the drawer. These might be smaller that usual versions, if the space on the front of the container is limited. A child might be shown another, perhaps larger, and laminated if possible, copy of a photo of an object and asked to go and find the object, get it from a drawer and bring it to teacher, or take it to a child, (who additionally might be represented by a photo). When the object is finished with, the child might be asked to put the object away in its correct drawer, and again this could be done symbolically with pictures, or photos. We might also have photos for the lining-up to get musical instruments part of the routine. The idea of communication via photos can again be reinforced. Photos, one for each different possible choice of type of instrument, can be shown to the child at the head of the queue, and the child is given the type of instrument he requests. It might be better if the photos are stuck to the outside of the container of the actual objects. If this is a basket there might be a difficulty, perhaps they should substitute a different type of container, e.g. a box. We might have written instructions, in Thai, to tell the staff what the photos are about, and how to use them. We should get these typed out, and they should be stuck just above the photo array, and be protected with 'Fablon'. General: So, for destination/place photos we will have:- "What are these photos? They are part of the photographic communication system, (p.c.s.), which itself is part of the visual-motor communication system, (v.m.c.s.). Destination/Place Photos. These photos are of places to which the child might go from this place, (room), through this door. They are photos of empty places, with no-one in them. The arrangement of these photos roughly represents the relative spatial positions of the actual places. So if place Plx is further from the viewer than place Plz, then the photo of Plx is placed above the photo of place Plz. If a place Plw is more to the right of the viewer than place Ply then the photo of Plw is placed to the right of the photo of Ply. How to use the photos. If a child tries to pull you to this door, (and please allow the child to do this), gesture towards the photos and ask him "Where do you want to go?"("Ao pai nai?"), and get him to point to one of the photos. When he does so, quickly take him to that place. Similarly if the child shows by other means that she wants something, e.g. the toilet, by e.g. pulling down her pants, holding her crotch, etc. again take her to the photos , and again ask: "Where do you want to go?" etc. If she doesn't point to the 'correct'photo get her to do so. When the adult is taking the child to some place from this room, the adult should point to the photo of the destination place and say "Now we are going there",("Pai ti ni"), and take him there quickly and directly. It would actually be better, and more in keeping with the visual nature of this communication, to add to this picture communication some communication in sign, e.g. when the child is going to the dining room make an 'eat' sign. (Do not indicate or talk about the other photos, just the photo of the place the child wants to go to or is to be taken to)". Specific: From a classroom (rooms 30, 31, 34 and 35), a child might go to these places, and so we need photos of these, inside the room:- Toilet ('hawng naam') Dining room ('hawng ahaan') 'Living room' Sleeping room/bedroom ('hawng nawn') O.T. Department Psychology Department Special Education Room Dentist Exercise, gross-motor area (just outside the classrooms) Play area ('sanaam-dek-len') Rooms 30, 31, and 34 are ordinary classrooms, but 35 has the soft play stuff in it. From the dining room the child might go to these places, and so we need photos of these, inside this room:- Toilet Sleeping Room Classroom Home From sleeping room 33 children might go to the toilet, so we need a photo of the toilet inside the room From sleeping room 32 children might go to the toilet, or home, and so we should have photos of these. General: For activity photos we will have:- "These photos are part of the photographic communication system, (p.c.s.), which itself is part of the visual-motor communication system, (v.m.c.s.) Activity photos These are photos of acceptable, and possibly required, activities which can, and do happen in this place, e.g. room. How to use the photos. Say a child tries to get you to do something, e.g. by giving you the object, or objects, necessary in that activity, i.e. (communication via t.r.a.). To move him onto the picture level, (t.r.a./p.c.s.), gesture to the activity photos and ask "What do you want to do?" If necessary help him to point to the appropriate activity photo, and then immediately begin the activity. Or, if the adult is going to get the child to do an activity in a place, he should take the child to the correct activity photo and say "Now we/you are going to do that" . Preferably this communication should be supplemented by mime or sign." (This latter type includes photo instructions to "Now wash your hands", after using the toilet, put up in the toilet) For contents photos we might have:- "These photos are part of the photographic communication system, (p.c.s.), which is itself part of the visual-motor communication system, (v.m.c.s.) Contents photos These are photos of the things you may find in these containers, and they tell you where you should put an object back after you have finished using it. How to use the photos\par The adult might point to a photo of a particular object on the outside of a container, and ask the child to find that one in the container. Or in reverse she might select an object and get the child to point to the right photo. When putting things away the child might be helped to put the things in their proper places with the aid of these photos" Different types of photos might be used together. For example we can combine an activity photo and a contents photo:- "If the adult is going to get the child to do some activity involving an object or objects, after pointing to the appropriate activity photo the adult should indicate the image(s) of the object(s) used in the activity, and then see if the child can find the object, or rather the container holding the object, and then get the object. If not he might be taken to the appropriate container, got to point to the picture of the correct object, and then to open the container and select the right object". Or again after the adult has pointed to one destination/place photo the adult might say and sign, "Now we are going to the e.g. dining room").When they get there the adult could get the child to point to the photo by the outside of the door leading into the room, and say and sign, e.g. "dining room" . When inside, the adult could take the child to the activity photos on a wall of the place, point to the appropriate one and sign and say "Now we're going to eat our snack/lunch/dinner\" etc. This should be quickly followed by the actual activity of the child eating this meal. Specific: The bathrooms In the bathroom on the left hand side, as you go in, there are toilet seats only. There are picture instructions about cleaning teeth but these seem to be directed at the parents, as 1.they are too high for the child to see 2.they are not concrete and involve some kind of medical model of the mouth. They are however in the right place as far as being by the sink goes. We should 1.make the pictures lower 2.make them concrete There is a long mirror running the length of the long sink/washbasin, and just above it. The child can see himself cleaning his teeth or washing his hands. There is nohand washing picture. In the right hand side washroom there are some toilet seats and some standing urinals. There is a long sink similar to the one on the other room, but no mirror. There is a picture sequence about teeth cleaning which is more concrete than the other one but it is still an objective view. Also it is again too high for a child to see - it's at an adult's eye height. There is a tiny picture regarding hand washing but again it's at an adult eye height. Note that we might use a picture, a single picture to point at, and tell the child to engage in the activity pictured, but we would need a sequence of pictures to be able to tell the child how to do the task properly. For the present the former less difficult goal should be aimed at. We will pick two relevant activities, washing hands, and brushing the teeth. We might take either objective or subjective views of these activities. By each tap in the room without a mirror we might use subjective view photos of these activities. In the room with the mirror in front of the washbasin we can use objective view photos. We might stick an objective view photo near each tap, just above the eye level of the child. This will mean that the child can get an objective view in the mirror, of his activity, by looking at an angle of 90 degrees to the mirror, and compare this with the objective view photo of his activity placed just above his line of sight. This might help him understand objective view photos, help him develop an understanding of his image seen in a mirror, help him relate the picture instruction to, (if an adult points to it), do that activity, with the actual activity, since there is the mediation by the mirror image. The two images should be as close as possible. Specific: Regarding the O.T. department we need 1. Destination/Place photo of the department to show children who are to be taken there, from some place 2. Activity photos to be put up in the department itself, e.g. a. Exercise on the big ball b. the skittle exercise c. massage with the device (Incidentally we need a photo of massage activity itself) General and Specific: Psychology department -- photos 1. Photo of the entrance to the department. A copy of this will be used to show to the child if they are going to the department from some other place, e.g. from I.P. I suppose. This photo could be put up on a wall of the I.P. department. Where? 2. Contents photos. What things are in the containers 3. Activity photos To be put up the walls of the rooms in the psychology department. a. Photos of each psychologist sitting at a desk in a testing room, with testing stuff on the desk, taken from where the child sits. b. The idea depends on the existence of very different looking activities. Are there any such very different looking activities which are done by psychologists? Perhaps most of their work involves talking, (which gives no visual cues), or fine-motor, sedentary activities, (which are only cued or signaled by relatively slight visual cues, especially the different materials used in the manual activity) Compare this with the very different looking gross motor activities done by the O.T. staff. Relevant, criterial visual cues, and irrelevant, non-criterial, accidental ones Consider the psychology department at R.I.C.D. There is a very large picture, (photo?), of a waterfall in the entrance space or hall, of the department, on the wall facing the entrance door. This then figures importantly in the photo of the place, taken from this door. The picture is attractive and makes the room and the photo view very distinctive but it has nothing essentially to do with what this particular psychology department does, or with what psychology departments in general do. So while it might be a reasonably useful identifying feature for this particular psychology department it is not useful as a signal for other psychology departments, which do not have this picture. Even as a symbol for this particular place, it does not give information about the essential nature of the place. If we wanted to have a more general symbol of a psychology department, rather than a photo of a particular psychology department, this photo would not be of assistance. What we need are the activities typically and essentially carried out by psychologists, (child psychologists), especially those involving children and objects essentially and importantly involved in those activities. In cases where the activities and objects involved in them are visually very distinctive, and easily photographable there is not much of a problem here, we will see representations or images of the objects involved in the photo of the place. These may be first order images of the actual objects, or second order images of the images (object photos) of the objects, placed on the outside of drawers containing the objects, or images of the activities in images of images (activity photos) on the walls of the place. (Note again that since these images or images of images will be quite small we may need to increase the size of the place photos, above the 6" x 4" size we are currently using. What activities are characteristic and essential and visually distinctive, and what objects involved in the activities are characteristic and visually distinctive? What characteristically and concretely do the psychologists at R.I.C.D. do? a.They work with children so an objective photo view of the psychologist with a child may be much better than a 'subjective' view just showing the psychologist sitting at her desk with test materials on it. b.What activities does the psychologist do? She gets the child to do various activities, e.g. (i) do Block Designs, Object Assemblies, Picture Drawing tests, and so on. (ii) do verbal tests. So we see that many of these activities, due to the channel, (auditory-vocal), are not easily portrayed visually. (This is why the mentally handicapped child finds it difficult to develop verbal skills, because he can't see howthe sounds are made, how the vocal organs are arranged and what they are doing to make the sounds.) So of course we focus on the performance, manual, visual motor skills which the psychologist is trying to assess or develop in the child, to photograph, and put up on walls of the rooms used by the psychologist for these activities. For example the above mentioned Block Design, Object Assembly, Picture Drawing tests and so on. But there may be cases where an activity involves visual stimuli, but a verbal response, and where the visual stimuli are distinctive and characteristic. These again would be suitable to photograph for activity photographs to be placed on a wall of the room. Examples would be the child being shown test stimuli such as plates from the T.A.T. or from the Rorschach, which I was surprised to see still being used by the psychologists, and with children of low ability at that! |
(iii) Another example is that of play therapy and diagnosis via play activities. There is a special room set aside for this in the institute, a good thing, for reasons set out elsewhere. In this room there are toys such as a large dolls house, dolls, and doll house furniture for the child to play with. Although the intention might be to get at psychological problems, which are not picturable, the actual activity of the child is very distinctive, and highly picturable. This is then another good activity photo to take and put up on a wall of the play therapy/diagnosis room. (iv) Another activity is that of behavior modification, which the psychologists carry out in the department, and obviously wish to give parents training in, in the department. Any very verbal activity, is of course unsuitable to photograph but the nature of the children seen at the institute, ones of low ability, who will learn by non-verbal parental responses better than verbal ones, would seem to solve our problem. So for example we will stage a situation where a child, (a normal child of one of the staff, for example) is asked to pinch the psychologist on the arm, and the psychologist turns his head and face away from the child. This situation is photographed. The training of the parent will then be achievable in two ways, by the actual actions of the psychologist, his actual interactions with the child, and by the pictures of these actions, placed on a wall of the room where these typically take place. These activity photographs will then put up on the walls of the appropriate rooms, e.g. test activities on a wall of the two little test rooms, and the dolls house play on a wall of the play room, and the room photographed again. These photos of the rooms in the department, containing the activity photo images, will then be placed by the outside aspect of the door leading into the department, in an array which roughly describes the spatial relationship between the different rooms. So for example, as you enter the department, one is in the entrance hall or room, the psychologist's office is the first room on the right, one little testing room is on the immediate left, there is another slightly further in, again on the left, and the play room is just beyond the lounge etc. If a child is being taken to the department he can be shown a photo of the lounge, or of the specific room which he will be working in, e.g. the first little testing room. He could also be told what he will be doing, by pointing to the appropriate little activity photo image on the wall of the place, shown in the photo. Even more elaborately he could of course also be told who he will be working with, by being shown a photo of the appropriate psychologist. Then eventually we might eliminate all the irrelevant, distracting cartoony picture nonsense that adults think is necessary to stick all over the walls to keep the children happy. Instead we might have relevant, information-carrying pictures, but pictures which are also pleasant to see, because they represent pleasant and enjoyable activities which the child might have done before in that place, and/or will do there. These might be activities which are intrinsically pleasant such as playing with toys with a nice adult, or partly extrinsically pleasant, e.g. doing a test, partly because it is quite interesting in itself, but partly because the psychologist will praise the child for his work. If the child is doing an intrinsically pleasant activity, e.g. playing with toys, he might show this with a smile, and we need to show this in our activity photograph. The psychologist will ideally be kind to the child and get him to do what she wants; she will then praise him and give him attention and affection. She will give him recognition that he's 'been a good boy'. The pleasure of both child and adult might of course be clearly visually signalled by the smiling facial expressionsof these two people. This also must be shown in an activity photograph. Specific: 21.9.05 At last I have put up some photos in one classroom of the I.P. department. I put up a photo of the room on the outside, by the door, not on it, and three photos of destinations/places by the inner side of the door, i.e. toilet, dining room, and resting room. They were stuck directly onto the glass with double-sided sticky tape, and covered with 'Fablon'. An unexpected problem occurred in that light shone through the glass and it was possible to see the image of the place from the reverse side of the photo! So it was necessary to stick the photo to a piece of thin blue card, with the double sided sticky tape, and then stick this to the glass with the same sticky tape. For neatness, the photo of the room, on the outside of the glass, was aligned with one of the inside photos, actually the middle one. Labelling of the photo system In fact this incident reminded me of a principle I had adopted when I set up the system in the school for s.l.d. children in the U.K. I therefore decided to use the same idea in the institute. The principle is to label all the photos in the scheme by placing them on a piece of blue paper or card. This is slightly larger than the photos so that the photo is given a blue border. The photo is stuck to the blue paper with double sided sticky tape and the paper, in turn, stuck to the glass, or masonry,of the wall, with the same type of tape. This label is intended to mark the photos of the system, and indicates that they all share a common nature, and intended use, and goal. For example the child may see a picture of a tiger in his classroom. This may be simply decoration, we do not intend the child to refer to a tiger by pointing to the picture, and perhaps ask to be given a tiger, or for the adult to point to the picture to tell the child he is being taken to a tiger! Such a picture will not be given a blue border. I ask a nurse about the Thai names of various rooms. They are Living room (my 'general area') = 'hawng nang len' Toilet = 'Hawng nahm' Dining Room = 'Hawng Kin Kao' Resting Room = 'Hawng Pak Pon' Play area = 'Sanaam Dek Len' General The child's communication We want to describe the nature and competence of the child's communication, both a.Receptive and b.Expressive We wish to characterize the nature and extent of the communication, w.r.t. two channels, 1.auditory-vocal and 2.visual-motor The level of the child's auditory-vocal channel, verbal communication could be roughly assessed with the Denver II, although this doesn't separate receptive from expressive skills. The level of the child's visual-motor style of communication has also to be assessed. After the assessment we can attend to the work of teaching and training these skills I believe that the appropriate mode of communication for many s.l.d. and 'autistic' children, children who don't talk, who have communication problems, who may never learn to talk, is in the visual-motor channel. Communication skills in this channel might be developed through these stages, from least to most sophisticated, t.r.a. -----> t.r.a./p.c.s. -----> pure p.c.s. ----> s.c.s.---- --> mime -----> sign In fact we may get other hybrids, not just the t.r.a./p.c.s. one. So we might have mixed or hybrid n.r.a. and t.r.a.; part of the communication might be n.r.a., and only part t.r.a. As soon as we make a piece of communication more complex we open the possibility for the existence of hybrid forms. Therefore instead of our initially described t.r.a./p.c.s. hybrid we can postulate many, e.g.:- n.r.a. -------> n.r.a./t.r.a. -------> t.r.a. -------> t.r.a./p.c.s. -----> p.c.s. -------> p.c.s./s.c.s.--------> s.c.s. -------> ------>s.c.s./sign --------> sign. Actually we need more than a single line here, we need at least two or three. (Discuss) To make it easier to move from one stage to the next we should try to ensure that there are clear links between the different stages. So for example, a real cat has whiskers, (n.r.a. and t.r.a.), this will be shown in a photograph, (t.r.a./p.c.s. and p.c.s.), should be emphasised in a symbol, (s.c.s.), and a reference to this feature might be the sole content of a sign. As well as this, as said elsewhere, once the child has developed wide skills in one stage, e.g. t.r.a., through his communicative efforts in that mode being rewarded promptly, he should be moved on to the next stage, e.g. t.r.a./p.c.s., through withdrawing such reinforcements, and reserving these for his communications in the new, t.r.a./p.c.s. stage. This might be done gradually, as a phased process, as the child learns more and pieces of individual communication skills in the new mode. We have to discuss the difference between A.forward pointing implications/meanings e.g. child gives mother the car keys ----->child wants to go for a ride in the car ------> to the shops------> to buy some sweets and B.backward pointing implications/meaning e.g. child finishes a task <-------- child puts away the objects involved in the task Which is more sophisticated? What is the most primitive process - classical sign learning, the buzzer siggnifies that food is to follow. This is most like A. Is B more sophisticated? If it is we could perhaps turn it into forward conditioning somehow. Perhaps along these lines Child finishes a task <------- child puts the objects involved in the task away Child plans,represents,symbolizes finishing a task-- ----> child plans, represents, symbollizes, putting the objects involved away---> in implementation , the child actually finishes a task. Behavior can be more or less complex at any stage. We said that we should develop skills to some breadth at each level before moving on to the next level, e.g. develop n.r.a. properly and extensively, before going on to t.r.a. Poorly developed behavior in n.r.a. may yield primitive, incomplete, fragmented behavior, e.g. the baby cries to show it wants something but it isn't 'saying' what. It knows that it doesn't want things to be as they are, and is signaling this state of discontent, but doesn't know, or can't signal, just precisely how it want things to be. In terms of location and place, a child may know that it doesn't want to stay/be where it actually is at the time, and may be able to signal this by taking the adult away from the place, e.g. to a door leading out of the place, but may not know just where it wants to be. Recall the case of Z.F. at W.W., who would take an adult to a door, go through and then stop and not know what to do next. Possibly if one brought in recognition instead of recall memory, e.g. took the child to the place we guessed it wanted to be at, would it recognize this as the place it wanted, shown e.g. by a smile? Does a baby know what it wants? The mother hears the baby cry and knows from this that it needs something. The baby is not telling the mother just what this is however. (The baby is possibly not even telling the mother thisconsciously, if the crying is purely emotional and instinctive).The mother then uses this information, plus knowledge of the recent past history of feeding the baby, to diagnose a state of hunger in the child. If the hungry child is given a bottle of milk, or the breast, it recognizes that as the thing it wants, it smiles and sucks. N.R.A. The child has to learn where the things are in his environment, where the good, nice things are, and to a lesser extent where the bad things are. This is a primitive ability well developed in the most mentally handicapped of children. Before the child can show his mother, (in t.r.a.), that he wants a ride in the car he must know where the car keys are kept, before he can show her, (in t.r.a.), that he wants a drink of orange juice he must know where his cup is kept, and where the orange juice is kept, e.g. in the fridge before he can show his mother, (in t.r.a.), that he wants to go to his bedroom, e.g. to sleep, he must know where his bedroom is. Why might he wish to communicate to an adult? To get help or permission to get what he wants, or more generally carry out a plan. (Recall that these two are very similar, 'help' might be defined as assistance in removing an obstacle other than the person to whom the request is made, 'permission' might be defined as assistance in removing an obstacle posed by the actual person communicated with.) But this is only one part of a plan, which in n.r.a., if communicated to an adult, becomes t.r.a. We can look at all the other aspects and details of a plan and look at them in the same way. So we have:- 1. The goal object, situation, or activity In n.r.a. the child must discover, through exploration and experience, what objects, situations or activities are good, or bad, in an ultimate sense for him (Note that this is a generalisation, if the thing is good or bad at any particular time depends on the current need. Also note that the positive value of a thing is only another way of saying its incentive value is high and that the need-drive to attain it is strong. The positive value of the ultimate goal will be highest, next comes the sub-goal immediately before the ultimate goal, next the sub-goal before this one and so on.) where these objects, situations or activities are So, for example the child learns that orange juice is in the fridge sleeping is in the bedroom, etc. when these activities occur how to use them (Presumably how to use a goal object = the goal activity) In t.r.a. he signals these facts to an adult 2.Various means objects, situations, or events In n.r.a. the child learns, through exploration and experience, what objects, situations, events are good, (in a derived sense), where the objects, situations, events are when the activities occur what their uses and functions are what they are good for how to use them (For example to use a cup to hold liquid (a drink), you put it the right way up, take the container of liquid, and put it close to the cup, start to tip it over, with the spout at the lowest point of the rim, and just over cavity of the cup etc.) where these objects are In t.r.a. he signals these facts to an adult 3. Various obstacles, objects, situations, and events 4. Evaluation Is the goal achieved or not? In n.r.a. the child registers success with, e.g. an emotional smile failure with, e.g. an emotional frown In t.r.a. the child signals success via, e.g. a deliberate, conscious, social, smile. failure with e.g. a deliberate, conscious, social, frown. More complexly, various events should occur after failure, depending on the number of failures, e.g. try the plan again, revise the plan, revise the goal etc. Each of these will occur as n.r.a., and also be capable of being communicated to another person, e.g. adult, via various channels, e.g. t.r.a., pictures, symbols, sign etc. The functions and uses of objects We can class these, importantly from the psychological standpoint, in these ways:- normal common uses, the use or uses a manufactured object was designed for versus uncommon, original uses, but ones that are still constructive and useful For example a large tome might be read, or might be used as a step on which to stand to get that copy of "Lady don't fall backwards!" (as long as it doesn't damage the book) uses of an object, versus abuses of an object. An object, e.g. person, might be used properly, e.g. to make a cup of coffee for you, or abused, e.g. pinched, to get a reaction, and give the child pleasure and excitement n.r.a. and t.r.a. The adult's response to the above types of behaviour in the child Say a child abuses or misuses an object, uses it in a way which the adult does not approve of, (and which most adults would not approve of), and in a way for which it was not intended and which might be harmful or dangerous to the integrity of the object, or to the other objects it is being used with. For example the child starts to scribble in one of his father's expensive textbooks. Signal of disapproval/Response A An initial, weaker response is to look away from the child and what he is doing. A exaggerated head turning movement, or even a turn of the whole body away from the child should be used. Here you are separating your gaze from the child's unacceptable and abusing action with the abused object. What the child is interested in is not necessarily the action with the object, but the adult's awareness of, and reaction to, the child's action with the object. Signal of disapproval/Response B. A stronger signal consists of a removal of the object from the person doing the misusing. You separate the person from the object. You 'put the object away', to some degree, on behalf of the person or on behalf of their better self. Recall here the idea of degrees of 'put away-ness', child might work to get the object, again, if its appropriate. (But if it is quite inappropriate that he use the object at all, e.g. he is 3 years old and the book is a text on thermodynamics, then the book might be put away to a very high degree). If the object can be appropriately used by the child in some way, e.g. it's a toy, you might then give the object back to the child and see if he will now use the object properly. The removal, (temporary), of the object is n.r.a. and has a t.r.a. signalling component. The removal could vary in severity, may involve increasing distance, number and/or difficulty of obstacles, or time duration. The signal is one of the adult's disapproval of the child's use of an object. If the object a child is misusing is a person , or part of a person, the same principle might be applied, separation of the misusing/abusing person from the misused/abused person. (For example the child is pinching your arm, and you separate your arm from his hand, or even move bodily away from him, as a stronger signal. Again this might be done for a greater or lesser distance, ('restraining order'), and/or time. As an extension one may remove the child from a place, put him outside the door, in a little corridor, as another signal. This was done by me with the little aggressive boy at W.W., to great effect. This logically might mean that the child is misusing all the things in the room but is probably not usually intended to mean this, just done to mean "if you will not behave in this place, at this time, if you mistreat the things, (including people), in it, when we are doing this activity, we will remove you from the room". We could see this as a sort of emphatic statement like the other emphatic styles in t.r.a., e.g. exaggeration of a looking response. This response by the adult is clearly the opposite of a request to a child to start an activity, consisting of the adult giving an object or some objects involved in the activity to the child. So a request/demand that he stop his current activity is to take the object(s) away from him. We might consider this sort of separation of person from object, and/or putting away of the object as simply meaning "stop what you are doing now", or "I am stopping what I was doing" done by a child. To this latter belongs the child folding his arms after completing a B.D. task in a psychometric examination, to indicate "I have put my hands away, separated them from the task materials, (because I don't need my hands for the time being, because I have completed the task). Also here is the case of the adult getting a child to fold his arms which means "I want you to stop what you are/were doing", (used a lot, and correctly, at the institute) We perhaps really need an extra signal that the child was misusing the object(s), signalled, most naturally, by a frown . These ideal responses by the adult to unacceptable behaviour by the child, might of course, in t.r.a./p.c.s. be photographed, and put up on the walls of rooms. An ideal place is the psychology department, where parents come with their child. The photographs, of a staged situation, involving a normal child 'actor', necessarily, would be accompanied by a written caption also describing what the adult should do. These instructions might be written, or pictorial, or both. Since they are addressed to the adult this might be shown by having the material placed at the adult's eye height. The functions and uses of objects, continued There exists a particular sub-class of objects, which are containers . This is a very wide class which includes sub-sub-classes which are cases, boxes, bags, drawers, refrigerators, bottles, plant pots, cups, tumblers, cupboards, wardrobes, vases, rooms, houses, other buildings, wombs, vaginas, eggs, microwave ovens, cars, airplanes, garbage bins, toilet bowls, wash basins, bathtubs, etc. About containers The things that one does with a container, its uses, are:- a. (i) open it, if necessary, e.g. take off the lid, pull it out, (if a drawer) etc. (ii) put in the things that belong there (iii) close it, if necessary, e.g. put the lid back on, push it back in, (if a drawer) etc. or b. (i) open it, if necessary, e.g. take off the lid, pull it out, (if a drawer) etc. (ii) take out things in the container (iii) close it, if necessary, e.g. put the lid back on, push it back in, (if a drawer) etc. In a sense (a.) is a negative use of the container, (b.) is a positive use. In (a.) we remove the things in the container from the container and move them to the 'work area' to use them. As for (iii) there may be a lid or not. Even if there is a lid it may not be correct to replace it. For example if the contents of the container have been used-up, then one may not put the top back on, one may throw the container away . This happens if the container is a one-use item, e.g. a beer bottle. The use of a container, positively, is to hold objects. For this, the container must be opened, (e.g. a handbag opened, the lid of a box, if any, removed, a drawer pulled out, etc.). Then the objects are put into (preposition), the box and the container closed, (e.g. a handbag closed, the lid, if any, of a box replaced, a drawer pushed back in, and so on). The function of a lid to close a container is achieved by the action of putting the lid onto the container The final state, as a concept, is on the top of the box , a prepositional phrase. It has the reverse function, of opening a container, when the lid is taken away from the top of the box or whatever. In this case the original, starting position is important, the end, final position, ( away from the top ), is not important). Here the concept is really:- not on-the-top-of-the-box The greater the child's experience with specific containers, e.g. cups, vases, flower pots, boxes, cases, bags and so on, and their functions of holding particular items the more general the idea of a container, the more abstract the concept, and the idea of a wider class develops. (The female organs of sex and reproduction can be regarded as containers, and at a very basic level, by people of quite low intellectual level. Therefore specific containers, e.g. vases, flower pots, etc. can be symbols, in general, of containers, and then back, in turn, of specific containers, e.g. the female sexual and reproductive organs) Types of containers The different types or sub-classes of containers correspond to different types of things they are meant to contain. For example a fridge is meant to contain food that should be kept cool, a room is to contain furniture and often people, to keep the latter dry and warm, a woman's handbag is to contain makeup, fresh tampons, aspirin, condoms, etc. A waste paper basket is to contain unwanted paper, a kitchen bin to contain garbage or kitchen waste, a dustbin outside the house is to contain the waste from the kitchen bin, when it's full and so on. These different sub-classes, having different varieties of 'containing' will correspondingly have different forms, a fridge is different from a handbag, suitcase, or backpack etc. Objects in the latter group have another function, as well as containing things; they are meant to be portable, and to be carried, and so carry, things from place to place. A room is basically a container of furniture and sometimes people, and a cupboard or a set of drawers or a box is a container for small objects such as toys, and objects for activities like various manual or fine-motor activities. Therefore the basic style of signalling, e.g. by photos, what is inside the room or drawer, or cupboard or box should be the same. Children, in the institute, and in Thailand generally perhaps, seem to be well trained to put things away when they have finished using them. As well as being good from the point of view of teaching the child habits which will make his life more organized and efficient, (n.r.a.), it is also very useful from the point of view of signaling to others that an activity is finished, or that its termination is desired. The behavior may not be taught so thoroughly to children in the U.K., and so the putting-away-objects behavior, as a way of showing the desire for an activity to end, may be more common here than in the U.K. I remember a few cases of this type of communication in s.l.d. children in the U.K. but there do seem to be more here in the institute. Relationships between containers There may of course be various relationships, e.g. topological, between different containers. So in a house, one room, or space, is next to another and a door leads from one to the other. A cupboard or set of drawers is inside a room, which in turn is inside a house etc. (If we add the objects contained in the container, necessarily, by definition, inside the container, we get this sort of Russian doll nesting:- food inside the fridge, inside the kitchen, inside the house). A woman's vagina leads into her womb, and so on. As said elsewhere containers should have their contents signaled/labeled, on the outside of the container, on its side or lid etc. If one container is nested or contained within another this should be reflected in the labeling, e.g. The grouping together of objects, in containers, should be of a meaningful, logical nature, e.g. all objects used in a particular activity For example the objects involved in the child's activity of making a particular Block Design are i) the blocks ii) a picture of the design the child is supposed to make, the goal the psychologist has chosen for him, what he is supposed to do. In the W.I.S.C. the blocks are kept together in a little box, in turn in the test case, while the test booklet containing pictures of the designs to be constructed are also in the case. We would argue that the box containing the blocks, and the book of designs should be together in an intermediate size box, and that this box should be in the case. (What is not here are instructions on how to do this, but they could be. If they were this would be analogous to the case of e.g. an electric power drill in its case, together with instructions on how to use the drill, e.g. how to put bits in, how to get different speeds, how to get reverse movement, and so on. ) On the locations and placements of objects, including containers, symbolic objects such as photographs and so on. These must obviously be sited in the appropriate places. An appropriate place is a place where the object can be used properly and easily by the person or type of person for which it is intended So an object, e.g. a container, for toys should be placed where the child can reach it, at a low level. But objects, e.g. containers, for the use of grown-ups, (only) should be placed at a high level. So we place drugs, medicines etc. in cabinets placed at a high level. (n.r.a. and t.r.a.) Correspondingly the t.r.a./p.c.s. pictures or written instructions referring to the things to be used by adults will be by the object, on a high level, while the t.r.a./p.c.s. pictures or written information on the use of the things to be used by children will be by the object(s), on a low level. So all our t.r.a./p.c.s. photos are at a low level, at the eye level of that of the average child using the system. We will place instructions for adults, (only) at the eye level of the average adult. This has the added advantage that the amount of visual data is reduced for the person, and gets rid of some distracting visual noise. (As well as this I always suggest getting rid of some of the eternal goofy cartoon pictures which staff always believe the children want to see around them.) Another example is the activity photographs that depict the possible and acceptable things which can be done in a place. The possible and acceptable activities for a child, in a psychologist's office, include things like doing test activities requested by the psychologist, playing with the toys in the play therapy/diagnosis room, and so on. Pinching the psychologist or other adult is possible but not acceptable and so is not represented, at least not in the low eye level stratum. For the adult, the acceptable and recommended (by the psychologists) response to good behaviour is to show approval of this, give him attention etc, and this should of course be pictured. But also recommended are particular responses by an adult to negative, and unacceptable behaviors on the part of the child, e.g. aggression towards a child or adult. Such reactions might be to look away from the child, and deny him adult attention, a powerful incentive and reinforcer, for a child, remove him from the object or situation, and so on. These adult activities should also be pictures. All these recommendations, verbal and pictorial ideally perhaps, since they are for the adult will be sited in the upper stratum. The reason for the separation is based on the old experimental result from the Russian psychologists that, at a particular level of mental functioning it is useless to tell the child not to do something, he only responds to part of the message, doesn't process the 'not', and does what he's been told not to do! Stopping an activity and completing an activity Note the difference between an activity stopping , and an activity being completed . If an activity is completed it has stopped, but an activity can be stopped without being completed. When completed an activity has reached some sort of natural end. For example take the case of threading beads onto a string. If a thread is full, with 12 beads, then this is the natural end, and the completion, of the task of threading this piece of string. You cannot put any more on. But you could stop the activity at 7 beads, although the activity would not have reached its natural end, and not be completed. It is always better to have the child complete an activity. Why? Because gives a sense of completion and achievement, and organizes the child\rquote s life in a more satisfying way. ( See Gesell, Zeigarnik, and so on). We can extend this scenario and get a more complicated structure, as follows:- Child fills thread th1, and then fills thread th2, etc. When he has filled all the threads given to him he has completed the activity of threading; there are no more threads. The successive steps here can be seen as sub-goals, g1, g2, g3, etc., which, when successively achieved result in the achievement of the ultimate goal G. In this case the links between the steps are simply--- In the case of three activities:- Complete activity a1, and complete activity a2, and complete activity a3, then the total activity is completed. In this case we can regard the order as immaterial, it could be:- complete activity a2, and then complete activity a3, and then complete activity a1. The resultant goal is a simple addition of the previous steps. But it might be that one has to do the activities in a particular sequence, a1, and then a2, and then a3, in order to achieve the ultimate goal. This might be an arbitrary requirement by the tester/trainer/ teacher, e.g.:- action 1, a1, and then --> action 2, a 2, and then -----> action 3, a3 and then ---> Goal, (the trainer is pleased) Here there is a mere temporal relation between a 1 and a 2 etc. but a causal one between the whole sequence and the Goal:- [a1---> a2--->a3]------> teacher is pleased or we might have:- action a1 -----> action a2-----> action a3----> G. These can be called sub-goals, leading to the final goal. When one has finished using an object or objects one should put the things away, or 'put them away' in the appropriate storage containers, or 'storage containers'. This is useful as a t.r.a. signal to another person. So under this heading also comes the behaviour of our child at the school for m.l.d. children in the U.K. who folded his arms after completing a manual task the psychologist had set him, (a block design task in the W.I.S.C.R.) Overemphasis As often happens the behavior is emphatic and over-emphasised, as with exaggerated looking and so on. It is overemphatic, in this manner:- The child folds his arms, 'puts his hands away', so they cannot , (immediately), be used. So no manual task can be done. So the last manual task cannot be worked on. So that particular task is not being done. It is not being worked on because it's finished , or completed . We can contrast starting an activity with the opposite, stopping an activity. A related distinction is between beginning an activity and completing an activity. These are not the same, of course. We might stop an activity, but not complete it, in the sense of reaching some goal. Moreover we might start something, but not at the beginning, e.g. resume painting a picture, after a rest from painting. The person may signal stopping doing a manual activity by e.g. folding his arms, but he has not necessarily completed it. To complete it means to reach the goal to which the activity was directed. This additional element might be signalled so:- In n.r.a. by the other person's sight of the completed activity, e.g. task for a child set by the person, e.g. psychologist. In t.r.a. by a smile on the part of the person, e.g. child, to represent the fact that he has reached his goal, of doing the task, partly for itself, and partly to please the person who asked him to undertake the task. On the other hand the person might encounter an obstacle and decide to give up in his attempt to do the task, this might be signalled by the arm-folding plus a frown . |
Similarly a child who does not wish to even begin to do the
activity, may fold his arms, (or turn around in his chair to
remove his hands from the vicinity of the objects involved in the
activity, or close his eyes, [necessary objects in a visual motor
task], and frown . To move the child on from this, the n.r.a. stage it will be necessary to stop rewarding the behaviors in this stage and instead reward the child for engaging in the behaviors of the next,'higher' stage, i.e. t.r.a. (Any of the parts of this process, in n.r.a. can be communicated to the adult, via t.r.a., or of course by p.c.s., sign etc.) To move the child from n.r.a. to t.r.a. we might sometimes have to prevent the child from getting what he wants independently. We might have to put obstacles in his way, in order to make him communicate . Although the achievement of independent living skills is a very desirable goal for all children it may be necessary to put obstacles in the child's way to force communication. So for example to produce communication via t.r.a. we might put a desirable item of food on a high shelf, out of the child's reach, so that he must pull us to the problem situation, and get our help in obtaining the goal object. A later stage in a plan is to move out of the way, or put away, or throw away, objects which are no longer to be used. This may seem artificial but is present in the behavior of s.l.d. children and m.l.d. children with expressive speech problems etc. It might be considered to be a part of t.r.a., certainly it's n.v.c. The behavior is used by such individuals to mark the end of a plan, or the wished for, or recognized end of an activity with the objects, or a desire to not even start it. (So a child puts the Denver test materials away in their case to show that she wishes the testing session to end, or not even to begin). Or, with body parts, an m.l.d. child with expressive speech problems folds his arms to show that he has completed a design in the B.D. subtest of the W.I.S.C. If he has completed this manual task he no longer needs to use his hands, for the moment, and so he 'puts them away'. In this way, by a sort of backwards implication, the 'putting away' represents the completion of the task, and he is deliberately signaling this state of affairs. (Note that the above scheme is also applicable, as well as to objects, situations and activities, to symbols of these entities, e.g. photos, symbols, signs.) T.R.A. This is the use of real objects, situations and events, and is the natural language of the s.l.d. child, and of the younger normal child. While specific in details there is much in common in the t.r.a. communication of different children. Note that the behavior here is token in one or both of these two senses:- a.the child uses a token amount of force in getting an adult to move, by pulling or pushing him. He uses less than the amount he would need if the person were not a sentient creature. b.objects, places etc. are tokens since they symbolize something beyond themselves, e.g. swimming costume symbolizes events which often follow the child's sight of her costume, e.g. getting in the car, going to the swimming pool and swimming. Note the important distinction between pulling a person, and pushing them. (This distinction is obviously present in the previous, n.r.a. stage; the t.r.a. version might be a slightly reduced force version.) In the first case the child grasps the adult by, e.g. his hand, and pulls him to some place. He is holding onto the person and therefore he wants them to stay together. He is moving from place Plx to place Ply, and therefore he wants to leave place Plx, not to be in place Plx, but to be with the other person in place Ply. If this were verbalised it would be something like "Come- (with me)". In the second case the hand shape is quite different, it's a flat, 'B' shape hand, therefore the child is not holding onto the person, and doesn't want them to stay together. He wishes to stay where he is, in place Plx, not with the person he's pushing, but maybe with a third person. He wants the second person to go away, to place Ply, (or really to any place which is not-Plx). If verbalised it would be "Go- (away, from me)". For t.r.a. get a report from the parents, since this language is, to a degree, concrete, idiosyncratic and specific to the child's situation. (On the other hand there are general and universal elements of the meaning, e.g. car key = start the car, drive the car and go for a ride in the car.) Expressive communication How does the child express his wants, by using real objects, situations and events, by presenting these to an adult, if an object is small enough, or by taking the adult to them , ( if object is large, heavy or fixed, or if we're talking about a place), these two methods being psychologically equivalent. Get parent to say how the child 'asks' for a drink, for something to eat, for the toilet, etc. We want to know the extent of the child's 'vocabulary' and the complexity of his 'syntax' in this mode. For example, Vocabulary What objects does he use symbolically, e.g. Car key = a ride in the car, often a ride to the shops, to buy foods the child likes To develop this, the home and school need a large number of objects relevant to a large number of drives, biogenic and sociogenic. Syntax Putting objects, seen/used as symbols, together to more narrowly specify the meaning, what the child wants. So if the child gives the mother these objects:- Obj2, Obj5, and Object8, the child should be referring to a situation or activity involving these three objects. The child might present his mother with his empty cup and a container of orange juice from the fridge Cup = (I want) a drink--------- Container of orange juice = ------of orange juice To develop this we need to have a tumbler or cup, and a number of alternative drinks, each of which the child likes, e.g. a drink of orange squash a drink of milk a drink of coca cola Really we need the class A, (a drink, represented by the cup), and the class B, (a specific type of drink, e.g. orange squash), not to necessarily imply the other, but doesn't squash necessarily imply a drink of squash? We need a drink which can be used for other things, e.g. water can be drunk, or you can wash with it. Unfortunately water is not very motivating as a drink, and washing is not a greatly desired activity, at least by a child perhaps! We will also need to know how the parent responds to the child's communicative efforts in this mode. It is important to know if the child's communication development is being delayed or obstructed by the parent's, (or parent figure's, e.g. carer's) failure to respond properly to the child's communication. The adult may be ignoring the child and not finding out what the child wants. The parent may be too 'hung up about' developing the child's speech and want the child to say what she wants, a goal which might be quite unrealistic. (Similar remarks might be made about inappropriate efforts to develop academic or scholastic skills) Skills in this stage should be developed to an adequate degree before going on to the next stage, e.g. picture communication. This means finding out what the child wants, and if possible, giving him what he has 'asked' for, to reward a form of communication which is reasonably skilled, and admirable, considering the mental level of the child, and which is much better than simply crying to indicate displeasure, which requires the mother etc to try to determine what it is that the child wants. On the other hand when a good level of skill is developed in this stage, communication in this mode will begin to be not rewarded as much and efforts to communicate in the next, higher stage, rewarded instead. This process is to be repeated for all the stages, and all the transitions from one stage to the next. (Note that some other meanings of objects, objects used symbolically in other ways, are not so everyday, and down to earth, not so deliberate, or so conscious. These are the Freudian types of meaning. Take for example the child who deposits his faeces in his bedroom at his boarding school. The interpretation is that while he may think the school is acceptable as a day school, it is not acceptable as a boarding school, in its role as a boarding school it is shit. Such a type of meaning is especially likely to appear if the relevant drive is strong and frustrated, then classes get abnormally large, e.g. any long thin object is a penis. What do we do with faeces, we get rid of them because they are useless, so take up valuable space, or more than this, are positively undesired, or undesirable. If a thing gets crap on it, it becomes crap and should be rid of. So his school bedroom should be got rid of. There is a hint of obsessional, irrational, primitive thinking here, if a thing gets contaminated you can never completely get rid of the dirt, there may always be a few molecules left, once its got crapped up, always crapped up, so it should be thrown away). Photos and Symbols 1.Given an object, situation, event, process etc. the child must select and maybe assemble the correct symbols. 2.Given individual symbols, or complexes of symbols, the child must select the correct real object, and select or produce the corresponding real situation, or event etc. Objective versus Subjective views of activities Objective view This is the view from the outside of the person, of someone else doing the activity, or a view in a mirror of yourself doing the activity. The face of the person doing the activity can be seen. We can take a camera shot of this type, but for the child to really understand it we really need to use mirrors. When the child is doing an activity the adult by the child should occasionally get him to look at his activity in a large mirror. This links the physical proprioceptive and kinaesthetic sensations from the activity with the visual ones. So we might use the nice big mirror in classroom 31. Subjective view This is the view from the 'inside', the actual view of the person doing the activity, of himself. In this kind of view, the face of the person cannot be seen, only parts of his body, e.g. hands, arms, legs, feet, etc. So, with the O.T. activity on the big ball we would have to put ourselves in the place of the child. We would just photograph a close-up of the ball, with the photographer trying to get the camera in the position of the child's eyes. Now the child's proprioceptive and kinaesthetic sensations from the activity are linked with this actual subjective view, and will easily be associated with a photograph of this view. A group activity What of the case of a group activity, e.g. the group of child-mother pairs playing the musical accompaniment to the music-computer animation-video? Here consider taking the photo from the back of the group, furthest away from the T.V. One sees the backs of the pairs, which is what the child will see. One sees the front of the teacher, which again is what the child will see. One might get a subjective view of a particular child at the back, if one gets the camera close to his eyes; then one might have a view of his arms, hands, and the instrument he was playing. But it would be an objective view of the other children doing the activity. The child's eye level In both t.r.a./p.c.s. and pure p.c.s., when photographing places and activities we must always try to take the photo from the place where the child's eyes might be, e.g. at the eye height of the child. This depends on how tall the child is and his posture , whether he is standing, sitting on a chair, sitting on the floor, or lying on the floor, etc. As for the height of the child we must, for convenience, take an average eye height, and take photos with the camera held at this level. In t.r.a./p.c.s. the printed photos must then, of course be placed in position, at around the eye height of the child. This allows him to see them easily. In the case of a large array we might wish to have the middle picture at the average eye height of the group of children concerned. Of course physical features of the place may interfere with the ideal arrangement, e.g. the metal bars across the doors at the Institute are at a rather inconvenient height for our system. The order of taking and placing photos In both t.r.a./p.c.s. and pure p.c.s. there is an optimum way to do this, so that the photos are as accurate as possible in representing the place. This is:- 1. Take the activity photos for a particular place\ 2. Put them in position on a wall of the place, away from a door. But they do not show the image of the activity photos and so:- 3.Re-take the activity photo and replace the old activity photos with the new one. But this does not show an image of-- This could go on and on indefinitely but the inaccuracy becomes very slight and practically unnoticeable as the images get smaller and smaller, so we can stop quite early in the process, probably at stage 3. 4.Take the photo of the place Px, from the door, and use this as a destination/place photo, which is placed a.outside the room Px, by the door and b. inside places, e.g. rooms, by doors which lead out to the place Px. By this means the photo of the place is more accurate because it shows something actually in the place, a set of activity photos. one can see, in the place photo, not just what place it is, but what activities can be done there. This means that an early, elaborate communication might be possible. a. By pointing to the place photo the child can show what place he wants to go to or the adult can show the child where he wants him to go. b. By pointing to the image of an activity photo in the place photo the child can show what he wants to do in that place or the adult can show the child what he wants him to do there. This means of course that the place photo has to be big so that the images of the activity photos are large and clear enough to be easily seen. This means that the place photos should perhaps be larger than 6" x 4". Updating photographs It is of course necessary to update photographs and replace the old photographs, (which in t.r.a./p.c.s. are put up on walls, by doors etc.), when there is a major change to the appearance of a place. This might occur if the place gets new carpets, curtains, decoration or furniture etc. The first two may not be of relevance in the institute, where such soft furnishings are not used, (although as said elsewhere, these items might be desirable, to reduce the noise levels in classrooms etc.). But it is possible that the walls might be repainted, and if this is in a different color one would have to re-take the photo of the place and replace the old one with this. t.r.a./p.c.s. Activity photos Can be organized in two ways a.Simply group together all the photos of activities which occur in place Plx, e.g. a room, and stick these up on a wall of the room, (away from a door). b.If the activities all occur in the same place, and if a regular sequence of activities regularly occurs we can also sub-organise these photos in terms of before and after relationships. So we can have a strip photo timetable. Since time is usually treated as linear, and we're not considering different sequences for different days we might adopt a linear array. The orientation of this line should correspond as nearly as possible to a time line used in a sign language e.g. b.s.l., e.g. the line stretching horizontally out from the signer in front of him. So we might have a vertical orientation, with earlier activities lower down and later ones higher up. A good sequence to try would be the morning activities in the I.P. ward. We would have to have the photos bigger than the usual 6 inches x 4 inches, e.g. 9" x 6", or 12" x 8", to allow children at the back of the group to be able to see the photos properly. We also need to put in the bathroom activity photos of someone washing their hands, or a sequence of hand-washing photos, and a sequence of photos of someone brushing their teeth. These might well be subjective view photos. At the present time, (27.10.05), the situation in the bathroom of the I.P. Department is this:- In the bathroom on the left hand side, as you enter, there are only toilet seats, small, as they should be, of course. There are picture instructions on how to clean one's teeth but these seem to be directed at the parents, since:- 1. they are too high for the child to see 2. they are not concrete and involve some kind of medical model of the mouth They are in the right place as so far as they are placed by the sink, however. For the child's benefit we need to:- 1.have photos lower, at the eye level of a child, the average child in the department. 2.make the photos concrete, probably have these a subjective view. These means placing the camera at about the child's eyes and point it at the child's hands holding his toothbrush There is a long mirror just above the sink so child can see himself brushing his teeth. This is good but where will the photos of cleaning the teeth go? There are no hand washing pictures here. These need to be taken also and put in position, by the sink, at the eye height of the child. These again, could be a subjective view. In the right hand side washroom the situation is this, as of the same date:- There are some toilet seats, and also some standing urinals, for boys. There is a sink, but here there is no mirror. There is a picture sequence about teeth cleaning which is more concrete than the one on the other washroom, but this is again an objective view. Also it is too high for a child to see - it's at an adult's eye height. There is a tiny picture of hand washing but again it's at an adult's eye height. Note that these pictures have the functions of a.telling the child he should clean his teeth, or wash his hands, now , if an adult points to them and b.perhaps how he should do this , especially if there is a sequence of pictures. If the activities do not all occur in the same place, then we have left the system where photos of objects, situations and events are tied to the places where they are, or occur, (t.r.a./p.c.s.), and gone into the p.c.s. system. The size of the photos. In p.c.s. the size of the photos might be quite small, perhaps smaller than 6" x 4", perhaps 3" x 2". There would be two reasons for this:- a.the photos would form a sort of map, or book, and must be easily carried about by the child b.the child is going to be at a higher level than one using t.r.a./p.c.s. In t.r.a./p.c.s. the size of photos might be varied, according to various factors. Place/destination photos, by doors We found that 6" x 4" was a good size for these photos- the child is looking at the photo from close up. General and specific:- Activity photos in large spaces, for use by large groups of children. This applies to the exercise area outside the classrooms in the I.P.ward, and to the classrooms themselves. Such photos must be larger than 6" x 4", e.g. 12" x 8", or A4 size. Why? They must be properly seen by children at the back of the group, as well as those at the front of the group. The objects used in the activity are cues as to the nature of the activity and the images of these would be too small in an ordinary size photo. We might try to ensure that the angle made at the child's eye by the photo should always be about the same? Contents photos Single object photos, of things kept in a container, e.g. a drawer of a stack of drawers, to be placed on the outside/front of the drawer. These might be made smaller than 6" x 4" , e.g. 4" x 3". Why? (i)The viewer might be very close to the photo (ii)There might be many objects in the container and limited space on the outside of the drawer on which to stick the photos. (iii) This makes the activity photo image significantly bigger than the photo image of an object used in the activity, which is natural, and follows the actual relation between an actual object used in an activity and the actual activity. General and specific: Sign How is the level of a child's command of sign assessed? Are there tests for assessing the degree of competence, both receptively and expressively, in B.S.L., in Thai sign language, and so on? There must be, for use in deaf schools etc. For the most part the level of competence for the s.l.d. or autistic child, and the adults who work with them is going to be zero, in Thailand. Note that there seem to be these factors operating against developing these important skills in Thailand a.Parents will reason that their children are not deaf and so they do not need to learn to sign. This should be countered by the evidence that signing can gives the child with sufficient ability a valuable means of communication, and that it does not interfere with the acquisition of language. Many s.l.d. children may never learn to speak to any significant extent anyway. There is a feeling that only children use animal actions, etc. and adults may feel silly using gestures and sign. The counter should be that sign is a sophisticated type of language, and worthy of respect. The person should be taken to the school for the deaf in Changmai to see if he has any idea what the children are talking about. This ought to convince them that sign language is a highly sophisticated means of communicating most, if not all, of what a spoken language can. In testing sign we want to test a.Vocabulary- the sheer number of signs known b.Syntax - putting signs together to make more complex structures Both of these must be considered in Receptive and Expressive modes. So to pictures of objects, or the objects themselves, the child must give the correct sign, or if the adult makes a sign, the child must point to the correct picture, or actual object, out of a choice of, say three. And for grammar or syntax the adult could show a picture of a person doing an action, or a series of pictured events and the child must render this in sign. Or the adult can sign a story and the child might pick the correct picture story. We can use a mime/sign for raising the flag, doing the dancing and musical exercises playing musical instruments On the height at which information is displayed on walls etc. t.r.a./p.c.s. Information, presented verbally or pictorially, or both, for the use of adults will be presented at the most convenient place for a standing adult, i.e. at the eye level of a standing adult. Similarly, information, verbal and/or pictorial, addressed to, and intended for, children will be presented at the eye level of a standing child , if the child is to read, (or 'read' ) the information whilst standing, or at the eye level of a sitting child, if the child is to read, (or 'read') the information whilst sitting. So we will present information for the child at one (low) height, and information for the adult at another (higher) level. This might have the welcome side effect of clearing irrelevant material from the view of the child, and here we should remember the principle of getting rid of pictures which are there simply to 'make the place look nice for children', pictures of cartoon animals, nursery rhyme characters, and so on. We might use this idea in conjunction with the principle in t.r.a./p.c.s. of only showing behaviours acceptable to an adult, perhaps to a sub-group of adults, e.g. an ideal, psychologically knowledgeable group. So for example at the child's eye height we will not show a picture of a child engaging in unacceptable behaviour, e.g. aggression. At the adults' eye height we will also only show the adult behaving in ways which are acceptable to some other named adult group, e.g. the enlightened psychologists, in a psychology department, who are to use behaviour modification techniques, with a child. So parents, and other adults looking after children, visiting the department, can learn from this verbal and visual information, even the not so literate ones. Now this may involve pictures of a child behaving unacceptably, e.g. aggressively, but the child will not see these, or will not easily see them, ideally. So, for example, at the high adult eye level, of a standing adult, there might be a picture of a child engaging in petty aggression against an adult, e.g. pinching his arm, and the adult turning his face away from the child. There might also be picture of positive behaviours of both adult and child, e.g. the child behaving acceptably and the adult giving the child attention, e.g. looking at him and smiling. The height at which containers, or other objects, are placed n.r.a. and t.r.a. If these are to be used by adults they should be placed at the sitting shoulder height if the adult is to use the object whilst sitting, and at the standing shoulder height if the object is to be used whilst the adult is standing. Similarly, if these are to be used by children they should be placed at the sitting shoulder height of the child if he is to use the object whilst sitting, and at the child's standing shoulder height if the object is to be used whilst the child is standing. So we place drugs, medicines etc. in cabinets placed at a high level, (n.r.a.), so the t.r.a./p.c.s. pictures or written instructions for these will also be at a high level. We place toys, etc. in boxes placed at a low level, (n.r.a.), and in t.r.a./p.c.s. pictures relating to these objects will also of course be at a low level. In general terms objects should be placed in a position where they are most easily used by the appropriate person. Even more generally we should say that the objects must be placed in conditions where they are best used, so for example, as well as thinking about the height at which fixed pictures are displayed we must also of course think about other conditions, e.g. here lighting conditions, since the stimuli are visual . There are various special cases to be considered here. Things for the use of adults. Objects to be used are fixed, on the wall. The objects are pictures, visual symbols. In this case the objects are used by the adult directing his eyes to the object and decoding them. They should therefore be in a position where he can easily see them, at around his eye level, considering the posture he will most likely be in when he views the picture. Things for the use of adults. Objects in cabinets. Here the adult may have to grasp the object(s) and manipulate it (them), so the objects should perhaps be at shoulder height. Similarly for children. What about things to be used by adults or children? If the objects are to be manipulated, used by the hands, the height will have to be at a height suitable for children since, an adult can bend down, but it is much more difficult for a child to make himself taller. What about things to be used in some ways by children, and in some ways, maybe not exactly the same ways, by adults? An example is the device by the door into the special education room in the institute for child development in Thailand. This device, is to be read, or 'read' by both adults and children, (for children the slightly lower part, for adults either or both the writing and the pictures). For children it is a 'read' only device, and so it is best put at a convenient looking height for them, but at height which makes it more difficult to use to be manipulated by them, because we don't want children fiddling about with it. For some adults it is also a 'write' device, i.e. the members of staff of the special education department: they will use it expressively to tell other people about the status of the room, if its empty, or whatever. So for adults the device should be at a height easy for them to alter its settings, by manipulating it. More generally it should be of a construction which makes it easy for adults to use in the sense of altering its settings, but much more difficult for children. The placement of the written instructions for the use of my system, e.g. in the institute in Thailand. These are to be placed above the pictures, perhaps not too far above so it is clear to what they refer. This relates to the above discussion in that they are for the use of adults, not children. If a child can read the instructions he does need these pictures to allow him to communicate! Pex I shall only spend a very brief time in discussing this system - any more would be a waste of the readerr's time. I began my researches into n.v.c., including picture communication, with the severely mentally handicapped child, and had developed my system to an advanced stage, long before I heard of the above mentioned system. As one form of picture communication it should be clear to the clear thinker that it is seriously flawed, right from the outset, and by its very title. Exchange is a seriously faulty model for communication, e.g. the use of symbols. Two objects are used, in n.r.a by associating them in some way, by putting them into some sort of relation, e.g. spatial proximity. This delimits the possible function of each object. For example if one 'puts together' an object o1, which has possible uses f1, f2, and f3 with object o2, which has possible uses f3, f4 and f5 then the possible combined function is f3. If one of the objects is a sentient creature, e.g. a person, one of the objects might be used by the person by putting it into proper relation with a part of the person. So for example one puts a pencil into the hand of a person, in t.r.a., if one wishes for the activity of drawing, or writing to occur. If one simply wants the person to look at the object and register its existence in that place, one puts it into some proper relation with the person's eyes, so the line of sight is clear of obstacles, the object is at a suitable distance from the eyes, not too near and not too far etc. Graphic, visual symbols, by definition, are to be used by presenting them to the person's eyes, not his hands. An appropriate situation for exchange is e.g. in situations of barter or using money. The child must be taught that if he goes into a shop and wants a sweet he must give the shopkeeper money. Goods are exchanged for money. The child's first task is to communicate to the shopkeeper what it is he wants. This, in p.c.s. he can do by showing the shopkeeper a photo of what it is he wants, and perhaps pointing to it. This achieves the function of telling the shopkeeper what the child wants. Beyond this, in addition, an exchange of money for goods must be made, as said above. |
© John and Ian Locking