特殊孩子的平常事

oy

你们具体是怎么训练目光对视以及追随的呢？是用他感兴趣的玩具吸引还是用手托他下巴迫使他和你目光对视，或者有其他技巧？－－－我很想知道你们是怎么训练保证了孩子的joint attention 一直稳定很好。我孩子的这方面常常是on and off.不consistent.－－－很多时候与他身体状态很有关系。

我对你们那个大学的研究项目很感兴趣（因为它综合了其他的元素）。请问他们有专门网站介绍吗？

谢谢



以上文本借助www.InputKing.com在线中文输入法输入

LittleKoala

儿子喜欢吃,所以食物是最好的强化物.训练目光对视时,手中握有吃的,放在眼睛附近,然后叫他的名字,或者是"Look at me"or"Hello".如果他看了,就给他,逐渐延长时间.如果他不看,把食物在他眼皮底下晃一晃.

千万不要用手扶他的脸或者托他的下巴,很多孩子会厌恶这样.反而有反作用.

他们的项目依然正在进行,好象有发表的成果,但没放在网站上.

BTW,为什么我每次写贴子都要写标题,有什么窍门不用写吗?

oy

use the default title: Re:起步虽晚,加速很快---Little Koala的成长

rachel

你的那些joint attention training 方法很好，借鉴了！

LittleKoala

儿子还在睡觉,抽空写一下他昨天的表现:
上午9:45-11:45,senior therapist S女士做训练.对于她的到来,与头一天不同,儿子表示欢迎,脸上露出了笑容,也应要求挥手表示hello,还给了一个blow kiss.刚开始训练,也很配合,自己在小椅子上坐下,开始的几个任务做的不错.我们觉得今天形势很好.但他对于S女士的physical prompt越来越不耐烦,终于在10多分钟后火山爆发.持续了10分钟,归于平静,然后大家合作愉快.休息时候,也与S女士有互动.第二节课,小子从一开始就不合作,大部分时间仍然是斗争和平息战火.最后,在他平静时候,拿出他最喜欢的玩具让他玩,然后宣布下课,保持了一个happy ending.

今天小子没有咬人,虽然有企图,不过我的保护措施也准备充分.

下午1:00-2:00,自己训练,配合很好,任务完成的不错.中间逃跑一次,用他最喜欢的nemo的书把他招回.然后是一个长长的午休,趁机修剪了他的脚指甲(他不反对剪手指甲,脚的仍需训练).
晚饭前后,带他出去跑了两趟,美美地享受了sensory diet.8:00-9:00进行了当天的最后一次训练(以前是晚上两次).小子表现很好,受到非常隆重的表扬(吃,喝,抱,亲等).

Ean妈妈

这么细心的妈妈，小考拉一定会越来越好！期待你的我们与ABA(5)",

LittleKoala

老早就想写一个这方面的贴子,一个是因为没有时间,另外是发现我想说的话早就被别人说过了,只有同意的份.偷个懒,提供两段书摘与大家分享:

第一段是Lovaas (2001: 334-5)的,关于训练的进度:
Avoid overwhelming the student.Certain students move along very rapidly,learning difficult concepts such as colour,shape,size,and prepositions within the first 3-4 months of treatment.Such student can be very reinforcing for the teacher who,because of the tremendous progress,continues to teach more and more difficult tasks at a rapid rate. To everyone's surprise, this student will most likely suddenly and unexpectedly aggress toward the teacher or withdraw into self-stimulation (e.g. gaze off into the distance).The student will likely become overwhelmed by too many demands,and have no way telling the teacher that the rate of introduction of new tasks is too rapid.

If this occurs with your student,we recommend dropping most if not all demands for the next few days,replacing lessons with play,and then going back to the beginning, reinforcing the student (e.g. with food) for just coming to you and then leaving without having to work.Reintroduce the teaching in a gradual manner.Reestablishing the teaching situation as one associated with success is likely to bring the student around.

不知道其他父母的经验如何,这一段话简直就是小考拉前几个月的真实写照.目前,我们仍然在领他回到快速进步的轨道上来,但步伐的确慢多了.

第二段是Julia Moor(2002:258)关于如何看待孩子进步的:
It's easy to forget 'where we are' with our child developmentally. We can get stuck on trying to encourage just one or two activities or get swamped in hopeless because our child isn't making much progress in one area.Don't just focus on one field at a time....

If you have little time and energy, try keeping a dairy, just a record perhaps of new words or actions, things that have acused distress and things that he particularly enjoyed.Once every six weeks or so, revisit the last entries, ...and compare it to the previous six weeks. Appreciate and understand that as he gets older he is developing.

lsk

我想报名，在请教一下在那里下载报名表？我只看到了测评表，那位知道的帮我指点一下，谢谢了！

LittleKoala

很长一段时间以来,儿子的状态是时好时坏,最主要是行为的问题.从上月底他生病以后,情绪就变得很不稳定,有时候很高兴的时候也会突然变天.最近,训练基本能够进行,但强度取决于他的情绪.有时候即使准备工作做得很充分,状态好的时候,如果要求多了,或者prompt多了,就有可能引发火山爆发.

仔细分析一下,他的认知能力还好,学东西仍然很快,而且很可能知道好多我们以为他不知道的事物.但是,由于训练强度的减弱,他在目光对视,对名字的反应和配合方面有所退步,但最明显的还是行为问题,不愿意做下来学习,经常会大哭,还会咬人.

我们觉得很有可能是他明白的事越来越多,要求也越来越多,可却无法表答,因而挫折感很强.我们打算:一是立即着手教一些手语,减少他交流的困难,二是以后对他发脾气不能简单置之不理,要努力了解他的想法,然后加以解释,力图让他懂得更多的事情,和如何表达愿望.虽然知道不能着急,虽然知道他会走过这一段,可有时还是郁闷啊!

melon

Koala Mom,

How much verbal immitaion does your current ABA program have? How does little Koala do with those programs? As you know, Melon didn't start talking until we did ABA for 6 months, which is much later than many other kids, especially when he was doing well in almost all other programs. If you currently don't emphasize on this, I would start adding content like this to motivate him to 'talk'. Also, find the most motivating thing for him to say could also be very helpful. Do you know what was the first word ever that Melon say? 'Key'! Why? Because he likes my car key - he always want to put the buttons on it so the lights on the car will blink. For him, that's fansinating. I still remember the day when he first said that word, after we arrived at the beach on a hot summer day -- after he said that, I immediately gave the key to him so he happily got off the car and started to push all the keys and looked all the lights.

And before Koala starts to communicate verbally, using 'sign language' and PECS will sure help and neither of these will hinder his progress on using verbal language. Melon used both before he can talk verbally, he even put signs together, e.g. 'help please', 'more drink' etc. I still remember how cute he was while he was rumbling his tummy for the 'please' sign.

Also, you may want to try 'picture schedule' and/or 'visual timer' if little Koala has trouble to sit down for the session. I wonder if that's because he doesn't know how long it will last. We have used each of them alone and also combined to keep Melon on task. Even now, if he is doing something that he doesn't like to do, we still use visual timer, so he can see 'how much longer' he needs to do it.

Hang in there...

Melon's Mom

下面引用由LittleKoala发表的内容：

很长一段时间以来,儿子的状态是时好时坏,最主要是行为的问题.从上月底他生病以后,情绪就变得很不稳定,有时候很高兴的时候也会突然变天.最近,训练基本能够进行,但强度取决于他的情绪.有时候即使准备工作做得...

快乐小鱼

      训练目光追随还有一个好办法，不知你们有没有试过——吹气球。先吹气球，然后放开气球，气球就飘走了。一般的孩子都很喜欢气球，所以基本目光都会随着气球跑。你还可以让孩子把气球捡回来进行下一次游戏（这又是一个互动）。

kwenma2

下面引用由LittleKoala发表的内容：

老早就想写一个这方面的贴子,一个是因为没有时间,另外是发现我想说的话早就被别人说过了,只有同意的份.偷个懒,提供两段书摘与大家分享:

第一段是Lovaas (2001: 334-5)的,关于训练...

My son had similiar experiences one years before.

In his first 4-5 months, he learned all colors, shapes, etc.. fast, and then in September, he was almost fighting with the therapist and learning nothing because he did not want to sit on the table. And then the fight continued for 3 months , October, November and sometimes, the whole two hours session with some therapists were fighting and my son sneaked out from the back of the sofa and got the way out from the door. The therapist did not catch him :-)

Then starting from Dec, we have our private ABA therapist came and he can sit there for 2 hours with Lori and engaged. Amazing!! However, he looked very lazy and no attention or put his head on the table when he was working with EI ABA people. Then in January, floortime introduced and the floortime therapist came, he was happy with them. Of course, no sit down on the table. They all sitting down on the floor.

So almost more than half year with EI ABA, he has no interest and no engagement although his program still go forward ( I think he's smart and he can finishes items very quick). He was not happy. Sometimes, the EI therapist changes, then the new therapist came and he can cooperate with the new lady for a while.

So what I was thinking about this is:
(1) He was bored with the therapists because EI ABA therapists were lack of affect;
(2) He was bored with the toys because they always had the same toy and no new toys;
(3) He worked very nice with Lori (private one, even now, it's one year) because Lori has some advanced toys (not the simple one with music and lights that EI people had, but Lori had those for preschooler) and great affect. Of course, great skills!!
(4) Floortimer just have fun with him and just doing the play therapy, so he love to do that. He was always happy in their session and no more cry;
(5) He had spent a lot of time to fight with the therapist because he did not like the session. We had thought maybe 1 month he'll be fine. But finally we found it was not. Now one year past, when we looked back, we think, we shall drop EI's ABA or partially drop and hire more great therapists by ourselves or switched to other EI center. (The thing is our EI center are part time job, so normally those are Moms who want to have a part time job, they are not professional as those full time therapist. I already contacted a person in another EI center who can provide 18 hours of ABA -- their center are more professional. However, we thought current EI provide us 25 hours ABA and the transition may take time, then we dropped the new EI center. )  Now, we felt so regret we did not do that one year ago. So the most important thing is getting the great therapist!!
(6) If you can engage your child and he can show you the affect, but he can not engage to therapist and no affect, then you shall think about the quality of the therapist or the skill of the therapist.

Those are my thoughts based on our experiences.

LittleKoala

Melon妈妈

谢谢你的建议.小考拉今天与S女士合作不错.当然,我们也做了充分的准备,与S女士取得一致意见,多让他玩玩具,少提要求,少physical prompt,最主要是注意他的cues,及早避免麻烦.现在看起来,有效的交流的确非常迫切,非常重要.

我们已经复印了PECS的training manual,自己打印了一些图片,并且准备订购communicaiton book.S女士有教PECS的经验,可能效果会比我们自己做好.

LittleKoala

Kwenma

非常感谢你的经验和建议.小考拉近2个月的情况稍微复杂一点,他不但是对therapist,而且对我们也一样,不高兴就哭,厉害的用嘴伺候.目前,似乎在一点一点好转,前提是我们必须准确读懂他的信号.

我们非常同意你关于therapist的经验之谈,这太重要了.我们很长一段时间自己做的原因,就是找不到好的,一般的junior therapist既不如我们了解孩子,也没有丰富的经验和理论;或者即使有一点积累,但是人很死板,这样的人做了比不做还糟.我们更不愿再花时间去培训新人.

我反反复复琢磨Dr Lovvas的书,发现最好的therapist既应该坚持原则,又应该有很大的灵活性.最终的目的是教会孩子学习的能力,而不是其他.对孩子不强迫不行,可总让他不高兴绝不是好老师.

此外,正如你所言,好的therapist能让孩子感受到affect,即使是pretended.我们的孩子有足够的指挥智慧你是否喜欢他.要是孩子不喜欢therapist,训练也就很难做了,至少在起初的阶段是如此.

BTW,才发现以琳网上有最新的,完整的CARS scale,thankstoyilin早就做了很多漂亮的工作,只是我们没时间踏实坐下来仔细看.
http://www.elimautism.org/leadbbs/Announce/Announce.asp?BoardID=83&ID=8201&E=1&EID=18

LittleKoala

今天订购了PECS的图片和通讯本,才70美元,但到澳洲的邮费要80美元,整个就是明抢.虽然澳洲也有Pyramid分部,却没有相应的产品.要是象他们推荐的自己打印相片和过塑,成本高不算,还得贴上时间.没办法,只好被抢了.

最近,儿子进步不大,读了一些书,一位母亲讲了她的体会:什么是能做的,什么是不能做的.感觉很有启发,摘下来,自勉也与大家共勉:

What we are not going to be able to do:
* We cannot shout,scream or cajole the autism out of our child
* We cannot make him 'join us back in our world' by forcing our attention and demanding his response
* We cannot allow our feelings of hurt and anger to express themselves if our child ignores a toy we were sure he would respond to, or if he rejects our attempts to touch,hold or comfort him
* We cannot use the same behaviour strategies we might use on a non-austic child - 'time out',removal of social activities etc.(these would probably be seen as rewards to a child trying to escape involvement)
* Likewise we cannot use the same motivating strategies for good behaviour - 'trips to the cinema'.'bowling'etc.(these would probably feel like punishment).
* We cannot expect that if we devote ourselves for years and years to the 'recovery' of our child that he will grow into an adult without autism.No matter how well he can function,he will have a brain that works,thinks and processes information differently.(heartbroken while reading)
* We cannot constantly compare our child to both his non-autistic and autistic peers - his experience is unique.

What we can do:
We can however have a positive impact on his developing brain, we can give him coping mechanisms, we can understand his condition to a point where his behaviour no longer fills us with frustration and more importantly we can maximize his potential to learn, interact and experience life.Ultimately, parenting any child is not about what we can reap back for ourselves but about waht we can give to our children. If that child is special then what we have to offer him must meet that special need!

LittleKoala

好长一段时间以来,如何提高儿子学习的兴趣和避免他的tantrums是一大挑战.

食物:儿子爱吃,所以食物是最好的强化物.可再好的食物也有够的时候,我们经常给他尝试和轮换不同的食物,到目前为止,效力仍可,可只能是锦上添花的份,生气的时候再好吃的也不要了.

玩具:刚发现他的问题时候,他几乎对什么玩具都没兴趣.经过几个月的努力,在正式参加干预项目时,他已经发展出兴趣并能正确地玩.这对保证训练的正常进行很关键,很多时候他哭着还能玩.可是他的优点又是缺点是啥事总有够.为了给他找玩具,我们除了在各大商场利用年中减价大肆采购不算,还经常逛garage sale,给他买了大量的二手玩具.现在已经攒了满满5大箱,朋友的孩子来玩时能一坐2个小时不动窝,可对他还是不够.现在只好对他是时不时大规模轮岗.

社会性的夸奖:这一招原先很有效,帮助他掌握了很多技能,避免了很多麻烦.例如,在训练中他要发脾气的时候,我们立刻让他会做的动作,象鼓掌,他做了我们立刻予以表扬,他就高兴了,局势也就转危为安了.可现在,这招不灵了.也可能'Good boy','Big boy'和'Well done'之类的话听得太多了,他好象有点无动于衷了.现在正在努力用更多的新的表扬用语.

惩罚:ABA不鼓励用,我们也不想,可有时实在没办法.例如,最近他在要求没被满足时会咬人,可如果采用忽视的办法,就得把手生生地贡献出去,还不止一次.如果说'no'或者打他的小手,又不确定是否会反面强化他.还在探索,苦恼中.

现在,总算明白这是持久战了.原来以为只要在3岁半以前投入足够的精力和时间,就会如何如何,这种想法似乎越来越远了.

melon

Little Koala Mom,

Does little koala have enough break/down time during his therapy time? since he just turned 3 not long ago, he is still little and may need more down time than he has now. We had always encouraged Melon to finish task quickly, so he can go do something of his choice, and we had adjusted the programs constantly to make sure it's just the right one (difficulty, motivation) for him. For the ones he didn't get before, we'll just wait a bit and bring it back later on.

And talking about toys, our house has more toy than Melon's school class. Melon is not the neatest toy player, so clean up /organizing toys have more and more become a big daily task. I found it's easier to organize them with clear cases, and I label them for what's inside (and always put the same toys back to the same case).

Hang in there!

Melon's Mom

LittleKoala

昨天可能是过去1个多月来小考拉表现最好的一天,全天的训练都能很好配合,虽然有几次想逃跑,但接受了劝阻而且没有发脾气,多数时候还很高兴,让全家都心情愉快.

训练结束后,我与爱人回顾了他大半年来的经历,觉得我们自己首先要调整心态,用积极的眼光看待他的发展.其实,他的问题一直存在,不过在我们觉得他进步快的时候,每天都以欣赏的眼光看待他的每一点点的成绩,同时对其他的问题视而不见;而最近一段时间,我们对他的要求有点苛刻,当然他的想法多了和没有有效的交流手段也是很重要的原因,结果每天都在数落他的不是,心情不好不算,恐怕也会连带影响他.我们现在要努力发现他的优点,尽量忽视他的不足.

下面写几件他最近有进步的事:

* 以前去车库,只要爸爸进门,不管后面有谁,他都关门.上周,他要关门时,发现妈妈,姥爷和姥姥在后面,就在门口等着,等大家都进来了才把门关上.大家很高兴,着实夸了他一番.

* 朋友来作客,他能和小姐姐坐在一起看Nemo,虽然没交流,但却相安无事,而且他对家里来生人并没有紧张和反感.

* 现在与therapist S女士的关系很好,她来时候能挥手欢迎,并面带笑容;休息时候有很好的互动;再见时除了挥手拜拜.还能给飞吻

LittleKoala

看到这个坛子里好多朋友的孩子,与小考拉年纪相仿或者小很多的都早早开口说了话,心中有时禁不住嘀咕:这是不是双语环境造成的呢?或者有很大关系呢?

要说刺激不够,至少是在发现他有问题之后,我们早已加大力度了,而且早就统一为英语了.我曾经在文学城的论坛里发过一个贴子,请教双语教育的问题,很多好心妈妈回贴,建议统一到英语.因为随后的ABA训练需要用英语,我们就这么做了.

儿子对英语的理解应该没有问题,不太复杂的句子能听懂.但我们感觉他的中文理解程度更好.1年多前,他听中文的CD故事就很好了.例如,他听到小象打水的故事中象妈妈夸奖的话时候,会非常高兴;听到小老鼠变成一根铁棍时会很不高兴.还有,他喜欢中文的故事,不喜欢英文的.尽管他非常喜欢Nemo的DVD(千看不厌),可就是不喜欢带有电影配音的Nemo英文故事.

也许这跟我们在家说中文有关.毕竟,我们没办法在家讲英文,水平既没高到那个程度,要是那样做了不也会很别扭.可真不知道将来,小考拉终于开口了,水平提高了,我们差劲的英语怎么对付.

女儿是天使

这个问题可能永远也纠缠不清。我们这里还不只双语......

很多自闭孩子的语言都是从一岁半到两岁左右退化的，但正巧也是在嘟嘟一岁半时我又出来工作的，开始时难免常常琢磨，如果我一直在家里照看她讲中文会不会不同呢？

嘟嘟的训练师说，在她听来，嘟嘟的发音都是中文，跟别的孩子不一样。我也这么觉得。虽然那不能算语言，但她曾经说出来的词基本都是中文，很多胡乱的发音都是中文基础上的。

如果问一个自闭专家，他一定会说多语言不是自闭的原因。但如果问一个有丰富经验的常跟所有语言上有困难的孩子打交道的语言治疗师，他会认为语言的发展跟环境跟父母驾驭这种语言的能力有极大的关系。到最后，认为多语言不是原因的自闭领域的专家建议我们只统一成一种语言，而认为语言和环境很有关系的语言领域专家反倒认为不必拘泥于统一，最重要的是我们自己表达起来觉得舒服。

现在我不再纠缠了，既然不能改变环境，就只有适应它、接受它。既然嘟嘟是我们的孩子，既然她在这里出生并要在这里成长，就要和她的父母一道去迎接这些挑战和面对这些困难，一如她父母的当年，无论她是不是自闭儿。先天的能力的确重要，后天的努力也很重要。我们自己不也一样吗？尽管我自己的语言天赋不高，不象有的人单词听一遍就记住了，但我也有我的学习方法啊，我仍然可以比很多人强啊，因为他们没有学，而我在学。终生干预这个词没那么可怕。任何一个人都有无限的潜能，但要一直去挖掘，一直一直去努力，才能得以发挥。一个人有学习的能力，比能力本身更重要。