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Saturday, October 9, 2010

Video Footage - Before and After RDI

Here is a video of one child before and after RDI

Tuesday, February 16, 2010

When is Coordination Mastered?

How do you know when your child has mastered coordination?  Basically, if s/he is able to truly follow your lead, in familiar complementary and familiar frameworks, then coordination is mastered.

Beware of the tendency to "psuedo-coordinate" with your child.  Your child should be able to follow your lead, without your needing to hold onto them, and without your adjusting your actions to theirs. 

For complementary coordination, your child should be able to fulfill his role independently while following your lead.  If you are sweeping the floor, he is able to move the dustpan to the appropriate place by watching you and following your lead.  You do not need to be moving quickly, and it is acceptable to be doing the activity in a familiar setting with familiar materials.  You should not have to cue your child as to where to go.  S/he should be able to watch you and follow. 

For parallel coordination, it is not necessary for your child to be perfectly synchronized with you, like the Dallas Cowboy Cheerleaders.  Basically, we just want to see that s/he can stop and start when you stop and start, and that s/he can speed up or slow down when you do.  Your child should also be able to follow simple variations, like skipping or hopping (as long as there are no motor planning issues). 

If your child is able to do these things consistently, then you are ready to work on collaboration. 

Sunday, January 31, 2010

Parallel Coordination - an example

Let's go back to our friends Ben and Sara.  Now they are working on parallel coordination.  Parallel coordination occurs when both partners are completing the same role simultaneously.  The child learns how to adjust his pace and actions with those of his guide.  Parallel coordination tends to be a bit more challenging than complementary coordination, because the child must be able to appraise his partner's actions while adjusting his actions simultaneously.  This is very challenging at first, so it is important to start out slow. 

For parallel coordination, Sara and Ben are walking together.  Sara moves slowly, holding Ben's hand at first.  They walk together, and then she stops.  Ben keeps walking until he notices that she is still holding his hand.  She does not pull him back, but she does not let go.  Ben moves back to her on his own (though she still needs to hold his hand at this point), and they start to walk again. As they continue to practice, Sara might add more variations, like moving more quickly or more slowly. 

Eventually, after several weeks of practice, Sara lets go of Ben's hand.  He can now match his pace to hers without physical contact.  He still has a tendency to keep walking a few paces when she stops, but he notices that she is not next to him after a few steps and comes back to her without prompts.  At this point, Sara starts to add more variation, like walking backwards for a few paces, or skipping. 

Parallel coordination is mastered when the child is able to adjust his movements to those of his guide without prompts.  At this point, we would look for this in familiar frameworks (any activity that you used to practice this with your child), and with familiar guides.  Your child may be able to do this in familiar settings, but have more difficulty in other settings, like at the mall, where you may need to go back to holding hands.  

Friday, January 15, 2010

Complementary Coordination - an example

The best way I can think of to describe complementary coordination is to describe a hypothetical family putting it into an activity. 

Meet Ben.  Ben is an 8 year old boy on the autism spectrum.  He is verbal, but not conversational.  His speech can be scripted.  He has some sensory issues, mostly auditory, though he also benefits from a sensory diet at school.  When he is feeling challenged, he tends to wander off. 

Ben's mom, Sara, is working on coordination.  They have been working on co-regulation for several months.  Ben is at the point where he loves to roll a ball back and forth with Sara.  This game has evolved into bouncing the ball, and eventually into catch. 

In order to move this into coordination, Sara has started to add movement into their game of catch.  She starts out slowly, moving only a foot or two to the side after throwing the ball to Ben.  Once he is able to adjust to her movements by throwing the ball to her in her new spot, she starts to vary it even more, moving more often, and with bigger distances.  Ben must monitor her movements in order to figure out where to throw the ball. 

The first time Sara tries this, she does not move much.  She stays quite close to her original spot, and only moves occasionally.  Once Ben is able to coordinate with her here, she starts to move more often, but she continues to stay relatively close to her original spot.  As Ben's competence increases, her movements become bigger. 

It is important that Sara is aware of Ben's cues, and that she adjusts to his needs every time they do this.  There may be days when he has more difficulty than others - perhaps he has had a difficult day at school, or he is coming down with a cold.  If this is the case, she needs to take it down a notch, even if he has been successful in the past.  However, it is equally important that she add small challenges in increments that Ben can handle.  He may need extra help, perhaps in the form of an indirect prompt, when he is uncertain of where to throw the ball.  Sara also needs to understand that she will make mistakes in this process, and that this is okay.  The important thing is that she consistently works on this, and does not let the setbacks get her down. 

Wednesday, January 13, 2010

More Evidence That Autism Is a Brain 'Connectivity' Disorder

ScienceDaily (Jan. 11, 2010) — Studying a rare disorder known as tuberous sclerosis complex (TSC), researchers at Children's Hospital Boston add to a growing body of evidence suggesting that autism spectrum disorders, which affect 25 to 50 percent of TSC patients, result from a miswiring of connections in the developing brain, leading to improper information flow. The finding may also help explain why many people with TSC have seizures and intellectual disabilities.


This article details new research that supports Dr. Gutstein's work in RDI - that autism is a disorder caused by underconnectivity of the brain.  Here is a link to the full article: 

http://www.sciencedaily.com/releases/2010/01/100110151333.htm#

Friday, January 8, 2010

Coordination

Once your child has mastered coregulation, you are ready to move on to coordination.  There are two types of coordination, complementary and parallel. 

In complementary coordination, each partner has a different, but complementary role.  Each partner's role must be coordinated in order to complete the task.  For example, you might sweep the floor while your child holds the dustpan.  Your child must monitor where you are sweeping and coordinate with you in order to place the dustpan in the right spot. 

In parallel coordination, each partner is completing the same role simultaneously.  For example, when you are walking down the street with a friend, you are engaging in parallel coordination.  If your friend slows down, or stops, you automatically slow down or stop also. 

In my experience, I've found that most children find complementary coordination easier to master, so I will often advise families to start there.  Remember, any type of coordination involves a great deal of monitoring and adjusting, and this will not come naturally to your child at first.  It will take a lot of time, practice, and repetition, so start slowly, with simple roles, and be patient. 

Here are some common frameworks we use to work on coordination:

Complementary Coordination
*Sweeper - dustpan holder
*Sprayer - wiper (washing windows, countertops, etc.)
*Loading/unloading the dishwasher (giver-receiver - hand child a dish, child places dish, etc.)
*Picking up toys, clothes etc. (carry basket or box, child places items in box as you move it)

Parallel Coordination
*Walking together
*Freeze dancing
*Taking out the garbage (pushing the garbage cans together)

These are just a few examples of ways to work on coordination.  It is possible to fit coordination into many of your daily routines.  The key is to slow things down and to make sure your child has plenty of time to follow your lead and process his or her role.

Sunday, January 3, 2010

When is Co-regulation Mastered?

How do you know when your child has mastered co-regulation?  Here are some things to look for:

1. Your child should no longer be resistant to being with you.  In fact, s/he should start to want to participate in your familiar, co-regulatory activities.  Once your child starts initiating these interactions with you, you are well on your way towards mastery.

2.  Your child should be more interested in the variations you are adding to the pattern than in the initial pattern itself.  If you recall, the steps to setting up co-regulation consist of: a) establishing the initial pattern, b) adding small variation to the pattern, c) if child likes variations, keep them, if not, return to initial pattern.  Your child should be showing more interest in the variations than in the initial pattern.  If your child is still focused on the initial pattern, keep working on it. 

3. Your child should notice when you are engaged and abruptly become disengaged.   If you are sharing a moment of face-to-face, excited emotion sharing with your child (you are smiling at one another in anticipation or celebration), let your face go blank.  Your child should a) notice that your face has changed, and b) make an attempt to get you to re-engage (smile again).

If you are consistently noticing all three of the above, then it is likely that your child has mastered co-regulation, and is ready to work on coordination.  This is where many families are likely to rush things.  It is important that you are noticing these things consistently.  If you notice that your child is doing some of these things, some of the time, that is a good sign that they are getting closer, but you should see these things more often than not.  This is where it is helpful to review video clips, and even to have a third party who is not emotionally involved take a look at them.  It can also be helpful to compare new clips to clips that were filmed last week or last month, to see if there are changes.  Co-regulation is the foundation for social interaction, so it is very important to master it fully. 

Remember, you will be noticing these things when you are working with your child one on one, in familiar settings with familiar activities.  Other people, like teachers and family members, might start to notice subtle changes, but at this point, the biggest differences will be seen at home, one-on-one.