Wednesday, November 14, 2007

Let the kids make mistakes

Other day we had one of our friends visiting us along with their two children. Mary, 1year old and Martha, 5years old. As we all sat round the dining table sipping hot tea, I gave juice to Martha. Mary was just going round the room enjoying banana chips but Martha wanted to join us in our conversation. Just to get attention, Martha was again and again trying to reach her mom who was sitting across her. As we were all busy talking, Martha tried to intrupt the conversation and tried to touch her mom. Next we saw, juice all over the table. Mother quietly rushed into the kitchen, brought a cloth and wiped the table. She neither said any angry words to Martha nor showed any expression of anger on her face. After all cleaning was done, she politely told Martha to go and sit on the sofa chair. Martha replied,"Mama, I want to be with you." Mama just took Martha in her arms.

I do not know if it was accident or intentional act of Martha but the way mama handled the whole situation was remarkable.

We all learn from our mistakes.

Rita James

Sunday, November 11, 2007

Developing A Behaviour Support Plan

A few months ago I attended a workshop in Kerala where Dr. Mythili Chari was a speaker. She spoke about how important it was to have a team of people to support a family who has a child with autism. Personally I think this is applicable to all children with special needs. Here’s some of it which I would like to share with you.

Behaviour management mean teaching the child to manage his/her behaviour. It does not mean one up man ship or having to be on top always. Somehow persons with autism have always been at the receiving end because of our own lack of awareness about the condition. Accepting the individual with autism means not sitting and judging over his/her behaviours. When we have elderly people in the family, we accept them for what they are rather than compare them for what they were. We tolerate their idiosyncrasies, ignore their persistence on trivia, and accommodate their self centeredness. We do not punish them for making unbecoming sounds, losing bowel and bladder control, spilling or breaking things or making noises that do not go well with social norms. We accept family members with allergy, asthma, diabetes, Alzheimer’s, dementia, senility, etc. but a person with autism is often punished for spinning, rocking, making noises, being hyperactive, or for not behaving socially appropriate. In short we are punishing the person for being autistic!

Dr Horner and associates from the University of Oregon were concerned with the manner in which people with challenging behaviours were treated by professionals and the community at large. He emphasized that just giving rewards or punishments did not solve behaviours, in fact according to him all the inmates of an institution had challenging behaviours which persisted over all their lives, in spite of professional attempts at modifying them. Thus positive behavioural support system was evolved.

Positive behavioural support is a set of procedures that focuses less on the manipulation of consequences, rather focuses on minimizing the reinforcement of challenging behaviours and redirect the person to more appropriate behaviours.

Philosophy behind PBS

People with challenging behaviours are individuals.
They are members of families.
Social relationships reflect the quality of life of a person’s life.
People with challenging behaviours are members of society.
People influence their circumstances that are personally meaningful.
People have the right to be treated with dignity and understanding.

How to build a comprehensive support plan?

IDENTIFY the PEOPLE who will be with the person with autism; parent, sibling, cousin, grandparents, peer in class, therapist, teachers, neighbours, etc.
IDENTIFY the SETTING; home, class, therapy centre, club, restaurant, public places, etc.
IDENTIFY the SYSTEM; policies, procedures, administrative support. What are the resources available, parents have a large compound in front of their house, and they could put some play equipments like a see-saw, swing or slide so that children from adjacent flats will come and play and thus provide social companionship to their child with autism. Or you have membership in a club where there is a swimming pool, volunteer to take another child as your guest to also provide some much needed peer company.

Collaboration and teaming ‘sum is more than parts’

Collaborators share the same dream, responsibility and challenges. The team is built on parity and each member is voluntarily teaming up to help the child. Mother or class teachers do not have more power than say the sibling or therapist. Instead of working by one self if a collaborative team is built, then energy, talents and strengths of individuals can be pooled and forge a strong partnership. For example one member could be a good communicator, another a goof organizer, a third in analytical and reasoning skills, a fourth a go getter and the fifth member good at meticulous planning and record keeping.

Creating conditions for change

Team members need to begin with a clear understanding of the focus on individual’s gifts and capacities. Strange as it may seem we focus so much on the negative aspects.
All members need to have a shared common dream. It is only logical to include the person too if s/he can share her or his personal dream.
Frequent brainstorming sessions meetings should be arranged. When each member leaves s/he should have a clear action plan. Every member should be aware of others’ tasks.
One member; either the parent or teacher (who usually spends a lot of time with the individual) should be the case manager.

Ground rules for team members

Pay attention to what others are saying.
Take notes.
Regular attendance (in fact if for 3 consecutive meetings one member is absent, s/he should be dropped).
Circulate any relevant information (one person can be in charge of making copies for circulation).
Meet new members of the team as a group.
Keep the members informed through email or through phone about any development.
If missing a meeting inform in advance.
Commitment.

Here’s an example by Dr. Mythili Chari
Mother and principal reported that V aggressed towards others unprovoked, pulled at hair of children, pushed others when they were coming down the stairs or threw objects out of the window on to the road. Recently he broke a teacher’s very expensive spectacles. Sending him to the principal’s room or teacher threatening to lock him up in the bathroom (though she never did lock him up) did not help. Throwing objects through the window was observed at home too. Mother usually threatened that she would tie him to the chair if he threw things but never carried out the threat.

Teacher said V was very good at studies and the problems started when he had spare time or he was directionless, e.g. during terminal examinations. It was observed that both at home and school V never got positive attention, the only attention he got was when he misbehaved. We decided the teacher should reward him with stars for good behaviour also. When he did something wrong she took away 2 stars, a sort of response cost. He was given puzzles to work on when he had free time; these puzzles were not given at other times.
I conducted a workshop the flowing week where the participants were split in 2 groups and V’s team had 7 members; one occupational therapist, 2 mothers, one retired professor of genetics, one developmental therapist, one special educator, and his mother. Though it was a mock team the brainstorming session produced a plethora of workable suggestions for the mother.
Within a month when both at home and at school mother and teacher had been consistent his behaviour very dramatically improved. V got the 2nd prize in a fancy dress competition; he also recited the school pledge and the national anthem. Yoga, Reiki and music have been added for relaxation and as a hobby.

We had better quality of life at school. He developed close friendship with another peer and she was currently teaching him to dance, he became adept at copying movements while dancing. The teacher, correspondent, principal and mother herself were pleasantly surprised by the turn of events. This academic year he is promoted to the second grade where he and 4 teachers who teach various subjects and he is doing fine.

Compiled by Deepika Jacobs

Thursday, October 11, 2007

Be a good example

Jay(name changed) and Janey(name changed) got down from the school bus and next I saw a crowd surrounding Janey and Jay sitting in an auto ready to go home. As I looked at Janey, her right cheek had turned red imprinted with finger marks. Jay has slapped her very hard. I called them inside our home. Gave firstaid to Janey. Then I turned to Jay and requested him to tell me all the story of Janey's face. Jay very clearly told that he slapped her very hard on her cheek and forehead. Later he said that he did not beat her but just gave her a dose. Jay's parents were called and they responded very promptly. Jay's mom and grandpa came to pick him. I made him narrate the whole story which he did without any hesitation. I asked the mother and grandpa to explain the way they treat Jay at home. Grandpa very clearly explained that theirs is a very orthodox family. His father beat him and he used to beat his son even after he was married. Beating was the only way they knew to correct a child when their patience ran out. I asked them about what did Jay meant by 'dose'. Grandpa explained that when ever Jay did not obey his father, he told him, " I think you need a dose by showing him a tight fist." You can fill in your self what happened next.



Did you get the message?

Yes! we adults need to be good examples and good role models for our children. We should be able to tell our children, "Follow me". I really appreciate the words of Paul the apostels in the Bible, " Follow me as I follow Christ". 1 Corithians 4:16

Lets strive to be good examples.

Wednesday, September 26, 2007

Don't ask "WHY?"


When we address misbehavior, it's important not to ask question "Why?" It only leads to blame instead of solution. It points, "I've caught you being bad, and I'm going to let you dig a bigger hole for yourself before I really come down on you hard." After learning this, I have tried to use this while handling behaviour of children in our school.
Joy's (name changed) mother had just asked her the question, "Why did you write the date on the record when I had told you not to write?" In anger Joy wripped off the whole record book.
Yesterday I received a bag of torn records of a Joy who is going to write 10th Std. exam with in two weeks. Records were so neatly written and completed and ready for exams but now only pieces to throw in the garbage. I called Joy and about to ask the question, "Why did you tear your record?" I reminded myself and told her, "Aunty will be very happy if you tell me the true story of this torn record." After few minutes silence, Joy replied, " I do not want my mother to ask me questions. It makes me angry." I asked Joy if she does not want her mother to point her mistakes. To this she answered, "No, I want my mother to tell me when I am wrong." I asked her then what shall your mother tell you. Joy answered, "Explain me." I think mother should have told her to erase the wrong dates and write again. We are looking for solutions rather than reasons to blame.
You can also try this.
Changing behaviour takes time. Don't loose patience.

Tuesday, September 25, 2007

Music Therapy at Asha Kiran

Sunil is a 12 year old with autism, Reena is a 28 year old professional who suffers from depression, Sunitha has been diagnosed with Alzheimer’s Syndrome at the age of 71, and Ram is a 43 year old infected with HIV. One thing common among all these people is a detriment in health and an inability to function at an optimal level. Music therapy offers an effective and non evasive medium to such people to attain a certain level of health, even if they are unable to reach their full potential.

What is music therapy? Who can benefit from it? Will the client be able to play an instrument better? Can the improvements due to music therapy be measured? These and many other questions come to mind when we talk about music therapy. It is grounded on the belief that everyone can respond to music, no matter how ill or handicapped they are. Music forms a very important part of our being. At a very basic biological level, the heart-beat which is rhythmic in nature, is primary to our life, just like rhythm which forms the heartbeat of music. Children learn to move to a beat before they can walk and talk, and can respond by smiling when their mother sings for them. As they grow older, these movements get more complicated and diverse, and each person develops their own style of responding to music.

At Asha Kiran, we have begun music therapy sessions for the children between the ages of 5 and 10. It’s a special moment with the kids, when we see these children listen, respond to, and are stimulated by music. The children have learnt to imitate rhythms, communicate through music, improvise with various instruments, and also sing many children’s songs. The unique qualities of music as therapy can enhance communication, support change, and help these children to live more resourcefully and creatively. It provides access to a world of emotional, mental, physical, social and spiritual experiences.

Some of the general goals of music therapy involve strengthening a child’s potential for responding to and initiating contact and communication, developing contact with emotions, improving their quality of life through shared experiences, a greater sense of identity, and to develop social skills. While the specific needs of each child is different, the goals of the therapy would also differ. But one thing that can be said is that music provides a creative avenue for expressing emotions and feelings that words can’t. Singing pre-composed songs, listening, improvising on an instrument, playing together in an ensemble, learning an instrument, moving to music, using drama or art in therapy, and other creative means, are useful tools in music therapy. Through musical involvement, the strengths of each child is enhanced, and transferred to other areas of their life. While music cannot cure a them of a disease, it forms a compliment to the treatment or rehabilitation that a person is receiving.

Music therapy is a relatively new field, and there is a lot of research being done on the efficacy of the arts as therapy. But when, through the music, an autistic child relates to another on a meaningful level, or a depressed adult can communicate feelings and emotions, or a HIV infected person can enjoy the rest of his days, the value of music as therapy cannot be debated.