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03/17/2000

Meeting notes for Mar. 16, 2000 from 4:30 pm - 6:00 pm.

Today TingTing was very upset and crying during meeting time when she was asked to perform certain drills.  She started with very passive behaviors: such as avoid eye-contact, eye wandering, refuse to stand-up, and then look for help from people, such as Mei. When those cues all failed and she was still asked for the work, she started to dip her head, squeeze her mouth, and then tears drop. People continued to ignore her, and waited for her to calm down before doing anything else.

This is not a typical day as well as behaviors for TingTing, as I knew her.  I suspect it was due to early wakeup (7:00 am) to school, and no naptime after lunch, followed by more than two hours of drills prior to meeting.  Also this meeting is more rigid to ask more for her cooperation with each tutors to review the program progress.  She did very poorly for most drills during today's meeting.

Hope next meeting, the situation could be improved with forcing her to take a nap after lunch, and then  a transition time between drills and meeting.  Then it should be much easier to ask her to behavior peroperly. The meeting date/time is scheduled as April 7 (Friday) from 4:00 pm - 5:30 pm.

Review of Current Drills

===================:

     - choices: Double the size of pepper in the cassette to make the second choice became more visible than before.

     - compilance: "come here" is still not very consistent. However, since this drill is designed more toward "function" than "compliance", it could be changed to more a nature and different format, such as asking T to "come here" when she stands/walks on the lawn.

     - "Excericse": "going upstairs" should be performed across all tutors and family member to ask T to walk all the way to upstairs with left hand holding the rail for assistence.

     - "Eating" with fork : T seems to perform this task really well. Tutor should allow time for her to pick/bring fork to the mouth independently.

Other areas:

Behavior: When she cries and refuse to cooprate, just let her cry. When she calmed down ask for her to perform the task.

     Behavior: When she used crying against certain tasks or requests, parents/tutors should not give up and increased the chances she would use the same crying to refuse work or requests.

     Binder: It becomes very full now, some data sheets should be archived separately.


02/18/2000

  • choices

    • - Decrease down to F-2 and intro non-prefer item (small piece, initially) as distractor.  If T chooses nonprefer, let her taste it.
  • Compliance

    • - "Come Here", Reintro as drill format, back in the room and always use food as SR+. Place T in  front of table & therapist will be in front of her ~ 3 to 4 steps away.
    - "Sit down/ Stand up", continue as is.
  • exercise

    • - "therapy ball", have T stand in front of therapy ball and  with her stomach laying down on the ball. Slowly or quickly push her forward and have T extend  her hands to touch the floor and uses her hand to move forward and backwrd few steps. Repeat for  3-5 trials per session.
    - "Walking", let T ambulate in the environment independently (or light touch in her vest)  with her helmet on.  Allow T to walk on different  surfaces and watch for her transitions.  She will balance herself most of time.
    - "upstaris", continue as is.  Let T do most of the work by herself.  She will complain by whining or  crying sometimes.  But most of time she is capable of walking all the way up.
    - take notes on her behavior.
  • Switch Operation (Barney Tape)

    • - Have T sit in fromt of TV and the therapyist hold the  "yellow" AbleNet TV/VCR switch in front of her.  Let T tap on the switch to turn on "Barney" show on the VCR tape.  The whole drill is for observing her behavior on the cause and effect.  If she turns her attention or eye gaze away, therapyist will tap the switch to turn it off.  Repeat the sequence in a random pace to prompt her ability to initiate the request..
    Tip: If the switch only turns on the TV, do the following: put the dip on the back of the switch to center and tap the switch to turn off TV.  Then put the dip back to VCR mode.
  • Put-In

    • - Fade away bowl and use only hand.  Ok to use HOH at this point.
  • receptive commands

    • - "Raise Arm", make sure therapist's hand gesture for raise arm is at T's eye level.
    - "Bau-Bau", stay as is.
    - "hold cup", with HOH  to guide  T hold on to the bottle first and then release the help to allow her to bring the bottle to drink independently.  Help T gently put down the bottle with HOH and "Put Down" command.  Use the sippy bottle with blue cap.  Make sure the tip is all the way down to one side.
  • self help (finger food and fork-feeding)
  • -Enhance  this skill to various settings as,  during drills, lunch hours, snack time, and at school.
  • story time

    • - Stay as a free format for now.  Theraphists will explore following few ideas  and take note on T's attendance to the book:
     * Have T listen to the story with switch/latch/tape recorder.  T has to initiate her request by hitting the  switch for more story in the book.  HOH tapping on switchis ok if T does not respond.
     * Make/Use some adaptive book for T
     * Use touch book and HOH helping T to extend her finger to point to the book
     * Use book with sensory input, such as texture surface or push buttons of sounds.
     * Use simple book borrow from library (Mom to apply a library card for T)
  • play skills

    • - Stay as is and a free format..  With See/N Say, HOH to help her to pull the handle while T stand by the play center.  Take the note for T's behavior and attendence.
  • others

    • - Discuss the attentive meeting time per month. (Friday 4:30 pm - 6:00 pm)
    - Bring everyone up for T's IEP goal and objective at school and see how will some of those goals be implemented at home.      

    10/28/1999           1 
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