Ever leave the house without your watch? Eek! Ever sitting at work on a Friday at 3:30 only to look at the clock and be relieved you only have 30 minutes to go? Ever sitting at a continuing education training wondering when the first potty break will happen? Ever in a workout class wondering how many reps you will have to complete? Ever wonder what it is like for some of our kiddos on the Autism Spectrum? Those with decreased receptive language? Low attention span? Or motor planning challenges? I love my trainer who writes down the expectations for our classes. Some days I am really tired and it is all I can do to get to the gym let alone participate in a challenging workout. If I know what to expect my ability to complete the task increases. Recently a colleague and I were discussing expectations of our children in therapy and follow through with activities. I think it is important to be consistent with our children and to have expectations. However, sometimes “One more minute” is not enough of a warning. “First, then” may not work all of the time. These strategies paired with other supports can help our kiddos with attention and completion of tasks. It may also improve the ability to transition to another activity.
These concepts can be used across all disciplines too. If you want your child to do a puzzle set the puzzle pieces out. When all pieces are in, the child has completed that activity unless you have a tab system in place. Do you have that kiddo who has melt downs when you as the therapist think “Lets do it again?” The kiddo is thinking “Woohoo, I’m done.” If you have a child who consistently struggles with this or a similar activity consider having some type of numbered tab system (This is my personal favorite) available. State the expectations at the beginning of the activity with the visual support of the tabs. Personally, if I know what to expect my ability to complete the task increases. Visuals are especially helpful when the child has been in school all day, or the child did not sleep well, etc. In my experience clear beginnings and endings to activities decrease anxiety and increase task performance and participation.
Countless activities have the “tab” system built into the activity. If you want the child to put pegs into a pegboard set out how many you want the child to do. This visually depicts the expectation of how many for the child. I see some kids with Childhood Apraxia of Speech. Speech is challenging for those kiddos! I show each child how many Kaufman Cards we will attempt and use tabs to help those kiddos power through the challenging activity. If you set up an obstacle course for a kiddo use the tabs to show the child how many times through. Use the tabs to let the child know the expectation. Raise your hand if you cover the treadmill monitor so you don’t keep looking at the time? I typically put a towel over mine. We have clocks, timers, visuals so why shouldn’t the kids? Use the visual to complete a less preferred task or to let that child know how many more of their preferred task. Use the timer on the microwave or an egg timer from the kitchen. I will be the first to admit I look at the clock often while at continuing education trainings. My mind stops being able to absorb information after about 60 minutes. My body gets ancy. We can set our kids up for success with less meltdowns through the use of visual supports. Often times in a pinch I will write down 1-5 or 1-10 on a piece of paper and cross off a number after each trial. There are so many types of numbered tab systems. Anyone willing to share their favorite tab system with our readers?
For some of my older and higher functioning kiddos I use the numbered tab system in a different way. Do you have a kiddo who attempts to negotiate and barter? Have the child who exhibits an unwanted or perseverative behavior which gets in the way of learning? (Our kids are smart!) I explain the expectations and have the child repeat the expectations back to ensure our thinking bubbles match as discussed in last week’s post. I will provide a numbered tab system and cross a number off each time the child exhibits the predetermined behavior. If all of the numbers are crossed off before the end of the activity the child does not receive the reinforcement. If a number is left, then he/she is rewarded. Many of the kiddos I see do not have that pause button to maintain some thoughts/actions in their thinking bubble without that thought entering their talking bubble. With an appropriate reinforcer in place children can learn to pause.
I would rather help a child complete a shape sorter one time vs. struggling to complete the sorter a second time. In developing a relationship with a child I attempt to navigate how that child is feeling on that given day when I am there. Many of the kiddos I see do not sleep well, have reflux, constipation and/or struggle with more than just speech. Eliminate power struggles through the use of visuals. Having clear beginnings and endings to activities helps foster that relationship while setting the child up for success.
In a future post we will talk about visual schedules and PECS (Picture Exchange Communication System). In the meantime I would love to hear how you are using tabs within activities to help support our kiddos. And, who wants to talk about food? One of my favorite topics!! Next week I will share how I use some foods/drinks within my sessions, why, and what I have found works with some of my kiddos. To receive my weekly posts via email consider subscribing in the box below. Grab a cup of coffee and a friend and lets learn together!