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speech language therapy

Bella

When I notice a behavior in a student, I think about it. I spend time analyzing, thinking, hypothesizing. There’s almost always a reason the behavior is occurring; it’s like a puzzle and I want to solve it.

So I’ve been thinking about Bella, one of my little elementary-schoolers – adorable Bella, with significant communication and social difficulties, among other challenges. A lot of the behaviors Bella exhibits, the things she says, or the games she plays, might remind you of what your preschooler says. But that’s not the concerning part. Bella acts the way she does, because that’s where she’s at developmentally. When a child didn’t yet have language, or any sort of interaction skills in preschool, they never got the chance to go through the phases of sharing, turn-taking, cooperation. They might not have had the experiences of having a toy grabbed out of their hands, grabbing at someone else’s toy, crying because they lost a game, getting angry when they can’t go first. So sometimes, we see those behaviors at age 9, because now they’re there.

Bella has been mean lately, to her friends. And I’ve been thinking – trying to figure out why she’s acting mean. And the other day, I watched through a different lens, and it clicked.

Bella and her friend Nicole came into speech the other day. When I asked how her weekend was, Bella told me that she had gone to a playground with Nicole.

“I went down the slide!” Bella told me excitedly, arms flapping.

“I went down the slide, too!” Nicole added.

Bella stopped flapping. She glared at Nicole. I watched.

“I also swung on the swings,” Nicole said.

Bella slammed her hands down on the table. “I swung on the swings! STOP COPYING ME!!”

Nicole looked at me, and then back at Bella. “I’m not copying you, Bella. We went together! We did the same things together!”

Oh.

When I thought back to when Bella gets upset, the pattern emerged. She gets “grumpy” and gets “Mean Jean” in her head when she perceives a friend to be copying her. And during those times, the friend is not copying her. The friend is agreeing with her, sharing a similar opinion, talking about a shared experience, or adding to the conversation.

While we often see kids get frustrated when someone has a different opinion (e.g., You can’t like tomatoes! Tomatoes are disgusting!), this is a little different in presentation. But it comes down to the same principle – understanding that different people have thoughts in their heads. Those thoughts might be the same as ours or different than ours, but everyone’s brain thinks its own thoughts.

So, I whipped up a social story, and the next time I saw her, she and I read it together:

When we were done, we played with some animal figurines, and Bella processed what we had just read by acting it out. My monkey figurine kept accusing her duck of copying me. Then the bear teacher reminded the monkey that two animals could have the same thought. Then during recess, the monkey and duck talked about movies and games that they liked. They realized that when they liked the same things, it was fun.

It’s a struggle for Bella to generalize much of anything she learns. Chances are good that we will need to read this again, and again, and again. And play, and act it out, and give her chances to practice.

The ultimate take home message – there’s always a why. Bella is not innately a mean kid. She’s not going through a mean streak. There is a reason she gets angry and frustrated about certain things.

There are locks, and there are keys, and some are clear and some are hidden, but we look. We don’t ever stop looking until we find them, put them together, and figure them out.

The best story ever

I just have to share this with you all, because I love every single thing about it.
In speech/language therapy, some of my kids have been working on story elements – characters, setting, problem, solution. Last week and this week, they planned out their own story or comic, and then turned their story elements into an actual story. The goal of this activity was not to have perfect grammar or punctuation or spelling; we were focused on including salient story elements. Consequently, one of my fourth-grade kids wrote an amazing story, in which his own adorably unique use of words, grammar, and syntax, shined through. He wrote it as a “Flow Map” (step-by-step boxes) but it isn’t uploading well so I’m just going to type it into 6 small paragraphs.

Enjoy :)

The Story
Once upon a time in N.O.L.A. there are a family “lets meet the fam they are awesome the firt one is the twins Lucas and Joe they love to hang out with me.” “then there is that girl named Amanda she loves to play ball with me”. The mom and the dad and the cat. The Dad’s name is Ethan the mom’s name is Jenny and the cat’s name is Mazie. The cat Mazie is mi hermano.

When they woke up this morning there is some wind blowing hard and there is making a lot of storms. Baton Rouge is starting to flood. And Mike and Mazie have superpowers, and they can save the day. And then they can solve it.

During the hurricane we are outside to try to stop the hurricane but suddenly we heard an evil laugh. It was Schweinstiger the evil cat who makes storms and hurricanes. Schweinsteiger says “we are going to make the lower southeast region ruined!! hahahaha!!”

They said “never!!” And then Schweinsteiger was trying to attack them with his storm powers. Then they are dodging. Suddenly Mazie the cat got hurt by this lightning. Mike said “Are you okay?” Mazie said “is this god?” Mike said “No it’s me Mike! We need to stop Schweinsteiger making hurricanes to make the Gulf of Mexico have no more hurricanes!” And then they went back home quickly and tried to get them into their superpowers.

They are trying to stop them and then Schweinsteiger has really good dodging! They were trying to attack him and his health is 92…80…75…62…55…48…30…27…18…1…then Schweinsteiger is dead! But then there is still wind going on. How are we supposed to stop the wind? Our house is about to flood. And we have no power! Mike has magic and he made the weather sunny to make it warm and replace it and the rains are going back p to the sky and the floods are going back up to the sky and then they put it on the newspaper. The newspaper is called Hero Dog and then everyone was cheering and has pictures and some viral videos of it. And that’s the end of the story! No more hurricanes in the Gulf of Mexico. The End.

Credits:
George Lopez as Mike the Dog
Jennifer Lopez as Mazie the Cat
Kiefer Sutherland ais Schweinsteiger the Evil Cat
Meghan Trainor as Jenny (mom)
Nick Jonas is Ethan (dad)
Ariana Grande is Amanda (daughter)
Chris Brown is Lucas (brother)
Jason Derulo is Joe (brother)

Talking ‘Bout the Brain

Sometimes something just works and feels right. And maybe there’s no evidence-based practice, but I feel it, and I notice the shift in energy and connection and action, so I run with it.

I’ve been talking about my students’ brains a lot.
I think it helps them understand.
I’ve noticed a shift.

In the past, when I’ve said things like, “Kelly, it looks like you’re not paying attention” or “Kelly, are you paying attention?” the response is usually defensive, anxiety-filled, or frustrated. “I am paying attention!” Kelly will say, even if we both know she’s not. When I’ve said, “Kelly, it looks like your brain is thinking about another thought” or “Kelly, is your brain distracting you?” more often than not, she will agree, and accept ideas to re-focus.

Really, it’s just a subtle shift. From “you” to “your brain”. But for whatever reason, it’s working. I wonder if it’s because it allows them to accept their actions from one step removed. It lets them understand why they’re doing what they’re doing. It doesn’t mean letting them off the hook, it doesn’t mean telling them they “can’t help it”. It just gives them a little cushioning to accept that yes, they are behaving in this way, yes, they are speaking in this way, yes, they are acting in this way, and it’s okay. It reassures them that they are not intrinsically “bad” (which is often how a lot of our special ed. kids portray themselves and name as the reason for their struggles), but their brain causes them to act in certain ways. It gives them a reason for why. And it seems to help them be more open to trying to get past whatever obstacles their brain is throwing their way. I’ve noticed a shift in their willingness to embrace their actions, and work to find strategies to bypass the obstacles.

So I say things like:
“Did your brain forget that word?”
“Looks like your brain is thinking about something else”
“Tell your brain that we’re moving on from that topic”

Remember Joey? (We still do the silly 911 script at least once during each speech/language therapy session – he now takes the “phone” from me and sometimes talks to “911” himself.)

I’ve been using the “brain” terminology with him, and he took it and ran with it. Joey used to push, giggle, or yell when he felt something. If anyone asked him why, he couldn’t identify a reason. He would say, “I’m not sure” or “I felt like it.” Now, he can often say, “Because I’m worried about _______” or “Because I’m mad about ______.” And, sometimes, even before he starts to push, giggle, or yell, he will say, “My brain is feeling worried” or “My brain is feeling disappointed.” (Do you see how huge that is for him? To identify how he’s feeling.) And that has evolved into a script, too.

He will say, “My brain is feeling disappointed” [or whatever he is feeling]
Then he says, to me, “Be like, ‘Brain? Why are you feeling disappointed?’”
So I say, “Brain? Why are you feeling disappointed?”
And he says, “Brain says, ‘Because it’s not my day to use the ipad’” [or whatever reason]
Then it’s my turn, because he’s still learning. So I say, “Hmm. I have an idea. What if we tell your brain, ‘Brain, it makes sense that you are feeling disappointed. What if we take a few deep breaths and remind your brain that you get to use the ipad tomorrow?’” [or whatever suggestion is pertinent]
Then he usually nods, and grins, and we move on.

And it’s working. For now. And when things work, I keep it going.

In Declan’s head

Ed note: The following is from the (imagined) perspective of Declan, an autistic 7th grader who I have seen for speech language therapy for several hours each week for two years. Some of this he was able to express in my words to me. Some of it I could figure out. And some is imagined based on what I know. I hope some day he will be able to tell me what I got right, and what I missed. Be kind, this is a weird kind of writing for me! I’ve never done anything remotely fictional before. All names have been changed.

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I walk down the hall, feeling the squirmy feeling in my stomach. It is excitement. Jen is outside her office, like she always is. She says,  “Hey Declan! It’s good to see you.” A few times earlier in the year she forgot that second part, so right before we began class I’d whisper to her,  “It’s good to see me.” I whispered because that way it would not bother the other friends. And then she would remember and say it to me.

I look at my friends in the room with us. When I was a little boy, Mommy and Daddy and teachers at the other school called everyone friends. But these two are my real friends. They like me and I like them! I grin and whisper to one of them,  “C for Carly!” and Carly smiles and says back like she always does,  “That’s right Declan!” She understands why I’m saying that, I think. It is because on the show that is Sesame Street that was on when I was a little boy, there was a girl named Carly and that’s what they said. And when I say that to Carly now it is to show her I like her like I liked Sesame Street. And she likes me too. Then I look at Maya, my other friend. I do our Friday routine. I say to her,  “What day is it, Maya?” and she exclaims,  “Friday!” We like our routines.

I am feeling so happy. Everything is right. Except then Carly and Maya start talking about who will be the teacher when they play school. This makes my belly squirmy but not the good kind.

“Ugh,” I tell Jen. “I really want to start our work. ”

Jen say, ” I know. But we can give them one minute to talk.”

“Because why?” I ask. If there is a reason, it makes my belly calm down. Jen knows that. She always tells me the reason.

“Because it is okay to let people have a minute to talk. It is good practice for them to talk to each other. And it is good practice for you too. Like, is this a 5 problem?” Jen asks.

I grin because not only did Jen give me a good reason, she is launching into one of my most favorite scripts that always makes me make happy noises.

“No it is not a 5 problem. We don’t have to say….” I wait for Jen to do her part.

“We don’t have to say,  ‘AH!  STOP TALKING WE HAVE TO WORK RIGHT NOW!!” I love when Jen fake screams. I make some happy noises.

“We could just say…. ” and together we say, “Oh well, I can be flexible.”

Now I’m feeling much better. I watch the videos in my brain from when I could not be okay with that, from when it would make my belly feel so awful that I might scream. It is different now! I’m a bigger boy and I can use my scripts to help me feel soft and squealy instead of hard and breakable!

We get started with our activity. We are talking about problems and solutions. We talk about what’s a wacky solution and what’s a smart solution. We are practicing calling 911 because Carly wants to act out one of the situations. She is in theater club. My brain knows that in the file of Carly that is in that folder in the brain.

Carly pretends to dial 911 and Jen pretends to be the operator. This is pretend. I know that now because there is not a real phone. I play pretend too sometimes, like when I feel heavy because a friend is absent so I pretend call and talk to them so I feel better. Jen is telling Carly that the pretend officers will be there right away. It is sillyscarystrangefunnybumpyhardwhirly so my mouth laughs. Jen says,  “I know! It’s a little funny pretending.”  I am glad she doesn’t tell me to stop laughing. I am not laughing. I think other friends and teachers hear laughing but that is not what my body is trying to do. I don’t know how to explain that. But my friends and Jen get it.

I start thinking about going over a bridge because I love bridges. And then I imagine putting the bridge on my head. Jen used to teach me that we could script about that, but in real life, it isn’t possible to do things like that. I know. But in my brain real life isn’t going on. Anything can happen which is why I am making a bridge go on my head. I start laughing and then remember, OOPS! Out loud I remind myself,  “Pause that thought! You can save it for later.” Jen gives me a thumbs up. I pick up my pencil and on the paper next to me, I write,  “Putting a bridge on my head.” This is a paper where I can write anything I want so that the words are still there, just not in my mouth, and my brain will remember because my eyes will look there later so I can tell Jen and Carly and Maya about it.

I give one last squeal, because I am excited to tell them about the bridge, and then I make my ears listen to the group.

My place on the spectrum

I am not autistic. That’s a statement that would never be questioned by anyone. I simply, would not qualify for a diagnosis of autism.

However.

I firmly, truly, in my core, believe in what so many of us think and know: that autism is a spectrum. And it includes neurotypicals. NTs and autistics are not fundamentally different – they just fall on different parts of the spectrum. 

So, if it’s a spectrum – that means that at some point there’s a midline, right? A midline where one thing becomes the other. Where Neutorypical meets Autistic. And that’s near where I fall. I am not autistic. But I am close enough to that midline to GET that other side of the spectrum. 

I believe that’s why I love working with autistic kids. I believe that’s why I understand them. I believe that’s why they understand me. I believe that’s why sometimes I intuitively just KNOW why they do or say something. 

I believe that I’m lucky to land on the spectrum where I do. I believe that I get the benefits of both the NT and the autistic aspects. I believe that despite not being autistic, I can firmly consider myself an understander, and an ally, because I Get It.

I believe that I’m lucky.

I believe in Autism Awesomeness.

Progress Reports.

It’s Progress Report time, which, for a special education school, means reporting on the progress of each benchmark within each goal, for each student. For me, it’s reporting on their progress towards their Receptive/Expressive Language (speech/language) goal.

And while doing that, I’ve realized how much of our data is confounded. I mean, obviously. There are a million different factors and that goes with the job, with the therapy. But I have so many students who live very much in their heads. Some who can even express what it’s like to be inside their minds and their bodies, who can explain, whether it’s through a script or a drawing, how their brain works.

And it isn’t easy for them to come out of their heads. And it isn’t easy for them to learn in the way that we teach. Easier when we modify, easier when we cater toward their needs and personalities, but still not easy.

So when I report that a student did not achieve a benchmark, did not obtain x/y/z skills, I’m struggling with it. Because I want to put in bold underneath:

Disclaimers:
-Student may know way more than s/he is able to show us.
-Student’s performance varies based on his/her internal state and sensory regulation.

Now I don’t know how much the Dept. of Ed. would like that (sarcasm) so I don’t do that. But I want the parents of my students to understand. That it’s not necessarily that their child can’t do something. Yes, there are things they can’t do, can’t understand, can’t comprehend. But I truly, firmly, strongly believe that more often than not? It’s that the world around them is not shaped in a way where they can SHOW what they know. Where they can access the knowledge that’s being taught. Where they can truly express their knowledge, thoughts, and comprehension.

I just want parents to know that. That I think their kids, all of them, are brilliant. That I understand them. A lot. On a nonverbal way, on that I-understand-him-through-my-soul way. That no matter what my Progress Report says, no matter how many benchmarks are or are not achieved, I will not give up. I will not think their child is incapable, not think that they have plateaued in development, not think that they do not or cannot understand something. I will not stop trying to meet them on their level, and I will not stop trying to teach in a way that they get. And if that means scripting back and forth with a student for 20 minutes so that I can explain a concept in a way that they understand? You bet I’ll do it.

Your kids are brilliant. All of them.

Please know that I know that.

Standards of behavior

I was driving to the gym this morning, thinking, with a smile on my face, about last night. Last night, my boyfriend and I walked hand in hand to get some frozen yogurt. Along the way, I was filled with joy and decided to skip. He laughed at me, kindly. He has long-since embraced my quirkiness, and I can be my true self around him. And he said, in a lovingly, jokingly way, “Do you think people can’t see you?” And I replied, “Of course they can see me, but I don’t care.” And I went on, to say, “They probably laugh and then think how envious they are of me to be so comfortable with myself.”

And that was it. And it wasn’t until this morning that I realized. How fine of a line it is. When we work with our autistic, Aspie, NVLD kids. How often do we tell them, “That’s unexpected, that will make someone have a weird thought about you,” when if it was a neurotypical individual doing it, we would view the behavior as, “Wow, they have enviable self-esteem to be so comfortable with themselves that they do x, y, or z without worrying about it.”

I last wrote about not extinguishing “weird” behaviors unless they are detrimental to one’s becoming their true self. But it goes deeper than that. Our standards, our viewpoints, the lens in which we view behavior is so different, and it hit me big today.

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